I asked readers: what specific event crystallized your decision to leave your last job?
I was asked if I’d be willing to relocate after 3 years at one office. Said yes so my manager started the process. He never even told me what the HR package was, as it was so insulting. Knew then that it was time to leave the (slowly) sinking ship.
The PE firm that bought our company had little interest in the actual work we were doing. The CEO they put in place fell asleep in the first customer meeting I took him to and then after the meeting told me the customers in the meeting were idiots and he would rather get a needle stuck in his eye than attend another meeting like that.
Was notified by McKesson in fall 2016 my job would end March 31, 2017. Two months later was told I would need to train offshore resources how to utilize and quality test a large piece of clinical software. Given my training and years of front line experience in hospitals, my principles were on the line and no amount of severance was going to compensate me for principles. I turned in my two-week notice in early 2017 with several irons in the fire, but no offers. On my last day at McKesson, I got a call at noon offering me the job I was hoping for.
I took an early retirement package equaling a year’s pay, easing the way into lucrative consultancy for the next few years. However, the event that crystallized my decision was the concurrent layoff of valued colleagues who did not qualify for the package. It was the right choice.
To start a new company and see an idea turned into reality. Hopefully, hah.
Micromanaging leadership and leaders out for self-promotion over the company’s goals.
I was working 60-70 hours per week, seven days a week. My boss assigned me another project, and when I told him I couldn’t, he said something about digging deeper and that I could do just a little more. I already knew I was going to quit, but was trying to hold off one more month. That sealed me. They distributed my work among nine people.
I was a founding but minority partner in a consulting firm. After Having several disagreements with our managing partner about the future direction of the firm, I reached out to our board chair for advice. He made it clear that the managing partner was the majority owner and he would run the firm as he pleases. Great advice. I left and and subsequently founded a very successful and highly regarded consulting firm.
When the company that had acquired our niche software provider changed my network username from a name-based alpha to a nine-digit number.
Cruel management.
Realizing they owed me nothing, and I was simply in the way.
Missing a concert of one of my favorite performers to finish up something “critical” at work then driving home from the office so late that the sun was rising.
Promoted the worst director to be the new CIO.
Realization that in five years with an HIT consulting firm, we never once talked about “the patient.” Our mission statement was embarrassing to read.
Promoting and doctor to be the head of all IT clinical applications, over 100 people, when this doctor had NO experience being in charge of any size of team before, as he told all of us when he announced his promotion. No experience leading any organization whatsoever, no business or HR training, nothing. Talk about promoting someone to his level of incompetence. How often does leadership in healthcare think that just because someone is a doctor they can do anything?
A VP valuing contracts over business ethics and being completely detached from the realities of the marketplace, both in terms of realistic revenue targets and competitive compensation for our top talent, combined with a failing new product that was doomed from the start. The final acceptance of the fact that none of this was ever going to change was the “event.”
I left my last job because it was acquired by another company that was based in the South and I didn’t want to move from the SF Bay Area. Turns out to be the best decision.
A wholesale reduction of the middle management positions in the organization, making communication with manager more difficult (had too many direct reports to effectively manage); pushing many of our previous manager’s duties down on my team with no acknowledgement, support, or consideration of any type; and finally, removing almost any chance for future career advancement in this organization.
The CEO was corrupt (the controller quit rather than approve the yearly numbers), misused federal funds (set policy to have healthcare navigators sign up patients for ACA who were illegal using made up SSNs), racist (but because he was pro-Hispanic, it was not considered racism), did not support his leaders, required the implementation of the EHR when the environment was not stable and had not been thoroughly tested, and put blame on anyone who did not agree with him. The only reason I stayed as long as I did was due to the poor economy. It was a horrible situation to be in. The CIO was the only bright spot and he left soon after I did.
I am in sales and in a previous job sold well over $XXM and as deployment of the promised technology continued to fail, we were at a point with these clients of moving into Phase 2 of the project which would have netted the company another $XXM+ and the clients stopped everything. Lawsuits quickly began to fly. It was at this point I realized my leadership at this company was simply lying. They had done the Wolf of Wall Street. Created imaginary software that was incapable of supporting the demonstration they had put together with bubble bum and duct tape. I lost over half a million in commissions on Phase 2 because they had also conned me into believing they could make it work.
It is a train wreck in healthcare and amazingly complex. The demo experience worked flawlessly on their perfect data, but drop that bad boy vision into the reality of healthcare data and KABOOM. “Mr/s. Customer, you have to give us perfect data or this won’t work. Sorry, no refunds.” Plus, their contracts were unreal with one of the customers saying they were longer and more complex than the ones they worked through with their EMR vendor.
Unbelievable. Investors should have gone after that executive team with guns blazing in a lawsuit. They even made sales pump up pipeline numbers by telling us if anyone even picks up the phone, it is a 20 percent opportunity. Then post-acquisition, if you deleted those inflated opportunities, the same executive team (CEO) would literally email you within five minutes demanding an explanation.
When the going got tough, the C-suite exec refused to take responsibility for any of the struggles being dealt with by the staff that reported to him. In fact, he was quite adept at not listening and throwing people under the bus. Finally got to the point where I got on the bus and rode off to another job.
My company was purchased and I did not believe in the management or strategy of the acquiring company.
I found termination for cause suasive.
Toxic medical director, toxic culture , being treated like three year olds .
My director seemed to be semi-sabotaging our market install. At core team meetings, she would ask leaders whether they were on schedule, and upon hearing they weren’t, she would only say OK before moving to the next person. We were months and about a million over. She knew I thought we should ask people what the hold-up was, if they needed help, more training, etc. We had a planned core team meeting with the market CFO to give a status and tell him whether we felt on track and could make our live date. My manager came in to my office right before the meeting and told me to keep my mouth shut at the meeting. I sent my resume out the next week.
When my boss left, and HIS boss left within a day of each other. This was just after a new CEO took over.
My division was sold. The buyer offered a voluntary severance package within two weeks of the sale being final.
My company was acquired by a competitor. That’s probably the most obvious sign that’s it’s time to move on.
Our company was acquired. Marketing and accounting are the first to go.
Continually getting new “managers” who kept asking me how they should do their job.
When I realize the culture and the legacy leadership was never going to change.
My boss, the CIO of a large, multi-state IDN, falling asleep in my annual performance review.
New CEO hired through board member good-old-boy network was threatened by my skills and influence over the organization. Good thing my employment contract had a decent severance clause. CEO actually offered to extend the severance for signing a draconian non-compete agreement that went far beyond original employment contract. I turned him down. CEO was fired by the board a few months later after running the company into the ground with extravagant spending on a flawed strategy.
I decided to leave my job when I was told the CFO wouldn’t support me to be named the director of the business unit I was already leading. She would have to sign off on the position even though it didn’t report up through her. We had brought in $5m of unbudgeted money into the organization. It was a political mess and I am so glad that I left for a similar director position.
HHS appoints Genevieve Morris, MA as ONC’s principal deputy national coordinator. She was previously senior director of HIT policy with Audacious Inquiry.
Unlike her predecessor Vindell Washington, MD, Morris has no clinical education or experience (her master’s is in political science), having spent her nine-year career working on HIEs and Meaningful Use.
Reader Comments
From Significant Other: “Re: Partners HealthCare. I worked at Partners for many years and attended a February conference featuring CEO David Torchiana, MD (who had an insightful presentation, btw.) I asked the last question, which was ‘Can you talk a bit about Partners 2.0?’ His answer was quite candid — since its formation 23 years ago, little has been done to consolidate within the now $10+ billion organization. He expects to see a $500 million reduction over the next few years as the network reinvents itself. The Brigham and Women’s Hospital early retirement offering has nothing to do with Epic and that cost.”
From Hospital Personality: “Re: Epic. Announced that they are developing a fetal monitoring solution so that customers don’t need to turn to a third party such as Perigen, GE, or Obix.” Unverified.
From Diego: “Re: hospital MU3 attestation for Athenahealth users. For the Athenahealth spokesperson, how many of the company’s stated 35 live hospitals are using the complete inpatient solution, including clinicals? How many have actually attested with the inpatient product? How many users have fully implemented the inpatient product, including clinicals, within a 12-month timeline with the past two years?”
Epic’s App Orchard
I received more reader comments about working with Epic’s App Orchard.
#1
The experience with App Orchard thus far has been very disappointing. After paying the hefty fee for the Silver tier, we expected to receive all of the perks of the tier as discussed in the App Orchard documentation. Unfortunately, upon receiving access to the App Orchard program, it became readily apparent that much of what was promised was either not available or, in some cases, not yet built. Additionally, we were informed by App Orchard personnel that our "Sandbox" access would only be for a testing Sandbox and not an environment that we could use to demonstrate our solution to clients. The original documentation was highly misleading on this point.
The documentation also suggested that any press releases were to be submitted to the App Orchard team for review. After we went through a lot of effort constructing a press release with our PR firm and submitting it to App Orchard personnel for review, we were told that Epic would be providing developers with a standard press package.
All of this inconsistency is making us very uneasy. While we appreciate that we are one of the first few companies to join the App Orchard, and that we will be helping define the process for other companies in the future, we expected the process to be far more robust and established.
On the plus side, the App Orchard personnel have been very responsive and have provided as much help as they could given the under-developed state of the Orchard at the moment.
#2
We applied to the Epic App Orchard right when it was opened to vendors. Our initial interaction with Epic required us needing some detailed information on the different levels that App Orchard offered. I was pleasantly surprised to see how quickly they replied and how helpful they were as we worked through this decision.
Our application was processed timely and we got the access that we needed to start working on the technical integration. We are currently working on the technical integration and will soon be planning the marketing efforts. So far, so good.
#3
The team has been very responsive and the APIs are robust. We wish there were a bit more clarity on the pricing model for the live application (transactions vs. revenue share structures are a bit hard to follow). We also wish we had a clear sense of the timing / duration of the approval process for an application, as well as acceptance / rejection criteria.
HIStalk Announcements and Requests
Mrs. G’s DonorsChoose grant request was for STEM and engineering kits for her elementary school’s Robotic Rumblings program, noting that the city-wide STEM science fair includes few minorities and females. She reports, “The materials obtained through DonorsChoose are having quite an impact on my students. They are giving my students the opportunity to grow in the area of robotics. Their creative juices are definitely starting to soar. They are thinking and developing deeper thought processes on how to manipulate the materials. They are also learning how to better work together cooperatively. The students like working in small group settings. They appear to be quite focused when using the materials and do not want to leave when the session ends. We thank you from the bottom of our hearts. There are definitely some rumblings going on around here!!!!!!”
Webinars
None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.
Acquisitions, Funding, Business, and Stock
NantHealth reports Q1 results: revenue up 16 percent, adjusted EPS –$0.24 vs. –$0.18, missing expectations for both. NH shares continued their slide on the news, now down 83 percent since last year’s IPO.
Specialty EHR vendor Modernizing Medicine raises $231 million in a private equity investment, increasing its total to $322 million.
People
New York-Presbyterian promotes Peter M. Fleischut, MD to SVP/chief transformation officer.
Ivenix promotes Jesse Ambrosina to COO, George Gray to CTO/VP of R&D, Janice Clements-Skelton to VP of HR, Carolyn Malleck to VP of finance, and Ben Powers to VP of infusion systems.
Announcements and Implementations
PokitDok will build its healthcare transaction recording platform on the Linux Foundation’s open source Hyperledger Sawtooth blockchain project along with Intel Software Guard Extensions.
Vermont Information Technology Leaders and Medicity connect the Vermont HIE to the Veterans Health Information Exchange, allowing clinicians in the VA and the HIE members to view each other’s records for a veteran patient.
MModal announces enhancements to its computer-assisted physician documentation technology.
WellSpan Health brings its initial sites live on Epic.
Government and Politics
Officers in West Virginia’s state capitol arrest a veteran journalist who was attempting to ask HHS Secretary Tom Price if domestic violence would be considered a pre-existing condition under the House’s American Health Care Act. Dan Heyman was taken away in handcuffs and charged with “willful disruption of state government processes,” with the Secret Service agents who were protecting Price and White House Special Counsel Kellyanne Conway claiming they had warned Heyman that he was interfering with their work by shouting questions that Price was ignoring.
HIMSS reports that while Congress’s spending bill still won’t allow HHS to spend money to develop a national patient identifier, it encourages HHS and ONC to provide technical assistance to non-governmental organizations trying to address the patient identification issue.
President Trump threatens to withhold $7 billion per year in ACA cost-sharing reduction payments to insurance companies, which would likely drive more insurers out of the exchange market or raise premiums. The President said in an interview, “There is no Obamacare. It’s dead. Plus we’re subsidizing it and we don’t have to subsidize it. You know if I ever stop wanting to pay the subsidies, which I will, anytime I want.”
Privacy and Security
Memorial Hermann Health System (TX) pays $2.4 million to settle HIPAA charges following a 2015 incident in which it issued a press release that named an illegal immigrant who was arrested after using a phony Social Security card at one of its clinics. The hospital said it called police because of concerns about fraud, not immigration status. The woman’s husband was also in the country illegally, but had insurance through his employer.
Hackers breach two old data servers of a Memphis, TN family medicine practice using valid login credentials and demand a $10,000 ransom after encrypting its files, which the practice declined to pay since they switched EHRs 18 months ago and only those older records were involved.
Innovation and Research
Cerner says it’s interested in just-announced Microsoft technology that can identify, name, and index objects depicted in photos or video, saying it could be useful for alerting hospital nurses of patient actions that require their attention.
Other
Healthcare Growth Partners analyzes the valuation differences for enterprise vs. healthcare software as a service companies, concluding,
If the set of health IT companies were able to grow more quickly, it is likely that their valuations would become more in line with general enterprise SaaS companies. The reason for health IT’s slow growth rate is no doubt a complex combination of factors including longer sales cycles, heavy regulation, and slow adoption rates. Potentially it may be due to the relative immaturity of the healthcare software market and a different mix of publicly traded comps in health IT as compared to the larger and more mature enterprise SaaS market.
Sonar studies at University of Mississippi Medical Center (MS) reveal that up to 7,000 human bodies are buried on the hospital’s grounds, believed to be those of patients who died in the state’s mental hospital from 1855 to 1935 when it was located on what is now hospital property. Construction work turned up 2,000 bodies three years ago. The medical center, faced with a $21 million estimate to relocate the remains, is proposing to exhume a few of them for research and then just build a memorial.
A scientific editor trolls one of the many predatory medical journals with lofty-sounding titles that will run articles from publication-desperate researchers in return for cash. He submits an article built entirely around “Seinfeld” episodes as researched at the prestigious Arthur Vandelay Urological Research Institute, listing himself as the primary investigator under the name Dr. Martin van Nostrand. The Urology & Nephrology Open Access Journal accepted the article about a made-up condition nearly verbatim, billing him for its $799 fee (a mistake on their part since he declined to pay).
Eric Topol interviews the fascinating Pardis Sabeti, MD, PhD: member of a family who emigrated from Iran just before its 1978 revolution, Rhodes scholar, physician, scientist (computational biology and medical genetics), host of an education TV series about statistics, and singer/songwriter for Thousand Days, a decent alt-rock band.
Sponsor Updates
Advisory Board Chief Medical Officer Dennis Weaver, MD, MBA presented “Pragmatic Approaches to Succeed at Value-Based Payment and Care” at the World Health Care Congress Hospital and Health System Summit in Washington, DC last week.
EClinicalWorks will exhibit at the Ohio Association of Health Plans Annual Convention May 16-17 in Columbus.
GE Healthcare will supply over 200 Egyptian hospitals with 700 units of its advanced healthcare technologies.
Healthwise will exhibit at the Cerner Collaboration Forum May 16-18 in Kansas City, MO.
Huntzinger Management Group’s William Reed is named a Life Fellow Member of HIMSS.
Consulting Magazine names Impact Advisors VP Lydon Neumann one of the Top 25 Consultants of 2017.
Imprivata will exhibit at VA Healthcare 2017 2017 May 15-18 in Arlington, VA.
Entrepreneur Magazine features LogicWorks CEO Kenneth Ziegler.
Healthgrades recognizes Meditech hospitals for patient safety.
National Decision Support Company will exhibit at WEDI 2017 May 15-18 in Los Angeles.
Navicure and PatientKeeper will exhibit at Centricity Live 2017 May 17-20 in Boston.
Shane McCarran joins Orchestrate Healthcare as senior recruiter.
Experian Health will exhibit at HFMA WV May 17-19 in Roanoke.
InterSystems will exhibit at the NEHIMSS Annual Spring Conference May 11 in Foxboro, MA.
The US Patent Office awards Intelligent Medical Objects a patent for its medical terminology solution.
A DataBreaches.net investigation finds that up to several million records of Bronx-Lebanon Hospital Center (NY) were exposed after its revenue cycle contractor, iHealth Innovations, apparently misconfigured an rsync backup
Reader Comments
From Dr. Evil: “Re: EviCore. The specialty benefits manager is considering a sale or IPO, valuing itself at $4 billion. It pays to build a business around denying care.” The company describes its services as “comprehensive care management solutions,” although the emphasis seems to be on reducing cost via evidence-based solutions. It’s a good approach, although it fails to address out-of-control provider, drug, and device costs and instead focuses on restricting what is ordered. It’s an often-missed point that all of the political wrangling over health insurance would be much less necessary if costs were made reasonable, an even more daunting and therefore unlikely legislative accomplishment since the folks making fortunes on the backs of sick people also employ lobbyists.
Epic’s App Orchard
I received these unverified reader comments when I asked for first-person experience with Epic’s App Orchard.
I have worked extensively with Epic Corp over the past two years with their iterations of the App Orchard. The rules of the road require that an app developer permit Epic to take whatever IP they choose, if Epic believes it makes sense to include in future releases of Epic software. Epic will reject apps that directly compete with Epic functionality, as determined by Epic’s current and future roadmap. Further, the 30 percent fee they charge is too broad in scope for the app revenue (if there is any). Most importantly, originally, only Epic clients could submit apps to the Orchard, effectively locking out the global collective genius of non-Epic entrepreneurs (I am not sure if such a restriction remains). Based on the approach to their App Orchard, Epic seems to be trying to respond to the market demand for "open" as heavily advertised by Cerner as their competitive differentiator. However, Epic also seems to want to control the Epic app environment and has absolutely no motivation to loosen their model to the wild, as Judy mentioned several times that such a move would be the end of Epic.
We have started working with Epic to build out an API integration under the App Orchard. For us, the biggest concern are the revenue sharing terms. For a software vendor that is operating under tight margins in a competitive market, having to factor in up to a 25 percent gross revenue share is an impossible burden. From our perspective, the App Orchard is a blatant money grab from companies trying to innovate on the edges of the Epic ecosystem.
HIStalk Announcements and Requests
Welcome to new HIStalk Platinum Sponsor Softek Solutions. The Prairie Village, KS-based company’s OnTrack software and consulting services optimize revenue integrity and system performance for Cerner Millennium hospitals (and those preparing to move to Millennium). Its Charge Integrity Control provides visibility into revenue management by correlating patient orders and charges throughout the transaction process –one customer found a lab charge error that lost them $3 million in appropriate billing over four months before they found it instantly with Charge Integrity Control. Revenue Conversion Services allows correction of application, workflow, and configuration problems that otherwise would cause millions of dollars in lost revenue right after a Cerner go-live — a single hospital called Softek three months after go-live and avoided $20 million in annualized lost charges due to orders that weren’t charging, a location-specific workflow problem with ordering, and ED batch charges that weren’t actually charging. The company also provides Millennium system performance optimization software and services as well as conversion and purge maintenance assistance using proprietary diagnostics. Thanks to Softek Solutions for supporting HIStalk.
I finally pulled the trigger on replacing of my years-old, $300 laptop that I use for everything. I chose an Acer Aspire E15, which has pretty decent specs for $621: an AMD FX 9800p CPU with 2 MB L2 cache, 16 GB of DDR 4 SDRAM, a 128 GB solid state drive running Windows 10, a 1-terabyte hard drive for data, a 15.6-inch display powered by a Radeon R8 dual graphics video card with 2 GB of dedicated VRAM, and thankfully nearly zero pre-installed bloatware. I’ve had no problems so far getting it loaded up.
HIStalk readers funded the DonorsChoose grant request of Mrs. S in California, who asked for a 3Doodler child-safe 3-D printing system (it was actually inexpensive at just $113 for everything, plus our donation was matched). She reports, “I would like to thank you from 22 very excited third grade students that have really been enjoying and benefiting from your generous donation! We have been using our 3Doodler pen each Friday afternoon during our STEAM centers time and I have truly observed some fantastic skill building. Some of the benefits that are very noticeable to me are an increased attention to detail, improved direction following within a detailed task, increased patience for a task, increased observation of the steps necessary for a positive outcome, and an increased motivation to try something new! You have made a difference!”
Webinars
None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.
Acquisitions, Funding, Business, and Stock
Video visit provider Teladoc reports Q1 results: revenue up 60 percent, EPS –$0.30 vs. –$0.40, beating analyst expectations for both.
People
Reed Liggin (Athenahealth) joins electronic prescribing system vendor EazyScripts as CEO. He was president and CEO of the small-hospital information system vendor RazorInsights that was acquired by Athenahealth in January 2015.
Telehealth solution provider Avizia hires Joe Quinn (ComScore) as CFO.
Health Symmetric hires Bob Teague, MD (Quorum Health Resources) as chief medical officer. The company’s website uses a lot of vague gibberish in not saying exactly what it is they’re selling other than a “healthcare platform” that uses APIs.
Announcements and Implementations
Intelligent Medical Objects is awarded a patent for its concept-based terminology management system that allows rapid distribution of terminology changes to the company’s EHR vendor partners. Clinician-entered terms are matched with appropriate billing and reference codes that capture clinical intent.
Hybrid IT vendor TierPoint will expand its Hawthorne, NY data center campus for the third time, adding 38,000 square feet of raised floor to the existing facility that includes 52,000 square feet of raised floor plus a 70,000 square foot recovery and business continuity center.
PeriGen releases PeriWatch, a perinatal analytics system that integrates WatchChild fetal monitoring with PeriCALM decision support and adds a maternal dashboard.
Penn Medicine Center for Health Care Innovation (PA wins ECRI Institute’s health device award for its app development platform that extracts clinical information from the EHR and other sources.
Government and Politics
In England, the Cambridge University Hospitals trust will decide this summer whether to outsource commodity IT services that include enterprise infrastructure, service desk, and end-user computing in a tender expected to total $180 million over seven years. The trust says its increasing Epic use has created a need to expand its services.
The White House appoints Gopal Khanna (Illinois Department of Innovation and Technology) as director of AHRQ.
Innovation and Research
University of Illinois at Urbana-Champaign is working on a virtual physician agent that can describe lab test results to patients via a patient portal, targeting older adults with conversational speaking, context-appropriate facial features, and other body cues that can help with retention.
Other
St. Mary’s Hospital (NJ) celebrates Nursing Week by laying off seven nurses and 13 med techs.
Sponsor Updates
The local paper profiles Ability Network CEO Mark Pulido.
Black Book identifies 10 top MACRA trends challenging providers with value-based care and quality metrics.
Agfa Healthcare launches a new version of its Integrated Care Suite.
Besler Consulting releases a new podcast, “Healthcare in the first 100 days of the Trump presidency.”
Washingtonian names The Advisory Board Company CEO Robert Musslewhite as one of its biennial Tech Titans.
Casenet announces its Connect 2017 speaker lineup, led by client executives from Cigna and Healthfirst.
CoverMyMeds will exhibit at the American Academy of Ambulatory Care Nursing Annual Conference May 10-13 in New Orleans.
Boston Software posts a white paper titled “Eliminate the Pain of EMR Upgrade Testing” that describes use of its Cognauto system to validate and set appropriate expectations for each department regarding the added benefits of the EMR upgrade.
The Hartford Business Journal interviews Diameter Health CEO Eric Rosow.
Health Professional Radio interviews Docent Health co-founder Paul Roscoe.
Stakeholders react to news that HHS will launch a healthcare cybersecurity center this summer. By @JennHIStalk
While administrations may change and legislation come and go, the need for cybersecurity across healthcare’s many verticals seems to be a constant that will remain with the industry for the foreseeable future. News that HHS will create a Healthcare Cybersecurity Communications and Integration Center this summer highlights the federal government’s commitment to helping providers, payers, vendors, and (hopefully) patients prevent data breaches that could impact patient safety.
Modeled after the Department of Homeland Security’s National Cybersecurity and Communications Integration Center, the new HHS center helps to fulfill the Cybersecurity Information Sharing Act of 2015, part of a broad initiative under the Obama administration to bolster the government’s offensive and defensive cybersecurity capabilities.
“HCCIC establishes the mechanism to provide proactive and anticipatory analysis of cyber threats to both HHS and the healthcare and public health sector,” says an HHS spokesperson. (The department declined a formal interview.) “The HCCIC will act as a clearinghouse to drive healthcare-relevant cyber indicators, briefings, and actionable intelligence to and from a wide variety of stakeholders – both public and private. HHS aims to begin initial operations this summer.”
The timing is apropos given the impending release of a report authored by the Health Care Industry Cybersecurity Task Force, a CISA-mandated group put together last spring tasked with:
Analyzing how other industries have addressed cybersecurity threats.
Reviewing the security challenges associated with networked medical devices and software connected to EHRs.
Developing and circulating cybersecurity best practices.
Establishing a plan the government can use to freely share real-time intel regarding healthcare cybersecurity threats.
While HHS would not confirm the HCCIC will help to implement the task force’s recommendations, one can only assume that the two resources will converge to some degree. Industry stakeholders are of course eager to collaborate and benefit from the new center’s deliverables, which are yet to be fully determined.
“We are anxious to begin to see actionable data coming out of the HCCIC, including threat and vulnerability,” says Marc Probst, CIO of Intermountain Healthcare (UT), which formed a cybersecurity center last year with the University of Utah and several other partners. “The HHS goals around information sharing and analysis align perfectly with our organization and several that we are working with,” he adds. “We are anxious to contribute and develop automated feeds for the HCCIC.”
While emphasizing that long-overdue federal cybersecurity risk assessment and risk management efforts will provide good implementation guidance, Probst and his colleagues are reluctant to see cybersecurity become a compliance effort or a certification program. “Many of those currently participating are vendors or people with a product to sell,” Probst explains. “We hope the committees and chairs will seek more payer and provider participants.”
While selling a product to providers in need would surely be seen as a positive outcome for any vendor involved, Divurgent CISO Stephen Watkins sees the benefit of an HHS-sponsored cybersecurity center as one of cohesive collaboration. “For advisory and consulting services organizations like ours,” he says, “these centers allow us to share and contribute our strategic, operational, and tactical insight from the field as well as act as both sounding boards and feedback loops for best-practice implementation guidance from the HCCIC, especially for small providers that may not have in-house IT security staff.”
Real-time cybersecurity guidance to the healthcare community will surely be welcome in light of today’s constant stream of data breach announcements, which have become so banal as to no longer incite the media hysteria it first engendered a year or two ago. While it may be too much to hope the center and its collaborators can help providers, payers, and vendors stay ahead of constantly evolving cyber threats, stakeholders no doubt hope HCCIC resources will become some of the strongest defenses in their cybersecurity arsenal.
Billionaire investor Warren Buffett says in the annual Berkshire Hathaway shareholders’ meeting that the American Health Care Act would be “a huge tax cut for guys like me,” adding that, “Medical costs are the tapeworm of American economic competitiveness.”
Buffett also complained that private equity firms load their acquired companies with debt, announced that the company has sold one-third of the IBM shares it holds, and joked in answering a question about how much his successor will be paid (Buffett is 86) that, “If the board hires a compensation consultant, I’m coming back.”
Reader Comments
From Chiming In on CHIME: “Re: CHIME. You asked why people are quitting HIMSS. I’d like to see the same anonymous question about why people are quitting CHIME. I’m considering it since it has changed from a CIO networking organization to a vendor-driven one, where companies pay for CIO time.” I created a rather awkwardly worded survey here and will report the results next week.
From 300-Buck Gyp: “Re: radiology report. A friend’s pelvic CT scan had this radiologist comment in the report: ‘CT pelvis. Reproductive organs – the uterus and ovaries are normal. I guess the fee includes copy/paste issues since the patient is a male.” Perhaps “normal” could be loosely construed as meaning that the lady parts are “absent” in male patients, thus streamlining the radiologist’s report template even more.
From Privy Pathway: “Re: Brigham and Women’s. Any thoughts on the offering voluntary buyouts as a cost-cutting measure? It used to be that Epic only got the C-suite fired, but Brigham, MD Anderson, and Southcoast are proving a trend. I’ve also heard that a notable health system is cutting annual compensation increases for the rank and file given capital and operating constraints associated with their Epic go-live.” My cheap-seats view would be this. Epic is fanatical about forcing customers to budget the entire project’s expense. My survey of C-level execs of health systems that use Epic (which got pretty big participation) found that 75 percent of projects came in at or under budget, with just 15 percent saying they spent a lot more than they expected. Therefore, I’ll postulate that it’s probably simplistic to assume that Epic is guilty just because it was present at the crime scene:
Health systems that choose Epic should not be surprised by its upfront and ongoing costs. That would seem to be the case with most of its customers since few have had disastrous, permanent financial challenges purely because of Epic, especially those that have been live for a few years.
Leaders of financially challenged hospitals typically find a scapegoat, whether it’s unions, government payments, IT, or regulatory compliance costs. They haven’t blamed Epic all that often, but even when they did, the reality might not be quite so simple, especially if the executives are looking to justify unpopular decisions.
The type of health systems that choose Epic (large, aggressive, market-leading health systems) are those most likely to have had their bottom line hit by government, payment, and marketing challenges as the emphasis shifts away from heads in the bed and the extraordinarily high cost of hospital-provided care, especially in those with massive market clout that drives negotiation with insurers.
Timing is everything. Epic gained a lot of customers in the past 3-4 years and financial conditions have changed considerably since then, so those significant upfront costs may be hitting at an inopportune time for some health systems.
Having poor financial performance after Epic doesn’t necessarily mean Epic was the problem. Some hospitals screwed up their implementations with bad decisions, while others were poorly managed both before and after Epic. Sometimes you read about a high-profit health system choking on Epic and think to yourself, based on what I know about them, I’m not too surprised they managed to mess it up. Software ROI is usually more related to the client than the vendor.
Some of the hospitals are cutting back because of future expectations, not necessarily due to concerns about their current bottom lines.
It’s going to get a lot worse of the ACA is repealed and many millions of hospital patients go back to being charitable write-offs, shrinking health system profits.
HIStalk Announcements and Requests
Nearly 80 percent of poll respondents haven’t bypassed insurance to pay cash for a better ongoing PCP. Stephen pays an $149 annual fee to belong to One Medical even though the actual visits are still covered by insurance. Nonsequitur took the concierge route for his father since few decent doctors in his area accept Medicare, adding that the new practice provides nearly 24/7 secure communications via Twistle. Amy says she hasn’t done it for a PCP, but does so for other services because some providers offer a cash price that’s cheaper than paying her high-dollar insurance deductible. Rose goes out of network to keep a particular PCP even as insurance contracts change frequently, although she’s cautious to get orders for expensive lab and rad tests ordered by an in-network provider since some plans won’t pay for them otherwise.
New poll to your right or here: what was your reaction to the House’s passage of the American Health Care Act last week? Feel free to elaborate further by clicking the poll’s “Comments” link after voting.
HIStalk readers provided an Amazon Fire TV and accessories for Ms. D’s California elementary school class in funding her DonorsChoose grant request. She reports, “Technology is always changing, so my teaching strategies need to accommodate the needs of my students. Most of them are visual learners, so I play YouTube clips and videos all the time when I am teaching science. In addition, the Amazon Fire TV has allowed my students to visually see the concept as they are watching science videos on TV. Now, my students are extremely excited about science! On behalf of my students, thank you for supporting them as they continue to reach for their goals!”
This Week in Health IT History
One year ago:
Theranos announces a reorganization that includes the retirement of President and COO Sunny Balwani.
HHS spells out details of its proposed MACRA program.
NextGen ceases development of its NextGen Now cloud-based PM/EHR as it moves focus to its acquired HealthFusion product.
The FDA rejects the application of the “digital pill” that uses technology from Proteus Digital Health.
Apple releases the CareKit developer’s framework.
Internal documents from University of Texas indicate that MD Anderson Cancer Center blames its Epic implementation for a nearly 60 percent year-over-year income decrease, although noting that it had already assumed some negative impact.
Siemens changes the name of Siemens Healthcare to Siemens Healthineers.
Five years ago:
Partners HealthCare chooses Epic to replace Siemens Soarian.
ONC launches its Health IT Dashboard.
The Nashville Medical Trade Center names six companies that will join HIMSS as tenants.
Medseek announces plans to conduct a management buyout of the company.
Weekly Anonymous Reader Question
I asked readers to describe the best career advice they have received:
You can do better without working more hours.
From Ben Franklin: ask people for help in order to make them like you.
From my first professional manager who that had been employed for our then-current employer for the previous 30 years, "Don’t make the same mistake as me and think that you need to stay with the same company your whole career." Knowing what I know now, and having held various positions with several different employers over the course of 25 years, I would have loved the opportunity to have been given the option to stay put.
Perception is reality. It doesn’t matter what you think — if people perceive X, then X is true.
Always put yourself in the other person’s shoes — most people have good intentions, so if they don’t behave in a good way, understand why from their point of view.
When I was thinking of starting my own independent, HIT consultancy in 1985 — terrified every step of the way, but more terrified not to do it — my mentor at the HIT company where I was employed advised me that, so far, my track record for getting through rough days is 100 percent and that’s pretty good.
Be nice to the administrative assistants.
When you walk somewhere, go fast so you look like you’re actually on your way to do something.
Realize when it’s time to recalibrate. Your vision of your life when you were 18 is probably different than it has turned out to be when you reach 40, so focus on the accomplishments rather than regrets.
Being told that I was not a good writer, and as such would never be published in one of the B2B magazines owned by the publishing company I worked for. While not your typical piece of advice, I took it as a challenge to prove the naysayers wrong. I believe my ensuing track record of published pieces for a variety of media outlets speaks for itself.
My daughter just became an RN and has started working at our local hospital. In her first week or so, she was introduced in passing to an OB/GYN who happens to be my wife’s and also happened to be the doctor who delivered my daughter. She says "Hello, Dr. A," to which he replies "Get out of healthcare, kid."
People will always remember how you’ve made them feel. Don’t be a jerk.
Don’t listen to your parents. They really think they know you, but they can’t because you only become you by following your nose and that takes time, experimentation, trial and error, and the occasionally do-over. In fact, don’t listen to anyone. Do something that is new every day, and when it stops being new at least a little every week, then move on.
Listen. You may be the smartest person in the room. Listen anyway. You’ll learn something.
If it’s not going to matter in five years, it doesn’t matter now. Pull back and reconsider your response to the situation.
You need to read HIStalk.
When the horse has died, dismount. (Ross Perot)
Your boss cares about results, not the path you took to get there.
If you are young and take a travel job for the higher pay, have an exit plan. Otherwise, you’ll find yourself still on a plane traveling every week when you are 65 years old, having missed so many family and friends moments because you were always on the road.
You can love your job, but it will never love you back. No job — no matter how rewarding either financially or emotionally — is worth destroying your peace or sanity for.
Do not let one person ruin your job. (Advice I should have taken.) I left a job after 6.5 years because I could not stand my boss. Other people just ignored or tolerated him. Many of them are still there today, 15 years later. He has since retired.
Back in the early 1980s: learn to type. Sounds dated now, but as my mother said, you can always fall back on being a secretary if needed. Thankfully I took four years of typing in high school, and went onto college to get my bachelors. I type for a living now in IT.
Earlier in my career, I was really ambitious and wanted a promotion after my direct manager left. I wasn’t ready to be the department manager but i met with the VP making the decision anyway. He learned more about my background and experience and said to me, "You have to ask for the job you want, otherwise no one will know you want it." It was a revelation to me. A plain spoken truth and something so simple would be the best career advice I ever received.
My first CIO taught me not to ever say “no” to my business partners. Say “how long” what they want will take to acquire and/or develop, and “how much” it might cost. This is our obligation as IT professionals serving an organization.
Taking the path of integrity and good character will not always result in promotion within an organization. You must be willing to stick to your professional values and be ready to move on to new adventures if your superiors do not like your answers.
You hold yourself back more than anyone or anything. You are good at what you do. Have faith in yourself, be heard, make a difference.
Spend more personal time with your team. Show your human side. Both will build more trust, which will make the team closer and stronger.
Never talk to a reporter. Your response should always be "no comment."
Don’t do anything rash.
When you have an issue with the way the organization is being run, address it by tying it to core values or customers, not by calling out the way a specific person does things.
You should spend 10 percent of your time looking for your next gig.
Do what you say you’re going to do, when you say you’re going to do it. Return the call or email promptly even if you don’t have the answer. In other words, be there. If colleagues and customers know they can count on you, you’ll be given more opportunities (and responsibilities) to grow your career and, at the same time, build a network that will be increasingly valuable.
Arrive at a meeting at least five minutes early, and if you are leading, a meeting ensure that it ends on time or earlier.
I was having trouble getting what I needed professionally from a boss. The advice I received from a mentor was, "She will never be the kind of boss you need. So how do you make the most of what she has to offer and get your other needs met elsewhere?"
Live on what you currently make so your employer will never "own" you. I stayed in positions because I wanted to be there, not to get a paycheck.
Worry about the sale. The margin will take care of itself.
Advice to a just promoted CIO: "Remember that you are a VP of the organization, not just of IT."
Don’t apologize if you have not done anything wrong. Said to me by the late great Steve Macaleer, of the Macaleer/SMS family, who died way too young at 49.
Every five years or so, change jobs. You have probably developed bad habits that are best discarded. You can do this within your current employer or by getting a new employer.
Ninety-five percent of the time you are right, but 95 percent of the time your delivery sucks. You need to work on your delivery AND timing.
This week’s question: what specific event crystallized your decision to leave your last job? (or another previous job if you’ve got a good story from there).
Welcome to new HIStalk Platinum Sponsor CSI Healthcare IT. The Jacksonville, FL-based company, which has offered services nationally for 20 years, provides training and implementation solutions for EHR and coding as well as IT staff augmentation, legacy system support, and infrastructure staffing. Case studies: Houston Methodist (CPOE activation), Norton Healthcare (a 300-contractor Epic go-live), Sutter Health (Epic training), and Grady (big-bang Epic go-lives). The company’s consultants voted it to Inavero’s Best of Staffing Talent List, which recognizes fewer than 1 percent of staffing agencies in North America. The company provides customized consulting and staffing solutions that provide unmatched results at a fraction of the cost. Thanks to CSI Healthcare IT for supporting HIStalk.
Thanks to the following companies that recently supported HIStalk. Click a logo for more information.
Last Week’s Most Interesting News
The House passes the American Health Care Act that would repeal most of the Affordable Care Act, sending the bill to the Senate.
Thoma Bravo buys Lexmark’s Perceptive Software business and moves it under its Hyland Software portfolio company.
Computer systems at University Hospitals (OH) go down for several days due to unspecified causes.
ONC launches a patient matching algorithm challenge.
Meditech announces Q1 earnings per share of $0.39 vs. $0.51 in the same quarter last year.
Internal medicine physicians at Canada’s Nanaimo General Hospital are disciplined for going back to paper orders in declaring patient safety concerns with Island Health’s Cerner system.
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 Allscripts earnings call, following the quarterly report in which the company beat expectations on earnings and met on revenue:
A strong segment was Payer and Life Science.
The company expects its acceptance into the UK’s NHS London Procurement Partnership to help it maintain UK momentum.
The Netsmart acquisition contributed around $50 million of the quarter’s bookings.
Paul Black says the company is watching the market evaluation being performed by the VA and Coast Guard, noting that the Allscripts loss in the DoD bid wasn’t due to technology, applications, workflow, security, or company background – it didn’t make it to the final round because of price.
The company is not seeing the decline in claims volume as reported by Athenahealth, although it notes that Athenahealth has greater exposure than Allscripts because of its business model.
Allscripts will focus on increasing the client base’s adoption of Sunrise Financial Manager rather than trying to roll out outsourced inpatient revenue cycle management services.
Decisions
Central Montana Medical Center (MT) will switch from Evident to Infor supply chain management in 2017.
Children’s Hospital Of New Orleans will go live with Epic in 2018.
New Orleans East Hospital (LA) will switch from Cerner/Siemens Soarian to Epic in 2018.
Thomas Memorial Hospital (OH) replaced Siemens with Meditech on March 1, 2017.
These provider-reported updates are provided by Definitive Healthcare, which offers a free trial of its powerful intelligence on hospitals, physicians, and healthcare providers.
People
New York-Presbyterian Hospital (NY) promotes Rosemary Ventura, MA, RN, DNP to the newly created position of CNIO.
Announcements and Implementations
Reaction Data publishes its “Big Mega HIT Purchasing Report,” which finds that the top spending item of health systems and standalone hospitals in the next 12 months will be inpatient and ambulatory EHRs (Epic was #1 in mindshare for both, followed Cerner and Meditech that were nearly equal in score). Hospital-owned physician groups will focus on information security, while independent practices place telehealth as #1 with equal interest in four vendors.
Definitive Healthcare adds quarterly inpatient and outpatient Medicare claims data for hospitals, clinics, and long-term care providers to its provider data, intelligence, and analytics product line.
Government and Politics
VA Secretary David Shulkin reiterates that he will announce the VA’s plans for VistA in July, choosing to either replace it with a commercial system or turn VistA over to a private company to convert it into a single, cloud-based, externally managed instance. When asked about the historic lack of technology cooperation between the VA and the Department of Defense, Shulkin promised better, saying, “We’ve always found ways not to do that.”
Privacy and Security
Hacker The Dark Overlord posts records of 180,000 patients online from medical practice hacks last year, most likely because those facilities declined to pay the extortion demanded.
Other
A Utah-based orthopedic surgeon is ordered to turn over 10 website domains to Intermountain Health Care, which complained that the doctor had no legitimate reason to have purchased domains related to Intermountain’s Cedar City Hospital and was instead was trying to use them to convince an insurance company to add him as an in-network provider.
Here’s the finale of Vince and Elise’s series on physician practice vendors, this time looking at the “other” ones.
The House votes 217 to 213 to repeal the Affordable Care Act, sending the American Health Care Act to the Senate. President Trump said afterward in a White House victory celebration, “We’re going to get this passed through the Senate. I feel so confident,” adding a promise that premiums and deductibles will go down.
No Democrats voted “yes,” while 20 Republications voted “no.” Two more “no” votes would have killed the bill. The House allocated 40 minutes for discussion before the vote.
The voting was held just before the House leaves for an 11-day recess. Congressional Budget Office scoring of cost and the change in the number of uninsured has not been completed.
Just about every medical and consumer group urged rejecting the American Health Care Act, which would:
End Medicaid as an open-ended entitlement.
Give the wealthiest Americans a $300 billion tax break over 10 years.
Allow insurers to charge older citizens five times the premium rate of younger ones (increasing it from three times).
Allow states to eliminate the requirement that insurance companies issue policies without considering pre-existing conditions.
Eliminate the requirement that individuals buy insurance.
Remove the penalties for large employers who don’t want to provide insurance to their employees.
A change added to the bill in a last-minute amendment would allow states to remove the out-of-pocket maximums now required of employer-provided insurance.
The expected millions of people who would lose insurance under the proposal would leave hospitals at risk for providing their emergency care without payment since the Affordable Care Act reduced hospital Medicare payments on the assumption that more of their patients would be insured.
The Senate’s debate on the bill will begin in June.
Reader Comments
From LongInTheTooth: “Re: Australia’s Telstra Health. You mentioned them as being shortlisted for an EMR tender in Northern Territory. After making over a dozen health IT acquisitions in the last few years, they have decided to trim down and focus solely on the Australian market. New Managing Director Mary Foley is trying to turn around a larger-than-required health vertical without a coherent strategy and has just announced a massive reorg which includes layoffs. Last week they sold their Arcus EMR business in Asia to private buyers. Their CTO Roy Shubhabrata (ex-Epic, GE Healthcare, Microsoft) couldn’t save the sinking ship. Another acquisition, Dr. Foster in the UK, is up for sale as well.” Telstra Health is a business unit of Telstra, the biggest telecommunications and media company in Australia.
From Polite Patrician: “Re: Epic’s App Orchard. The site seems to be free of legal disclaimers. I’m wondering how the submission and approval process works.” I’ve heard concerns that Epic asks a lot of questions about submitted apps and could theoretically use that information to guide its own product development. Epic could also reject apps in claiming without proof that they encroach upon planned future Epic functionality. It seems farfetched to me that Epic would use App Orchard submissions to glean product enhancement ideas or that it would deny applications without a good reason, but at least some small companies seem to worry about that possibility. I’m interested in hearing (anonymously) from anyone who has experience in working with Epic on App Orchard since we’re otherwise just sitting around wringing our hands without facts.
From Old Relay Dev: “Re: McKesson. Sweeping layoffs in NewCo/Change starting last night.” Unverified. An anonymous post on TheLayoff.com quotes a claimed internal email indicating that 394 employees were let go along and 89 open positions were closed, predicting that another RIF will follow in June.
HIStalk Announcements and Requests
HIStalk readers funded the DonorsChoose project of Mrs. F in Virginia, who asked for headphones for her kindergarten class. She reports, “During our group rotations, when students are not working with one of the teachers, then they are on the computer using a program that they sign into so that reading, word recognition, and spelling are at the student’s level. The headphones allow only the student who is on the computer to hear the program without distracting the groups the teachers are working with. The students on the computer are also not distracted by what the teacher is teaching. These headphones allow my classroom to run smoothly. The donors who help make my room complete are angels.”
This week on HIStalk Practice: Compulink develops all-in-one HIS solution for ASCs. MDLive CEO hints at the important role telepsychiatry will play in its future business model. NCQA develops Oncology Medical Home recognition program. Charlotte Eye Ear Nose & Throat rolls out Epic. Practice Velocity announces ownership changes. Change Healthcare helps Saltzer Medical Group transition to independence. Kerri Wing, RN of IHealth Innovations outlines the IPPS proposed rule’s peace offering to physicians.
Webinars
None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.
Acquisitions, Funding, Business, and Stock
Private equity firm Thoma Bravo will buy Lexmark’s enterprise software business — which includes Kofax, ReadSoft, and Perceptive Software – and will then sell the Perceptive business (image capture, vendor-neutral archive, and a universal viewer) to its portfolio company Hyland Software. The Kofax and ReadSoft businesses will be rolled into a new Thoma Bravo company under the Kofax name. Lexmark acquired Perceptive Software for $280 million in 2010, bought competitor Kofax in 2015, and then sold itself to a China-based investor consortium for $3.6 billion in 2016.
Allscripts announces Q1 results: revenue up 20 percent, adjusted EPS $0.13 vs. $0.13 as GAAP earnings swung to a loss, meeting earnings and revenue expectations. Shares were unchanged early in after-hours trading and are down 9 percent in the past year.
Germany-based CompuGroup Medical reports Q1 results: revenue up 5 percent, EPS $0.27 vs. $0.22. Share price has risen 20 percent in the past three months.
Analytics vendor Inovalon reports Q1 results: revenue up 5 percent, adjusted EPS $0.07 vs. $0.05. Share price is down 22 percent in the past year, valuing the company at $1.8 billion.
EHR prescription drug coupon vendor OptimizeRX reports Q1 results: revenue up 22 percent, EPS -$0.03 vs. –$0.01. OTC-listed shares are down 29 percent in the past year, valuing the company at $22 million.
Analytics vendor Koan Health buys ZirMed’s value-based care analytics business.
China-based insurer Ping An launches a $1 billion investment fund that will focus on overseas financial and healthcare technology. The company’s health Internet subsidiary, which offers free online doctor consultations, raised $500 million in a Series A round last year,valuing it at $3 billion.
People
Patient engagement technology vendor Conversa Health hires Chris Edwards (Validic) as chief marketing and experience officer and Becky James (WebMD Health Services) as VP of operations.
Phil Spinelli (Visiant Health) joins Ingenious Med as SVP/chief revenue officer.
Kyruus hires Scott Andrews (Athenahealth) as SVP of delivery.
Video visit vendor Doctor On Demand integrates its system with those of lab companies Quest and LabCorp, allowing its doctors to order lab tests and for its patients to choose a lab based on insurance coverage, availability, and location. The company — co-founded by TV psychologist Dr. Phil and his TV producer son – has raised $87 million in three funding rounds, although the largest and most recent was nearly two years ago. Among its investors are Athenahealth’s Jonathan Bush and Virgin’s Sir Richard Branson. It offers medical sessions for $49 along with ongoing psychology and psychiatry counseling.
In Australia, Pulse+IT reports that a Victoria-wide implementation of Epic did not receive funding in the state’s new budget.
Surescripts extends its real-time medication history service to long-term and post-acute care facilities.
Government and Politics
The CEO of insurer Molina Healthcare – the son of the company’s founder who, along with his CFO brother, was fired Tuesday despite improved quarterly results – says his criticism of the Republican repeal-and-replace movement may have cost him his job. He says, “People are afraid of the administration. Why take an aggressive stance if you think you have nothing to gain, or if you think you have something to lose?” He adds, “The most troubling development has been the attempt to get votes from the Freedom Caucus by allowing states to get rid of the ban on pre-existing conditions … The Trump administration is destabilizing [the marketplaces]. Health plans need to plan ahead. He can pull the rug out from the health plans at any minute.” Molina shares rose 25 percent on the news as investors speculated that the company is now an acquisition target, having jumped 41 percent in the past year and 152 percent in five years.
Privacy and Security
DataBreaches.net reports that an anonymous hacker is running a “summer sale” on his or her inventory of 500,000 recently stolen patient records from pediatric practices, offered at $3 per child. The site verified the validity of a sample of the records even though no cumulative breaches of that magnitude have been reported. The hacker, “Skyscraper,” says he or she simply searches for “patients,” adding that, “For some stupid reason, entire databases show up” and clarifying that the searches don’t involve the known weaknesses of IoT-connected devices or FTP servers. Asked what practices should do to protect themselves, the hacker says they need to pay for their software: “You wouldn’t believe how many of those offices run on cracked / downloaded software and outdated 2015 versions.”
University of California regents sue several doctors and pharmacies, claiming that they defrauded the student health insurance of $12 million over six months by running Facebook ads offering students $550 to participate in phony clinical trials for a pain cream and recruited other students as sales reps for a drug “startup” at a campus job fair. The 500 respondents to both solicitations were required to provide their student health plan numbers, which the lawsuit claims were used to bill prescriptions for custom compounded, Ben Gay-like creams that cost the student health insurance up to $5,300 per tube. The prescribers did not examine the students, who were unaware that they were being billed for the creams. One podiatrist wrote 600 prescriptions for the creams in a single day, costing the system $1.7 million.
Other
Ever-increasing patient cost-sharing has hurt the collection rates of medical practices, according to a Health Affairs article co-authored by Athenahealth’s Jonathan Bush that studied the company’s practice data. Patients paid around 90 percent of balances that were less than $200, but once they owed more than that amount, the figure dropped to 67 percent. The article also notes that collection rates are lower for specialists (because they charge more) and that practices must wait weeks to receive an EOB from the insurance carrier to find out what the patient owes, greatly reducing the chances of getting paid once the patient has left the office.
An article in The Economist says that data rather than oil is the world’s most valuable resource, suggesting an antitrust evaluation of the companies that are profiting massively from it (Google, Amazon, Apple, Facebook, and Microsoft). It notes that access to consumer data gives those big companies an early warning (“a God’s eye view”) of potentially competitive upstarts that they can either copy or buy, highlighting Facebook’s $22 billion acquisition of 60-employee, zero-revenue WhatsApp in 2014. The article suggests that antitrust regulators look not only at company size when evaluating the consumer impact on a proposed merger, but also the extent of the data assets of the companies. It also proposes that companies be forced to let consumers know what information about them they hold and how much money they make from it; that governments open up their own data vaults; and that countries require at least some industries (as is being done with banks in Europe) to share their customer data with third parties.
A Wall Street Journal article examines whether public outcry over a company’s $89,000 drug (previously sold for $1,200) forced that company to sell the drug to yet another company and effectively put itself out of business. Marathon Pharmaceuticals bought a old UK muscular dystrophy drug, paid $370,000 to buy study data from universities, researchers, and the Muscular Dystrophy Association that it used to earn FDA approval, then set an $89,000 per year US price. The CEO’s previous company bought another rare disease drug and upped the price from $289 per vial to $1,950, a formula it repeated in buying “under priced” drugs from big companies and increasing US prices by an average of 500 percent. He made $60 million when he sold the company for $900 million. He expected to sell the current company, Marathon Pharmaceuticals, for several billion dollars before the pricing backlash, but even though he fell short, the company received $140 million in cash and stock, 20 percent of future sales revenue, and a potential $50 million payout, all thanks to 20,000 young boys afflicted with Duchenne muscular dystrophy.
A survey of 800+ health IT workers (two-thirds of them consultants, most of them working on Epic) finds that 86 percent of them feel optimistic about their career opportunities and nearly half say they make $100,000 or more per year. The most important factors in deciding whether to accept a contract are pay, company reputation, and the expense reimbursement model, with the least-important factor being the ability to work from home. Interestingly, two-thirds of consultants would consider a full-time role, which represents a huge jump over surveys from previous years, although salary expectations seem to be a barrier given the tiny number of respondents who say they’re willing to take a pay cut.
Wilkes Regional Medical Center (NC) will convert from McKesson Paragon to Epic as its lease is turned over to Wake Forest Baptist Medical Center on July 2, when it will be renamed to a name that will surely almost never be used in its entirety, Wake Forest Baptist Health – Wilkes Medical Center.
An interesting study finds that parents who Google the symptoms of their child are much more likely to question their pediatrician and seek a second opinion because they don’t understand the differential diagnosis process the doctor used. The author suggests that physicians explain how they arrived at their diagnosis during the office visit to avoid treatment delays caused by patient second guessing.
Vending machines are offering $4 HIV test kits as part of a government pilot project in China, where people often don’t undergo testing because homosexuality — and with it, HIV and AIDS — are taboo subjects and hospitals reportedly regularly turn away HIV/AIDS patients even though the law forbids such discrimination.
Weird News Andy says 50-times-faster brain surgery is fine as long as it isn’t done half-fast. University of Utah develops a robotic, CT-mapped surgical drill that may reduce surgery time from two hours to 2.5 minutes, although it hasn’t actually been tested on humans.
Sponsor Updates
Impact Advisors delivers 200 backpacks filled with craft supplies and games to patients of Florida Hospital for Children.
EClinicalWorks will exhibit at the 2017 ASCA Annual Meeting May 3-6 in Oxon Hill, MD.
Nuance recaps recent hospital sales of its computer-assisted physician document system and publishes a new report titled “CAPD 2017: Improve physician documentation at the point of care.”
Evariant will host its third annual Converge User Conference May 7 in Austin.
ECG Management Consultants will present at the 2017 ASCA Annual Meeting May 4 in Oxon Hill, MD.
An Emory University research study finds cost savings for CABG surgery, supported by Glytec’s Glucommander for personalized insulin dosing.
The HCI Group publishes “Selecting the Right Interface Engine – Top 5 Considerations.”
Healthcare Growth Partners supports the sale of Clockwise.MD to DocuTap.
Imprivata will exhibit at the Canada Collaboration Forum May 8-10 in Whistler, British Columbia.
Influence Health releases a new whitepaper, “Healthcare Consumer Experience in 2017.”
InterSystems will exhibit at the Blue Cross Blue Shield National Summit May 9-12 in Orlando.
Kyruus publishes “Health System Call Center Experience Report: Are Top Health Systems & Hospitals Answering the Call to Provide a Better Patient Experience?”
Liaison Technologies begins accepting applications for its new Data-Inspired Future Scholarship.
NVoq will exhibit at the MGMA NE conference May 10-12 in North Falmouth, MA.
Experian Health will present at HFMA Eastern Michigan May 12 in Livonia.
Wellsoft will exhibit at the Rural Health Conference May 9-12 in San Diego.
Computer systems at University Hospitals (OH) remain down following unspecified connectivity issues that started Monday.
Hospital executives say the lack of computer access is not affecting patient care.
Reader Comments
From Nantwatcher: “Re: NantHealth. President Robert Watson has been separated, effective immediately. Co-Presidents Mark Dudman and Gary Palmer, MD are also gone.” The company hasn’t responded to my inquiry. However, those three folks have been expunged from the company’s leadership page. The year-ago cache of that page shows that of the eight executives listed then, only three remain – the CFO, chief people officer, and general counsel. The LinkedIn pages of Watson and Dudman remain unchanged, but that of Gary Palmer – NantHealth’s chief medical officer and president of its GPS Cancer division – says he left in January and is now chief medical officer of genomic sequencing and analytics vendor Tempus. The slide in NH share price continues – it’s down 40 percent in the past month and 85 percent in the 11 months since the company’s IPO.
From Conjoined Triplet: “Re: Huron Consulting. Completed its fifth round of layoffs in two years Friday, this one targeting revenue cycle and technology consulting teams. They paid $30 million to acquire Vonlay three years ago and there’s hardly anyone left on the Epic team.” Unverified. The company hasn’t responded to my inquiry. Huron’s earnings and revenue beat expectations in Monday’s quarterly report, but CEO James Roth said in the earnings call that healthcare revenue (52 percent of the company’s total) was down 14 percent, mostly due to “softness in our revenue cycle offering within the performance improvement solution” as projects shifted to smaller engagements. He says that Huron “will continue to make adjustments in our cost structure to manage our profitability in this segment.” Shares rose Monday following the earnings announcement before the market’s opening, but are still down 19 percent in the past year.
From Seal Flipper: “Re: speaking invitation. Check out this health IT magazine’s ‘invitation’ to pay to speak at its conference.” I can’t say I’m shocked that revenue-desperate health IT sites are brazenly selling pay-for-play article space on their sites and speaking slots at their conferences, no doubt encouraged by the similarly commercial behavior of HIMSS. I can only assume that providers will eventually wise up that they’re being fed vendor commercials and will push back, especially if the underlying content isn’t very good.
From Kermit: “Re: algorithms. This comic makes me think of all the non-HIT firms that have jumped into HIT thinking they can ‘solve’ healthcare with their years of business experience.” There’s an uneasy tradeoff (in healthcare, politics, the arts, and other endeavors) in bringing in a fresh set of outsider eyes that can provide either: (a) brilliant insight and fresh inspiration; or (b) embarrassingly inept floundering while confidently trying to use a hammer to pound in a screw.
From Jump Back: “Re: HIMSS. Their buy one-get one offer seems to be a sign of trouble in paradise.” I think it’s probably a sign that HIMSS members fuel its revenue not by paying dues, but rather by making themselves available as a target for big-vendor marketing. That was made clear when HIMSS announced its Organizational Affiliate program years ago in which everybody in a participating company can join at no incremental cost. The “Ladies Drink Free” model makes HIMSS a fortune as an intermediator and explains why they cater to vendor members and exhibitors rather than employees of non-profit health systems. I’m not sure there’s much value in joining HIMSS (and thus directly supporting some of its questionable behaviors) other than to earn a discount on the annual conference registration.
HIStalk Announcements and Requests
We funded the DonorsChoose grant request of Mrs. B in Washington, who asked for building blocks for her kindergarten class. She reports, “The kids were over the moon about them, and though we don’t know who you are, they all think you are the best ever. While they are just thinking about playing, these skills (persistence, trying even when something goes wrong, working in a team, asking for help) learned in play now can help support them in the future in math classes, science classes, reading, and in their relationships. Now that is a lot from just a few more sets of toys! This is something I couldn’t have provided my kids without your support and I hope you understand how overwhelmingly grateful I felt when I got the email that said this project was funded (it actually came Christmas morning). Thank you so much, again.”
I tested my new cheap phone’s speed over AT&T’s cellular network and was shocked to see 60 Mbps down and 15 Mbps up. I got the same result testing in different locations on different days, all while connected via VyprVPN. Perhaps I missed some mobile speed developments while using my ancient iPhone 5 that I bought when LTE had just been rolled out.
Replacing my old phone was my #1 priority, while replacing my equally old laptop was #2. I ordered one from Amazon at a great price, but it was delivered yesterday with a giant gash in the package and a cracked display (thanks, US Post Office). I had the issue resolved in a couple of minutes – click Return on the online order on Amazon.com, provide a reason, choose refund or replacement, and print a UPS-paid return label (or schedule a free pickup). Today I got an apologetic email from Amazon’s Akshay, who fast-tracked my replacement to two-day shipping, passed my problem on to “the higher authorities at Amazon,” and wished me “a beautiful day.” You want to know why Amazon is killing retailers, look no further.
I’m enjoying the responses to my “best career advice” survey, so much so that I’m encouraged to remind you to respond if you are so inclined.
Webinars
None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.
Here’s the recording from last week’s HIStalk-sponsored webinar, “3 Secrets to Leadership Success for Women in Healthcare IT,” presented by Nancy Ham (WebPT) and Liz Johnson (Tenet Healthcare).
Acquisitions, Funding, Business, and Stock
India-based outsourcing firm Infosys will hire 10,000 Americans over the next two years and will open four technology and innovation hubs, the first in Indiana. Perhaps the company hopes everyone will forget that it paid $34 million a few years back to settle charges of widespread US immigration fraud. Several offshore companies, worried about President Trump’s “Hire American” policies, have announced similar hiring programs, although experts question whether the highly publicized plans will ever materialize.
The board chair of EpiPen maker Mylan was paid $164 million last year, will receive $1.8 million per year now that he’s no longer an employee, and was given another $37 million worth of stock. Even though he’ll remain as board chair, he received a $22 million termination benefit, including $4.6 million to use the company’s jets for three years. I tried listening to music by his son Tino Coury, who is signed to the record label owned by good old Dad, and it’s really no better or worse than most of the other imitative, sterile, computer-enhanced dance music out there. Dad was caught in 2012 using Mylan’s jets to haul Tino around to concerts, but that shouldn’t be an ongoing problem since Tino’s musical career seems to have died young.
Baptist Memorial Health Care (TN) and Mississippi Baptist Health Systems (MS) complete their merger to form a 21-hospital, 16,000-employee health system. The president and CEO of Mississippi Baptist says, “With the cost of technology, it makes sense to spread that over 22 hospitals.” Baptist’s Epic system is being installed at Mississippi Baptist.
The Chicago business paper profiles 13-employee care coordination software vendor PreparedHealth, which just raised $4 million in its first significant funding round. The co-founders came from Medicity.
Sales
Athenahealth chooses electronic prescribing legal updates from Point-of-Care Partners to ensure its compliance with state laws.
HealthlinkNY selects Diameter Health for normalizing, de-duplicating, and enriching clinical data to enable interoperability and allow the HIE to advise members on the quality and completeness of their clinical documents.
People
The board of UMass Memorial Health Care (MA) elects health IT entrepreneur Rick Siegrist, MS, MBA as chairman. He founded decision support vendor HealthShare Technology (sold to WebMD in 2005 for $31 million) and PatientFlow Technology (sold for an unstated price to Press Ganey in 2009, who made him CEO).
Medicare and Medicaid fraud detection software vendor MedicFP names board chair and private equity firm owner Ruben Jose King-Shaw, Jr. to the additional role of CEO. He was formerly secretary of Florida’s AHCA and deputy administrator and COO of CMS. The company offers biometric identity validation.
LifeBridge Health (MD) promotes Jonathan Ringo, MD to president and COO of Sinai Hospital of Baltimore. He joined health system in 2014 as its first CMIO.
Government and Politics
ONC announces a $75,000 patient matching algorithm challenge, apparently giving up on the idea of a national patient identifier that would make such fuzzy logic necessary.
Innovation and Research
Johns Hopkins University’s venture arm opens FastForward 1812 — the latest of its several business incubator locations — which will support companies hoping to create products based on Hopkins patents and licenses. Baltimore-based EHR security vendor Protenus was launched in the original FastForward.
MIT researchers develop WiGait, a wall-mounted sensor that can measure the stride length of multiple people over time to potentially detect injuries and gait-affecting conditions such as Parkinson’s disease
Other
Friends and family members of patients in 150 NHS hospitals are forced to pay per-minute charges to call their rooms, which includes having the meter running while listening to a 70-second-long “please be patient” message. The government outsourced phone services to in-room entertainment vendor Hospedia, which says it uses a third party’s service that allows it to give each patient’s room its own telephone number instead of being routed through the nursing station.
In England, five hospitals of Barts Health NHS Trust are cancelling surgeries and chemo treatments after the failure of its radiology, PACS, dictation, and chemotherapy systems. A hospital manager’s email said cancer teams had to rebuild patient records from scratch. Systems were restored Tuesday after being down for 11 days. Barts declined to describe the cause of the problem, but previously had major downtime in January caused by a Trojan malware attack
In Australia, Northern Territory budgets $60 million for the first year of its $195 million clinical systems replacement project, for which it will name a prime contractor this month from the short list of Telstra Health, Epic, Allscripts, and InterSystems.
A study published in Health Affairs finds that high-priced medical practices – which charge an average of 36 percent more than low-priced ones – offer better care coordination and management, but don’t perform any better in overall care ratings.
Weird News Andy concludes that in not focusing on the job at hand, “Now he’s broker.” Miami-based OB-GYN Ata Atogho, MD is hit with a $34 million malpractice lawsuit judgment for a series of mistakes he made in the delivery of a baby who was born with brain damage, one of which was to disappear from the mom’s room for eight minutes to consult with his stockbroker.
Sponsor Updates
LogicStream Health will host a happy hour Tuesday at The Great Dane Pub in Madison, WI during Epic XGM 2017.
Spok releases part two of its mobility in healthcare survey report.
Optimum Healthcare IT renames its go-live support application GoLiveSupport.com as Skillmarket.
CenTrak launches a charitable program to provide enterprise location services to cancer centers, with Vidant Medical Center (NC) the first participant.
Mediware will integrate CoverMyMeds electronic prior authorization into its CareTend specialty pharmacy software.
The Milwaukee Journal Sentinel names Nordic to its Top Workplaces for 2017.
Aprima Medical Software receives the 2017 United States Frost & Sullivan Award for Product Leadership.
Arcadia Healthcare Solutions publishes a Quick Guide on “Identifying Childhood Immunizations.”
AssessURhealth wins the GE Health Cloud Innovation Challenge.
Datica CEO Travis Good, MD will speak at the HITRUST Annual Conference May 8-11 in Dallas.
Besler Consulting releases a new podcast, “Coding clinic updates for first quarter 2017.”
CCSI employee Keith Yourg earns PMP certification.
From the Athenahealth investor call, which follows disappointing revenue and earnings quarterly results that sent shares down 19 percent Friday:
CFO Karl Stubelis blamed the miss on lower-than-expected claims. lower collection volumes, and slow onboarding of new customers.
The company lowered revenue, earnings, and bookings guidance for the fiscal year and expects a lower operating margin for 2017.
Jonathan Bush says office visits and payment per visit are both down for the first time, bucking the trend caused by hospitals buying practices and increasing their prices. He attributes the drop to consumer uncertainty around the Affordable Care Act and higher deductibles that consumers are unwilling or unable to pay.
Bush said, “When we get into a meeting with a prospect and that prospect decides to do something, 80 percent of the time they go with Athenahealth. That doesn’t suck. That does not suggest retrenching, going to cash flow, ceasing the entry of the hospital market. It suggests breathing into the beating until things get better, which we believe they will.”
Bush says the company had planned for doubled customer attrition for the year after its rollout of the Streamlined clinical product, but Net Promoter Scores have since rebounded.
The company was not considered in some deals due to its lack of a viable inpatient product, but Bush expects that to change as it expands its inpatient EHR, which he describes as, “For a one-year-old product, kicking ass” that more than pays for itself with elimination of capital expenditures and an improvement in collections.
Future drivers of what Bush says will be a restored higher growth rate are improved scalability of the inpatient product implementation, a cost guarantee for doctors, and automating practice tasks beyond previous government-mandated functionality.
Bush disagreed with an analyst’s slightly combative observation that the company’s guidance is aspirational and often at odds with actual results, thereby reducing investor confidence, saying, “While our goals remain ambitious, our guidance is something that we think is a balanced handicapping of what we think will actually happen on the field. My goals, my team, the guys who are out there in the field still think they can get this number, but they’re not prepared to reassure you in that regard … One thing we all took for granted is that Athena would know its revenue a year out … The one place that we all need to get our confidence back is understanding the activity in the practice. And believe me, we’re studying it.”
Bush concluded the call with, “Metamorphosis hurts. We’re feeling the crunch of several coming-of-age moments all at once here at Athenahealth. Attrition hangover from last year’s Streamlined rollout and the customer service issues, adjustments to Trumphealth from Obamahealth, a totally new guard at our senior management team, a tale of employee disruption from the change to it. Adjusting guidance hurts us, but it’s mostly the shame of coming to grips with that hurt. Our strategy is right, our traction against our challenges is better than ever, and optimism at the senior-most levels of this company is at an all-time 20-year high. Hence we enter execution mode.”
Reader Comments
From Carrot Bottom: “Re: MUMPS. Curious, you mentioned a blog post about developers complaining about MUMPS. It wasn’t very long after your post that you changed the link from Hacker News to some academic professor’s personal wiki on MUMPS. Now when I go to the original Hacker News link, it also has been taken down. Were you pressured to remove this information by an unknown legal team from Wisconsin?” I didn’t change the link in my original post from Hacker News and that link still works. However, in trying to figure out what you are referring to, I noticed that Lt. Dan (who writes the daily headlines) inadvertently used a different link in his headline. I actually didn’t get any private feedback on that post.
From Harry Angstrom: “Re: Jonathan Bush’s Instagram. This was quickly removed a few minutes later.” Unverified. The screenshot shows JB’s comment to Friday’s huge ATHN share price drop as, “K Thanks Bye.” Regardless, his other photos provide a glimpse into what life is like being raised rich and living hyperactively smart and quirky (like being one of a tiny number of trust fund kids to commendably serve in the Army).
From Causative Agent: “Re: charity for sale. Given your stance on charities, I thought you would find this highly offensive and in-your-face advertisement interesting.” An unnamed Dallas charity offers itself for sale for $2.4 million, urging prospects to “do the math” since they can “legally keep $200,000 as a salaried director.” Beyond enriching the new owner, the charity sends handicapped children to Orlando theme parks “and helps other charities as well,” with the owner helpfully suggesting expansion via new fundraising offices, telethons, squeezing business for donations, and running galas. I couldn’t figure out which charity it is, but I’d be curious about its reviews on Charity Navigator, Guidestar, and CharityWatch. Most surprising to me is that somebody can just “sell” a charity to whomever ponies up the cash, although I supposed the owner can simply install the buyer as board director and then resign even though the assets can’t be transferred short of a merger with another non-profit. For that reason, paying $2.4 million to buy a $200K job seems like bad financial planning, and hopefully the new owner will reap what they sow.
From Soiled Skivvies: “Re: suck-up writers. This writer lost objectivity and it’s obvious they were star-struck.” Much of the health IT content out there is written by newbies, underachievers, and raging introverts who are way too easily influenced by the phony, smarmy charm of some Type A industry bigwigs who turn it on knowing they’ll get uncritically positive PR as a result. It’s kind of like being that cubicle-bound programmer who mistakes minor casual exposure to the boss as newfound social acceptance. The inhabitants of mahogany row did not ascend to the throne being unaware of the org chart caste system and they are not like you. Which is probably OK since someone has to have the swagger, however misplaced, to get everybody else to follow orders.
HIStalk Announcements and Requests
Poll respondents predict that the VA’s biggest problem if it decides to implement Cerner or Epic will be budget overruns, with lack of internal resources being another potential problem. Red Tape goes with “none of the above” in predicting that governance and bureaucratic decision-making will create an impossible struggle to stay on track. Daddio62 warns Cerner clients that if the company wins the deal, it will pull their experienced consultants off to the VA and replace them with greenhorns. Art Vandelay (welcome back, Art) says VistA was built around requirements that have no equal in the rest of the healthcare world and says user acceptance of a COTS will be a problem, possibly requiring a wrapper solution around the core product to support the VA’s unique needs. Cerner User also warns of the limited availability of skilled Cerner consultants and the pressure on the VA to increase productivity that will conflict with clunky software workarounds that reduce productivity.
New poll to your right or here, based on a reader’s comment: Have you ever bypassed your insurance and paid cash to choose a better ongoing PCP? It’s often depressing to have to settle when choosing a new PCP from your insurance company’s provider list (which is usually not only outdated, but fails to note that most of the docs listed aren’t taking new patients for their particular low-paying plan). You are often out of luck if you want a doctor who’s been out of school long enough to not be dangerous yet who isn’t past normal retirement age; one who attended a decent US medical school and residency; or a PCP whose Healthgrades reviews are better than appalling. In other words, you might not want to join a club that would accept you as an insurance-wielding member, while plopping down cash opens up endless (but expensive) possibilities. I suspect most of us just grit our teeth and choose the best-sounding of the substandard choices who will accept our insurance.
We funded the DonorsChoose grant request of Mrs. R in California, who asked for egg shakers and a rhythm set so her elementary school students can have fun with music as a break between tough subjects. She reports, “We have Fun Friday every week and I have been able to give a small music and rhythm class using the instruments and shakers. It is a hit! The students love it! Sometimes we make our own music and sometimes we follow along to child-friendly versions of today’s radio hits. Other teachers have noticed the fun and have borrowed the instruments and shakers to enjoy with their students. It has been a true blessing to have the instruments and shakers as a stress reliever for both the students and myself!”
This Week in Health IT History
One year ago:
Nokia announces plans to acquire consumer health device vendor Withings to create Nokia Digital Health.
CMS releases the warning letter it sent to Theranos in which it stated that, “The laboratory’s allegation of compliance is not credible.”
Verks Analytics agrees to sell its Verisk Health business to Veritas Capital for $820 million.
Caradigm quietly announces that Microsoft has sold its 50 percent stake in the company to JV partner GE Healthcare.
A science publication questions the privacy and exclusivity terms contained in the agreement between NHS and Google’s DeepMind.
Quintiles merges with IMS Health.
Joint Commission gives its OK (later reversed) to send orders via text messaging.
Five years ago:
Allscripts shares lose more than one-third of their value following announcements of poor quarterly results, the departure of its CFO, the firing of board chair Phil Pead, the resignation of three board members who supported firing Glen Tullman, Tullman’s erratic defense of his performance in the investor call, and the company’s loss to Epic in two UK decisions.
Merge Healthcare shares shed 36 percent on poor quarterly results, with the company announcing that it will divide itself into two operating divisions, the traditional Merge imaging business led by Jeff Surges and a consumer kiosk and clinical trials division under Justin Dearborn.
Chicago Mayor Rahm Emmanuel pressures the state’s attorney general to back off its investigation of Accretive Health’s strong-arm patient collection tactics.
New health system CIO hires include Jocelyn DeWitt (University of Wisconsin Health) and Pamela Banchy (Summa Western Reserve Hospital).
Weekly Anonymous Reader Question
I asked readers to who have either considering quitting HIMSS or who have actually done so what motivated them:
Almost useless organization. What Epic has done to hospital IT cost should never have happened. HIMSS needs to be more than a vendor show.
Simply cost vs. benefit. HIMSS motives are suspect anyway.
Annual conference was my main involvement. It’s gotten too big to be useful. One cannot do anything of substance on the exhibit floor. Classes have been good, but it’s just too much. I’d rather be involved in a more focused group, like ATA (telemedicine) or something like that. Cramming it all into one show dilutes things.
I have been an individual member for over 20 years. No longer! Not continuing membership or attendance at national events. HIMSS is just about money, vendors, and more money. But the main reason is association with Federal government and DOD has taken over focus. Government nerds are not technological leaders. They have nothing to offer healthcare technology … boring bunk. Finally just bored with the agenda.
Increasing irrelevance ever since HIMSS changed from a member-driven org to a "mission"-driven one. Individual members have little impact or recognition, even those who donate numerous hours on committees. Smaller specialty associations provide more return on the membership fee. Also hard to justify the annual conference cost when the only value is networking.
Retirement.
I considered quitting until I changed my expectations from education and knowledge acquisition to it being a huge shopping mall. It fits that bill, not the other. It’s a reasonable way to keep in touch with product domains.
It has become such a racket. It has become nothing more than a vendor forum, which is very disappointing.
I left HIMSS about 15 years ago because: (a) the organization became exceedingly political with no requests for input from members, and (b) the focus shifted from users to vendors and thus had little value to me.
I did not renew in 2017 because of the increasing power of the vendor. The last straw was that the head of my state chapter was a vendor who behaved very badly in my organization (e.g. contacted board members when he didn’t get what he wanted from me). I prefer CHIME over HIMSS because I don’t feel like I’m a sales target every time I am on a phone call or in a meeting.
Haven’t quit yet, but working at an HMO presently, I don’t see a lot of value in HIMSS other than interacting with members from the provider side. While that is of great value to me, over half of the new people I meet are consultants or contractors.
The cost outweighs the benefit.
HIMSS educational and networking offerings had value for me early in my career. Now, I have experience in the field and am not a decision-maker in IT investments. HIMSS repeats the same "Informatics 101" and "Learn about TIGER!" webinars every quarter and they seem to be efforts to market products rather than educate members. I don’t know if this is a change from past years, if I was less aware of the context in early days, or if I’ve just grown old and jaded. Now I only renew membership in years in which my employer sends me to the annual conference, since registration + membership is more affordable than registration as a non-member. Otherwise, I see no return on the investment. I’d rather pay membership dues to AMIA.
Former HIMSS member here. I quit because as an IS analyst supporting the revenue cycle side of operations, the HIMSS focus is clinical. I wasn’t seeing the value.
Too much focus on vendor revenue.
Worthlessness of HIMSS CPHIMS certification. They sell it relentlessly but don’t even support it with networking at the annual conference or advertising to employers.
This week’s question: What’s the best career advice you’ve received that goes beyond the usual platitudes? In other words, not just “work hard, learn, market yourself” and other obvious recommendations.
Last Week’s Most Interesting News
Greenway Health is hit with a ransomware attack that affects customers of its hosted Intergy systems.
Cerner announces good quarterly results., while Athenahealth shares drop sharply on missed earnings and revenue expectations.
Leapfrog Group’s hospital patient safety participants report nearly universally available bar code medication administration scanning systems, but with inconsistent usage.
The Coast Guard issues an RFI for an EHR following its failed attempt to implement Epic.
Ambulatory EKG monitoring services vendor CardioNet pays $2.5 million to settle HIPAA charges following the 2012 theft of an employee’s laptop.
The Trump administration dismisses US Surgeon General Vivek Murthy, replacing him in interim with Deputy Surgeon General Rear Admiral Sylvia Trent-Adams, who is a nurse.
Webinars
None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.
Acquisitions, Funding, Business, and Stock
Meditech announces Q1 results: revenue flat, EPS $0.39 vs. $0.51. Product and service revenue were both basically unchanged over Q1 2016.
From the earnings call of Cerner, whose Q1 results beat expectations for both revenue and earnings and sent shares up 8 percent Friday:
Domestic revenue increased 13 percent, while non-US revenue was basically flat excluding currency fluctuations.
The company noted several wins over Epic, which it says is in a defensive stance following more coverage of its client cost overruns.
Cerner says its advantages over Epic are predictable total cost of ownership, more modern architecture, better ability to demonstrate value, and strong population health management capabilities.
The company says its Department of Defense work “is making Cerner better” in ways that will benefit all of its customers, adding that the remaining three DoD pilots are on track .
President Zane Burke says IT is the best way to drive down cost, which hasn’t been addressed by either party’s healthcare platforms that focus instead on access and insurance reform.
The company sold no new ITWorks IT management contracts in the quarter, but expects record sales of that product in 2017 as larger health systems conclude that some aspects of IT aren’t their core business.
Burke declined to specifically say if Cerner is taking ambulatory business from Athenahealth, saying only that, “We’re taking share from all competitors.”
Burke also declined to provide an update to previous comments that Cerner is seeking a CRM partner.
Sales
In the UK, Burton Hospitals NHS Foundation Trust expands its agreement with Summit Healthcare following its Meditech 6.1 go-live to include continued management of interface strategy, education, modifications testing, and developing additional interfaces as needed.
Decisions
OhioHealth Mansfield Health (OH) switched from Infor to Oracle PeopleSoft supply chain management in December 2016.
Franklin Memorial Hospital (ME) will replace Meditech with Epic in 2018.
These provider-reported updates are provided by Definitive Healthcare, which offers powerful intelligence on hospitals, physicians, and healthcare providers.
People
Nordic promotes Vivek Swaminathan to president of its managed services division; Katherine Sager to EVP of consulting services; and Matt Schaefer to EVP of strategic services.
Other
In Canada, 15 internists at Nanaimo Regional General Hospital go back to paper medication ordering in defiance of Island Health’s mandated use of its Cerner system dubbed IHealth. Doctors have long complained that the system causes medication errors. One of the internists was given a one-day suspension and another faces disciplinary action. The hospital says it can’t support paper orders and therefore has assigned other doctors to enter their paper orders into the EHR. Island Health previously tried bribing doctors to use IHealth, while the hospital’s ICU and ED doctors had gone back to paper in May 2016 — nine weeks after rollout — because of patient safety concerns. Island Health shut the CPOE system down in February 2017 following a 75 percent no-confidence vote by the medical staff, but restarted it a month later in saying it is too connected to other systems remain offline.
University of Utah Health Care CEO Vivian Lee, MD, MBA resigns after she fired its cancer center director by email and following her acceptance of questionably motivated donations from NantHealth’s Patrick Soon-Shiong. Billionaire donor and cancer survivor Jon Huntsman’s threat to withhold his planned $250 million donation to the cancer center named after him forced the university to reinstate the fired director and to rearrange the org chart so that she reports directly to the university’s president. Huntsman called Lee a “one-person wrecking crew” and “the least ethical, least disciplined woman in the world.” Meanwhile, Utah House Speaker Greg Hughes has asked state auditors to review Soon-Shiong’s $12 million donation – which a STAT report suggested came with strings attached in requiring the university to buy products from his various companies – to determine whether a formal state audit is warranted.
NBC News covers the often expensive consumer confusion between doc-in-the-box urgent care centers and freestanding emergency rooms, highlighting the case of a mother who pulled in what looked like a retail clinic in getting antibiotics for her daughter’s chest infection that ended up costing her $1,700 (later reduced to $1,000). She was flabbergasted when her insurer told her that PrimeCare Emergency Center is actually an ED, replying, “It was next to a nail place!” The report says 35 states allow freestanding ERs, most of them as off-campus hospital locations, but some are operated by for-profit companies. A class action lawsuit claims that now-bankrupt Adeptus Health, which runs 99 freestanding ERs, intentionally tricks patients into thinking they’ve entered a cost-effective urgent care center. A couple who took their child to an Adeptus ER racked up a $7,700 bill for an X-ray and pain reliever for what turned out to be constipation.
Here’s Vince and Elise with their HIS-tory of the top 10 physician practice EHR vendors.
Sponsor Updates
QuadraMed, a division of Harris Healthcare, will exhibit at the CHIMA Annual Meeting May 4-5 in Westminster, CO.
The SSI Group will exhibit at LA HFMA Annual Institute April 29 in Lafayette, LA.
SK&A publishes the “2017 Guide to Effective Email Marketing.”
GE Healthcare partners with Partnerships for Affordable Health Access and Longevity to address the healthcare needs of underserved communities in India.
Sunquest Information Systems releases a video celebrating Medical Laboratory Professionals Week.
Surescripts will exhibit at the annual Health Plan and Payer Summit April 30-May 4 in Washington, DC.
Wellsoft will exhibit at Emergency Medicine Update May 3-5 in Toronto.
ZeOmega will host its annual client conference May 2-4 in Plano, TX.
ZirMed will exhibit at ASCA 2017 May 3-6 in Washington, DC.
A Leapfrog Group report finds that while 98 percent of hospitals have bar code medication administration scanning technology connected to their EHR, only 30 percent of those hospitals are meet ingLeapfrog’s BCMA standard.
The most common reasons for falling short are (a) not having all seven decision support elements available (most often missing were vital signs and allergies), and (b) not using the BCMA system in at least 95 percent of total bedside administrations.
Reader Comments
From Dad’s Tie: “Re: David Butler’s article. That guy is terrific. What he describes is exactly what my hospital organization needs.” Agreed. Dave’s article on marketing IT, written from his health system CMIO perspective, is a breath of fresh air. I hope he contributes regularly.
From Industry Watcher: “Re: Caradigm. Another huge round of layoffs last week with nearly the entire senior leadership team included other than the CEO.” Unverified. The cached version of its leadership page from three weeks ago suggests that seven of the 13 executives have departed, including four of five SVPs. I don’t assume that executive turnover under a new CEO is necessarily a bad thing, though (except obviously it often is for the people who are gone). Companies usually bring in new blood to make changes, not to preserve the status quo.
From Unimpressed: “Re: Greenway Health. Working with the FBI after being hit by ransomware. Hosted customers on one of their platforms are still down, possibly until Monday. The company has had a long period of bad news and execs jumping ship.” Greenway says the attack affects its Internet-hosted Intergy customers, but adds that it expects to restore all their data from backups. The company was also involved in 2016 breach in which it misconfigured the patient portal of Florida Medical Clinic so that some patients could view the balance due statement of other patients. With regard to executives, the year-ago cached version of Greenway’s leadership page suggests that five executives remain of the 12 listed then. Greenway Health was formed in 2013 when Greenway Medical Technologies was taken private by Vista Equity Partners and combined with Vitera (the former Sage Software, previously Medical Manager) and SuccessEHS. Greenway’s HIMSS17 booth was noticeably downsized.
From Expired Mallow Cup: “Re: IT history. Forty years ago today, I started my first IT (data processing in those days) job at a hospital. I am showing people a 1977 photo of my desk with no PC in sight – I started with a mainframe with punched cards. Today I am working at a hospital converting from Soarian to Cerner Millennium. I’ve decided to stick around to support Soarian, but no Millennium for me. When they insist that we take our 390+ order sets that I have built on Soarian and duplicate those on spreadsheets for some young just-out-of-college person at Cerner to then transfer using the nice build tool in Millennium (that we’re not allowed to touch until August), I was out of here. Having to tell a physician that their problem entering medication orders is a known bug and they have to hand-write the order because it won’t be fixed for a few months — I’ve had enough of getting yelled at over the phone. Read your posts every day when I can. Thanks for letting me vent.”
From Dangling Participle: “Re: County of San Bernardino, CA. Has posted an RFP for a new EHR to replace Meditech C/S after halting efforts to connect to a neighboring hospital’s Epic system last year.” Looks right — I found this RFP for Arrowhead Regional Medical Center that also includes possible expansion throughout the county’s entities.
HIStalk Announcements and Requests
One day after whining about the paucity of good Readers Write submissions, I received two excellent ones from David Butler and Joe Petro. I’ll use those a springboard to urge readers (especially non-vendors) to write pieces of their own. The process is good for organizing and presenting thoughts, the content is more important than writing perfectly, and the audience is substantial.
We funded the DonorsChoose grant request of Ms. S in Missouri, who asked for an Osmo coding set, a pencil sharpener, and five sets of headphones for her second grade class. She reports, “My class is able to stay engaged in their learning without distractions from those around them now that we have enough headphones for everyone. They are learning so much from the coding Osmo. They are becoming deep thinkers and problem solvers with this interactive tool. These skills will be lifelong necessities for them as our world becomes more and more digital. Thank you for being a part of creating an equipped tomorrow. We are extremely appreciative of people like you.”
The mental and physical decline of my four-year-old iPhone 5 was accelerating, with puzzling call failures, poor LTE connectivity, and sluggish performance. Since I don’t use my phone broadly (mostly just browsing, checking email, and GPSing while away from home), I just couldn’t get excited about spending $800 or more on an iPhone or Samsung Galaxy. I did a lot of research and concluded that beyond fanboy upgrades, the smartphone market has matured, with little innovation and sales that are propped up by user ego rather than added value. My solution: Motorola’s Moto G Plus from Amazon Prime for an astounding $240 (partially subsidized by Amazon lockscreen ads that I don’t find intrusive, plus I’m always using Amazon services anyway). Features:
It’s unlocked, so you can easily swap out the SIM at any time when traveling overseas or changing carriers. I popped my own AT&T SIM in without incident.
The Moto G has 4 GB of RAM and 64 GB of storage, plus it accepts a standard Micro SD card that allows adding up to 128 GB more storage for around $50.
It comes with a nearly stock version of Nougat, the latest version of Android (Google, thank you again for creating a competitive market in developing Android). The learning curve in moving from iOS is nearly zero.
Battery life is long and the TurboPower charging adds six hours of use after just 15 minutes of plugged-in time.
Content that’s connected to your Google account (Gmail, Maps, YouTube, Drive, Photos, etc.) is instantly available on the phone.
The fingerprint sensor works great to lock/unlock and is placed on the front of the phone where it belongs.
The camera is 12 MP and the front one offers a wide-angle selfie cam that I’ll probably never use (since as a curmudgeon, I find selfie-takers to be irritatingly vain and self-congratulatory).
It fits in my pocket even though the display is much larger, sharper, and brighter than that of the iPhone 5.
It’s so cheap that phone insurance or delayed future upgrades are unnecessary.
The only items I’ve missed: FaceTime (use Google Duo, Skype, or my choice, WhatsApp, instead) and “unread items” counter badges aren’t displayed on individual app icons – use a third-party app like Nova Launcher to add them or just pay attention to the notification bar and lock screen messages.
This week on HIStalk Practice: Prime Healthcare ACO (CA) implements population health analytics and benchmarking from Persivia. DiagnosisAI develops new Alexa medical advice skill. Salus Telehealth adds urgent care consult capabilities. Portland healthcare darling Zoom gets exits the health insurance business. Consumers keep their enthusiasm for AI-powered healthcare to a minimum. SimonMed Imaging signs with Zotec Partners. Oncology Consultants selects Navigating Cancer technology. US Oncology Network physicians discuss carrots versus sticks when it comes to VBC compensation.
Webinars
April 28 (Friday) 1:00 ET. “3 Secrets to Leadership Success for Women in Health IT.” Sponsored by HIStalk. Presenters: Nancy Ham, CEO, WebPT; Liz Johnson, MS, FAAN, FCHIME, FHIMSS, CHCIO, RN-BC CIO, Acute Care Hospitals & Applied Clinical Informatics – Tenet Healthcare. Join long-time C-level executives Liz Johnson and Nancy Ham as they share insights from nearly three decades of navigating successful healthcare careers, share strategies for empowering colleagues to pursue leadership opportunities, and discuss building diverse executive teams. This webinar is geared toward female managers and leaders in healthcare IT seeking to further develop their professional careers. It’s also intended for colleagues, executives, and HR personnel who are looking to employ supportive techniques that ensure diversity in the workplace.
Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.
Acquisitions, Funding, Business, and Stock
Health system supply chain technology vendor Jump Technologies raises $3.5 million in a venture funding round.
Urgent care PM/EHR vendor DocuTap acquires Atlanta-based Clockwise.MD, which offers patient queue management and survey systems.
Athenahealth reports Q1 results: revenue up 11 percent, adjusted EPS $0.32 vs. $0.34, missing expectations for both. Shares were pounded in early after-market trading following the announcement, down 16 percent.
Cerner reports Q1 results: revenue up 11 percent, adjusted EPS $0.59 vs. $0.53, beating expectations for both. Shares were up 4 percent in early after-hours trading.
Sales
University of Michigan Health System chooses Phynd for managing the information of its 67,000 providers across its clinical systems.
People
Dana Moore (Centura Health) will join Children’s Hospital Colorado (CO) as CIO.
Precision medicine technology vendor GNS Healthcare hires Ben Bielak, MS, MBA (Harvard University) as CIO.
Point of Care Decision Support names Jay Syverson, MBA (Coherent Solutions) as president.
Solutions vendor Formativ Health hires David Harvey (Health Healthcare) as CTO.
Datica promotes Kevin Lindbergh to chief revenue officer.
Announcements and Implementations
MedData launches MyMedicalMe, a mobile app that allows users to manage their medical bills.
Partners HealthCare’s Connected Health expands its Online Second Opinion Service to allow collecting medical records, radiology, and pathology results through West’s HealthAdvocate Solutions.
A Kyruus study of 40 health system call centers finds that three-quarters of them can’t match callers with an available appointment within the following three weeks, 60 percent are unable to meet gender-specific provider requests, and half are incapable of matching a patient with providers in their desired location.
Government and Politics
ONC seeks feedback on a proposed measurement framework for interoperability.
Privacy and Security
Microsoft ends support of Windows Vista, which doesn’t necessarily mean that PHI-containing systems running on it constitute a HIPAA violation, but HHS says the resulting lack of security patches in unsupported operating systems warrants risk analysis (translation: you’re screwed if your old OS’s lack of security patches allows a breach). Windows 7 is the next to cross the rainbow bridge in early 2020 and then it’s Windows 8 in 2023.
In England, a 20-year-old man who had made $300,000 from selling a distributed denial-of-service attack tool that he built when he was 15 is sentenced to two years in prison.
A former Army sergeant pleads guilty to filing fraudulent tax returns using UPMC patient data that be bought from an online hacker marketplace.
Other
Brigham and Women’s Hospital (MA) offers voluntary buyouts to 1,600 employees, warning that a lack of takers will require layoffs.
Moody’s affirms Vanderbilt University Medical Center’s bond rating, but observes that its financial performance will temporarily moderate with its November 2018 implementation of Epic.
A NEJM opinion piece takes a mixed view from the “what problem are we trying to solve” perspective of requiring investigators who are running clinical trials to share their data with other researchers. It notes that data sharing increases clinical trial cost, assumes that whoever consumes the published data can really understand it since they weren’t involved in collecting it, and devalues the “currency of academic achievement” in giving investigators less opportunity to publish career-enhancing journal articles. The author also notes that participation in such sharing has been minimal and research benefits are uncertain despite the theoretical advantages.
Sponsor Updates
Eye Care Leaders, which offers an EHR for optometry and ophthalmology practices, will integrate DrFirst’s medication management and e-prescribing into its products.
Phynd is exhibiting at NAHAM in Dallas, TX this week.
LogicWorks achieves AWS Service Delivery Partner status.
MedData will exhibit at the Advanced Institute for Anesthesia Practice Management April 29-May 1 in Las Vegas.
CloudWave’s OpSus Live infrastructure as a service earns its third annual Best Practice rating in the Meditech Infrastructure and Supporting IT Process Audit.
Meditech will exhibit during HIMSS UK e-Health Week May 3-4 in London.
ROI Healthcare Solutions will sponsor the Inforum Conference July 10-12 in New York City.
Zynx Health customer North York General Hospital wins the 2016 HIMSS Enterprise Nicholas E. Davies Award of Excellence.
Navicure will exhibit at the Oregon/Washington MGMA meeting April 30-May 2 in Spokane, WA.
Health Data Specialists sponsors the Cerner Southeast Regional User Group May 3-5 in Jacksonville, FL.
Netsmart will exhibit at the Care Coordination Summit May 1 in Baltimore.
Revenue recovery software vendor Ontario Systems adds the ReconBot claims automation from Recondo Technology.
Obix Perinatal Data System will exhibit at the AWHONN Michigan Annual Conference May 5 in Frankenmuth.
CloudWave achieves a best practice rating for OpSus Live.
PatientKeeper will exhibit at Hospital Medicine 2017 May 1-4 in Las Vegas.
The Coast Guard posts an RFI for an EHR that can achieve interoperability with the EHRs of the Department of Defense and VA.
USCG gave up on its Epic implementation in 2015 without going live anywhere and finally elected not to renew its Epic contract that expired in early 2016, citing unspecified risks. It had spent five years and several dozen million dollars, also deciding along the way to add the US State Department to its ultimately failed rollout.
After the Epic project was halted, the Coast Guard determined that it could not revert back to its previous CHCS/AHLTA system and went back to paper instead.
The lead contractor in USCG’s Epic project was Leidos, which later won the DoD $4.3 billion bid in offering Cerner.
SAIC, which spun itself off in 2013 as its parent company renamed itself to Leidos, originally developed the DoD’s CHCS system (interestingly, as a customization of the VA’s VistA) in a billion-dollar 1988 initial contract. The DoD is rumored to have spent at least $20 billion on CHCS and its add-on AHLTA, which was not interoperable with the VA’s VistA. Defense contractor Northrop Grumman was paid at least $5 billion to develop AHLTA, rated in a 2016 physician survey as the worst EHR in the country. The DoD keeps giving Leidos and Northrop Grumman high-dollar contracts to keep the old systems running.
Cerner should have a slam dunk here unless a well-connected defense contractor takes the Coast Guard down a puzzling path or if the DoD’s project isn’t faring as well as they’ve announced. Leidos might have taken a black eye in the Coast Guard’s failed Epic project, but I still assume they’re the frontrunner as long as Cerner is game to partner with them again, which surely they are given their strong bidding position after their DoD win. Or maybe the Coast Guard will figure out how to participate in the DoD’s Cerner contract instead of mounting a separate project, given that it’s a uniformed service just like the Army, Marines, Navy, and Air Force.
Reader Comments
From Indigenous Species: “Re: Orion Health. Laid off 20 people last week – I have the list of those affected if you want it. My position was eliminated two weeks ago. Share price is way down from last year.” The New Zealand-traded shares of the company have shed 66 percent in the past year, valuing it at $223 million. The stock was pounded earlier this month on the company’s announcement of expected lower annual revenue and continuing (but improving) annual operating losses. CEO Ian McCrae said in that announcement that Orion will launch a cost reduction program and will evaluate partnership or minority investment interest.
From Dense Matters: “Re: Readers Write articles. Some of them are pretty lame. Do you run all of those submitted?” I actually reject most of them. Folks with creative ideas and insightful opinion apparently aren’t writing articles since most of those I receive are PR-polished vendor fluff pieces. I justifiably rejected one of those this week by randomly choosing five sentences from it and defying the PR person who sent it to me to find a single original or interesting thought in any of them (example: “Payers and providers recognize that future survival in the fee-for- value world depends on having the right systems in place.”) Restating dull, obvious facts isn’t a good way to draw the interest of my readers and yet people keep proudly sending me that crap like it’s wonderful. If you don’t like what I’ve run, imagine how bad the articles were that I rejected.
HIStalk Announcements and Requests
We funded the DonorsChoose grant request of Ms. B in Arizona, who asked for a document camera for her second grade class. She provides this update: “Since I teach math, we use it almost every day and now I wonder how we survived without it before! My students love it because they get to see what I and their peers are doing from the document camera to the projector. It arrived at the perfect time — the week before our measurement unit. I put the ruler under the camera, and when it appeared huge, detailed, and gigantic on the screen, the class was in awe. I know that thank you letters were not requested but my students seriously thank you. They feel lucky that there are people out there who care about their educations that they spent their time and money donating an expensive tool to their classroom to benefit their learning. It is so, so helpful. You really helped out a great group of second graders immensely.”
I needed to get my medical records from an old, distant provider today and called the office. They need me to sign a release form, which is fine, but the only way they can send me this generic, blank form is via fax or mail. The conversation went like this:
Office person: We can send that form to you. Do you have a fax machine? Me: No, this is actually the 21st century, where the only fax machines left running are in hospitals and doctors’ offices. I don’t even have a landline even if I wanted to set up my multifunction printer to fax. It’s just a blank form. Can you email it to me? Office person: No. If you don’t have a fax machine, we will have to mail it to you and you can fill it out and mail it back.
My only secret weapon is those online fax services that allow you to send an ad-supported free fax, where I can at least scan and send the completed form back to them quickly. I am baffled why no doctor’s office I’ve ever asked can (or will) send email attachments for routine, non-PHI containing forms like this. Probably because nobody’s willing to pay them to change their ways.
Listening: Kiefer Sutherland (yes, Donald’s boy Jack Bauer). Movie stars obviously get a fast track for crossover music deals (especially when they own the record label as Kiefer does), but his 2016 album is really good with his gruff, whiskey-sounding voice, which is probably appropriate given his string of DUI arrests and prison time. The album has been characterized as country, but despite an occasional on-stage cowboy hat, it sounds more like blues-rock tinged Americana to me. Here’s a healthcare connection – Keifer’s grandfather created North America’s first universal healthcare program in Saskatchewan, Canada as the father of Canada’s Medicare program. If you’re instead feeling proggish, there’s a new album by former Genesis guitarist Steve Hackett, who provides an alternate ending to Phil Collins turning the shockingly talented prog rockers into the Archies.
Webinars
April 26 (Wednesday) 1:00 ET. “SSM Integrated Health Technologies Clinical Data Migration: Functional and Technical Considerations.” Sponsored by Galen Healthcare Solutions. Presenters: Sandy Winklemann, MHA, RHIA, project manager, SSM Integration Health Technologies; Tyler Mawyer, MHA, managing consultant, Galen Healthcare Solutions; Kavon Kaboli, MPH, senior consultant, Galen Healthcare Solutions. GE Centricity and Meditech to Epic EHR transition. Join us for a complimentary webinar as present the decisions that are important to consider when performing a clinical data migration from the point of view of the healthcare organization program manager, the clinical analyst, and the technical implementation team. Our expert panel will survey data migration considerations, best practices, and lessons learned. The webinar will present a unique client perspective, offering insight into considerations surrounding staffing, clinical mapping, legacy application support, and validation and testing.
April 28 (Friday) 1:00 ET. “3 Secrets to Leadership Success for Women in Health IT.” Sponsored by HIStalk. Presenters: Nancy Ham, CEO, WebPT; Liz Johnson, MS, FAAN, FCHIME, FHIMSS, CHCIO, RN-BC CIO, Acute Care Hospitals & Applied Clinical Informatics – Tenet Healthcare. Join long-time C-level executives Liz Johnson and Nancy Ham as they share insights from nearly three decades of navigating successful healthcare careers, share strategies for empowering colleagues to pursue leadership opportunities, and discuss building diverse executive teams. This webinar is geared toward female managers and leaders in healthcare IT seeking to further develop their professional careers. It’s also intended for colleagues, executives, and HR personnel who are looking to employ supportive techniques that ensure diversity in the workplace.
Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.
Acquisitions, Funding, Business, and Stock
Specialty drug prescribing software vendor ZappRX raises $25 million in a Series B funding round, increasing its total to $33 million.
Mpirica, which publishes surgery quality scores for hospitals and surgeons using claims data, receives a $4.6 million crowdfunding investment.
Clinical communication system vendor Doc Halo receives $11 million in a Series A funding round.
Care management company Lumeris acquires analytics vendor Forecast Health.
HealthVerity, which sells drug companies de-identified healthcare research data that it assembles from 30 suppliers, raises $10 million in a Series B round.
UK-based video- and chat-based virtual visit provider Babylon Health raises $60 million in funding, valuing it at $200 million. The company is also working on an AI-powered chatbot for NHS’s 111 non-emergency line and plans to further develop AI-powered diagnosis.
Surgical Information System acquires SourceMed, which sells ambulatory surgery center software. SourceMed’s president, CEO, and board chair since December 2014 is Jamie Coffin, PhD, who was VP/GM for Dell’s healthcare and life sciences business from 2007 to 2013.
Announcements and Implementations
Epic will offer patients health information from Mayo Clinic in its MyChart and MyChart Bedside tablet apps, available by clicking an Infobutton or on a keyword.
Apache Software Foundation releases v4.0 of its open source cTakes natural language processing engine for healthcare-related free text.
Smartphone clinical study participation vendor Medable will use API services from Redox to integrate EHR data into their system.
PolicyMedical announces GA of Integrity Manager, which automates the electronic review of vendors, business associates, and employees to meet the compliance requirements of OIG and OCR.
Cerner will integrate concussion management software from NeuroLogix Technologies into its HealtheAthlete health management system. I’ll be honest in admitting that I’ve never heard of HealtheAthlete.
This seems bizarre: Klick Labs releases a “tele-empathy” device that allows Parkinson’s Disease patients to transmit their tremors to a Bluetooth-connected muscle stimulation armband, allowing whoever is wearing it to feel their tremors and understand their effect on activities of daily living. The company says future versions will transmit symptoms to remote doctors for diagnosis. It’s also working on “symptom transference” for diabetes and COPD and hopes to use virtual reality to “virtually put other people in that patient’s shoes.”
Partners HealthCare will work with Persistent Systems to create an open source, SMART/FHIR-powered platform that will allow providers to exchange best practices knowledge.
Medsphere releases a patient scheduling tool for its OpenVista inpatient and ChartLogic ambulatory EHR.
QuintilesIMS will develop Salesforce solutions for managing clinical trials, recruitment, and marketing that will be marketed to life sciences companies.
Government and Politics
Former President Barack Obama will speak at the healthcare conference of Wall Street investment banker Cantor Fitzgerald in September for a rumored $400,000 fee. I bet someone at HIMSS is talking to his people about opening HIMSS18, which would certainly represent an improvement in the string of vendor CEOs to which HIMSS has recently bestowed the prime time speaking slot, although maybe the former President is too expensive (HIMSS paid Hillary Clinton $225,500 for her HIMSS14 speech). You’ve likely heard the Cantor Fitzgerald name – 658 of its 960 New York-based employees died in the World Trade Center attacks of 2001.
Privacy and Security
Ambulatory EKG monitoring services vendor CardioNet pays $2.5 million to settle HIPAA charges following the 2012 theft of an employee’s laptop that contained the PHI of 1,400 people. HHS OCR found that the company didn’t perform adequate risk analysis and risk management and hadn’t implemented its draft security policies. My conclusions from this:
CardioNet would have had no HIPAA responsibilities if it were simply a technology vendor, but the company provides services to Medicare patients and thus is a covered entity subject to HIPAA.
It would seem true in most cases that a breached covered entity could be accused of failing to provide adequate risk analysis and management.
The company will begin encrypting laptops, flash drives, SD cards, and other portable media.
I’m not sure what this means, but HHS will require the company to implement training that includes “out of-office transmissions.”
Other
A Nemours Children’s Health System survey finds that while only 15 percent of parents have used telemedicine services for their children, 64 percent plan to do so within the next year, the unlikely massive uptick in projected usage recalling that consumer responses to surveys often differ vastly from their actual behavior. It was also an online survey, which doesn’t necessarily draw a representative sample of all patients. I couldn’t find the 2014 version of the Nemours survey, which I expect contained rosy telemedicine projections that didn’t pan out. Respondents said they favor using telemedicine for their own convenience (acute conditions such cold and flu) but have little interest in having the chronic conditions of their children managed remotely.
Erlanger Medical Center (TN) posts improved quarterly revenue, but the CEO warns the board that its $100 million Epic rollout that starts May 1 will temporarily cause reduced revenue due to loss of productivity until staff become comfortable with it.
This is not sustainable in a globally competitive environment: healthcare employs one in nine Americans as communities embrace expanding health systems whose swollen headcount replaces jobs lost from dying industries. More than half of the $3.4 trillion spent annually on healthcare is made up of labor costs, with each physician being outnumbered by 16 other workers, half of whom function in non-clinical roles.
A Warren Buffett-backed insurer offers life insurance for poorly controlled diabetics in the UK using a process called “robo-underwriting” in which the insurer uses technology-powered medical data analysis to set premiums based on user behavior such as medication adherence and having their blood glucose levels tested regularly. Customers are required to comply with the company’s diabetic control policies, with their annual monitoring results sent directly to the company for premium adjustments that can range from a 4.5 percent discount to a 7.5 percent penalty.
Kaiser Health News notes the proliferation of breast milk banks, some of which are run by for-profit companies that pay new moms $1 per ounce for milk that they then resell to other mothers and even hospital NICUs for up to $300 for a one-day supply or to drug companies who use the milk in manufacturing. The facilities are not overseen by the FDA and studies have found that a significant amount of the product being sold is either contaminated with bacteria or has been diluted with plain old supermarket milk.
I missed this great story from last month. Myron Rolle — a former NFL player and a Rhodes Scholar from Florida State University – has not only earned a master’s in medical anthropology at Oxford, but has also graduated from FSU’s medical school and has matched to Mass General’s neurosurgery residency program. He says he had football playing years left, but was anxious to avoid the potential concussions and hand injuries that could have ended his dreams of becoming a neurosurgeon.
Police use home network and fitness tracker data to charge a Connecticut man with murdering his wife. Home network logs showed that the husband logged into Outlook at the time he claimed to have been at work, the couple’s home security system log showed doors opening at times that didn’t agree with his story, and the wife posted to Facebook and recorded her Fitbit steps after he claimed to have found her dead.
Sponsor Updates
Impact Advisors publishes a new white paper titled “Ensuring Effective Physician Engagement.”
Besler Consulting releases a new podcast, “A look at the United Healthcare orthopedic bundled payment program.”
The Advisory Board includes CareVive Systems in its Cancer Care Transformation Playbook.
Casenet will deliver evidence-based content from XG Health Solutions via its care management platform.
Crossings Healthcare Soutions GM Justin Monnig is featured in a Goliath Technologies case study.
Health Catalyst wins the Gallup Great Workplace Award for the second year in a row.
Cumberland Consulting Group will exhibit at the Asembia Specialty Pharmacy Summit 2017 April 30-May 3 in Las Vegas.
Direct Consulting Associates will exhibit at the iHealth 2017 clinical informatics conference May 2-4 in Philadelphia.
ECG Management Consultants will present and exhibit at the 2017 ASCA Annual Meeting May 3-6 in Oxford Hill, MD.
EClinicalWorks will exhibit at the CAMGMA 2017 Annual Conference April 27-29 in San Diego.
Evariant will exhibit at the Healthcare Communications Conference May 1-3 in Baltimore.
Healthwise will exhibit at ZeOmega’s client conference May 2-4 in Plano, TX.
US Surgeon General Vivek Murthy, MD, MBA resigns as the Trump administration announces its intentions to replace the ACA-supporting, Obama-appointed physician.
Serving as interim is Deputy Surgeon General Rear Admiral Sylvia Trent-Adams, BSN, RN, MSN, PhD.
Trent-Adams is the first non-physician to hold the role (either as interim or permanent) since veterinarian Robert Whitney served as acting Surgeon General for a few months in 1993. Whitney was at that time the first non-physician to hold the role since its creation in 1871.
Reader Comments
From Obi-Wan 2.0: “Re: HIMSS buying Health 2.0’s conferences. What’s your take?” I’m not sure I have a relevant opinion since, as an enterprise health system IT guy, I just can’t get interested in startups that often feature unoriginal or irrational ideas, spotty execution, questionable leadership, and naiveté about how to sell into health systems if indeed that’s their target market at all. That’s not to say that interesting companies never make it to the next level, only that I don’t waste time following the gaggle until they beat the long odds and actually do it (otherwise, it’s like scouting tee ball games to find future MLB stars). It’s a great exit for the Health 2.0 folks, who matched up with the only potential buyer who had the money and unbridled ambition to buy their conferences since HIMSS has to spend its profit on something relevant to its non-profit mission. In that respect, it’s a poetic ending since most of the companies in their universe dream similarly of finding a willing, deep-pockets buyer (for many of those techno-toddlers, it’s a race to cash out before the wheels come off). Matthew Holt and Indu Subaiya presumably get deservedly rich, while their ragtag band of pink socks-wearing, self-proclaimed disruptors who cling together seeking relevance among far bigger players are left to wonder whether they will find a comfortable home within Diamond Member-fawning HIMSS, the odds of which are not favorable. I’m not clear on what happens with the remaining parts of Health 2.0, or in fact what those parts actually are.
From Conga Dipper: “Re: Medhost. I doubt its website visitors are fluent in translating nursing benefits from Lorem Ipsum filler text.” Maybe it’s a sales message for prospects in Latin America.
From TxHIT45: “Re: MedStar. Interesting idea mixing ride-sharing and healthcare in this way.” Inexpert HIT fanboy site writers often misstate a hospital’s “partnership” with Uber for patient rides home as though it were hot technology news (failing to see that it’s no different than giving patients a cab company’s telephone number), but this is a bit more interesting. A Texas ambulance service’s nurses are triaging 911 calls and sending low-acuity callers a Lyft ride instead. It costs $450 to roll an ambulance, while that same amount covered all of the 38 Lyft rides it substituted in February. At least that’s a small step in trying to manage costs incurred by people who visit the ED for non-emergent conditions for a variety of reasons, some of them rational only because our healthcare “system” is anything but.
From Oregonian: “Re: Mid-Columbia Medical Center’s layoffs due to losses. The additional $3 million in unpaid debt appears to be due to legacy AR write downs as a result of the audit, which has nothing to do with what rev cycle product is being installed.”
From Reluctant Epic User: “Re: the MUMPS programming language. Made it to the top of Hacker News a few weeks ago with a lot of talk about Epic and Meditech. The 176 comments make common complaints that we’re mostly already aware of, but some of the defenders raise interesting points as well.” Some of the points made:
All variables are global and are named with a maximum of six capital letters.
Meditech writes all of its own languages, databases, operating systems, and tools.
Meditech’s new programming hires, most of whom aren’t computer science majors, go through a 6-12 month training program that allows them to succeed at Meditech, but they are stuck there because experience in a company’s proprietary language isn’t worth much elsewhere (a similar situation holds true for Epic developers, another commenter says).
“I find Epic to be more horrifying than Meditech because Epic has somehow managed to convince many healthcare workers that it is a ‘modern’ product worthy of praise despite all evidence to the contrary. People talk about SmartPhrases like it’s some miracle instead of a damn snippets manager (and a bad one at that). The fact that they’re moving away from VB6 to a web-based front-end in 2017 should be reason enough to assume that whatever they come out with is going to be excruciating.”
“The MUMPS codebase I worked on in the 80s was so fragile that deleting a single global string could cause the whole system to break down in ways that required a restore from backups. Don’t ask me how I know that.”
“A MUMPS program tends to be an unreadable mess to anybody who hasn’t touched it in the last 30 seconds.”
“I’m very, very happy to not be using this language any more. After my first year on the job, I read some JavaScript code and I nearly wept at how comparatively beautiful it was.”
“The tech stack was a real resume killer. I still get contacted by recruiters desperate for MUMPS developers and they make me feel like someone trapped inside a house besieged by zombies. I get really quiet and hope they don’t break any windows.”
“Companies like Epic are why healthcare costs in the US are huge and growing. Epic never refactors anything that still works well enough to hold together with some expensive human labor. It is a technology company that runs on well-trained people instead of well-designed code and processes.”
“I found Epic MUMPS to be remarkably readable. Lots and lots of documentation, quite consistent coding standards, and although I would have preferred to write SQL queries rather than MUMPS routines, I didn’t find it that abhorrent.”
From Big Data Hard Times: “Re: Atigeo. The analytics software firm seems to have been hit by hard times, listing 95 employees in April 2016 and now listing only 49. That seems to be the wrong direction for a company that received $18.5 million in VC investment in late 2015. I’m looking to including them as part of the vendor pool our hospital is looking at, but won’t if they are headed for the big data crunch in the sky.” Unverified. The company was founded in 2005, has received funding only through a Series B round, and lists no customers or recent sales on its site. The company’s “About” page grandly describes it as, “Atigeo is a compassionate technology company for a wiser planet,” which makes me think that maybe too much of that Series B money went toward hokey marketing. The company’s excessive tweeting dried up to nothing in October 2016, suggesting that something happened then (I like to think that the corporate tweeter was the “wiser planet” hack and the company wised up to their prior lack of supervision).
HIStalk Announcements and Requests
About half of poll respondents have volunteered to give up their seats on flights. Me being one, which worked great the two times my offer was accepted (most recently, I got a $400 voucher for giving up a seat to take a flight just three hours later). One reader recommended going for cash, not a voucher, and trying to wangle a first-class upgrade. Nick longs for the good old days when airlines sometimes offered a voucher good for a ticket to any domestic destination served by the airline. Everyone seems to agree that if you can get a seat on another flight that leaves shortly, or if you can choose a nearby airport and drive to your destination, it’s a pretty good deal.
New poll to your right or here: what will be the VA’s biggest challenge if it decides to implement Cerner or Epic?
Grammar peeve: the innumerable folks who write sentences such as, “The building houses 10 different companies,” apparently believing readers require the redundant clarification of “different” to comprehend that it’s not 10 of the same company.
Vocational dissonance: the puzzlement that results from trying to reconcile the lofty accomplishments and skills claimed by someone on their inflated, largely fictional LinkedIn profile with first-person knowledge that suggests far more modest capabilities.
We funded the DonorsChoose grant request of Mrs. O in Texas, who asked for programmable robots and electronics kits for her library maker space. She reports, “The technology that was donated is really helping my students become independent problem solvers. My students are learning to work with one another and most importantly communicate effectively with one another in order to learn how the new technologies work. Students come to the library in the mornings for about 50 minutes of maker space time and I give them the opportunity to use all the different technology. I provide a risk-free learning environment and give them this time to engage in creative play, but they don’t realize that they are really learning because they are having so much fun! Surprisingly, more girls than boys are attending the maker space technology days. I am really impressed that the girls are really drawn to creating things with the Little Bits.”
Listening: new from Chris Cornell, who in addition to his solo career is also lead singer and songwriter for both Soundgarden and Audioslave. He has an amazing voice and his compositions are strong.
This Week in Health IT History
One year ago:
Federal prosecutors launch a criminal investigation to determine whether Theranos misled investors about the state of its technology and operations.
UnitedHealth Group pulls its plans from ACA exchanges, citing $1 billion in losses.
CMS announces that it will hold off on publishing quality ratings for hospitals for several weeks amid questions from healthcare providers and Congress over its methodology.
Five-hospital health system Centra (VA) contracts with Cerner to replace EHRs in use at each of its hospitals and 50 ambulatory and long-term care facilities.
New York insurer EmblemHealth lays off 250 IT and operations employees after contracting with Cognizant to modernize its IT systems.
Five years ago:
Cerner CEO Neal Patterson makes the cover ofForbes in a piece called Obamacare Billionaires.
Mediware closes its $2.2 million acquisition of Cyto Management System, an oncology management system.
Thomson Reuters announces it will sell its healthcare unit to Veritas Capital for $1.25 billion in cash.
Liverpool Heart and Chest Hospital chooses Allscripts Sunrise, the company’s first sale to a UK trust.
Weekly Anonymous Question
I asked respondents to describe the most patient-endangering IT issue they’ve seen personally, with these responses:
Medication reconciliation that isn’t a priority, done well, or enforced.
The usability of patient identity functions being so bad in a new EHR that the front desk just defaulted to making a new patient record and let HIM sort it out. Who then … didn’t. We found it later in trying to do analytics in support of an ACO.
The way that our major commercial EMR vendor handles medications. When you make an adjustment in the med dose without issuing a new script, there is absolutely no way to show that as part of the formal medication history.
At a previous hospital, we had a EHR from a vendor whose name starts with Mc. It was mixing up sigs on medications, literally assigning them to the wrong patient and med in the database. Issue was quickly discovered and software was declared unfit for use and was yanked.
On an old system no longer in use, there was not any logic not to prevent a new line in the middle of a medication dose. It happened leaving ‘0.’ on the line above and 10 beginning the next line. It was not until a patient was injured and a very competent nurse was devastated during root cause analysis that this issue came to light. At the time there was a comment about the "stupid nurse," which made my blood boil.
Wrong med given due to system having order on wrong patient.
Lab labels generating on the wrong patients.
Oh, my God, this one still causes me panic. Zero-day architectural decision in erx by people with no concern for safety or even basic understanding of the practice of medicine caused the wrong prescription to be created, depending on how a medication was ordered. The mistake was invisible to physicians in the UX, due to yet *another* terrible design decision. Two patients received scripts that would have killed them, one was caught by the doctor who thankfully double-checked the printed rx, the other by the pharmacist.
Lack of a singular and accurate person identifier across all systems.
Letting unqualified people do patient merges.
Malfunctioning IV pump used (on me), supposedly to deliver much-needed pain medication after emergency orthopedic surgery.
Upper EMR managers: "If it saves the physician one click, nobody cares about the downstream effects to <insert department>.” Do the customization.
CPOE architecture that required only selection of a single generic name as the drug product despite the directions (it’s too hard for physicians to select a specific product or dosage form). The product would be automatically selected by the CPOE system. The first item alphabetically would always be selected, so for instance, all fentanyl orders would be sent as Fentanyl 100 mcg/hr patch whether instructions were 50 mcg IV q1h prn, patch, PCA.
Allowing entry of orders prior to allergy entry.
Suppressing all physician alerts. Everyone ELSE needs to deal with allergies, duplicates, and order requirements.
Endless customization and lack of standardization. It might seem like a great idea to have a zillion versions of the same thing and have unseen programming operating in the background, but it is not.
Implementation of an inpatient EHR that included a pharmacy and MAR application, where the MAR had incorrect doses listed.
This week’s question: If you are a former or current individual HIMSS member who either considered quitting or actually did so, what led to your decision?
Last Week’s Most Interesting News
Alphabet’s life sciences business Verily launches its Project Baseline initiative, a four-year project to create a database that will be used to look for early warning indicators for a variety of illnesses.
AMA introduces a web-based EHR training tool developed by Regenstrief Institute that uses the de-identified records of 11,000 patients with built-in medical histories going back as far as 40 years.
Theranos settles its ongoing legal battles with CMS over unsafe practices at its Newark and California labs and settles its legal battles with the Arizona Attorney General, agreeing to issue a full refund to all 175,000 Arizona residents who received Theranos blood tests.
The Phoenix VA Medical Center announces plans to partner with CVS to expand coverage locations, including local MinuteClinics.
HHS Secretary Tom Price, MD announces the availability of $485 million in state grants for combatting the opioid epidemic.
Webinars
April 26 (Wednesday) 1:00 ET. “SSM Integrated Health Technologies Clinical Data Migration: Functional and Technical Considerations.” Sponsored by Galen Healthcare Solutions. Presenters: Sandy Winklemann, MHA, RHIA, project manager, SSM Integration Health Technologies; Tyler Mawyer, MHA, managing consultant, Galen Healthcare Solutions; Kavon Kaboli, MPH, senior consultant, Galen Healthcare Solutions. GE Centricity and Meditech to Epic EHR transition. Join us for a complimentary webinar as present the decisions that are important to consider when performing a clinical data migration from the point of view of the healthcare organization program manager, the clinical analyst, and the technical implementation team. Our expert panel will survey data migration considerations, best practices, and lessons learned. The webinar will present a unique client perspective, offering insight into considerations surrounding staffing, clinical mapping, legacy application support, and validation and testing.
April 28 (Friday) 1:00 ET. “3 Secrets to Leadership Success for Women in Health IT.” Sponsored by HIStalk. Presenters: Nancy Ham, CEO, WebPT; Liz Johnson, MS, FAAN, FCHIME, FHIMSS, CHCIO, RN-BC CIO, Acute Care Hospitals & Applied Clinical Informatics – Tenet Healthcare. Join long-time C-level executives Liz Johnson and Nancy Ham as they share insights from nearly three decades of navigating successful healthcare careers, share strategies for empowering colleagues to pursue leadership opportunities, and discuss building diverse executive teams. This webinar is geared toward female managers and leaders in healthcare IT seeking to further develop their professional careers. It’s also intended for colleagues, executives, and HR personnel who are looking to employ supportive techniques that ensure diversity in the workplace.
Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.
Acquisitions, Funding, Business, and Stock
A hedge fund that is suing Theranos deposes 22 former company employees or directors who told it:
Theranos formed a shell corporation to buy commercial lab equipment from companies like Siemens, then modified the machines to run its proprietary finger-stick blood samples.
The company ran fake investor demonstrations of what it claimed was its innovative technology that was actually equipment sold by other companies.
The company’s financial projections for investors that called for $1 billion of annual profit in 2015 were vastly different from similar estimates provided to the IRS just two months later, which estimated $100 million in 2015 annual profit.
Sales
Stephens County Hospital (GA) will deploy Wellsoft’s EDIS including clinical documentation, CPOE, patient tracking, results reporting, and charge capture.
People
Voalte founder Trey Lauderdale returns to the CEO role. Former CEO Adam McMullin has left the company after a year “to pursue other opportunities.”
Announcements and Implementations
Video visit provider PlushCare launches Lemur, the telehealth EHR used by its 50 doctors. The announcement (and the fact that the company felt compelled to make one) suggests that PlushCare is commercializing its EHR, but I think it’s actually just pointless PR puffery in describing its internal-only product.
TransUnion Healthcare adds a prior authorization solution to its patient access offerings and enhances its existing eligibility product.
In Saudi Arabia, King Faisal Specialist Hospital and Research Center goes live on GetWellNetwork’s in-room interactive patient services.
RadmediX launches its urgent care digital radiology solutions.
Privacy and Security
Computer systems of Erie County Medical Center (NY) remain down following an April 9 ransomware attack.
A patient seeks class action status for her lawsuit against virtual visit vendor MDLive, which claims that the company’s app sends an average of 60 screenshots per visit to an Israel-based app performance testing company.
A proposed class action lawsuit claims that Bose’s wireless headphone app collects the music listening habits of users and that the company then then sells that information to other companies.
Government and Politics
Some AMIA members participated in Saturday’s March for Science in Washington, DC and other locations, which depending on your point of view was created to: (a) protest the Trump administration’s policies; (b) highlight scientific acccomplishment; or (c) influence the government keep taxpayer dollars flowing into the pockets of scientists via federal research grants.
Innovation and Research
Atlanta NPR reviews blockchain in healthcare, with the CEO of one personal health record startup unconvincingly explaining why she’s trying to duplicate the health record storage practices of Estonia, 95 percent of which involves blockchain. A blockchain-related vendor disagrees in saying that blockchain isn’t good at storing large amounts of data, instead suggesting that its healthcare use focus on storing digital signatures of patient records to maintain an access log of who has viewed them.
Apple hires Steven Keating, the MIT mechanical engineering PhD who is best known for creating a 3-D printed image of his own since-excised brain tumor (he’s still on chemo). He described in a conference presentation last week that he learned from his experience in collecting 75 gigabytes of his own health information (his “medical selfie”) that it’s hard for patients to obtain their own data:
My doctors are incredible for sharing my data and encouraging me to learn more from it. However, the process raised some questions for me, as I received my data on 30 CDs, without easy tools to understand, learn, or share, and there was no genetic data included. Why CDs? Why limited access for patients to their own data? Can we have a simple, standardized share button at the hospital? Where is the Google Maps, Facebook, or Dropbox for health? It needs to be simple, understandable, and easy, as small barriers add up quickly. Imagine having your whole medical record that you could not only share with doctors and scientists but also with friends and family, too. Patients could get second opinions very easily, and doctors can follow what leaders in the field are doing.
Other
The dean of Stanford’s medical school says that “innovation is at the algorithmic level,” predicting that significant medical and health advancements will be driven primarily by the ability to interpret huge datasets.
Kaiser Permanente Chairman and CEO Bernard Tyson tells the Nashville Health Care Council that the future isn’t in “heads in the beds,” but rather in virtual visits. He asked the 300-plus attendees how many of them can do as he can in pulling up their medical record on their phones, which resulted in fewer than a dozen raised hands. Tyson also says KP is mimicking the Starbucks concept of community and coffee in creating buildings that provide walking paths, healthy foods, and areas where people can study and share health information.
A Reaction survey finds that nearly half of McKesson customers didn’t know that the company was spinning off its IT business with Change Healthcare, although both customers and non-customers were neutral about the potential effects and nearly no respondents say they’re more likely to buy products from the new company.
Bizarre: men are signing up for telemedicine visits using false IDs just to flash their video-connected doctors. Sherpaa says people have sent its doctors more than 30 unrequested penis photos, while American Well explains that as with face-to-face medical visits, the solution is to ban problematic patients and to verify all IDs by credit card. A guy must really be desperate to showcase his package to unwitting viewers if he’s willing to pay telemedicine fees to do so. Armed with this newfound knowledge, I’m sensing a business opportunity in creating an app that matches pervs to people willing to look at their private parts for cash (my working name is Glory Telehole).
A doctor in England faces suspension for looking up a patient’s personal details in her medical record; using her information to contact her to suggest having sex with him to help restore sensation in her genitals that had been reduced by multiple sclerosis; and then discouraging her from researching her condition in assuring her, “Trust me, I’m a doctor.” The married urologist’s version of the story is that the woman asked him for sex.
Vince and Elise review physician practice EHR vendors. I would, however, be cautious about assuming that each vendor’s client base can be inferred by the number of MU user attestations, especially given vendors like Epic that have relatively few (but also relatively large) health system customers that have lots of doctors as employees and affiliates.
Sponsor Updates
TierPoint completes its most recent round of HIPAA, PCI-DSS, GLBA, and SOC 2 Type II annual compliance audits.
ZeOmega introduces the Jiva Consultant Certification Program.
Employees of Clinical Computer Systems, Inc. raise $10,500 for the March of Dimes annual fundraising walk.
Visage Imaging will exhibit at ConHIT April 25-27 in Berlin.
First Databank Senior Director of Clinical Knowledge Charles Lee, MD will present the company’s recently acquired Meducation solution at Health Datapalooza this week.
ZeOmega will exhibit at Health Integrated Empower April 26-28 in St. Petersburg, FL.
ZirMed publishes a new infographic, “Riding the Sea of Change.”
Spok posts a case study of Hospital for Special Surgery’s use of Care Connect for medical, gas, and fire alarm alerting.
Alphabet’s life sciences business, Verily, launches its Project Baseline initiative, a project aimed at creating a database that will be used to look for early warning indicators for a variety of illnesses. The project will sequence the genomes of 10,000 volunteers, and then use an activity tracker to monitor a participant’s sleep, activity, heart rate, and other health metrics over the next four years.
Reader Comments
From Not Surprised: “Re: HIMSS buys Health 2.0. HIMSS continues to gobble up industry trade shows, this time opting for one that it hopes will ‘make it possible for HIMSS to have a greater influence on the cutting edge of health IT.’ While I’ve never been to a Health 2.0 event, I always got the impression that it was a far more energetic, grassroots affair than the typically straitlaced HIMSS events. Healthcare IT is already filled to the brim with boring suit-and-tie shindigs that, instead of moving the industry forward, serve only to line the pockets of organizers. I can only hope that this deal won’t result in Health 2.0 losing its edge.” HIMSS has indeed acquired the Health 2.0 conferences, which now span five continents. Health 2.0 CEO Indu Subayia, MD will join HIMSS as an EVP, while co-chairman Matthew Holt will move into a consultant role.
HIStalk Announcements and Requests
This week on HIStalk Practice: Providence Medical Group plans roll out of Chiron Health telemedicine services. GAO report outlines challenges, benefits to Medicare telemedicine programs. CMS proposes MU reporting changes, exceptions, and exemptions. Evans offers ambulatory providers emergency preparedness protocols. Michigan goes live with new PDMP. Practice EHR, Sequel Systems announce e-prescribing capabilities. Grand Rounds opens its first East Coast office. MDLive faces class-action lawsuit for alleged patient privacy violations. Thanks for reading!
Webinars
April 26 (Wednesday) 1:00 ET. “SSM Integrated Health Technologies Clinical Data Migration: Functional and Technical Considerations.” Sponsored by Galen Healthcare Solutions. Presenters: Sandy Winklemann, MHA, RHIA, project manager, SSM Integration Health Technologies; Tyler Mawyer, MHA, managing consultant, Galen Healthcare Solutions; Kavon Kaboli, MPH, senior consultant, Galen Healthcare Solutions. GE Centricity and Meditech to Epic EHR transition. Join us for a complimentary webinar as present the decisions that are important to consider when performing a clinical data migration from the point of view of the healthcare organization program manager, the clinical analyst, and the technical implementation team. Our expert panel will survey data migration considerations, best practices, and lessons learned. The webinar will present a unique client perspective, offering insight into considerations surrounding staffing, clinical mapping, legacy application support, and validation and testing.
April 28 (Friday) 1:00 ET. “3 Secrets to Leadership Success for Women in Health IT.” Sponsored by HIStalk. Presenters: Nancy Ham, CEO, WebPT; Liz Johnson, MS, FAAN, FCHIME, FHIMSS, CHCIO, RN-BC CIO, Acute Care Hospitals & Applied Clinical Informatics – Tenet Healthcare. Join long-time C-level executives Liz Johnson and Nancy Ham as they share insights from nearly three decades of navigating successful healthcare careers, share strategies for empowering colleagues to pursue leadership opportunities, and discuss building diverse executive teams. This webinar is geared toward female managers and leaders in healthcare IT seeking to further develop their professional careers. It’s also intended for colleagues, executives, and HR personnel who are looking to employ supportive techniques that ensure diversity in the workplace.
Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.
Acquisitions, Funding, Business, and Stock
Cardinal Health will acquire Medtronic’s Patient Care, Deep Vein Thrombosis and Nutritional Insufficiency businesses for $6.1 billion in cash.
Siemens Healthineers will acquire Medicalis for an undisclosed sum. Siemens plans to fold the San Francisco-based company’s clinical decision support, imaging workflow, and referral management technologies into population health management line.
Care Innovations will relocate and expand its R&D center in a $1.7 million project that will create 24 jobs in Louisville, KY. The Roseville, CA-based home health and remote monitoring company – a joint venture between Intel and GE – opened its first office in the area 18 months ago.
People
James “Butch” Baxter (Santa Rosa Consulting) joins Nashville-based secure messaging vendor Medarchon as CEO. Founder Baxter Webb will take on the role of chief strategy officer.
Announcements and Implementations
LifeBridge Health (MD) moves forward with an enterprise-wide roll out of Cognizant’s Onvida communications software.
NTT Data Services will offer Praxify’s Mira voice-enabled charting technology.
Technology
Experian Health works with MyHealthDirect to add patient self-scheduling to its line of self-service payment tools.
Surescripts develops an accuracy monitoring tool for e-prescribing to help providers and pharmacists reduce callbacks and faxes, and better understand utilization patterns.
Healthgrades rolls out CareChats to help providers and patients stay in touch between appointments. The automated text- and email-based communications software integrates with the company’s CRM.
ImageMoverMD creates a Web-based solution to import medical images into a user’s EHR.
Sales
Arkansas Surgical Hospital selects PeerWell’s PreHab mobile app to help patients prepare for and recover from joint replacements.
Hill Hospital of Sumter County (AL) will add CPSI subsidiary Evident’s Thrive EHR to its existing Evident financial management tech.
Privacy and Security
Tanium finds itself in hot water after the Wall Street Journal reports that the cybersecurity company tapped into live hospital networks without permission during product demos between 2012 and 2015. Desktop and server management details were exposed, with some even showing up in videos. While patient data was not compromised, providers like former Tanium customer El Camino Hospital (CA) are not taking the intrusion lightly. “We are dismayed to learn that desktop and server management information was shared,” a hospital spokesperson told the WSJ. “We are thoroughly investigating this matter and take our responsibility to maintain the integrity of our systems very seriously.”
Government and Politics
At a meeting earlier this week with White House officials, health insurance lobbyists and executives seeking assurances that subsidies would continue to be paid for low-income consumers buying individual marketplace plans – a step seen as critical to stabilizing the individual markets – were given no assurances and were instead told to take the matter up with Congress.
Innovation and Research
Nearly a month after Elon Musk announces his intent to develop an implantable brain-computer interface, Facebook unveils its plans to develop a similar interface that lets you type with your thoughts. The ultimate goal, according to Facebook researcher Regina Dugan, is to develop an interface that enables a person to to type even faster than they could with their hands, at close to 100 words per minute.
Other
AMA introduces a web-based EHR training tool developed by Regenstrief Institute that uses records from 11,000 de-identified Eskenazi Health (IN) patients with built-in medical histories going back as far as 40 years. The EHR training platform includes functionality based on Meaningful Use Stage 2 certification criteria so that the workflows will be similar to what residents will see in a hospital setting. I interviewed Regenstrief Institute CEO and Indiana University School of Medicine Professor Peter Embi, MD last month.
Sponsor Updates
Intelligent Medical Objects will exhibit at the European Federation for Medical Informatics meeting April 24-26 in Manchester, England.
LogicWorks will exhibit at the Alert Logic Cloud Security Summit April 26 in New York City.
MedData will exhibit at the HFMA Hawaii annual conference April 20-21 in Honolulu.
Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the Florida Perinatal Quality Collaborative meeting April 27-28 in Tampa.
PatientKeeper will exhibit at the MUSE Community Peer Group-Canada East Coast April 27 in Nova Scotia.
Optimum Healthcare IT publishes a new infographic, “The Importance of Data Security.”
PokitDok cofounder and CTO Ted Tanner will present at Business and the Blockchain April 24-25 at Rice University in Houston.
Sphere3 Consulting moves into new office space in St. Joseph, MO.
Surescripts will exhibit at Health Datapalooza April 27-28 in Washington, DC.
PMD makes the San Francisco Business Times 2017 Best Places to Work list.
Tail tucked between its legs, Theranos agrees to exit from the lab-testing business for two years as part of deal with CMS that will reduce its fine to $30,000 and reinstate its operating certificates. What’s left of the company’s employees are supposedly “looking forward” to helping Theranos work with regulators to commercialize its miniature lab-testing device.
Theranos also settles its legal battles with the Arizona Attorney General, agreeing to issue $4.65 million in refunds to all 175,000 Arizona residents who received Theranos blood tests over the last four years.
Webinars
April 26 (Wednesday) 1:00 ET. “SSM Integrated Health Technologies Clinical Data Migration: Functional and Technical Considerations.” Sponsored by Galen Healthcare Solutions. Presenters: Sandy Winklemann, MHA, RHIA, project manager, SSM Integration Health Technologies; Tyler Mawyer, MHA, managing consultant, Galen Healthcare Solutions; Kavon Kaboli, MPH, senior consultant, Galen Healthcare Solutions. GE Centricity and Meditech to Epic EHR transition. Join us for a complimentary webinar as present the decisions that are important to consider when performing a clinical data migration from the point of view of the healthcare organization program manager, the clinical analyst, and the technical implementation team. Our expert panel will survey data migration considerations, best practices, and lessons learned. The webinar will present a unique client perspective, offering insight into considerations surrounding staffing, clinical mapping, legacy application support, and validation and testing.
April 28 (Friday) 1:00 ET. “3 Secrets to Leadership Success for Women in Health IT.” Sponsored by HIStalk. Presenters: Nancy Ham, CEO, WebPT; Liz Johnson, MS, FAAN, FCHIME, FHIMSS, CHCIO, RN-BC CIO, Acute Care Hospitals & Applied Clinical Informatics – Tenet Healthcare. Join long-time C-level executives Liz Johnson and Nancy Ham as they share insights from nearly three decades of navigating successful healthcare careers, share strategies for empowering colleagues to pursue leadership opportunities, and discuss building diverse executive teams. This webinar is geared toward female managers and leaders in healthcare IT seeking to further develop their professional careers. It’s also intended for colleagues, executives, and HR personnel who are looking to employ supportive techniques that ensure diversity in the workplace.
Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.
Announcements and Implementations
Livongo Health will add Glytec’s EGlycemic Management System to its line of digital diabetes management tools.
Lancashire Teaching Hospitals NHS Foundation Trust in the UK adds integrated medication management to its implementation of Harris Healthcare’s QCPR EHR. Like all NHS facilities, Lancashire Teaching Hospitals hopes to go paperless by 2020.
Prime Healthcare ACO (CA) implements population health analytics and benchmarking from Persivia to assist its 70 practices with 2016 reporting requirements.
Grays Harbor Community Hospital (WA) will continue its use of CipherHealth’s post-discharge patient engagement technology and protocols after a four-month pilot that saw patient satisfaction increase and hospital readmissions decrease.
Acquisitions, Funding, Business, and Stock
HCA reports Q1 results: Revenue climbed to $10.6 billion compared to $10.2 billion in Q1 of 2016. However, net income dropped from $694 million to $659 million over the same time period; EPS $1.74 vs. $1.69. Revenue and net income missed analyst estimates, sending share prices down yesterday 3.6 percent.
UnitedHealth reports an increase in revenue and profits after exiting from the ACA exchanges. It expects a $3 billion increase in revenue over 2016, and a net income of $2.17 billion. The company predicts EPS will increase to between $9.65 and $9.85, compared to last year’s $9.30 to $9.60.
Mid-Columbia Medical Center (OR) attributes last week’s round of layoffs – its first in 20 years – to budgetary pressures related to its transition to Epic, as well as fewer patient visits during harsh winter months and uncertainty around Medicaid and Medicare reimbursements.
People
Kevin Hill (Leidos) joins Orchestrate Healthcare as area VP Southeast.
BJC HealthCare (MO) hires Jerry Fox, Jr. (Rockwell Automation) as SVP and CIO.
Sales
Wake Forest Baptist Medical Center signs a seven-year contract with Atlanta-based NThrive for outpatient RCM services.
Government and Politics
The VA awards Leidos company Systems Made Simple a potentially $29 million contract for IT development and support of its Repositories Program, which helps facilitate the sharing of health data between the VA, DoD, and other agencies. Leidos acquired Systems Made Simple as part of its $4.6 billion acquisition of Lockheed Martin’s IS and global services business last year.
A Black Book report evaluating Epic, Cerner, Allscripts, Meditech, and Athenahealth says Cerner is the best EHR vendor to replace VistA within the VA. The market research firm based its findings on customer satisfaction and how well each vendor’s offerings line up with the VA’s requirements. Allscripts and Epic round out the top three choices. The DoD, as you may recall, has opted to replace its AHLTA system with Cerner’s EHR. Fairchild Air Force Base went live in February; a full roll out is expected within the next four years.
The Air Force rebrands its MiCare patient communications portal to TOL Patient Portal Secure Messaging – the same name used by Army and Navy facilities.
The Phoenix VA Health Care System partners with CVS Health to increase access to care for veterans. Phoenix VA nurses can now refer patients to local MinuteClinics as part of the Veterans Choice Program. CVS entered into a similar arrangement with the Palo Alto VA HCS last year.
Privacy and Security
Erie County Medical Center continues to recover from a virus that shut down its IT systems April 9 – a process that has involved returning to paper charts; scrubbing 6,000 hard drives; and enlisting the help of IT specialists from neighboring Kaleida Health and Catholic Health, its EHR vendor, Meditech, GreyCastle Security, and Microsoft. The hospital has yet to confirm it was the victim of a ransomware attack.
Virginia Mason Memorial (WA) notifies 419 ER patients that their medical records had been improperly accessed over a three-month period last year by 21 employees. “We believe this to be a case of snooping, or individuals who were bored,” says Chief Compliance and Privacy Officer Trent Belliston. “[There is] no evidence that the information’s being used in an improper way.”
Other
The HHS Idea Lab previews Health Datapalooza, which will take place April 26-28 in Washington, DC, and include the launch of challenges related to patient matching and health behavior data.
Sponsor Updates
Besler Consulting releases a new podcast, “Episode Payment Model final rule explained.”
KLAS includes Casenet’s TruCare platform in “Best in KLAS for Care Management Solutions” for 2017.
Cumberland Consulting Group will sponsor and present at the Model N Rainmaker Conference April 24-26 in Miami.
ECG Management Consultants will present at The Governance Institute – Leadership Conference April 23 in Scottsdale, AZ.
Elsevier Clinical Solutions makes available a HIMSS presentation featuring BIDMC CIO John Halamka’s thoughts on the future of health IT.
EClinicalWorks will exhibit at the MPCA Spring Symposium April 19-20 in Helena, MT.
HCS will exhibit at the NALTH Spring Clinical Education & Annual Meeting April 20-21 in San Antonio.
Huntzinger Management Group’s Tanya Freeman joins the AEHIA Board of Directors.
Conduent’s pharmacy benefit management module, Conduent Flexible Rx System, receives federal certification in the state of Montana.
April 16, 2017NewsComments Off on Monday Morning Update 4/17/17
Top News
The FDA issues a warning letter to St. Jude Medical – acquired by Abbott Laboratories in January – for failing to respond to cybersecurity vulnerabilities that could allow a hacker to control implanted devices remotely and for failing to address battery issues that have been linked with two deaths. The warning comes three months after the FDA issued a similar notice warning St. Jude of the vulnerabilities. Further inaction could result in disciplinary actions that include “seizure, injunction, and civil monetary penalties.”
Reader Comments
From Athenahealth Spokesperson: “Re: ‘Will Athena be able to deliver, on time, for hospitals MU3?’ Athenahealth offers cloud-based revenue cycle and financial management, EHR, patient communication, and care coordination services for community hospitals. All of these services are on one platform, AthenaNet, which enables a single patient chart and a seamless Athena “look-and-feel” across the health system – inpatient, ED, outpatient, clinic, and ancillaries. The RazorInsights platform has been completely sun-setted. As of December 2016, we have over 90 contracted hospital clients, of which 35 are live on all or a portion of our AthenaOne for Hospitals & Health Systems service. These organizations are already seeing tangible results. For example, our clients saw an average of 106.5 percent of patient collections as a percentage of baseline during 2016. Stage 3 Meaningful Use is optional in 2017 and mandatory in 2018. Currently, AthenaClinicals for Hospitals & Health Systems is a 2014 Certified EHR Technology (CHERT), which allows our clients to pursue Stage 2 Meaningful Use this year. We plan on achieving 2015 CHERT status, which is required for Stage 3, in the second half of 2017. Thanks to our cloud-based platform, we can deploy the Stage 3 update to our entire client base overnight. All of our Meaningful Use services – a certified platform, real-time performance insight, performance coaching, and attestation – are included in our percentage of collections pricing. Our clients don’t have to pay hefty upgrade fees or endure cumbersome upgrade rollouts. Our results prove that our model works: 95.7 percent of our hospital clients successfully attested for Stage 2 Meaningful Use in 2015. We expect similar results for 2016, which will become available in the coming weeks.”
HIStalk Announcements and Requests
Just over a third of poll respondents teeter on the edge of full-blown enthusiasm for using at-home genetic testing kits to better understand their hereditary health risks. An almost even number of people are as eager to order their spit kit as are to likely not. No matter how you slice and dice the results, they are likely music to 23andMe’s ears – not to mention known competitors and those contemplating moving into it. MPW says, “I utilized their service a few years ago when some members in my family were testing positive for the same genetic abnormality, and have had no regrets. One thing to remember if you’re looking into this is that discovering a propensity for a trait does not mean it is an eventuality. For example, I’m listed as likely lactose intolerant. However, my Wisconsin roots and love for almost all things dairy says otherwise.” MineoPie explains that, “I voted ‘highly likely’ as my practical side sees the opportunity to plan appropriately whether that be treatment, an increase in health, life or long-term care insurance, or general peace of mind. There is also the potential to share these risks with my children for their own well-being. While I vacillate between this view and the one where I stick my fingers in my ears while yelling ‘la la la I can’t hear you,’ I ultimately see more benefit in having the data. Then I read the response from ‘no name’. I certainly share the concern that any negative results will not be proprietary leading to increased insurance costs and general shunning. I’m reminded of the Monty Python & The Holy Grail scene (‘I’m not dead yet, I think I’ll go for a walk’). Perhaps I’m more on the fence that I realized.” Barbara, on the other hand, thinks that “the public availability of this information will be used as a detriment in the future, i.e. insurance rates will go up, misinformation will be provided by targeting populations through Google/Facebook adds, etc. Not to mention the lack of professional interpretation resulting in self diagnosis, which could result in personal hysteria. This has already been evidenced with the advertising of medications and patients demanding of their physicians they be given this new, wonderful medication that may not be suitable for their situation. This should be done professionally where confidentiality is supported by both federal and state laws. No Name takes an even dimmer view: “I wish I trusted my government and insurers more, but don’t. I am now retired, but if I were still working, I don’t think I’d trust any employer to not use this info to possibly discriminate against employees who might prove to be high risk. Yep, that’s just the way it is.”
New poll to your right or here: Have you ever volunteered to be bumped from a flight? Share your circumstances – and the cash value you finally jumped at – by leaving a comment after voting.
This Week in Health IT History
One year ago:
CMS launches the Comprehensive Primary Care Plus model, a value-based payment program that will give PCPs more financial flexibility when caring for the chronically ill.
Epic wins $940 million in its trade secret lawsuit against Indian IT firm Tata Consultancies.
VA CIO LaVerne Council says she will unveil plans for a “new digital health platform” to replace VistA.
Intermountain Healthcare will partner with the University of Utah and several other organizations to create a joint security center focused on thwarting cybersecurity attacks.
Federal regulators propose banning Elizabeth Holmes from the blood-testing business for two years after Theranos fails to correct serious problems discovered at its California lab.
Five years ago:
The DoD Inspector General finds that drug abuse among Marines in the Wounded Warrior Battalion at Camp Lejeune, NC is hard to detect because of EHR shortcomings.
3M acquires CodeRyte.
HHS proposes a one-year delay for ICD-10 compliance, pushing the deadline to October 1, 2014.
Verizon announces a relationship with NantWorks to create the Cancer Knowledge Action Network.
Weekly Anonymous Question
Last week, I asked readers what passion they’d pursue given enough free time and money:
Play music … all acoustic band.
Dog rescue and fostering 24/7. I would get property and have a place to foster many dogs; and would collect codified data regarding the adopters/adoptees to be able to identify traits of good dog/person pairings.
Ride coast to coast on a motorcycle.
Create a business-school partnership to encourage additional learning opportunities for math and critical thinking; incorporate local in-person and online virtual mentoring.
Travel the world, meeting people from all different walks of life, and seeing the beautiful landscapes of our planet. I also would love to do something to help those in need, so maybe a nonprofit that combines my dream to travel and also takes disadvantaged children on these adventures. Having fun with them and seeing their reactions to experiences like that would bring me such joy!
Build community gardens in areas where fresh produce is hard come by.
I would do more volunteer work. And make quilts – a lot of quilts.
Instead of having one in five kids in the US go to sleep hungry at night, I would work to drive that number to zero.
Roadside BBQ stand. It’s done when it’s done and it’s gone when it’s gone.
When I grow up, I want to be a photographer. I would love to travel the world snapping pictures of whatever comes my way.
Traveling to the best restaurants around the world and return to food blogging. I had to quit my blog last year (after a six-year run) due to cost and limited time.
Finish that novel, get it out there. Write another one.
Art. Art. Art. Nothing but painting, drawing, sculpting, weaving … and gardening. All things visually creative that require getting my hands dirty!
I’d follow my favorite bands around the world.
Music. That’s been the dream ever since I started playing guitar at age 12. I knew it had a chance since I can play almost every rock/blues song that I hear just by ear, but a) I never found the right band and b) my desire to secure a career somewhere besides McDonald’s led me to attend college and get a "real job" as opposed to rolling the dice and heading from the North Country out to LA a la Neil Young. That doesn’t seem to work out as well in the 21st century as it did in the mid 60’s. I still do some local gigs on occasion and play everyday; it will always be my number-one passion.
Photography – Weird News Andy
Attending as many music festivals as I could across the US and when I feel that is fairly complete, move on to Europe, Australia, etc.
Coaching people on living a more balanced life to have time with friends and family, and to look after emotional, physical, and spiritual needs.
Building and promoting a not-for-profit, nationwide health IT co-op.
Rock and roll guitar. What else could there be?
Space travel.
Hosting international yoga and wellness focused retreats.
Right now, a free weekend to relax and read a non-technical book and some time to travel and see some new places sounds pretty good, albeit mundane. The list of top 50 restaurants in the world just came out and a checking out a new one every week would be fun.
Cruising around the world.
I’d help patients learn how to be informed advocates for their own healthcare and the health of their family and friends.
Coding! Python, SQL, JScript and everything in between. Nothing like coding to keep your mind sharp and busy. And I do have the time and money to do it, so I do it and love every moment of it. Strongly recommended.
This week’s question: What’s the most patient-endangering IT issue you’ve personally seen?
Last Week’s Most Interesting News
NextGen will acquire Entrada in a deal worth $34 million.
The White House finalizes its rules aimed at stabilizing the individual marketplaces.
Erie County Medical Center (NY) returns to paper after a virus brings down its network.
United Airlines suffers financial loss and extreme PR backlash after dragging a physician, later hospitalized, off a flight.
India-based provider appointment-scheduling vendor Practo lays off 10 percent of its workforce.
Webinars
April 26 (Wednesday) 1:00 ET. “SSM Integrated Health Technologies Clinical Data Migration: Functional and Technical Considerations.” Sponsored by Galen Healthcare Solutions. Presenters: Sandy Winklemann, MHA, RHIA, project manager, SSM Integration Health Technologies; Tyler Mawyer, MHA, managing consultant, Galen Healthcare Solutions; Kavon Kaboli, MPH, senior consultant, Galen Healthcare Solutions. GE Centricity and Meditech to Epic EHR transition. Join us for a complimentary webinar as present the decisions that are important to consider when performing a clinical data migration from the point of view of the healthcare organization program manager, the clinical analyst, and the technical implementation team. Our expert panel will survey data migration considerations, best practices, and lessons learned. The webinar will present a unique client perspective, offering insight into considerations surrounding staffing, clinical mapping, legacy application support, and validation and testing.
Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.
Acquisitions, Funding, Business, and Stock
EncounterCare Solutions wraps up the sale of its telemedicine and chronic care management operations to IGambit, which plans to market the services under the HealthDatix brand.
Salt Lake City-based Collective Medical Technologies announces plans to hire nearly 600 people over the next eight years. The company specializes in real-time care management tech for EDs.
People
Natoshia Erickson (Washington Health Benefit Exchange) joins Royal Jay as senior manager of solution delivery.
Announcements and Implementations
Trinity Health (MI) expands its home health telemedicine program, powered by technology from Vivify Health, to six additional states.
Miami Children’s Health System will work with telemedicine hardware and software vendor Tyto Care to expand its MCH Anywhere virtual consult services.
Decisions
Indiana Regional Medical Center (PA) will switch from MEDITECH to Cerner On May 1.
Sierra Vista Hospital (NM) will switch from Evident (a CPSI company) to Athenahealth on July 1.
Van Wert County Hospital (OH) Human Resources will go live with Infor this year.
Cameron Memorial Community Hospital (IN) Human Resources will go live with Oracle in 2017.
These provider-reported updates are provided by Definitive Healthcare, which offers powerful intelligence on hospitals, physicians, and healthcare providers.
Other
New Jersey Hospital Association President and CEO Betsy Ryan and NJ Dept. of Health Commissioner Cathleen Bennett attempt to drum up interest in the forthcoming statewide roll out of the electronic Practitioner Orders for Life-Sustaining Treatment program. The initiative will convert the state’s paper-based, end-of-life planning documents for patients to a digital format, and give physicians access to the documents via a Web-based portal.
Here’s Part 4 of the top 10 HIS vendors report from Vince and Elise.
Sponsor Updates
T-System will exhibit at EDPMA 2017 Solutions Summit April 25-28 in San Diego.
TierPoint will host a grand unveiling of its newest Chicago data center April 27.
TransUnion publishes, “Revenue Cycle POS and High-Risk Patient Toolkit.”
ZeOmega publishes a case study highlighting how a large health system implemented Jiva HIE to connect 36 disparate EHR systems.
ZirMed publishes a new ebook, “3 Ways to Take Control of Your Contacts.”
ClinicalArchitecture makes donations to Boy Scouts of America, Casa de los Ninos, and Compassion International on behalf of HIMSS17 contest winners.
Quality Systems subsidiary NextGen Healthcare will acquire mobile physician documentation and communication technology vendor Entrada in a deal worth $34 million. NextGen President and CEO Rusty Frantz says the company will focus on expanding Entrada’s capabilities.
Reader Comments
From Bob Oakley: “Re: Allscripts dbMotion. I no longer have a horse in this race, but feel compelled to write as I weathered the introduction of CareInMotion – including being miscategorized by KLAS. Setting expectations – this will hit about three or four of your bad branding hot buttons. You indicated that it was part of the Care Management population health platform, when it should have been identified as the CareInMotion population health platform. The confusion is not surprising, as CareInMotion (egregious capitalization not withstanding) is trying to corral several disparate applications under one brand, while working to create the common backbone necessary for it to be the platform it’s purported to be. Contributing to that is that the word Care prepends several legacy applications under the brand, including Care Management (the legacy ECIN utilization management, discharge planning, and referral management application). It is definitely confusing. I wish it weren’t, but its use is only a little over a year old and the dbMotion Azure announcement is heartening that the platform is being realized.”
From HIT User: “Re: Athenahealth. Athena seems to be making a lot of traction in the acute care space. This seems to mostly be to the attractiveness of their percentage of collections model for smaller hospitals that cannot afford most EHR price tags. What offering are they really providing to hospitals? Is it fully vetted or half-baked with RazorInsights hodgepodged with their ambulatory system? I see they are just now certifying this for Stage 2 per the CHPL site. Will they be ready by Stage 3 with all of the customers they are trying to reign in? I heard of one site – Cottage – that was delayed over a year from original anticipated go live (into the middle of 2018) for an install. Will Athena be able to deliver, on time, for hospitals MU3?”
Webinars
April 26 (Wednesday) 1:00 ET. “SSM Integrated Health Technologies Clinical Data Migration: Functional and Technical Considerations.” Sponsored by Galen Healthcare Solutions. Presenters: Sandy Winklemann, MHA, RHIA, project manager, SSM Integration Health Technologies; Tyler Mawyer, MHA, managing consultant, Galen Healthcare Solutions; Kavon Kaboli, MPH, senior consultant, Galen Healthcare Solutions. GE Centricity and Meditech to Epic EHR transition. Join us for a complimentary webinar as present the decisions that are important to consider when performing a clinical data migration from the point of view of the healthcare organization program manager, the clinical analyst, and the technical implementation team. Our expert panel will survey data migration considerations, best practices, and lessons learned. The webinar will present a unique client perspective, offering insight into considerations surrounding staffing, clinical mapping, legacy application support, and validation and testing.
Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.
HIStalk Announcements and Requests
This week on HIStalk Practice: CMS awards United Way of Greater Cleveland a $4.51 million grant to help it create an Accountable Health Communities Model. Thirteen people from three clinics are busted for their roles in a $24 million multi-clinic pill mill and fraudulent billing conspiracy. Physicians seem to favor faxes and phones over e-prescribing tech. Researchers determine community physicians are less likely to order unnecessary tests than their hospital-based counterparts. Dean Dorton acquires Metro Medical Solutions. Craft Behavioral Health Practice Manager Cara Farooque shares the challenges her practice faces in vetting technology for security and privacy controls. CareSync goes after customers for back payments. OCR gives Metro Community Provider Network a $400,000 slap on the wrist. ChenMed’s Jessica Chen, MD and Denise Hatzidakis offer insight into building and using IT for value-based primary care for seniors. Sign up for physician practice news here.
Acquisitions, Funding, Business, and Stock
Caradigm announces that it will reduce its workforce as part of a reorganization that it hopes will streamline operations. “GE Healthcare is committed to supporting the Caradigm team as they continue to evolve, positioning themselves to develop digital solutions for better outcomes in population health,” says Charles Koontz, chief digital officer, GE Healthcare. The company went through similar motions last fall, reorganizing product teams and its Services organization.
Sansoro Health raises $5.2 million in a Series A funding round led by Bain Capital Ventures. The Minneapolis-based company, which has raised $6.4 million so far, has developed a data integration tool for digital health apps and EHRs. It won the Venture+ Forum startup contest at HIMSS16.
Austin, TX-based healthcare cloud vendor ClearData raises $12 million, bringing its total funding to $55 million since launching in 2011.
Announcements and Implementations
Freeman Health System (MO) implements Access e-form and electronic signature software.
Kroger pharmacies connect to the Michigan Automated Prescription System with help from Appriss Health, which is helping the state develop and launch a new prescription drug monitoring system. Kroger expects to start sharing PDMP data between Michigan, Indiana, and Ohio within the next several weeks.
People
Verscend Technologies hires Chris Coloian (Welltok) as SVP of revenue and growth, and Michael Kapp (WellPoint) as SVP of government services.
Former State of Minnesota CIO Scott Peterson joins Avalere as VP of data architecture.
Technology
AMD Global Telemedicine updates its Agnes Interactive software to offer improved EHR integration.
Iron Bridge develops a portal to help providers query and submit data to public health registries.
Intermedix adds Web and mobile form configuration and management capabilities to its EMS patient-tracking software.
Sales
McPherson Hospital (KS) will implement EHR and RCM software and services from CPSI subsidiaries Evident and TruBridge.
Innovation and Research
Final Frontier Medical Devices wins a $2.6 million Qualcomm Tricorder XPrize for its efforts to develop a diagnostic device for multiple ailments akin to the one used in Star Trek. Runner-up Dynamical Biomarkers Group will take home $1 million for its attempt at developing a lightweight tool that can diagnose 13 ailments and measure five vital signs at the same time. XPrize organizers will use what’s left of the original $10 million purse to help both teams develop their devices. The Roddenberry Foundation, organized by Star Trek creator Gene Roddenberry’s son, has pledged an additional $1.6 million to the effort.
Government and Politics
The VA launches a website aimed at helping bring transparency to access and quality across its facilities. Patients can look up same-day availability, average appointment wait times, satisfaction scores based on those times, and hospital and outpatient compare data.
CMS issues a final insurance market stabilization rule. The 139-page rule, set to take effect next year, will, among other things, cut the enrollment period in half, allow lower minimum coverage requirements, and put health plan physician networks in the hands of the states rather than the federal government. CMS Administrator Seema Verma admits that, “While these steps will help stabilize the individual and small group markets, they are not a long-term cure for the problems that the Affordable Care Act has created in our healthcare system.”
Meanwhile, in an effort to draw Democrats to the healthcare policy negotiation table, President Trump threatens to withhold payments to insurers meant to cover discounts for low-income consumers, explaining, “I don’t want people to get hurt. What I think should happen—and will happen—is the Democrats will start calling me and negotiating.”
The VistA replacement saga continues as the VA issues a request for information on a commercial, SaaS-based replacement that would enable – eventually – easy updating across the entire system. Vendors have until April 26 to submit their proposals for streamlining the 130 variations of the system and migrating them to the cloud.
The Vancouver Island Health Authority decides against suspending the CPOE feature of its IHealth EHR as originally announced in February. Government officials claim the $174 million Cerner system, which has earned a fair amount of media coverage based on end-user concerns with patient safety risks and documentation quality, is too intertwined with other systems and workflows to be taken offline, even temporarily. This may be a decision that pushes some nurses over the edge: A British Columbia Nurses Union survey found that 32 percent of RNs had seriously considered leaving or retiring because of the software.
Privacy and Security
Erie County Medical Center (NY) returns to paper after a virus brings down its network early Sunday morning. A hospital spokesman refused to comment on speculation that the virus was actually a ransomware attack, and if it had been contacted by hackers or asked for payments to restore access. ECMC hopes to have patient data available today and its IT systems fully restored by Saturday.
Other
The Leapfrog Group launches a calculator designed to illuminate the impact medical errors have on an employer’s covered population. The calculator estimates the number of avoidable deaths among covered lives, how much employers spend annually due to medical errors within general acute care hospitals, and how much of their total health care spend goes to these medical mistakes.
A local media outlet publishes a nicely written profile of Epic founder Judy Faulkner. Some HIStalk readers may not know that Faulkner’s mother Del, who graduated high school at the age of 15, received a Nobel Peace Prize in 1985 for her work as director of the Oregon Physicians for Social Responsibility – an affiliate of International Physicians for the Prevention of Nuclear War. Those who have been in the industry since the company’s early days will appreciate the accompanying photos.
Sponsor Updates
Everest Group recognizes Conduent Health in two reports, “Healthcare Payer BPO – Service Provider Landscape with PEAK Matrix Assessment 2016” and “Contact Center Outsourcing Marketing for Healthcare Industry – Service Provider Landscape with PEAK Matrix Assessment 2017.”
Netsmart will exhibit at the VNAA National Leadership Conference April 19 in San Diego.
NVoq will exhibit at the TORCH Annual Conference & Tradeshow April 18-20 in Dallas.
Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at Symposia Medicus April 18-20 in Las Vegas.
Experian Health will exhibit at HFMA Hawaii April 20-21 in Honolulu.
The SSI Group will exhibit at the Alabama HIMSS chapter Spring Conference April 19 in Huntsville.
Sunquest Information Systems publishes a new white paper, “Build or Buy: Optimizing Informatics for Genetic Testing.”
The FutureTech Podcast features Sytrue’s Kyle Silvestro.
Solutionreach becomes a preferred partner of Crystal PM for optometrists.
A Kentucky-based physician with a troubled past is hospitalized after being dragged off a United Airlines flight. David Dao, MD was one of four passengers told to get off the overbooked flight to make room for United stand-by employees. Dao refused on the grounds that he needed to get back to Kentucky to see his patients, and was subsequently (and literally) dragged off the airplane by police. While United has faced extreme backlash over its handling of the situation, Dao’s criminal history hasn’t done him any favors when it comes to casting him as an innocent victim. United employees described him as disruptive and belligerent when told he needed to give up his seat. The incident brings up the issue of overbooking policies, which, as one Twitter observer noted, won’t be a problem for United if all their planes are empty.
Reader Comments
From NantWatcher: “Re: Layoffs at NantHealth. Another round last week – spread across multiple sites, departments, and seniority from entry-level to VP. Roughly 50 impacted.” Unverified, though Politico reports that shares of the company fell 15 percent earlier this week – a circumstance it seems to directly attribute to its exposé of Soon-Shiong and his self-serving philanthropic efforts.
From NewCrop VP Randy Barnes: “Re: NewCrop losing customers. This is nothing short of FAKE NEWS. NewCrop continues to grow at a steady pace. EHR losses to competitors are extremely rare. What have we been doing? Patient support programs, real-time benefits across a multitude of insurance companies, intelligent prior auths, pharmacogenomics, lab integrations, patient portals, secure communications, immunization registry reporting to support all 50 states, new UI and more.”
Webinars
April 26 (Wednesday) 1:00 ET. “SSM Integrated Health Technologies Clinical Data Migration: Functional and Technical Considerations.” Sponsored by Galen Healthcare Solutions. Presenters: Sandy Winklemann, MHA, RHIA, project manager, SSM Integration Health Technologies; Tyler Mawyer, MHA, managing consultant, Galen Healthcare Solutions; Kavon Kaboli, MPH, senior consultant, Galen Healthcare Solutions. GE Centricity and Meditech to Epic EHR transition. Join us for a complimentary webinar as present the decisions that are important to consider when performing a clinical data migration from the point of view of the healthcare organization program manager, the clinical analyst, and the technical implementation team. Our expert panel will survey data migration considerations, best practices, and lessons learned. The webinar will present a unique client perspective, offering insight into considerations surrounding staffing, clinical mapping, legacy application support, and validation and testing.
Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.
Acquisitions, Funding, Business, and Stock
Azalea Health acquires San Diego-based EHR and PM company LeonardoMD for an undisclosed sum.
A new CB Insights report shows that, while the large majority of digital health funding has gone to US-based startups, young companies globally are also addressing the challenge of improving healthcare. On a quarterly basis, equity funding to private US-based digital health companies saw a 128-percent increase from $768 million in Q4 2016 to $1.75 billion in Q1 2017. Meanwhile, funding to digital health companies outside the US saw a 146-percent increase from $252 million in Q4 2016 to $621 million in Q1 2017. Deals to US-based companies, which picked up at the end of 2016 after taking a dive in Q3 2016, again fell in Q1 2017, down to 147. This marks the second lowest quarter of the last three years. Deals outside the US, however, have surged recently from 55 in Q3 2016 to 102 in Q4 2016 and 104 in Q1 2017.
People
Impact Advisors promotes Rob Faix and Mike Garzone to vice president.
Health Catalyst hires Stanley Pestotnik (Pascal Metrics) as VP of patient safety products, and Carolyn Simpkins, MD (BMJ) as CMIO.
Teri Thomas (UNC Health Care) will join Orion Health in May as EVP for global sales, marketing, and strategy.
Doug Abel (Encore) has joined North Kansas City Hospital (MO) as CIO.
Recondo Technology names Dan Grote (ReadyTalk) CFO and Tom Cooke (Advisory Board) (not pictured) VP of channel sales.
Sales
Lancashire Care NHS Foundation Trust selects UK-based Servelec’s Rio EHR.
St. Joseph’s Healthcare System (NJ) will move from Cerner’s Soarian EHR to its Millenium EHR and HealtheIntent population health management system. It has also opted for the company’s RCM software and services.
Arizona-based Banner Health will roll out patient access and provider management technology from Kyruus at its facilities in six states.
Announcements and Implementations
Lake Regional Health System (MO) prepares to roll out a single patient portal for its clinic and hospital patients. The portal, presumably part of the system’s conversion to Meditech 6.1, will go live in May. CIO Scott Poest has advised patients to print out any medical records related to care provided prior to May, since data from the previous portals will apparently not carry over.
Trinity Health (ND) implements Acute, Population, and Practice Performance software from WhiteCloud Analytics.
Mercy (LA) wraps up a six month implementation of an imaging management system from Medicalis across its 50 imaging facilities. It plans to connect the system to its virtual care center in the near future.
Research and Innovation
A Pennsylvania Patient Safety Authority report released several weeks ago reveals that, in the first half of 2016, hospitals in the state reported 889 medication errors that were attributed in some way to EHRs and other healthcare IT. Nearly 70 percent of those errors – the majority of which involved missed or incorrect dosages – impacted patients, eight of whom were actually harmed. Co-author and pharmacist Matthew Grissinger counter intuitively stresses that while these results are the “classic tip of the iceberg” when it comes to uncovering medication errors, many of which go unreported, patients should feel no less safe.
A University of Michigan study finds that participation in one or more value-based care programs resulted in fewer hospital readmissions and greater cost savings. Researchers looked at patient care from 2,877 hospitals over a seven-year period and found that participation in Meaningful Use, ACOs, and/or bundled care payment programs helped the organizations save a combined $32 million.
Technology
CPSI will add TruCode’s Encoder coding software to its Evident and Healthland EHRs.
AthenaHealth adds electronic prior authorization technology from CoverMyMeds to AthenaClinicals.
Allscripts puts its DbMotion software – part of its CareInMotion population health management platform - on the cloud via Microsoft Azure.
Aprima Medical Software will add ActX’s genomic decision-support technology to its EHR.
News Corp Australia discovers that privacy settings on the nationwide My Health Record are set to “universal access,” giving the government’s 650,000 registered providers access to the information.
Tullamore Hospital in Ireland mistakenly sends a fax containing PHI to the office of the Data Protection Commissioner.
Brooklyn-based artist Ace Volkov depicts computer viruses as comic book-like aliens as part of his “Brief History of Computer Viruses” series. Brain.A earns a special place in hacker history for its role as the first detected virus. Characterized by Volkov as a menacing mass of magenta-hued lines, the MS-DOS-based virus was created in 1986 to infect floppy disks.
Government and Politics
President Trump nominates University of Minnesota healthcare economics professor Stephen Parente for assistant secretary for planning and evaluation at HHS, a role that would position him as the main advisor on policy development to HHS Secretary Tom Price, MD. Parente has had a taste of government work, having served as a health policy advisor for Sen. John McCain (R-AZ) during his 2008 presidential run.
Other
In Australia, SA Health CIO Bill Le Blanc defends the system’s beleaguered enterprise patient administration system after a coroner complains he can’t properly investigate a patient’s death because the EPAS won’t print out readable paper copies. “It was never designed to be used as a printed medical record,” Le Blanc says. “While we have already made significant improvements, the readability of printed records is an emerging issue across almost all jurisdictions using different electronic medical record systems and is not specific to the electronic medical record system used by SA Health.”
Sponsor Updates
Besler Consulting will present and exhibit at the 2017 HFMA Northern California Annual Spring Conference April 13 in Sacramento.
ECG Management Consultants ranks as a top consulting firm in the KLAS report, “Vendor Selection 2017: Crucial Factors to Consider When Choosing a Consulting Firm.”
AdvancedMD expands its professional services team.
ZeOmega releases 2017 updates to integrated patient assessments for its Jiva population health management software.
The local paper profiles Hartford Healthcare’s (CT) plans to build a predictive analytics “command center” powered by GE Healthcare.
India-based provider search and appointment-booking tech company Practo lays off 150 – a 10-percent workforce reduction the company attributes to “a combination of natural redundancies that emerge as we integrate our five acquisitions and evolve our businesses, as well as the performance required for the next phase of Practo’s growth.” The company operates in four other countries, and has raised $180 million since launching nine years ago. It acquired Fitho, Genii Technologies, Qikwell Technologies, Instahealth, and Enlightiks – all India-based businesses – between April 2015 and December 2016.
Reader Comments
From North West: “Re:Larry Krassner’s passing. He passed away after a long battle with cancer in late December. I was shocked that it isn’t more widely known and thought that you might want to include something in HISTalk. He was well known in the 70s through early 2000s in the HIT industry. He was part of SMS in the early days, TDS, McKesson, and IDX (before it was bought by GE). He was the consummate salesman and probably responsible for many of the big enterprise deals that SMS and TDS did in the 70s-90s.”
From Harvest Gal: “Re: Word on the street is that NewCrop has been losing EHR customers – and end-user doctors – over the past couple months. We’ve also heard that those EHR vendors are moving to e-prescribing company DrFirst. Is greater industry consolidation on the horizon?” Unverified. I wouldn’t be surprised given the general state of health IT affairs. NewCrop’s e-prescribing tool has been on the market since 2003, and has been flying fairly under the radar (at least from a media perspective) for the last several years. I last mentioned them in September 2016, when the company added specialty medication prescribing software from AssistRx.
From Lab Tester: “Re: Theranos vs. 23andMe. Seems like Elizabeth Holmes could learn a thing or two from Anne Wojcicki. Both companies faced governmental scrutiny; one continues to go down in flames, while the other seems to be trying to play by the rules.” The Theranos saga does indeed continue: Media reports suggest that founder Elizabeth Holmes owes her own company $25 million - a fact made semi-public after reports surfaced that some investors were considering suing the company. 23andMe, meanwhile, has seemed very intentional about recovering from the reprimand it received from the FDA in 2013. It seems to have eschewed the media-blitz machine Holmes favored to instead hunker down and legitimize its business model.
From Ambulance Chaser: “Re: Ambulance rides via Uber. It boggles my mind that people are opting for rides to the ER from ride-sharing services like Uber and Lyft. Have any of your readers noticed an increase at their facilities in drop-offs from these services?” AC is no doubt referring to this article focusing on the use of ride-sharing companies to get emergency patients to the hospital. While I doubt ER staff have time to pay attention to patient transport, I’ll invite readers to weigh in. It’s just another nail in healthcare’s already deteriorating coffin, if you ask me. The industry has yet to (and probably never will) become the nimble, Amazon-like company that caters to consumer whims – much less one based on a gig-economy model. The regulatory tape is wrapped too tightly at this point, and administration in-fighting would suggest it’s not loosening up anytime soon.
HIStalk Announcements and Requests
Nearly a third of poll respondents expect blockchain to have a significant impact on healthcare in five to 10 years. Perhaps the more compelling result is the 25 percent of respondents who “don’t know, don’t care.” Realist explains that, “Blockchain will never have a significant impact on HIT; in the short-run, it will be a boost to conferences, consultants, and marketing. In the long-run, it will be utilized but won’t have any material impact.” HITgeek takes a less pessimistic view: “We do not need yet another niche, domain security control. Instead, what we desperately need is a ubiquitous one. Blockchain is a contender for that. We need to determine who will pay for it. Nominally, the beneficiaries will pay through some proxy rather than taxpayer funding. The boundary between what is health data and what isn’t is shifting and porous. Any security technology that draws a bright line border will soon become obsolete. On the other hand, security technology that straddles or ignores the boundary has a greater and continuing return on investment.”
New poll to your right or here: How likely would you be to use a company like 23andMe to better understand your hereditary health risks? Feel free to explain your level of likeliness by leaving a comment.
This Week in Health IT History
One year ago:
Massachusetts General Hospital, Massachusetts Eye and Ear, and Newton-Wellesley Hospital all go live on Epic over the weekend as part of Partners Healthcare’s $1.2 billion Epic implementation.
A CMS inspection report confirms that Theranos’ proprietary blood testing analyzer, Edison, failed internal quality control tests 29 percent of the time, while its California lab was also cited for doing tests with unqualified personnel and storing samples at the wrong temperatures.
e-MDs completes its acquisition of McKesson ambulatory products Practice Choice, Medisoft, Medisoft Clinical, Lytec, Lytec MD, and Practice Partner.
The DoD brands its Cerner implementation project MHS Genesis.
Pfizer backs out of its plan to acquire Allegran and move its headquarters to Ireland for tax reasons after the Treasury Department puts new rules in places to make tax inversions less lucrative.
Five years ago:
The Gingrich Group LLC, doing business as the Center for Health Transformation, files for Chapter 7 bankruptcy in a Georgia court.
The Coast Guard prepares to go live on its Epic-based EHR.
A new KLAS report says that Cerner, Meditech, and Siemens are the only HIT vendors that provide their solutions to all world regions.
A National eHealth Collaborative paper says that HIEs have great potential to improve care and reduce cost, but despite ONC emphasis and incentives, not a lot of value has been realized so far.
Weekly Anonymous Reader Question
Last week I asked readers to share their favorite moment from any past HIMSS conferences:
Leaving.
Getting my leadership to explain why a bunch of gray beards in suits with no health IT market experience were getting paid trips to HIMSS, while our actual industry experts (like me) weren’t.
HIStalkapalooza in Chicago ’15!
The stillness in the office as the bosses are all gone!
Going home.
(From Dr. Jayne) My favorite moment was at HIStalkapalooza in New Orleans at the Rock’n’Bowl. I managed to have pictures taken with both Judy Faulkner and Jonathan Bush. I keep them in a hinged frame on my desk so they constantly have to look at each other. It makes me smile when I am writing for HIStalk.
This week’s question: What passion would you pursue given adequate free time and money?
Last Week’s Most Interesting News
The FDA authorizes 23andMe to market direct-to-consumer genetic health risk tests and reports.
VA CIO Rob Thomas confirms the agency is on track to make a decision by July 1 on whether to replace Vista with a commercial EHR vendor.
Cleveland Clinic launches an investment business, Cleveland Clinic Ventures, that will work with its innovation department to turn new medical breakthroughs into funded spin-off companies.
Former CMO of Siemens Healthcare, Donald Rucker, MD joins ONC as National Coordinator.
A media company that Patrick Soon-Shiong, MD rescued from a hostile takeover attempt with a $70 million investment claims that its CEO was forced to personally invest $10 million in NantHealth’s initial round in exchange for the help.
Webinars
April 26 (Wednesday) 1:00 ET. “SSM Integrated Health Technologies Clinical Data Migration: Functional and Technical Considerations.” Sponsored by Galen Healthcare Solutions. Presenters: Sandy Winklemann, MHA, RHIA, project manager, SSM Integration Health Technologies; Tyler Mawyer, MHA, managing consultant, Galen Healthcare Solutions; Kavon Kaboli, MPH, senior consultant, Galen Healthcare Solutions. GE Centricity and Meditech to Epic EHR transition. Join us for a complimentary webinar as present the decisions that are important to consider when performing a clinical data migration from the point of view of the healthcare organization program manager, the clinical analyst, and the technical implementation team. Our expert panel will survey data migration considerations, best practices, and lessons learned. The webinar will present a unique client perspective, offering insight into considerations surrounding staffing, clinical mapping, legacy application support, and validation and testing.
Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.
Acquisitions, Funding, Business, and Stock
Meditology Services opens offices in Denver, Nashville, and San Diego. The company, which seems to have repositioned itself as a privacy and security consulting firm since I first mentioned it in 2013, already has offices in Atlanta and Philadelphia.
Announcements and Implementations
Northern Arizona Healthcare’s Verde Valley Medical Clinic – Camp Verde implements Versus Advantages Clinic patient flow technology from Versus Technology Solutions.
Several facilities within the Dubai Health Authority (UAE) go live on Epic.
Decisions
Johnson Memorial Hospital (IN) will go live with Optimum HRIS in May.
Madison Memorial Hospital’s (ID) HR department will go live with Paychex MyStaffingPro this year.
Womankind Obstetrics and Gynecology (OH) will switch from Athenahealth to Epic ambulatory next month.
These provider-reported updates are provided by Definitive Healthcare, which offers powerful intelligence on hospitals, physicians, and healthcare providers.
Other
Here’s Part 3 of the top 10 HIS vendors report from Vince and Elise.
Sponsor Updates
The Chicago CIO Leadership Association honors TransUnion CIO & CTO Mohit Kapoor with its 2017 CIO of the Year Orbie Award.
ZirMed updates its Coverage Detection patient payment product.
CRM Magazine recognizes West Corp. with a 2017 CRM Service Leader Award for Contact Center Infrastructure.
ZeOmega publishes a new case study demonstrating how Community Health Network/Indiana ProHealth implemented its Jiva case management solution.
ZirMed releases a new eBook, “The Reality of Patient Payments.”
Clinical Computer Systems, Inc., developer of the Obix Perinatal Data System, announces that Jake Chacko, Philip Strang, and Chris Zoellner have completed field service manager certification training.
The Shkreli Awards, celebrating excellence in quackery! Be the Best at being the Worst! Innovate your way to prison and…