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News 11/27/19

November 26, 2019 News 7 Comments

Top News

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Federal prosecutors charge the two founders and two other executives of waiting room advertising technology vendor Outcome Health with fraud, claiming that the company inflated its revenue over a six-year period to help it raise $1 billion in funding, of which at least $225 million went directly into the pockets of the founders.

Indicted are the company’s former CEO Rishi Shah (33), former President Shradha Agarwal (34), former CFO Brad Purdy (30), and former EVP Ashik Desai (26).

Fascinating claims from the SEC litigation document:

  • A company salesperson warned Shah that company fraud was widespread, to the point that client performance reports were being edited directly in PowerPoint.
  • Desai joined the company as a 19-year-old intern, then became EVP over analytics.
  • Agarwal wasn’t really a co-founder even though the company positioned her as such. Shah’s original co-founder, an unnamed university classmate, left in November 2009. It was apparently Derek Moeller, who resigned as president to buy a Seattle-area company that recycles plastic into garden growing containers.
  • Shah had described the company’s “chicken and egg” problem, where it needed ad revenue to install more waiting room devices, but needed the devices to raise revenue. He decided to start forecasting the number of offices and device and sell that ad space even though it wouldn’t be available for months, which he later admitted in a meeting of entrepreneurs that, “It’s fraud, right, I mean you’re selling something you don’t have.” The company billed and recognized the full amount immediately.
  • The “selling of futures” became such an ingrained part of the company’s culture that its analysts were tasked with producing scheduled “delta report” that tracked the difference between claimed offices and devices with the real, lower number.
  • The company’s controller warned the executives that GAAP revenue recognition is based on actual delivery of ads rather than upfront invoicing, after which they kept the controller in the dark about the “delta reports.”
  • Desai falsified an ROI study in showing that Outcome’s ads boosted prescription counts by 27% in six months with a confidence level of 80%, when the actual figure was a 4% increase with 71% confidence. That allowed the company to claim that the ads generated $2 million in drug company revenue vs. the actual $116,000. For another drug ad, the company claimed that prescriptions increased 35% from Outcome ads when they actually decreased 3%.
  • In a Theranos-like move, a newly hired Outcome COO found himself out of a job within three weeks of warning Shah of the falsified ROI reports. He wasn’t named in the filings, but it was Vivek Kundra, a former White House CIO and Salesforce EVP who is now COO of CRM software vendor Sprinklr. His LinkedIn omits his nine-month stint with Outcome Health.
  • Also Theranos-like was that the company was exposed by a Wall Street Journal investigative report.

Reader Comments

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From Dr. Herzenstube: “Re: Exponential Medicine conference earlier this month. I’m wondering if any HIStalk readers went and can comment on whether it’s worth the astronomical price tag?” The Exponential Medicine conference was held early in November at the Hotel del Coronado in San Diego, with a registration fee of $4,750 and “favorable rates” offered to non-profit and government employees. It’s run by TED-aspiring Singularity University, which despite its name and .org web address, is a for-profit company rather than a real university, offering programs to rich executives instead of poor students. The web page is a thicket of buzzwords (“curate,” “reimagining,” “blockchain,” and “recharging” at yoga sessions and dinners under the stars) and speakers ranged from the mildly interesting to the clearly self-promoting, entertaining the junketeers who lived it up far from the prying eyes of their patients who are being bankrupted by their expense-bloated bills. I’m sure everybody had a good time, though.

From Eriksson: “Re: Cerner in Sweden. See this article.” The ComputerSweden article says that Region Skåne has postponed its Cerner implementation because the company has failed to understand the extend of Millennium changes that are needed to support the Swedish Patient Data Act. The region chose to store its data in Cerner’s cloud – unlike another region that is hosting its own system locally – and US cloud data protection is too weak to comply with Swedish law. Cerner has proposed sending patient data to 12 of its business units across nine countries, but the region wants processing of its most sensitive patient information to be performed within Sweden. The impact of the EU’s more stringent approach to privacy is creating interesting challenges for vendors based in the US, where privacy requirements are often contained in negotiated contractual terms rather than in enforced laws. Some of Sweden’s requirements:

  • Systems must have adequate access control to ensure that only people who need to see a patient’s information for their jobs can do so.
  • The patient has a right to block data from the view of their own provider and from other EHR-using providers.
  • The patient has a right to see their information.
  • The provider must provide a patient with a list of healthcare entities that have accessed their data so they can determine whether it was justified.
  • A provider can see the information of a patient of another provider only if they also have a current patient relationship, if the patient has consented, and if the person accessing the information checks a box to indicate that they understand before proceeding.

From Insider: “Re: KLAS. Changing vendor scores right as we approach final submissions for Best in KLAS. Scores from the question added earlier this year, ‘Does this vendor consistently exceed your expectations?’ will be eliminated from the scoring algorithm, effective today. It will be restored to the algorithm on July 1, 2020 to give all clients who were interviewed within an 18-month window the chance to answer this question before it affects a vendor’s KLAS scores.” Seems reasonable, although you wonder why KLAS walked its decision back and why it didn’t anticipate problems. Timing might suggest that some lesser-performing vendors complained once they saw how their scores would be affected.


HIStalk Announcements and Requests

In the spirit of Thanksgiving, here’s an anonymized, excerpted version of an email that a reader  — a former big-time CIO and industry long-timer whose name you would recognize unless you’ve been living under a rock — sent to Lorre this week, which touched her (and then me) deeply in putting life into perspective:

I want to say thank you to Mr. H and associates for this really valuable blog. I became disabled a while ago from a head injury that forced me to retire from healthcare, with a long road to recovery. Your blog helps, as it challenges me to remember stuff (my memory is episodic) and to get up to speed in the never-ending drama we call healthcare here in the US.

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I’m distracted today by the sharply divisive debate that has been raised by the AP Stylebook’s Twitter – do you “pre-heat” the oven or do you just “heat” it? I would argue that you do neither and rather “set” the oven and wait until it reaches temperature (since you’re heating the food, not the oven), but given the choices, I’m going with B since I also don’t like the terms pre-authorize, pre-arrange, pre-board, pre-medicate, pre-order, pre-pay, pre-wash, and pre-record for the same reason — “pre” doesn’t modify the word, but rather is a lazy shortcut to what should be a procedural instruction (heat oven to 350 degrees, then put in the turkey). I dislike “pre-existing conditions,” but I don’t have a better replacement unless it would be “pre-coverage conditions,” and but even then you might have had coverage, just with a different insurer.


Webinars

December 10 (Tuesday) 1:00 ET. “Move on from the age of the inefficient EHR.” Sponsor: Intelligent Medical Objects. Presenters: Jim Thompson, MD, physician informaticist, IMO; Obaid Baig, product manager, IMO. The EHR seems more like transactional workflow system rather than an intuitive clinical documentation tool, creating the possibility of loss of data consistency and the need for manual workarounds. The presenters will describe how to turn an EHR into a powerful tool that can help improve workflows and documentation so that clinicians can focus on care, not coding and reimbursement.

Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Government and Politics

Politico calls out the well-funded effort by healthcare’s profiteers to shut down anything that looks like socialized medicine (such as Medicare for All), including the American Hospital Association, America’s Health Insurance Plans, individual insurance companies, biotech companies, Chambers of Commerce, health systems, and trade associations. Their talking points, which omit the real motivation of preserving the patient-funded golden goose, are that Americans would lose choice (like they have a lot of choice anyway), everybody would be forced into a “one size fits all” system, and Americans would pay more and wait longer for worse care. The AMA has pulled out of the group, with the remaining members publicly accusing it of caving in to the liberal left. Healthcare companies spent $568 million lobbying the 535 members of Congress in 2018 alone, more than any other industry, and their bucks seem to be working since nobody is doing much to upend the healthcare cash register.


Other

Google Health posts a video describing the EHR search project it is doing with Ascension. It contains a mock-up of the combined information dashboard, which to my eyes looks little different from the standard tools provided by Epic, Cerner, and other EHR vendors, with the biggest differentiator that it combines information from multiple EHRs for those ever-expanding big health systems that are in perpetual replacement mode. The search function could be useful depending on how much intelligence powers it beyond simple text string scanning. The doctor who’s narrating is Alvin Rajkomar, MD, who is coming up on three years with Google, but also continuing his practice as a UCSF hospital medicine attending.

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CNBC reports that medical students and residents are teaching themselves to perform surgical procedures by watching unvetted YouTube videos. The article cites a study of 68,000 videos that show how to perform a fracture procedure, of which only 16 met even the most barebones criteria, such as identifying the on-camera person who was doing the teaching. UCSF’s Atul Butte made a good point on Twitter about potential oversight, however – textbooks aren’t regulated and at some point you have to trust your doctor for choosing appropriate learning material. After all, the surgeon who would have taught them in person could have been incompetent.

A study finds that US life expectancy, unlike that of most wealthy countries, has declined for three straight years after 60 years of increasing longevity, with key contributors being midlife drug overdoses, suicides, and organ system diseases. I suppose the glass half full side of the argument is that this is an indictment of our society, not our hospitals, and even the authors dismiss our dysfunctional health system as a cause and instead point to lack of social and support systems, poor education, and lack of living wages, all of which lead to “deaths of despair.” The largest number of excess deaths occurred in Pennsylvania, Ohio, Kentucky, Indiana, and Florida.

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Medical University of South Carolina says drug purchasing software that was developed by one of its IT network engineers is saving it millions by looking for the best price in the supply chain at any given moment. It has spun the company off as AscendRx, with the former IT employee Jonathan Yantis serving as CEO. I would tell you more, but the company’s Squarespace website returns a “Website Expired” error.

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Geisinger says its researchers can predict arrhythmia and death using AI analysis of ECG data, but our HIStalk AI expert Alexander Scarlat, MD provides a critique, which should always be employed before believing any attention-seeking AI headline since it’s never as straightforward as it sounds:

  • Mortality is by definition an imbalanced dataset (since more people lived than died) so area under the curve is not an appropriate metric. F1 score would be better suited.
  • It isn’t surprising that AI performed better in analyzing raw ECG data than humans. It’s like showing a cardiologist the actual ECG rather than a summary of its features.
  • Someone could die with a normal ECG for two reasons – either their cause of death wasn’t cardiac related or the model could be predicting on perhaps a 0.51 chance of being abnormal, barely over the default 0.5 cutting point.
  • The neural network should have been queried on the reasons and features it made it decide on the abnormal ECG.

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This is the best “excessive hospital charges” story ever. A three-year-old girl sticks a shoe from her Polly Pocket doll in each nostril. Her mother was able to remove one of them with tweezers, but the urgent care was unable to extract the second one and advised taking her to a Dignity Health hospital’s ED. Mom says the doctor there removed it within one second, having had ample practice with slippery Tic Tacs. She was billed $2,659 ($1,732 for the hospital, $927 for the doctor) and her family is stuck paying the full amount because of her high-deductible insurance plan. The hospital declined to provide the methodology behind its price, but scolded Mom in an emailed response to a media inquiry that she should have understood her plan better and gone to urgent care. Medicare would have paid the hospital $101, which you could argue is either a defense or indictment of why they charged her more. By the way, Dignity’s CEO made $10.3 million last year, the CIO made $2.3 million, and 27 executives exceeded $1 million in compensation.


Sponsor Updates

  • HIMSS names Audacious Inquiry Director Lindsey Ferriss a 2019 Extraordinary Women in Health IT awardee.
  • Datica and InterSystems will exhibit at AWS re:Invent December 2-5 in Las Vegas.
  • Spok earns top secure messaging and clinical communications honors in Black Book’s annual cybersecurity study.
  • ISalus Healthcare integrates prescription price transparency and electronic prior authorization solutions from CoverMyMeds with its EHR and practice management software.
  • Elsevier Clinical Solutions, Hyland, and InterSystems will exhibit at RSNA December 1-5 in Chicago.

Blog Posts


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Contacts

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


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Monday Morning Update 11/25/19

November 24, 2019 News 6 Comments

Top News

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Wisconsin-based nursing home IT vendor Virtual Care Provider, Inc. is hit by ransomware, taking down electronic patient records, Internet service, email, billing, and phone systems across 80,000 PCs and servers running hundreds of nursing homes in 45 states.

The hacker is demanding $14 million to provide the encryption key, which the company says it can’t afford.

VCPI says some of its client facilities may be forced to shut down due to their inability to order drugs, generate bills, and pay employees.

Ironically, VCPI sells IT security and HIPAA risk analysis services.


HIStalk Announcements and Requests

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Over 80% of poll respondents think that Ascension’s data analysis agreement with Google is legal, but two-thirds also think the relationship is unethical.

New poll to your right or here: Have you ever been laid off or otherwise lost a job other than for performance issues? Click the poll’s Comments link after voting to share your experience.

I regularly worry that my 2.5-year-old, inexpensive Acer laptop will fail and leave me without a backup other than my Chromebook, which works great but doesn’t run some niche Windows apps that I need. I’ve been watching for a deal on something similar and saw a pre-Black Friday offer on an HP Pavilion 15z with AMD Ryzen 5, 16 GB of memory, 256 GB SSD storage, and a 15.6” touch display. I wanted 16 GB (which isn’t as common or cheap as it was a couple of years ago for some reason) and SSD since I’ve become spoiled by both, so my $480 order is in. I’ll report back after it arrives early next month.


Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

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Google’s venture fund provides $4 million in seed funding to Rad AI, a radiology workflow optimization software company that was started in 2018 by a radiologist who entered medical school at 16 and now practices in North Carolina.


Sales

  • SCL Health will offer virtual services using Bright.md’s SmartExam asynchronous virtual care platform.
  • Steward Health Care chooses Health Catalyst’s Data Operating System and Rapid Response Analytics. 
  • Humber River Hospital chooses CloudWave to support Meditech and its infrastructure.

People

Cooper University Health Care promotes interim CIO Dustin Hufford, MBA to SVP/CIO


Government and Politics

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The VA says that it hasn’t worked out jurisdictional issues with the Department of Defense over patient information that will be stored in their respective Cerner systems, admitting that nobody really thought about data sharing issues when the projects were conceived. Existing laws may require veterans to make separate requests to the VA and DoD to obtain their health records despite the goal of a single record for each patient. The VA also acknowledges that its March go-live at Mann-Grandstaff VA Medical Center (WA) will involve a limited implementation that will require employees to toggle between Cerner and VistA. 


Privacy and Security

Medical researchers observe that European Union’s General Data Protection Regulation has caused problems for their studies that cross national borders outside the EU. NIH Director Francis Collins says his study of diabetics in Finland ground to a halt when NIH could not meet the privacy requirements of its national equivalent in Finland. Neither the US nor Canada are recognized by the European Union as providing adequate data protection, so researchers must sign contracts to accept Europe-based audits or to cede legal jurisdiction to the originating country’s courts. GDPR isn’t an issue when patient information is anonymized, but countries haven’t agreed on how that anonymization can be performed and some studies include sample data that cannot be stripped of identifying characteristics.


Other

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Bloomberg notes that Inovalon Chairman and CEO Keith Dunleavy, MD is a billionaire once again following a 60% run-up in the analytics platform vendor’s stock price in the past year. Timing is everything, though — the company went public in early 2015 at $27 per share and is down 36% since, while the Nasdaq rose 74% in the same period.

Allscripts defends its work on an $18 million software implementation in the Bahamas that has resulted in no applications live after three years and $8 million in payments. The company responded to a newspaper’s request for comment that it is in full compliance with the contract and is waiting on approval from the government, which says it is looking for a replacement system. Allscripts misidentified its client in the response as the “Public Housing Authority” rather than the “Public Hospitals Authority.”

Medical residents in South Korea complain that while their weekly work hours are newly capped at 80, they are seeing more patients without much help from specialists in learning new procedures. They also claim that hospitals shut off after-hours EHR access to make it look like they are complying with the hours cap, but give them other work to perform instead.

In Australia, a government review of misused private data looks at Queensland Health’s Cerner IEMR, which allows employees and staff at any of its 14 hospitals to view the records of all patients. The government worries that the hospitals don’t fully understand how to configure the system’s privacy controls, such as flagging high-profile records to warn users that any inappropriate access will be investigated. However, one hospital’s HR director says its P2Sentinel access monitoring system issues reports that aren’t that useful, leading to a huge backlog of potential inappropriate viewing incidents that the hospital doesn’t have time to investigate. 

Two Colorado state agencies announce that a bug in their tracking system allowed several batches of contaminated medical and recreational marijuana to be sold, triggering a recall of such products as Ghost Cake Killah and Grape Ape.


Sponsor Updates

  • Chilmark Research highlights Bright.md in its new report, “Primary Care for the 21st Century: Technology-enabled and On Demand.”
  • Greenway Health’s Intergy EHR receives five industry accolades in 2019.
  • Nextech Systems gives its customers access to Relatient’s patient self-scheduling, automated waitlist, and patient intake capabilities.
  • The Chartis Group announces the winners of The Chartis Center for Rural Health 2019 Performance Leadership Awards.
  • Hyland Healthcare’s Advisory Councils share insight into top health IT trends including AI, cloud, and optimization.
  • LiveProcess will exhibit at the National Healthcare Coalition Preparedness Conference December 2-4 in Houston.
  • Gartner recognizes NextGate as a ‘Notable Next-Generation EMPI Vendor.’
  • Nordic staff volunteer at The River Food Pantry and donate gifts for 65 local children.
  • KLAS Research recognizes PatientPing as a high-performing, emerging healthcare IT company.
  • SailPoint will exhibit at AWS re:Invent December 2-6 in Las Vegas.
  • Visage Imaging will exhibit at RSNA December 1-5 in Chicago.
  • Wolters Kluwer Health publishes a new report, “Mending Healthcare in America 2020: Consumers & Cost.”

Blog Posts


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Contacts

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


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News 11/22/19

November 21, 2019 News 7 Comments

Top News

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The American Medical Association adopts a policy that calls for increased state and local funding to modernize public health IT systems. AMA also wants provider EHRs to be capable of automatically sending reportable conditions to public health agencies.

AMA is also encouraging state governments to engage state and national medical specialty societies and public health agencies when considering new mandatory disease reporting requirements.


Reader Comments

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From Fatted Calf: “Re: layoffs. Your list of the steps people go through after being laid off should have included advice.” That wasn’t the reader’s question that I was answering via my reality check, but here you go:

  1. Don’t be ashamed at being laid off and don’t try to hide the fact that you are involuntarily seeking employment. Layoffs are a failure of executives and only they should feel shame. Develop a one-sentence description of why you no longer work there (general cutbacks, product sunsetted or sold, etc.) and practice succinctly answering the question, “Why did you leave?” because it will be asked often.
  2. Set your alarm to get up early every day, dress in real clothes, keep a calendar, make calls, exercise, and treat every day like a workday whose goal is to find a new job. Lack of time is no longer an excuse.
  3. Spend a day debriefing yourself in writing. What did you like and dislike about your job and employer? What did you and they do wrong? What good and bad job decisions did you make?The only point of this is to get that crap out of your head so you can move on to more productive pursuits than moping around and second-guessing. It’s amazing sometimes how committing something to writing frees up brain storage and mental CPU cycles.
  4. Don’t badmouth your previous employer. You stayed in your rut until the choice wasn’t yours, so there’s no virtue in complaining only afterward how bad it was.
  5. Take several days to plan your ideal career and who might hire you to practice it. You have the opportunity, no matter how unwelcome, to change your preconceived notions about yourself and the niche into which your former employer placed you.
  6. Polish your LinkedIn, adding your job’s end date, changing your title for “seeking a new opportunity,” and make sure your “About” section is punchy and reflects your abilities. Please don’t use stuffy third-party wording, aka the Godcam view of yourself, such as “Seasoned health system manager” – make it personal, direct, and memorable (and include a decent headshot that isn’t cropped from a phone photo from your last beach trip). Then create one-page, one-sided resume that gets to the point with the most important information listed first. Hiring managers don’t care too much about your personal statements and they already know that you’ll provide references on request. Unless you’re applying for a low-level job, you won’t get hired via an application or resume anyway, with incompetent corporate HR departments being one big reason, so make calls and get out of the house instead of staring at your laptop trying to use IT skills alone to get hired.
  7. Attend a local conference such as a HIMSS chapter if you aren’t willing to relocate or a national conference if you are. Those can be target-rich environments for job searches, or at worst, for learning about how the world revolves outside your former company. I also got a couple of good jobs working with a recruiter who I vetted pretty carefully, so while not everyone’s experience is positive, it worked for me.
  8. Decide if you are willing to move under any circumstances. If not, then your job search and networking activities will look different than if you’re willing to relocate.
  9. Increase your visibility with LinkedIn articles, tweets, or anything else that could catch a potential employer’s eye, assuming that your insight and writing ability match your job expectations.
  10. Reach out to everybody you know via email or LinkedIn messaging and keep a worksheet of who you contacted and when. Use the six degrees of separation power of LinkedIn to figure out who might hire you and the email searching ability of Google to get that person’s work email address so you can introduce yourself. You only need to hit one home run to forget the swings and misses.

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From RansomwareHitsHome: “Re: Casamba LLC. A ransomware attacked has forced some agencies that use its software back to paper records and forms.” The California-based post-acute care EHR vendor hasn’t publicly acknowledged the attack, but this update was provided by one of its customers.

From FlyOnTheWall: “Re: Allscripts layoffs. The highest number I heard was greater than 350, but I’ll stand on my 125-150 let go until I find out more. They are in publicity damage control.” Unverified. I checked WARN notices for Illinois and Pennsylvania for the last several months and didn’t see any Allscripts entries, but WARN applies only to office closures and mass layoffs since they’re intended for giving the state rather than the employees a heads-up.


HIStalk Announcements and Requests

A reader approves of my activation of two-factor authentication to secure my Gmail accounts, but warns that the SMS-based verification option is not secure. He has first-hand experience – he lost $4,000 within minutes of someone using a SIM port hack to steal his cell phone number, which then allowed the hacker to reset the passwords for Gmail, banking, Twitter, etc. I took his advice and switched the authentication method to Google Authenticator, a free app that – like those flashing hardware dongles in the old days – generates authentication codes every few seconds. It’s like SMS messaging, except you open the phone or tablet app to get the current code and the mobile device doesn’t even need to be online at the time (unlike the SMS option). I had a few false starts in trying to figure out how to link the app to multiple email accounts from multiple mobile devices, but I finally figured it out by Googling. Another option is Google Prompt, which allows you to simply touch a phone pop-up acknowledging that it’s really you logging in on the other device, but it only works when the Gmail app is open and I don’t use it.


Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.


People

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Jon McAnnis (Providence Health Plans) joins Zoom+Care as CIO.

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Regenstrief Institute promotes Indiana University School of Medicine professor Shaun Grannis, MD to VP of data and analytics.

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Nick White (Deloitte) joins Orbita as EVP of patient care solutions.

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OurHealth promotes Brian Norris, RN, MBA to EVP of population health.


Announcements and Implementations

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Orbita announces GA of OrbitaAssist, a bedside virtual health assistant designed to complement nurse call systems. Back-end software routes patient requests to the appropriate member of the care team, while front-end AI assures the patient their request is being fulfilled.

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Datica will debut its new cloud compliance technology, including end-to-end cloud managed services, in early December.

Imprivata announces OneSign 7.0, which adds single sign-on for web based applications.


Government and Politics

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Kaiser Health News publishes a retrospective look at stalled federal efforts to ensure the safety of EHRs. Ideas have included developing a database to track reports of deaths and injuries related to health IT and establishing an EHR safety center, neither of which have come to fruition due to funding and oversight issues. The issue gets even thornier thanks to a 21st Century Cures Act clause that prohibits the FDA from getting involved. Medical informaticist Dean Sittig, PhD says, “There wasn’t a lot of interest [at ONC] in talking about things that could go wrong. They gave out $36 billion. It’s hard for them to say EHRs aren’t safe.”

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The Mann-Grandstaff VA Medical Center in Spokane, WA is hiring 108 more employees to cover anticipated productivity losses during its Cerner go-live on March 28. VA officials insist they are on track to meet that deadline, but will have no qualms about pushing it back should patient safety become an issue.


Privacy and Security

Google Health lead David Feinberg, MD attempts to clarify the company’s HIPAA-compliant work with Ascension, pointing out that the health system is piloting an interface concept he first mentioned at the HLTH Conference last month.

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In the wake of Google’s Fitbit acquisition and health data trust debacle with Ascension, Wired offers step-by-step instructions on how to manage the privacy settings of popular health apps like Fitbit, Apple Health, and Google Fit. Some consumers have become so wary of Google and its plans for their health data that they have abandoned their Fitbits. One concerned user explained, “I’m not only afraid of what they can do with the data currently, but what they can do with it once their AI advances in 10 or 20 years.”


Other

A hospital in Bangalore, India will use its patient data to map areas where pothole-related injuries send up to four cyclists each day to its ED.

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Kaiser Permanente will name its new medical school after former CEO Bernard Tyson, who passed away earlier this month. The school will open next summer in Pasadena, CA and will offer free tuition to its first five graduating classes.

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A former marketing SVP of Novant Health sues the health system for reverse discrimination, claiming that as a white male, he was fired as part of a corporate diversity push and was replaced with two minority hires. David Duvall, MBA, MPH says that at least five other white male executives, including the CIO, were terminated and replaced almost immediately with “either a racial minority and/or female.” He was let go right before his five-year anniversary, when his termination would have entitled him to 18 months of base pay, 1.5 times his previous bonus, $200,000 in retirement benefits, and company-paid health insurance.

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Digital health investor, consultant, and author Terri Mead critiques her second annual visit as a participant in Verily’s Project Baseline Health, a four-year study announced in 2017 that aims to create a database of the sequenced genomes of 10,000 volunteers. Study participants like Mead also agree to wear activity trackers that share their sleep patterns, activity, heart rate, and other health metrics with Verily researchers. Her criticisms:

  • The “archaic” use of Google Forms to capture patient intake data.
  • The risk of inconsistent and unreliable data thanks to manual data entry that does not use drop-downs that are tied to medical terminology.
  • The study expressed no interest in her “female parts,” which left her assuming that they consider females “a standard deviation away from males.”
  • Lack of follow up on patient adherence to use of wearables, some of which she stopped using months before.
  • Abandonment of lung/breathing tests due to budget issues.

Sponsor Updates

  • AMIA inducts Intelligent Medical Objects VP of Customer Experience Steven Rube, MD and VP of Clinical Informatics Eric Rose, MD into its 2020 class of fellows.
  • Optimum Healthcare IT publishes a new case study, “Cerner Millenium Implementation at Ellis Medicine.”
  • The Chartis Group publishes a new paper, “Being a Digital Health System: It’s No Longer a Question of If or When.”
  • Pivot Point Consulting releases the first episode of its new Get to the Point podcast, “Flexibility vs. Interoperability. Can Clinical Documentation Do Both?”
  • Imprivata updates its OneSign authentication and access software to offer users seamless cloud-based access from any device.

Blog Posts


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Contacts

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


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News 11/20/19

November 19, 2019 News 9 Comments

Top News

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The American Medical Association adopts a policy that calls for EHRs to be able to collect the preferred name and clinically relevant, sex-specific anatomy of transgender patients.

AMA’s policy aligns with recommendations that medical documentation contain the patient’s preferred name, gender identity, pronoun preference, and history of medical transition history as well as current anatomy.


Reader Comments

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From Creative Juice: “Re: being laid off. I’m thinking about suing. Advice?” Don’t bother. Allow me to list the steps you’ll go through after being laid off, ending with the distant speck of light at the end of the unemployment tunnel:

  1. You will experience the ultimate humiliation in coming home early to notify your family that you are no longer employed, threatening your identity in ways you could not have imagined. 
  2. For a couple of days after being marched out, you’ll embrace false hope that your former employer will call to explain it was all a big mistake or that they want you to come back in a different role.
  3. You will expect an uprising from customers that will never happen, or expect those customers with whom you worked closely to call you cold with job offers, which will also never happen.
  4. You will commiserate with former co-workers who also got the axe, convening depressing lunches and not-so-happy hours where the conversation gets louder and faster as you try to convince each other that the company or your former boss will fail without you, which they won’t. 
  5. Most of your “work friends” will disappear from your life permanently because (a) they weren’t really your friends, they just shared employer space with you, and (b) nobody wants to hang around former colleagues who were marched out and who are now seeking comforting scuttlebutt about how bad things are at work.
  6. You will consider legal action, which is pointless. Even if you are legally right (and you aren’t), it would take years to arrive at a resolution that will not include hiring you back. Not to mention that employment lawyers want their money upfront (they know you won’t win) and it doesn’t really matter anyway because you signed away your right to sue as a condition of receiving severance.
  7. You will belatedly update your resume and think about overdue networking as the reality sets in that your income stream is ending. The grim reality of signing up for unemployment will cause endless anguish because you don’t see yourself as one of those pathetic people.
  8. Initially you will apply for no positions because of the indignity of the hiring process, then later you will apply for every job in sight because of the indignity of being unemployed.
  9. You will struggle with the idea that many of the seemingly good jobs are located in far-away areas where you don’t want to live, requiring uprooting the family with new schools for the kids and a new job for your working spouse (if you have either). You will also rage at the Catch-22 fact that you might get more money later if you move, but you need money now to move.
  10. You will eventually find some kind of job, either (a) a short-term one or even a contracting gig that will help pay some bills while you keep looking, or (b) one that is better than your previous one. Then you will rejoice that your incompetent former employer kicked you out of their sorry nest. I’m not one to offer unjustified cheerleading – if you are competent and willing to work, your lot will improve, and if not, then I don’t blame your previous employer for booting you.

From Oingo Bongo: “Re: Allscripts. Heard from a contact that there’s been another round of Paragon staff. Got any info on that?” The company laid people off last week, and while I haven’t heard anything specifically regarding Paragon, I can’t imagine that’s a growth area. Also relevantly not growing is MDRX share price, down 12% in the past year vs. the Nasdaq’s 22% gain.


HIStalk Announcements and Requests

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Reader AC made a great suggestion to turn on two-factor authentication for Gmail and other important services that don’t enable it by default, following my story about a hospital employee stealing co-worker logins using a keylogger program. I did it and it was painless. Gmail prompted me to enter a one-time verification code that it sent via SMS message, which it does each time I log in from a new device. Once I did that, it’s business as usual with no further verification unless I (or someone else) logs in from a different device. That means a hacker who has obtained my login credentials still can’t hijack my email account. An extra feature – you can ask Gmail to generate a bank of one-time codes to use when you won’t have your phone. Thanks for that advice. I can’t even imagine the headache and security exposure that would be involved with someone gaining full access to my email account, including all the personal and confidential information it contains.

Listening: the first, eponymous album by The Doors from 1967’s Summer of Love. “The Crystal Ship” alone is worth the ride. Mr. Mojo Risin’ had just turned 23 when the album came out, the beginning of his four-year term as the country’s most dangerous and reckless poet, musician, and performance artist until the unfortunate intersection of drugs and bathwater sent him to “The End” (as it did Whitney Houston and Dolores O’Riordan of the Cranberries). I’m also enjoying new from singer-songwriter JP Saxe, who I think is probably going to be pretty big.


Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Sales

  • Mary Free Bed Rehabilitation Hospital (MI) will implement Epic in an $8 million, 10-year Community Connect agreement with Covenant HealthCare.
  • Cooper University Health Care chooses Phynd for provider management.
  • Novant Health will implement KenSci’s AI platform to match workforce demand to capacity and to identify patients who are at risk for longer stays or readmission.
  • Visiting Nurse Service of New York selects Netsmart CareManager for care coordination, data reporting, and analytics support for its population health management programs.

People

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Ryan Miller (Anthem) joins Change Healthcare as SVP of corporate development.

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Medical practice software and services vendor IKS Health hires Kelly Reed, DO (The Iowa Clinic) as SVP of clinical services and outcomes.


Announcements and Implementations

Collective Medical will add HIE CCD data to its care team platform, connected by Kno2.

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Virtusa will add EHR data to its VLife life sciences platform from the InterSystems IRIS for Health interoperability solution .


Privacy and Security

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National Veterinary Associates, which owns 700 veterinary hospitals and boarding facilities, is struggling to recover from an October 27 ransomware attack that affected 400 of its locations. The company declined to answer questions about the malware or whether it paid a ransom.


Other

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American healthcare in a nutshell: the manufacturers of heart stents assure their investors that a widely praised study that proved the less-than-expected value of such procedures won’t hurt their business much. Translation: hospitals, doctors, and device manufacturers aren’t about to let medical evidence get in the way of their profits, meaning your odds of being stented won’t change just because we now know that it doesn’t work any better than a prescription. Meanwhile, a cardiologist whose research helped develop a new drug for a rare type of heart failure criticizes the manufacturer for setting the price of the capsule at $225,000 per year versus the estimated cost-effective price of $17,000.

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A Bahamas senator says he “makes no apologies” for his involvement with the 2016 signing of an $18 million contract with Allscripts and Infor that was supposed to transform healthcare there, even through the Public Hospital Authority warned Allscripts in late 2018 that it wasn’t happy that the company hadn’t installed any software anywhere despite having been paid $7 million. The local newspaper speculates that the government will give Allscripts a 60-day cure notice, then terminate the contract with expectation of a full refund. The government blames Allscripts in “a glaring lack of oversight” for “a staggering increase in implementation costs” beyond agreed-on amounts, with consulting firm Avaap billing the government $1.5 million. The paper also notes that the Allscripts proposal was stamped as received 11 days after the tender’s closing, which had already been extended by 14 days. The country’s minister of health declares the project “a bust.”

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A free clinic in Syracuse, NY closes after 12 years when the part-time founding doctor found that she was spending more time maintaining its EHR than seeing patients.

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Johns Hopkins Bloomberg School of Public Health profiles Assistant Professor Smisha Agarwal, MPH, MBA, PhD in its magazine, which describes her as “the school’s first faculty for digital health” in a sharp contrast between investor-crazed US digital health and public-focused health projects overseas. Snips:

  • She says we don’t know how to integrate digital tools with health system, we don’t know if they are cost effective, and we need to be careful not to amplify existing healthcare inequities, such as improving health only in urban areas or for those people who own a mobile phone.
  • She hopes mobile clinical decision support tools can help shift caregivers away from triaging low-severity illnesses and providing preventive services, data from which could then be used to apply machine learning algorithms to predict poor outcomes for intervention.
  • She says that a downside of digital health is opportunity cost, where resources are moved from established programs to experimental digital programs.
  • She worries about gender inequity in countries where the men are the primary phone owners and the effect on needed pregnancy and newborn care.
  • She sees the biggest transformational opportunities for digital health being putting real-time data in front of caregivers, using analytics to target high-risk patients, assisting providers who have limited training with education or remote assistance, and counting births and newborn deaths.

Sponsor Updates

  • Avaya announces the availability of Google Cloud contact center AI integration with its IX Contact Center solutions.
  • Netsmart takes the top spot for the fifth year in a row for customer satisfaction in Black Book Market Research’s annual look at the post-acute health technology market.
  • Dimensional Insight will exhibit at the New England HIMSS Maine Conference November 21 in Portland.
  • EClinicalWorks posts a podcast titled “Telluride Medical Center: On the Primary Care Frontier.”
  • Collective Medical partners with Kno2 to add enhanced clinical data capabilities including continuity of care documents to its clinical insights and analytics software for HIEs.
  • Virtusa enhances the health data integration capabilities of its VLife life sciences platform with the integration of the InterSystems IRIS for Health Data technology.
  • Woman’s Hospital (LA) will expand its use of Spok solutions.
  • Vocera will resell Spectralink Versity smartphones, which has been certified for use with its clinical communication and workflow system.
  • Optimum Healthcare IT completes Epic go-lives at several hospitals under Deaconess Health System’s CareConnect program.
  • A five-year study finds that a health literacy incentive program using health education content from Healthwise lowered healthcare costs.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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Monday Morning Update 11/18/19

November 17, 2019 News 4 Comments

Top News

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HHS, as promised, expands its previous plan to require hospitals to publicly post all of their payer-negotiated charges by also requiring insurers to do the same.

Hospitals would also be required to post the cash payment they are willing to accept for 300 common, shoppable services.

The rule will take effect on January 1, 2021 in the imaginary world where no lawyers live (the American Hospital Association, Association of American Medical Colleges. Children’s Hospital Association, and Federation of American Hospitals immediately said they’re suing for HHS overstepping its bounds).

President Trump said in announcing his executive order:

First, we are finalizing a rule that will compel hospitals to publish prices publicly online for everyone to see and to compare. So you’re able to go online and compare all of the hospitals and the doctors and the prices, and, I assume, get résumés on doctors and see who you like. And the good doctors — like, I assume these two guys are fantastic doctors, otherwise you wouldn’t be here. (Laughter.) And the bad doctors, I guess they have to go and hide someplace. I don’t know. Maybe they don’t do so well, I don’t know. But if they’re not good, we — we are more interested in the good ones. It’s called rewarding talent.

Second, we’re putting forward a proposed rule to require health insurance providers to disclose their pricing information to consumers. We’re giving American families control of their healthcare decisions. And the freedom to choose that care is right before them on the Internet and elsewhere, but on the Internet. Very, very open. Very transparent. That’s why it’s called transparency.


Reader Comments

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From Who Diss?: “Re: Who’s Who. This CIO was recognized as a ‘Top Medical Professional’ by a seedy-looking organization’s press release.” A variety of “who’s who” scammers contact people cold, preying on their vanity by advising them that they have been “chosen” by their admiring peers or the company’s editor to be included as a member in a paid online listing. After that, they are hit with the upsell to buy lifetime memberships or vanity crap like wall plaques and hardcopy books. You CIOs, pharmacists, doctors, and nurses who I see listed on this particular one’s site got taken, I’m sorry to tell you. Please don’t list this laughable accomplishment on your resume, which in some LinkedIn examples shares space with bogus educational credentials. Above is the company’s luxurious office suite in Valley Stream, NY, conveniently located above the dumpster in which visitors can pitch their “award” and possibly their careers right out the window.

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From Gobsmacked Compliance Professional: “Re: SCL Health and Providence. I was having dinner adjacent to a restaurant’s ‘private’ dining room and was gobsmacked to overhear a detailed discussion about their plan to merge, including proposed timeline, financials, etc. Annual reports are due in December and will be interesting reading.” Unverified. SCL owns eight hospitals in Colorado, Kansas, and Montana that generate $2.5 billion in annual revenue. Providence operates 51 hospitals with annual revenue in the $23 billion range. Maybe this alleged privacy slip is yet another example of hospital people loudly saying things they shouldn’t within earshot of others.

From Register Ringing: “Re: HIMSS20. Look at this page of well over 1,000 things they’re trying to sell to exhibitors.” Vendors can whip out their checkbook to buy nearly every square inch of the convention center or to have HIMSS push their sales message to attendees, including:

  • Sponsor pre- or post-conference supplements to “own the conversation” ($20,000).
  • Pay HIMSSTV to record a panel discussion in their booth ($20,000).
  • Get the impartial, hard-hitting journalists at Healthcare IT News to tweet out links to “one of your thought leadership content pieces” ($20,000, or $22,500 if you want them to just write the piece themselves).

HIStalk Announcements and Requests

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Few poll respondents think the Allscripts-Northwell collaboration will result in a commercially successful EHR any time soon.

New poll to your right or here: How would you characterize Ascension’s data analysis agreement with Google? Click the poll’s Comments link after voting to explain.


Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

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Brighton Park Capital acquires a majority stake in patient engagement platform vendor Relatient and appoints former Siemens USA President Eric Spiegel as the company’s board chair.


Sales

  • Amedisys will deploy NVoq’s cloud-based speech recognition solutions for dictation and automation.
  • Thomas Health (WV) will add Meditech’s web-based Ambulatory solution to its Expanse system, implemented by CereCore.
  • San Gorgonio Memorial Hospital chooses the Azure-hosted Sunrise Community Care from Allscripts. Googling suggests that they are replacing Allscripts Paragon.
  • Beebe Healthcare (DE) will improve workflow efficiency and clinician communication using TransformativeMed’s EHR-embedded work management and notification modules to eliminate printed patient lists.

People

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CereCore hires Joe Wurzer (Leidos Health) as RVP of sales and business development.


Privacy and Security

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The FBI arrests a former IT employee of an unnamed New York City hospital, charging him with installing a keylogger program on dozens of employee PCs to capture their email login credentials so he could steal their photos and tax records. I was thinking that this sort of information shouldn’t have been stored on a work PC in the first place, but then realized that he probably grabbed their logins to Gmail or other web-based personal email services.


Other

The Washington Post covers “rural America’s busiest emergency room,” Avera Health’s telemedicine center in South Dakota that provides remote ED service for 15,000 emergencies each year covering 179 hospitals in 30 states “where the choice is increasingly to have a doctor on screen or no doctor at all.” Rural ED visits have increased 60% in the past 10 years, but hospitals are closing, doctors aren’t willing to move to small towns, and standalone EDs are going broke. One small hospital signed up at a cost of $70,000 per year after it received four critical automobile accident victims with just an single RN working, with no doctors available within an hour’s drive. Fun fact – the virtual service’s doctors wear scrubs and lab coats to their suburban office park location so they will look like real doctors to their TV patients. The virtual ED clinicians must work patiently with local nurses who may have no experience with intubating patients or who need help running a code blue. Avera ECare’s telemedicine network also offers services for ICU, school health, pharmacy, clinics, behavioral health, correctional health, and hospitalist coverage.

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The Pittsfield, MA paper covers the $35 million implementation of Meditech Expanse by Berkshire Health Systems. The article focuses on the hospital’s problems with the Allscripts FollowMyHealth patient portal – the inability to share data, uncertainty over how the company might use its data for marketing, low usage in the 30-40% range, and patients who either can’t sign on to FollowMyHealth or who sign up directly with the service instead of through the hospital-provided link. The health system is a longstanding Meditech customer for inpatient and is apparently replacing Allscripts ambulatory with Meditech.

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The Wall Street Journal profiles the technology underpinnings of the new $2.1 billion, 368-bed Stanford Hospital that opened this weekend. It was originally scheduled to be open in early 2018, but was delayed because Apple’s spaceship headquarters project sucked up all the Silicon Valley steelworkers. I was curious about Stanford’s financials, which show $4 billion in annual revenue, a profit of nearly $450 million, several executives in the $1-2 million range, and not-unreasonable IT compensation (the CMIO was paid $770K, while the CIO made $500K). Hospital features include:

  • Bedside keypads that allow patients to choose entertainment and control temperature, lighting, and window blinds.
  • Swisslog robotic dispensing for pharmacy and medication delivery by robots.
  • A fleet of automated guided vehicles for delivering laundry and collecting trash.
  • Tracking of staff an inventory in real time.
  • Remote patient monitoring.

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CIOs are expanding their use of “low-code” drag-and-drop automation tools such as Microsoft PowerApps to quickly create applications that automate business processes, which Gartner says will make up 65% of application development in the next five years. St. Luke’s University Health Network (PA) VP/CIO Chad Brisendine says his team has built 20 applications – none of which took more than 20 hours to create – to extract information from hospital systems. A non-programmer needed just eight hours to develop an app that extracts information from its Workday HR system to issue CME reminders to doctors. A Microsoft case study describes how Northwell Health used Dynamics 365 (and its Healthcare Accelerator) and PowerApps to develop a daily rounding app. I admit that the geek in me is aroused.

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Several readers forwarded the full text of a just-published article that tried to correlate physician-perceived EHR usability with burnout, with the big conclusion being that EHRs “received a grade of F by physician users.” My critique:

  • The sample size was just 870 doctors surveyed out of 31,456 invited, of which the authors used “a deliberate oversampling of non-primary care specialties.”
  • Perceived EHR usability was compared to “everyday items” such as Microsoft Excel (which also earned an F), an ATM, and a microwave oven.
  • I’m not clear on how the authors expected respondents to answer usability questions about “my EHR,” which would depend on their practice (one or more clinics, one or more hospitals, both, etc.)
  • The authors mentioned an “incentivized secondary survey,” which suggests that they paid people to complete it.
  • They note that respondents may have been conflating EHR usability with the burden of documentation it supports, with their pushback being against documentation requirements rather than the tool that captures it. 
  • A reader says that while one of the authors is an executive of the notoriously EHR-hating AMA, its own JAMA wouldn’t publishing the findings and it ended up in Mayo Clinic Proceedings, probably because of the low response rate.

Sponsor Updates

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  • OmniSys employees in Greenville, TX collect hundreds of canned goods for those in need.
  • The Wharton School’s “Work of Tomorrow” podcast features MDLive CEO Rich Berner.
  • The Salt Lake Tribune features Health Catalyst CEO Dan Burton.
  • OpenText and Redox will exhibit at Salesforce’s Dreamforce November 19-22 in San Francisco.
  • Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the Perinatal-Neonatal Symposium November 18 in Williamsburg, VA.
  • KLAS Research recognizes PatientPing as a high-performing, emerging healthcare IT company.
  • Surescripts and TriNetX will exhibit at AMIA’s annual symposium November 17-19 in Washington, DC.
  • SymphonyRM publishes a new white paper, “AI Next Best Actions vs. Traditional CRM.”
  • T-System adds EvidenceCare’s clinical decision support tool to its emergency department documentation software.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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News 11/15/19

November 14, 2019 News 7 Comments

Top News

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The HHS Office for Civil Rights will look into the HIPAA compliance of Google’s data-sharing arrangement with Ascension.

Google has pledged to cooperate with OCR investigators, stressing that its work with Ascension adheres to HIPAA and “comes with strict guidance on data privacy, security, and usage.”

The company added in an amended damage-control blog post that, “Patient data … is not used for any other purpose than servicing the product on behalf of Ascension. Specifically, any Ascension data under this agreement will not be used to sell ads.”

Google Cloud now knows that its parent company has a consumer image problem that, while not on the magnitude of Facebook’s, could still serve as a roadblock for its technical work that has nothing to do with search engine ads.

Perhaps most puzzling is why Google hasn’t enlisted its new high-profile healthcare hires to explain the project or to describe why it’s likely that patient data is more secure within Google’s systems than in those of any hospital or medical practice.

The odds that this deal violates HIPAA are zero. It only violates the data rights that consumers wish they had. 


Reader Comments

From RumorMonger: “Re: Allscripts. Reducing workforce today to cut costs, with a rumored 25-50 people let go.” Unverified, but reported to me by several readers, some of whom said weeks ago that the cutback was scheduled for November 18. Rumored areas impacted are Sunrise, support, and development.

From PizzaSlinger: “Re: Cerner layoffs. A manager apparently sent the layoff script to the associates he was laying off.” I hate that layoffs have become corporate business as usual, with companies unskillfully using them to (a) dump deadwood and high earners while dodging employment law issues; or (b) to quickly juice their financial numbers to arouse some bean counter. I get really worked up when the company cluelessly acknowledges the announcement with a cheery statement that while the valued (to a point) former associates will be missed, the company is hiring wildly otherwise. Maybe the “overall headcount increase” promise encourages investors and customers, but it throws salt in the layoff wound by clearly indicating that the affected “associates” aren’t worth retraining or reassigning. Still, I commend Cerner for sending its executioners a script – which was forwarded to me — to make the employee’s final contact with the company smooth. My summary of it:

  • Schedule the appointment ahead of time using an attached link (I assume using the link automatically alerts campus security to be close by at the designated time since that wasn’t emphasized nearly enough in the script otherwise).
  • “Anticipate their reaction so you can prepare.” Having laid people off myself, I don’t think you can do this with any degree of accuracy. Most employees are initially stunned, so the idea is to get them off campus without a working access badge before their Kubler-Ross’s “denial” turns to “anger.” I’m surprised that the instructions advised making the appointment ahead of time since that’s a sure sign of impending trouble, although it’s also awkward to have a layoff when some of those affected are on PTO and thus likely to hear from co-workers or a telephoning manager that they are now unemployed. It’s also a good idea to tell the survivors not to let their former co-workers into the building.
  • Coordinate with the co-worker who gets the fun job of marching the employee to the “offboarding support area” and then packing up their pitiful personal effects while they are getting the axe.
  • Don’t tell people their job has been eliminated while they are at a client site or driving.
  • Keep the conversation short, no more than 20 minutes, but book the room for 30-60 minutes so they can compose themselves without being kicked out of the room to make way for the next execution. 
  • Have Kleenex on hand.
  • Tell them not to return to the office, but advise them that they will remain an active employee through January 14, 2020.

HIStalk Announcements and Requests

The best lesson we can learn from the Ascension-Google controversy is that Americans are naive in thinking that HIPAA gives them broad privacy protection, so perhaps the shock – justified or not – that a company that most Americans know only for searching and serving ads is holding their medical data will open much-needed consumer privacy law discussion. Many people, even media types, seem shocked that HIPAA addresses only providers, or that they get a free pass under “treatment, payment, and operations.” I don’t question the data-sharing deal since it’s really not all that unusual other than consumers react more quickly when it’s Facebook or Google than if they found out that many, many other companies are sifting through their medical information, sometimes paying some other organization for the privilege. Bottom line – Ascension did nothing intentionally wrong, patient data is almost certainly safe, and both Ascension and Google now know they have a public trust issue that isn’t limited to just this tiny aspect of their businesses. I’m waiting to see if Ascension’s interest really is related to clinical outcomes rather than their own financial ones and whether anyone raises the issue of whether Ascension really has 50 million signed Notice of Privacy Practices forms on file (and whether those are valid if they were signed before Ascension acquired the original hospital). All this aside, the issue goes well beyond these two organizations.


Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

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NextGen will acquire patient intake, scheduling, and payment software company Medfusion for $43 million. Medfusion will spin off its data services business into a separate entity named Greenlight Health. Steven Malik sold Medfusion in 2010 to Intuit for $91 million, then reacquired it in 2013. He owns the North Carolina FC of United Soccer League and North Carolina Courage of National Women’s Soccer League and is working to build a $2 billion entertainment complex in Raleigh.

The planned merger of Sanford Health (SD) and UnityPoint Health (IA) to form one of the country’s largest health systems is called off, with Sanford’s CEO saying that UnityPoint Health’s executives “failed to embrace the vision.”


Sales

  • St. Joseph’s/Candler will implement Tabula Rasa Healthcare’s DoseMeRx precision dosing software across its facilities in Savannah, GA.
  • Willis-Knighton Health System (LA) selects Meditech Expanse.
  • Humana, GuideWell, and Trusted Health Plan will use Healow Insights integrated services from EClinicalWorks for interoperability among their networks.

People

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Surgical software vendor Provation Medical hires Daniel Hamburger, MBA, MS (Renaissance Learning) as CEO. He replaces Dave Del Toro, who will join the company’s executive board.

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Jamie Trigg (Seattle Children’s) joins Virginia Mason Health System (WA) as CTO.


Announcements and Implementations

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The St. Louis Children’s Hospital and Washington University Heart Center (MO) sends high-risk infant cardiac patients home with Locus Health’s remote monitoring app.

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Best Buy ups its digital health offerings with the addition of TytoCare’s at-home medical exam device and companion app. The $300 device comes equipped with attachments that can be used during a telemedicine visit with partners from several health systems and telemedicine companies.

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CHI Memorial Hospital (TN) implements Epic.

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WellSky develops the WellSky IO interoperability framework to help post-acute and community providers connect to patient data exchanges.

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The Michiana Health Information Network, Indiana Health Information Exchange, and HealthLinc will merge operations under the IHIE brand in January. IHIE executives believe the consolidation will create new value propositions and help scale services. IHIE has played around with several business models since launching in 2004, including its ThriveHDS clinical data repository services offshoot, which shut down after just nine months. The HIE’s CEO and COO presented “Said the HIE: ‘Reports of Our Death Are Greatly Exaggerated” at HIMSS earlier this year.

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Amazon Web Services launches AWS Data Exchange, giving users the ability to find, subscribe to, and use third-party data in the cloud. Healthcare use cases include subscribing to aggregated data from historical clinical trials to accelerate research activities, and subscribing to aggregated and de-identified healthcare claims and transaction data to improve care delivery.

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In Canada, Ontario health officials announce a Digital First for Health strategy that will aim to give patients the ability to book appointments online, access their medical records, and take advantage of more telemedicine services within the next three to four years. Providers will be given access to interoperable records, and enhanced data integration and predictive analytics.

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A KLAS report on remote patient monitoring finds that nearly all users get measurable outcomes, but the market is changing to demand products that are patient-centric, that engage patients, and that offer patient-provider interaction, all using consumer-based rather than proprietary medical devices. Health Recovery Solutions and Vivify Health are leading the evolution, but the report’s conclusions are incomplete because several vendors refused to participate (Resideo, Care Innovations, Medtronic, and Philips).

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Patient safety groups ECRI Institute and the Institute for Safe Medication Practices will merge, with ISMP becoming an ECRI Institute subsidiary.


Privacy and Security

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I can’t tell if this is satire or serious: Google’s alleged whistleblower takes to The Guardian to outline why he or she felt compelled to share concerns about “the Nightingale Project” with, presumably, the Wall Street Journal: “After a while I reached a point that I suspect is familiar to most whistleblowers, where what I was witnessing was too important for me to remain silent. Two simple questions kept hounding me: did patients know about the transfer of their data to the tech giant? Should they be informed and given a chance to opt in or out? In short, patients and the public have a right to know what’s happening to their personal health information at every step along the way. To quote one of my role models, Luke Skywalker: ‘May the force be with you.’”

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Health Care Cost Institute CEO and former CMS Chief Data Officer Niall Brennan tries to calm the masses.


Other

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The American Medical Association co-sponsors a study that finds that perceived EHR usability is poor and contributes to physician burnout. The article is paywalled so I can see only the highlights (except for the graphic above, tweeted out by one of the authors), although I notice that response rates weren’t good. The authors conclude that EHRs scored an F with self-reported doctor scores in the bottom 9% across all industries and then correlated those scores to burnout. The correlation versus causation issue would lead me to question, do EHRs burn doctors out, or do burned-out doctors hate EHRs as a tangible manifestation of their unhappiness? Also, I’m not sure that it’s fair to compare an EHR to Amazon, a Google search, or a microwave oven, especially since those tools are voluntarily chosen for personal benefit. Doctors are frustrated with their EHR, but they’re also frustrated with nearly everything else about their jobs (and many of them must be frustrated with the AMA itself as well, given that only a fraction of US doctors are members, so maybe the EHR vendors should study that phenomenon).

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STAT looks at the integral role remote healthcare coaches play in the success of headline-grabbing digital health companies like Omada Health, Livongo, and Fitbit. Omada Health CEO Sean Duffy admits that though he’s a big fan of tech, “It’s hard to recreate human accountability.”

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Results of the Apple Heart Study are in, leaving researchers with several solid takeaways regarding the Apple Watch’s ability to alert users to abnormalities. The eight month study of 400,000 users – one of the largest of its kind – found that the device notified two thousand of an irregular pulse; 84% of which were found to have atrial fibrillation. Researchers concluded that passive monitoring can be beneficial, but more work needs to be done for the Watch to be truly useful in helping at-risk, rather than young and healthy, populations. Apple just launched a separate Research app to study heart, movement and hearing issues, and women’s health.


Sponsor Updates

  • Apixio celebrates several milestones including its 10th anniversary, adding 17 new provider and payer customers in 2019, and making Deloitte’s 2019 Technology Fast 500 list of fastest-growing companies in North America.
  • Ellkay will exhibit at Momentum 2019 November 22-24 in Orlando.
  • Ensocare will exhibit at the 2019 Leadership and Physician Advisor Conference November 15-17 in Miami.
  • CarePort Health’s post-acute provider database and patient choice application, CarePort Guide, is now available in the Epic App Orchard marketplace.
  • HealthCrowd will present at the Florida Association of Health Plans 2019 Connect Conference November 19 in Orlando.
  • In Australia, Hyland integrates Medrefer’s referral technology with its OnBase enterprise information technology.
  • InterSystems will exhibit at Healthcare Providers Transformation November 18-20 in Denver.
  • Intelligent Medical Objects will exhibit at the AMIA 2019 Annual Symposium November 16-20 in Washington, DC.
  • Kyruus CTO Chris Gervais will present at Salesforce’s DreamForce November 20 in San Francisco.
  • AMIA inducts Clinical Architecture CIO Shaun Shakib into the 2020 Class of AMIA Fellows.
  • Recondo Technology announces that bookings for its automation solution for prior authorization transactions has accelerated in 2019 to 60 health systems, most of them Epic users.
  • ZDNet profiles Nuance.
  • Health Catalyst appoints Julie Larson-Green (Qualtrics) and S. Dawn Smith (Cologix) to its Board of Directors.
  • The Chartis Group publishes a new white paper, “Creating a Successful Physician Enterprise in Academic Health Systems.”

Blog Posts


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News 11/13/19

November 12, 2019 News 26 Comments

Top News

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Google announces Project Nightingale, a partnership with 150-hospital Ascension in which the company will gain access to the identifiable data of potentially all of Ascension’s patients to apply predictive analytics for patient care.

Business Insider reports that the information of 20 million patients has been uploaded to the cloud, with that of another 30 million patients scheduled for transfer in February.

The Wall Street Journal says the data being shared is not de-identified and is essentially the patient’s entire record. It also notes that at least 150 Google employees have access to the data.

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The organizations are testing EHR search software and tools that present EHR data graphically to clinicians.

Ascension’s patients and doctors were not notified of the project, except for the 2,000 doctors and nurses who are testing the EHR search function.

Ascension says the deal meets HIPAA requirements because Google has signed a Business Associate Agreement.

Quoted in the announcement was Ascension EVP / Chief Strategy and Innovation Officer Eduardo Conrado, who spent 26 years as a Motorola IT and marketing executive and four years as an Ascension board member before joining the health system’s executive team in September 2018.


Reader Comments

From Laid Off and Up: ”Re: recent layoffs. Why do companies fail to understand how bad they look laying off employees in November and December?” I assume that unrestrained desperation to make Excel cells jump forcibly through hoops to earn a bean counter hurrah outweighs the justified black eye that results from showing previously valued “associates” the door during the two-month holiday window. It’s never a great time to lose your job, but prospects are dim until after New Year’s, long nights invite depressing self-analysis, and it’s an unenviable acting job trying to appear upbeat along with holiday-spirited family and friends. Layoffs are a management failure, but November and December cutbacks suggest a higher level of knee-jerk incompetence. I’ll offer my advice from having served on both sides of the forced march out the door — you don’t want to work for a company that conducts regular layoffs anyway, so they’re doing you a favor by forcing you to choose a better employer.


HIStalk Announcements and Requests

I’m excited that my pre-ordered copy of “Man’s 4th Best Hospital” by Samuel Shem was deposited into my Kindle library upon its release today. I expect that will be the subject of my next book review. Meanwhile, if you think I should read a particular book and report on it, let me know.


Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

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Cerner lays off 131 employees in its latest round of cost-cutting. 

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Value-based care clinical quality platform vendor Apervita raises $22 million from an incremental investment.

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Premier launches Contigo Health, a network of member health systems that will use EHR-integrated, evidence-based clinical decision support to optimize care for employees of its employer members. It will also identify available employer health and wellness programs. Premier acquired evidence-based clinical decision support vendor Stanson Health a year ago for $51.5 million, which I would guess forms a key part of this offering. This announcement is a pretty big deal – as big tech companies start trying to figure out this maddeningly complex market, publicly traded Premier knows it inside and out (supply chain, quality improvement, analytics, technology, clinical delivery, etc.) and has now, via Contigo Health, formed relationships with 35 health systems representing 440 hospitals as well as several national employers to address cost and quality issues (also note that health systems are longstanding Premier member-owners). I wrote here several years ago that Premier was the company to watch in terms of disruption and execution and this announcement doesn’t throw water on that prediction. If I were Google or Amazon and was anxious to get a healthcare foothold… well, let’s leave it at that.


Sales

  • Mercy will implement Bright.md’s asynchronous virtual care platform to provide online triage, diagnosis, and treatment for patients at any location at any time.
  • In Northern Mariana Islands, Commonwealth Healthcare Corporation will upgrade its Medsphere legacy system to CareVue EHR and revenue cycle.

People

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Jon Zimmerman (Athenahealth) joins Holon Solutions as CEO.

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Datica CTO Travis Good, MD will leave the company’s management team. He will remain a Datica board member and is starting a new venture that is focused on personal data and privacy


Announcements and Implementations

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Cricket Health Chief Product Officer Geoffrey Clapp builds VA Care Finder, a free Amazon Alexa skill that allows veterans to provide an address and to be given the closest three VA locations by driving distance (including traffic conditions), powered by the VA’s Facility API. The screenshot above is from an Echo Show device. He’s working on enhancements to use Alexa’s default home location, answer questions about specific facility hours or address, and answer questions about service lines, such as mental health, rather than all locations. Alexa’s limitations don’t allow him to link to external services or to use mapping tools. He’s hoping to explore the VA’s many other APIs to see if appointment scheduling is a possibility. He concludes in his Veterans Day post,

With these APIs — and there is much, much more than just the facilities subset API that I’ve exposed here — the developer community can now get access to data we only dreamed about back in the highly-mentally-scarring VistA integration days of yore. The fact that nearly all the data that is available to internal development teams at the VA or USDS is also available to every hacker, startup, and BigCo means we can do what APIs are meant to — OPEN THE DATA — and build stuff no one ever thought of (or, thought of but didn’t have the budget for…I see you, VA) and there are few populations as deserving of innovation as our Veterans.

A Black Book survey of health information management professionals finds that 93% are optimistic that AI can streamline document creation and capture a holistic patient history to improve outcomes and revenue integrity.

Prepared Health develops an API that users FHIR 4.0 to connect home care agencies and other providers to health plans and hospitals for referrals, care management, and billing.


Government and Politics

Politico reports that CMS Administrator Seema Verma signed a $2.25 million government contract to hire at least 40 consultants to polish her personal brand, several of them former Trump campaign workers who billed taxpayers up to $380 per hour to perform tasks that have always been managed by CMS’s civil servants. HHS cancelled the contract in April 2019 after Politico reported on it, but at least $744,000 had already been spent.


Other

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In Israel, Sheba Medical Center says it will create “the first fully VR-based hospital.” That’s certainly a press release stretch, unless the hospital plans to sell off all those buildings in the photo above and instead pass out VR headsets to patients. They calmed down a little further down the page, specifically listing that the hospital will use virtual reality for therapy services and education.

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The non-profit Health Care Cost Institute gains access to de-identified Blue Cross Blue Shield claims in a multi-year partnership agreement. UnitedHealthcare stopped sharing its claims data with the group earlier this year, citing privacy concerns about HCCI, which is a non-profit competitor to its claims data-selling Optum subsidiary.

The Environmental Protection agency is proposing to ignore the conclusions of academic studies in its rulemaking unless the authors submit all raw data, including any patient medical records that were reviewed, for public inspection. EPA says outsiders should be able to independently review all study data to verify the conclusions of the researchers. The measure would make it more difficult to pass new environmental laws because the personal health information that was involved is often collected under confidentiality agreements. EPA’s proposed standard would exceed those for published medical studies, which do not require investigators to submit raw data.

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A newspaper in India interviews Viren Prasad Shetty, the COO of India-based Narayana Health, which plans to expand from its 30 hospitals and 6,000 beds to 30,000 beds. Interesting points:

  • The company plans to create a virtual health network that involves apps rather than buildings in an Uber-like model that will allow it to grow more quickly at a lower cost.
  • He says India’s plan to add a new medical school in every three districts of India isn’t adequate because many of the graduates leave the country, noting that the US has more India-graduated nephrologists than India itself.
  • He predicts that “the biggest export-earning industry of this country will be our manpower,” specifically medical caregivers as declining populations leave Western countries with no one to care for their senior citizens.
  • Narayana’s 20% annual growth in cancer services eclipses that of its primary focus of cardiac services, so “we will want to convert all our hospitals into cancer hospitals.”
  • He says the company’s strength is that is led by a core group of doctors – including cardiac surgeon and CEO Devi Shetty, MBBS – instead of business executives, which makes it attractive to doctors.

A man who expected his hernia repair to cost around $10,000 is shocked at the for-profit hospital’s $116,000 bill for the 91-minute outpatient procedure, including $1,700 for a pair of scissors. He had passed on buying real health insurance and instead enrolled in a health-sharing ministry that pools medical bills among self-pay patients outside the purview of insurance regulations. He was approved for up to $50,000, but inadvertently chose the most-expensive area hospital and didn’t realize that patients who are covered by health-sharing ministries are billed at the same rate as uninsured or cash-paying patient without the benefit of heavy insurer-negotiated hospital discounts. The hospital refuses to budge on the $67,000 balance he owes. He’s demanding that Virginia’s consumer protection office force the hospital to write off his balance, but an attorney with Virginia Poverty Law Center says the hospital will probably just sell off his debt to a collection agency for 10 cents on the dollar. 

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An American Osteopathic Association survey finds that 75% of Americans feel lonely. My free advice – forget your pretend friends on Facebook and make an effort to interact with actual human beings instead of accidentally trampling them on the sidewalk while staring down in wonderment at your phone’s compelling but imaginary world. The most provocative art I’ve seen recently is by photographer Eric Pickersgill (above), who showed what real life would look like once the “small, cold, illuminated devices” of social media addiction are removed. He describes it as: “This phantom limb is used as a way of signaling busyness and unapproachability to strangers while existing as an addictive force that promotes the splitting of attention between those who are physically with you and those who are not.”


Sponsor Updates

  • Apixio will exhibit at the Rise Annual Risk Adjustment Forum November 12-14 in Scottsdale, AZ.
  • Clinical Architecture will exhibit at AMIA November 16-20 in Washington, DC.
  • Diameter Health will exhibit at the Advent HEDIS 2020 Client Conference November 19 in Scottsdale, AZ.

Blog Posts


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Mr. H, Lorre, Jenn, Dr. Jayne.
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Monday Morning Update 11/11/19

November 10, 2019 News 4 Comments

Top News

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Kaiser Permanente Chairman and CEO Bernard Tyson died unexpectedly Sunday of unspecified causes. He was 60 years old.

EVP/Group President Gregory Adams will serve as interim chairman and CEO.


Reader Comments

From Jake the Snake: “Re: health IT blog sites. Some of them seem to be violating FTC’s endorsement rules in running puff pieces that don’t disclose payments or business relationships.” The reader provided examples in which (a) a company rep’s thinly disguised sales pitch that wasn’t listed as a paid spot even though I’m guessing it was; and (b) an article that talked about an industry issue, but then made the leap to quoting someone from the company or pitching their product as a solution. The Federal Trade Commission’s endorsement guidelines prohibit making a statement that a consumer might reasonably assume is an honest opinion and not an advertiser message. That includes being shown using a product, being paid to mention a product (even if indirectly), or being given a product to try and then either making misleading claims or failing to disclose being paid to mention the product. I doubt the examples provided run astray of FTC’s guidelines. For me, I quit reading one local food site that was pitching particular restaurants, chefs, or menu items in a blatant pay-for-play “featured restaurant” manner without disclosing it, which was pretty obvious since the same handful of places kept popping up despite unenthusiastic online reviews.   

From Ghost in the Machine: “Re: Cerner’s acquired Siemens businesses. Norway is very small in the overall story. Some of the platforms from that deal will be put out onto the market. Apparently the German workforce has been told that its multiple offices will consolidate to Berlin. The changes are unrelated to the Sweden delays — they are part of the business focus on earnings and product portfolio.” Unverified.


HIStalk Announcements and Requests

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Eighty percent of poll respondents believe that their employer gets at least 50% of the benefit of their conference networking.

New poll to your right or here: Will the collaboration between Allscripts and Northwell result in delivery of a commercially successful EHR within three years? Click the poll’s Comments link after voting to make your case in ways that a binary response cannot.

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I’m becoming more uncomfortable with the idea that when I thank a service member, my motivation might be influenced by my urge to feel virtuous by throwing out that increasingly automatic and empty saying. It’s better to hire a veteran or their family member, donate to support groups, and vote for politicians who support veterans (and ideally, who are veterans themselves who understand the responsibility involved in sending people off in harm’s way). I’m also not to sure that someone who has served in the military necessarily gets good vibes from a “Happy Veterans Day” greeting or anything else that requires them to acknowledge my recognition. For today, I will just say to veterans out there that I know you made a sacrifice that I didn’t and thus will never fully understand, and for that, I honor you. 

I haven’t thought of Robert Lorsch of MMR Global very much since I interviewed him in 2013 after his company filed lawsuits against EHR vendors, Walgreens, non-profit hospitals, and the government of Australia for developing personal health record technology that he claimed – not very convincingly — infringed on his intellectual property. Turns out he died in May 2017 and the company seems to have met its maker before Bob. 


Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

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Canada-based Intelerad Medical Systems is reportedly seeking a buyer. 


People

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Toni Laracuente, RN (Change Healthcare) joins Medicomp Systems as chief nursing officer.

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Accreditation Council for Graduate Medical Education hires Bruce Metz, PhD (University of Connecticut Health Center) as its first CIO.


Announcements and Implementations

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Michigan HIEs Michigan Health Information Network and Great Lakes Health Network will merge to form an organization with $28 million in annual revenue and 169 employees. The governor recently vetoed $1 million in funding for MiHIN.


Privacy and Security

University of Chicago wants its medical center dismissed from a class action lawsuit that accuses it of sharing patient information with Google in an agreement that the plaintiff says violates his HIPAA rights. The university’s motion says that while the plaintiff claimed that the de-identified information could be re-identified through timestamps and free-text notes, he never claimed that Google actually did so and that its contract with Google prohibits it from even trying to re-identify patient data. The university added that its Notice of Privacy Practices informs patients that their data might be used for research and they won’t be paid even if a commercially viable product results.


Other

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Sony expects to earn FDA clearance next month for Nucleus, an OR integration tool it acquired in 2016 that is sold outside the US. The hardware device displays multiple simultaneous images – including 3D and 4K — from video-based medical equipment that can also be recorded, broadcast, or routed to a different display.

In India, government-run Rajendra Institute of Medical Sciences will track its 300 doctors via GPS to make sure they are physically present in the building during their paid hours of  9:00 a.m. to 5:00 p.m. The hospital administrator says he expects doctors to eat in the building because leaving means they won’t make it back in their allotted one hour.

Weird News Andy awards an A for effort to this life sentence prisoner who argued that doctors who were treating his septicemia had to revive him with epinephrine, so that meant he was “dead” and thus had fulfilled his sentence. The appeals court disagreed, finding that life sentences aren’t satisfied just because doctors revive someone.


Sponsor Updates

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  • CereCore staff prepped and served lunch to over 400 people at the Nashville Rescue mission.
  • CMS selects Lightbeam Health Solutions as a stage 1 participant in its Artificial Intelligence Health Outcomes Challenge to demonstrate how AI tools can predict risk.
  • LiveProcess will present at the IAEM Conference November 15-20 in Savannah, GA.
  • Meditech congratulates customers recognized by CHIME as Healthcare’s Most Wired organizations, including Avera Health (SD), Frederick Regional Health System (MD), Lima Memorial Health System (OH), Woman’s Hospital (LA), and Doylestown Hospital, PA.
  • Mobile Heartbeat will exhibit at the Pediatric Trauma Society’s Annual Meeting November 11-16 in San Diego.
  • Nordic and Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the HIMSS Gulf Coast Chapters GC3 Conference November 13-15 in Biloxi, MS.
  • Gartner names OpenText a leader in its 2019 Magic Quadrant for Content Services Platforms.
  • PatientPing congratulates its national network of ACOs for generating more than $430 million in shared savings in 2018 under the MSSP.
  • Wisconsin Health News profiles Redox.
  • SymphonyRM publishes a new white paper, “AI Next Best Actions vs. Traditional CRM.”
  • Voalte will host VUE19 November 13-15 in Sarasota, FL.

Blog Posts


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Contacts

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News 11/8/19

November 7, 2019 News No Comments

Top News

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Just one in 10 discharged patients go online to access their medical information, according to a study that looked at data from 2,410 hospitals over a two-year period.

The analysis also found that patients at non-profit hospitals are more likely to take advantage of access than their counterparts at for-profit organizations, as are patients at teaching hospitals.

The authors conclude that “policy efforts have failed to engage a large proportion of patients in the electronic use of their data or to bridge the ‘digital divide’ that accompanies health care disparities.”


Reader Comments

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From Being There: “Re: HLTH conference. As a participant and attendee, I found this to be a first-rate event. Other than a couple of HHS speakers who seemed more intent on politics versus real healthcare, the rest were engaging, interesting, and first rate. I especially like the panel discussion format used in the tracks I attended. As an exhibitor, I was disappointed in the value provided for the cost incurred. Activity was low most of the time, including the happy hour which helped a bit, but not enough. My theory is that there is just too many good speakers and sessions which are running concurrently such that, if I didn’t have to be in the exhibit area, I would have been attending tracks and sessions instead. PS: the free Mimosas on Sunday morning were especially nice.”

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From Mandibular Process: “Re: HIMS. Why in the world would a company name themselves this?” I took “in the world” part of this question literally, assuming that a company that was started in 2014 would choose this name only if (a) it is clueless, or (b) it is brazenly hiding behind some other country’s less-litigious legal system. Not so. Even though the HIMS website does not list people or places (not uncommon with foreign companies trying to look domestic), I tracked them down to Arizona, where a postal race is probably unfolding to see whether our industry’s HIMSS or from the Viagra-selling website HIMS will land the first cease-and-desist letter.


Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

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Reuters reports that CompuGroup Medical is one of two top bidders for the health IT and integrated care parts of Agfa’s European healthcare business.

American Well acquires behavioral telehealth and telepsychiatry service provider Aligned Telehealth.

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Lawyers for Elizabeth Holmes contend in a hearing that the FDA destroyed emails that are vital to her defense. The former Theranos CEO and co-defendant Ramesh “Sunny” Balwani –a former Theranos executive and romantic partner of Holmes — face up to nine counts of wire fraud and two counts of conspiracy to commit wire fraud. The FDA has admitted to having only partial emails from the former director of its diagnostics regulatory division, which it blames on a faulty email storage system.


Sales

  • The Ohio State University Wexner Medical Center will implement Visage Imaging’s Visage 7 Enterprise Imaging Platform in all of its radiology departments, replacing its legacy PACS.
  • Boston Health Care for the Homeless will use an addiction treatment-focused EHR from Netsmart to help care for patients with opioid use disorder.
  • Prisma Health (SC) selects telehealth technology and services from MDLive.
  • Health and human service agency network Innovative Management Solutions (NY) will implement population health analytics and risk management tools from Arcadia.

People

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Federal health IT vendor DSS names Christopher Kunney (Coker Group) chief of strategy and business development and Roy Hammar (Cerner) chief of client engagement.


Announcements and Implementations

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The National Council for Behavioral Health and disaster relief non-profit Americares pilot a text-based messaging program at eight Texas health clinics that uses patient engagement software from Epharmix to help patients with medication adherence.

California-based HIE Manifest MedEx and HBI Solutions develop MX Analyze, a predictive analytics tool designed to help providers manage high-risk patients and care transitions.

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A new KLAS report says that the patient engagement ecosystem is a complex and overwhelming area of health IT that spans 80 capabilities and “a slew of vendors claiming to offer them.” KLAS analysts didn’t interview clients in this case – they compared vendor claims to provider priorities. Among vendor-agnostic products, Allscripts, CiperHealth, and GetWellNetwork offer multiple solutions that align with market priorities. EHR vendor patient portals from Epic, Athenahealth, and NextGen, even though their use is limited, meet the key provider demands for bill payment and self-scheduling. Sonofi Health and PCare lead in the interactive patient systems category, Orca and Luma are notable outreach vendors, and Salesforce and Docent Health perform well in the broad category of CRM, rounding, and wayfinding. KLAS notes that providers reap most of the benefit of these systems, with only 20% of vendors claiming improved clinical outcomes.


Government and Politics

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The VA gives all veterans access to their medical records via Apple’s Health Records app following an earlier limited rollout.


Privacy and Security

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The Government of Nunavut in northern Canada prioritizes getting its health department’s Meditech system back online after a DoppelPaymer ransomware attack over the weekend crippled digital services across its networks. Officials anticipate returning to normal operations within a week.


Other

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Researchers at Emory University in Atlanta find a direct correlation between opioid abuse-related tweets and overdose deaths in several Pennsylvania counties. The researchers hope to further refine their machine-learning algorithm to help public health officials monitor opioid abuse within certain populations.

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Kyruus surveys 1,000 consumers for the third year in a row to better understand their healthcare access preferences. A few findings:

  • Consumers are relying more heavily on hospital websites than in years past when it comes to searching for healthcare information.
  • Scheduling appointments by phone, while still the dominant method, is losing losing ground to online booking.
  • Consumers care more about insurance acceptance and clinical expertise than a health system’s reputation or appointment availability.
  • Thirty-three percent of respondents say they would switch providers for access to virtual visits.

Sponsor Updates

  • EClinicalWorks and HealthCrowd will exhibit at the TAHP Texas Covered Health Care Conference + Expo November 11-12 in Austin.
  • Ensocare will exhibit at the 2019 Leadership and Physician Advisor Conference November 15-17 in Miami.
  • EPSi will exhibit at the HFMA Region 9 Annual Conference November 10-12 in New Orleans.
  • Formativ Health will sponsor the Wounded Warrior Project Carry Forward 5K November 9 in Jacksonville, FL.
  • Patientco celebrates new office space in Atlanta.
  • Healthwise, Imprivata, and Intelligent Medical Objects will exhibit at NextGen UGM 2019 November 10-13 in Orlando.
  • Hyland names the State of Minnesota Department of Health as the winner of its 2019 Government Innovation Award.
  • InterSystems debuts its PulseCast podcast, “John Halamka: Making the Most of Decentralized Data.”
  • Definitive Healthcare SVP of Strategy Kate Shamsuddin wins the Worcester Business Journal’s Outstanding Women in Business Award.
  • Glytec publishes a new study focused on the “Current State of Inpatient Diabetes Care and Glycemic Management.”

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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News 11/6/19

November 5, 2019 News 9 Comments

Top News

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A federal jury orders behavioral EHR vendor ZenCharts to pay rehab EHR provider Kipu Systems $19.5 million in damages for stealing its trade secrets.

The court found that a now-closed rehab center signed a contract with Kipu 2013, then shared the design details of that product with ZenCharts so it could develop a competing product.

Evidence was introduced in which one of the rehab center’s owners said in a 2012 email, “I’m building an EMR for treatment centers” and discussed the possibility of reverse engineering Kipu’s product.

The lawyer for ZenCharts unsuccessfully argued that the rehab center’s contract didn’t contain a non-compete clause, that Kipu’s EHR didn’t contain anything novel, and that a substantial verdict would bankrupt ZenCharts and increase the costs of addiction treatment.


Reader Comments

From Palate Cleanser: “Re: Cerner Scandinavia. Heard it is shutting down its Norway offices. Related to massive delays on two Swedish projects, or just more cuts?” Unverified. A Swedish newspaper recently reported that the Cerner project in Västra Götaland has been delayed for a year because Cerner hasn’t finished work on localizing Millennium to accommodate data laws.

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From Banal Boy: “Re: your former 10×10 booth. HIMSS is pushing them specifically, maybe because as you mentioned they aren’t selling well.” HIMSS lists the benefits of the tiny booths that few attendees visit (five exhibitor badges and a booth guide listing are pretty much it). I should ask for a discount for buying several, then packaging them up with an HIStalk sponsorship that provides three and 365 days, respectively, of exposure. I could pitch them as a “neighborhood” of HIStalk-savvy vendors who can’t justify the cost of buying a big space that is used mostly by their reps for screwing around with their phones. I even have a Smokin’ Doc standee left over to serve as block captain. I was searching for a micro-booth photo when I rediscovered “The Smokin’ Doc Celebrates a Successful HIMSS,” in which some fun vendor folks took the cardboard character (they named him Dr. Brandon Pierce) out on the town in Las Vegas at HIMSS18, still one of the funniest things I’ve run here.

From Bookworm: “Re: health IT authors. This new one clearly used a vanity publisher.” I’ve seen a few books by health IT folks who hired vanity publishers that create low-quality books from whatever the “author” sends them, as long as one of the items is a check. Some vanity publishers repackage someone’s old reports and blog posts, conduct a short Q&A interview, then dump it all together into a “book” that requires no author effort. I suppose there’s nothing wrong with that, although labeling oneself an “author” on LinkedIn or Twitter is a bit of a stretch since it’s not like a publisher declared their manuscript worthy of their time and investment, then professionally edited and marketed the result and paid sales royalties accordingly.

From Snowflake Melter: “Re: UCSF doctor’s editorial on EHR screen wording. You failed to editorialize.” I think the doctor — whose LinkedIn suggests that she’s around 32 and considers writing, presenting story-telling shows, and podcasting as key elements of her identity – might have been unwise in complaining publicly about her employer’s tools and processes. She says Epic’s use of the word “deficiencies” is insulting, perhaps unaware that the term – which refers to the chart, not the chartist – was around long before hospital computer systems. She adds that  Epic doesn’t coddle her enough in failing to present “small islands of empathy” and thus “will continue to contribute to the profession’s growing sense of despair” (do SAP and Excel offer such user stroking?) Perhaps her insecurities are excessive, maybe she was short on something to write about, or perhaps she thinks she has life figured out two years out of residency, but crying to the public that Facebook (whose CEO’s name adorns the hospital that sends her checks) gives her birthday greetings that Epic doesn’t suggests that if this is the biggest issue with her job, she’s doing pretty well.


HIStalk Announcements and Requests

I bought a no-name, $20 128GB flash drive from Amazon that, perhaps predictably, didn’t work and couldn’t even be repaired or formatted by Windows. I was going to write it off as a lesson learned, but clicked Amazon’s “return” option for the first time ever, which is pretty slick. I chose the option to drop the item off at a UPS Store, where I will show them the QR code on my phone that Amazon emailed me and then I will walk away – they will box the item up, label it, and ship it back to Amazon. I’m ordering a different drive, but reviews for most are mixed even with the big-name products– people report premature failure, abysmally slow write speeds, and being locked out of their files. My new external hard drive won’t work in this case since I need to copy files from Mrs. HIStalk’s Mac and the file system isn’t compatible with Windows. Dropbox may be the right answer.

Thanks to the following companies that recently supported HIStalk. Click a logo for information. I see several new names on the list, so special thanks and welcome to the newcomers.

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Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

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Allscripts announces Q3 results: revenue up 3%, adjusted EPS $0.17 versus $0.16, beating Wall Street earnings expectations but falling short on revenue. From the earnings call:

  • The company says work on the EHR it is developing with Northwell Health will focus on user interface and workflows over the next six months, then development on top of the Avenel product, followed by Northwell’s implementation on the way to commercialization.
  • The Northwell extensions contributed zero to bookings since it was not incremental business. It flows into backlog.
  • Annual revenue from the Veradigm business is $150 to $175 million.
  • The company expects to see revenue from its NextGen partnership scale up and is talking to other EHR vendors about similar arrangements.
  • Allscripts responded to an analyst’s question about the technology involved in the Northwell project: “We’re definitely single database, multi-tenant, pure cloud technology. The focus is on ambulatory outpatient and so the workflows that go with that. So this is not an exercise to effectively integrate TouchWorks and Sunrise as we know them today, but this is a recognition that the user base would like a more user-friendly tool and we think they should do that with modern technology.”
  • Paul Black declined to answer an analyst’s question about a revenue share or marketing agreement with Northwell for the new EHR being developed.
  • President Rick Poulton says the company’s joint development effort with Northwell will not increase R&D spending.
  • The company says Cerner’s move to Amazon Web Services could benefit Allscripts since any Cerner customer that faces switching costs might need to issue a board-mandated RFP.

A private equity firm acquires EDCO Health Information Solutions, which offers technology that converts unstructured patient data to EHR-ready information.

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A Cerner spokesperson provided further information about my interpretation of an earnings call comment by EVP/CFO Marc Naughton, who said in discussing Adventist Health’s termination of its revenue cycle outsourcing agreement, “We aren’t going to do the full outsourcing.” I took that to mean that Cerner was exiting the RCM outsourcing business, but she says Naughton was referring to RevWorks, not revenue cycle management outsourcing (and I’ll admit that thought those were the same thing). The spokesperson explains:

At this point, the future of that business unit has yet to be determined. During the earnings call, Marc Naughton, Cerner’s Executive VP & CFO explains, “We’re going to look at the remainder of that revenue cycle business. If it doesn’t meet our selective criteria relative to margins, we’re going to determine what needs to be done with that business.”

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Reuters reports that Walgreens is talking to some of the world’s largest private equity firms about taking the company private in a leveraged buyout. However, many PE firms aren’t convinced about the company’s business prospects, its $17 billion of debt, and their need to partner with competing PE firms to come up with the $55 billion or so that the company is worth today. The Italy-born CEO of Walgreens, Stefano Pessina, holds shares worth around $9 billion.

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NThrive will eliminate 839 jobs in central North Carolina following the decision of Wake Forest Baptist Medical Center (NC) to bring registration and billing back in house after signing seven-year outsourcing deal with NThrive in 2017.


Sales

  • Interactive patient systems vendor PCare chooses Redox for integrating its system with EHRs and other hospital platforms.

People

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John Daniels, MSA (HIMSS Analytics) will join Building Industry Consulting Service International, a Tampa-based IT infrastructure professional association, as executive director and CEO.


Announcements and Implementations

A Black Book survey of hospital security professionals finds that nearly all respondents think that their security efforts are falling short and budget constraints are limiting their ability to protect their systems, leading Black Book to conclude that things will get worse in 2020. 

Collective Medical releases Flags, which allows health plans and ACOs to share member population information with point-of-care teams, with a use case example of patients who are concurrently taking opioids, benzodiazepines, and muscle relaxants.

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KLAS and CHIME review the use of AI in healthcare, providing a working definition (which would probably exclude most of the vendors who see AI as a marketing rather than a technical term) and a look at six vendors, only one of which (Jvion) has enough customer responses to earn a full rating and even it earns only mediocre customer satisfaction. DataRobot and KenSci earned good scores, IBM Watson Health is improving but offers questionable value, Health Catalyst has the strongest healthcare expertise and diverse use cases, and SAS is being increasingly used for predicting by academic medical centers. KLAS warns that using AI in healthcare consumes a lot of effort to prepare the data, requires maintenance to keep models viable, needs department buy-in and effort to improve outcomes, and requires a culture shift to get employees and clinicians to trust its recommendations.


Privacy and Security

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Slate magazine runs an excerpt from a new cybersecurity book that describes the NotPetya malware, which caused $10 billion in damage in 2017, including $870 million at drug maker Merck alone. The featured chapter involves Nuance, which reported a malware-caused loss of $92 million from its extensive transcription system downtime, but notes that hospitals – and thus patients, indirectly – were the real victim as they had to scramble to work around loss of a mission-critical system that directly impacts patient care. It highlights Sutter Health, which accumulated a backlog of 1.4 million patient record changes in the first 24 hours of Nuance’s downtime, which kept piling up over the two weeks Sutter needed to switch to a competitor’s transcription system. The author says Heritage Valley Health System (PA) lost every Windows machine as the malware spread to its systems from a single employee being logged into a Nuance server.

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University of Rochester Medical Center (NY) will pay $3 million to settle OCR charges resulting from the 2013 loss of an unencrypted flash drive and the 2017 theft of an unencrypted laptop. The incidents affected the records of a total of 580 patients. 


Other

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UPS delivers the first CVS Pharmacy prescriptions to customers via drone, dropping medications to two Cary, NC customers from 20 feet overhead. UPS’s UPS Flight Forward will expand the rollout of its FAA-approved drone service, which has completed 1,500 paid deliveries of lab samples at WakeMed Hospital (NC).

ProPublica calls out Dignity Health (motto: “Hello, humandkindness”) for billing one of its nurses $900,000 for the 105-day stay of her premature baby at UC Irvine Medical Center. UC Irvine’s billing department and her insurer assured her that the baby was covered, but she didn’t know that Dignity’s insurance plan required her to sign the baby up on its website within 31 days, so she didn’t. Dignity said it couldn’t make an exception and insisted she pay the bill, but when ProPublica picked up the story, Dignity added the baby to her coverage after the fact.


Sponsor Updates

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  • Avaya team members volunteer with Habitat for Humanity in Morristown, NJ.
  • InterSystems holds its first Healthcare Asia Pacific Customer Meeting in Bangkok, Thailand, with over 100 attendees sharing their digital transformation experiences. 
  • Glytec publishes results of a survey of healthcare professionals who are involved with inpatient diabetes care on the current state of inpatient diabetes care and glycemic management.
  • Audacious Inquiry will present at the Florida Association of ACOs Annual Conference November 7-8 in Orlando.
  • Arcadia releases a statement on predictive analytics and bias.
  • Artifact Health will exhibit at the ACDIS Symposium: Outpatient CDI Conference November 14-15 in Austin.
  • Bright.MD adds new functionality and content to its virtual care technology.
  • Imprivata and Fortified Health Security earn top marks for client experience in Black Book’s latest survey on end-to-end healthcare cybersecurity solutions.
  • CarePort Health will exhibit at ACMA Leadership November 14-17 in Miami.
  • Collective Medical releases new functionality, enabling ACOs and payers to more readily share member population information with care teams at the point of care.
  • Diameter Health publishes a case study titled “Ohio Health Information Partnership Delivers Consolidated Continuity of Care Documents to Support More Informed Clinical Decisions.”

Blog Posts


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Monday Morning Update 11/4/19

November 3, 2019 News 13 Comments

Top News

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CMS delays a requirement that Medicare-accepting hospitals share their secretly negotiated insurance rates in machine-readable format and online.

CMS Administrator Seema Verma said Friday that the government now wants to make insurers disclose their contracted prices as well. She says the revised plan that includes both hospitals and insurers will be rolled out by the end of the year.

Lawsuits that question the the government’s authority to compel private companies to disclose competitive trade secrets are inevitable.

Hospitals would be fined $300 per day for failing to comply with the disclosure requirement, which would cost a multi-billion dollar health system just $109,500 per year to keep its prices secret.

Verma also credits President Trump for lowering health insurance premium prices on Healthcare.gov via his Executive Orders as open enrollment begins.


Reader Comments

From Built to Spill: ”Re: patient name on labels. We changed our system to use the patient’s preferred name on wristbands and labels. The impact was positive, but now fewer characters print and the names are being truncated. Name length issues are a challenge, and this is an unexpected adverse outcome of trying to do a positive thing.” Label formatting is more maddening than a layperson would appreciate. You have limited space and the nature of most text fields is that, unless you use a fixed-width font, you can neither predict nor highlight truncation (names with I’s and E’s may not truncate, but those with M’s and W’s might). I’ve pored over reams of test data as formatted onto a Crystal Reports label or report, dragging the text box a tiny bit wider or narrower in shooting for the best outcome with critical drug and lab test names. You could do something to trigger an adjacent ellipsis to warn the user that the name has been shortened or perhaps check length and then override the default label font to a smaller one, but that leaves the problem unsolved. I vaguely remember that I once programmed a label to combine all its fields into a single big text box with programmatically-added spacing and line breaks in trying to squeeze it all in without truncating (since the odds of all data elements being oversized was small), but I seem to recall that the result didn’t line up nicely and clinicians accustomed to glancing at predictably formatted information were justifiably less than ecstatic.

From Dogged Determination: “Re: Ed Marx. Hope it’s not true that he has left Cleveland Clinic.” Ed didn’t respond to my inquiry, but I see that he has updated his LinkedIn over the weekend to indicate that he left the Clinic last month after 2 1/2 years as CIO and is now an independent consultant.

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From Sunny Jim: “Re: our industry. It never fails to not deliver! I took this in a health system-sponsored, grocery store-based convenient clinic during daytime hours. I told the receptionist it was down, but she just shrugged her shoulders like it happens all the time. We just can’t get away from the clipboard!” I’m amused that the kiosk’s splash screen helpfully explains that it is “Epic’s Self Service Check In Kiosk” and then someone has helpfully taped on a torn scrap of printed paper in an act of customization that announces “KIOSK.” This self-aware message reminds me of no-hunting signs that needlessly say “POSTED” or the legendary title and theme song of the late-1980s Showtime series “It’s Garry Shandling’s Show,” where the song’s opening lyrics were, “This is the theme to Garry’s show.”


HIStalk Announcements and Requests

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About two-thirds of poll respondents who attended HIMSS19 will be at HIMSS20, while a few folks who didn’t go last year will be in Orlando in March. HIMSS is trying to invoke the bandwagon effect of touting increased C-suite and physician registration compared to HIMSS19, but A-Rod’s keynote aside, I would still put my money on a modest attendance decline.

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New poll to your right or here, since people always say the biggest benefit of the HIMSS conference is the networking opportunities: how much of your conference networking benefits your employer versus you personally? Is it more than just socializing, catching up with old friends, having fun, and connecting for a possible job change?

Speaking of HIMSS, I still have a twinge of both regret and relief that I didn’t buy a tiny booth this year so Lorre could say hi to readers in the one time each year she sees them in person, but it involved a lot of money for minimal ROI.  The map of available booths suggests that 250 of the available 449 10×10 booths (the size I bought in previous years) are unassigned. The exhibit hall floor plan shows 1,126 booths taken, about two-thirds of the number available. It also shows just over 100 first-time exhibitors, although the usual churn (along with consolidation) will likely more than offset that number with non-returning HIMSS19 vendors. Total booth square footage leaders, at least by eyeballing, are Epic (12,064), Allscripts (10,800), IBM (10,110), and Cerner (9,074). HIMSS charges a base rate of $39 per square foot, which puts Epic’s basic rent for the three days at $500K, which must be a fraction of what the company will spend for freight, signage, travel and salary costs, and various forms of conference advertising and sponsorship.

I had some big site upgrades performed over the weekend, just in case you noticed something weird (and if you’re still seeing it, let me know since maybe I missed something, although I still have a couple of punch list items). I moved to PHP 7 (specifically 7.3), a faster and more secure version of the server-side scripting language that has been around since 2015. Newer versions are used by only a small percentage of sites since they breaks a lot of old code that someone has to analyze and fix, which to which I can personally attest. 

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Welcome to new HIStalk Platinum Sponsor Bright.md. The Portland, OR-based, physician-founded company offers SmartExam, an AI-powered, asynchronous virtual care platform that increases provider capacity by a factor of 10 and reduces care costs by up to 90%. Patients with hundreds of conditions can be treated in under two minutes and in just three clicks without the provider touching the EHR. The patient interface doesn’t require appointments, video visits, or a broadband connection. SmartExam serves as the virtual front door for health systems, the first step in a ladder of care that moves the patient along their care journey for more complex issues. It can be brought live in 10 weeks or less, delivering a quick win for physician satisfaction and patient delight. The company just delivered significant improvements that include care escalation to a 911 call when triggered by patient question responses, AI-powered interpretation of patient responses to eliminate dropdowns, configurable formularies, and an all-inclusive design approach that is also ADA compliant and does not require patients to choose a gender. Thanks to Bright.md for supporting HIStalk.

Listening: new from Tacocat, Seattle-based punkish, smart-assy pop rockers (whose name is a palindrome, I just noticed) who sound like high school best girlfriends who decided to form a band. Pitchfork summarized an earlier album as, “It feels like taking a joyride with four bonafide party experts egging you on as you drunk-text an ex.” On a more somber side is “Ghosteen,” a new double release from the always-poetic Nick Cave & the Bad Seeds, Cave’s first album written after the 2015 death of his 15-year old son. Nick Cave is a genius and master of art forms that include performing, writing, film scoring, acting, and screenwriting and the Bad Seeds are underrated in being more than just backing musicians. Their live performances are intense, although unfortunately next year’s tour contains no US dates so far.


Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

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Google will acquire Fitbit for $2.1 billion in cash, saying it will bring together the best hardware, software, and AI to build wearables. CNBC notes that Google’s hardware aspirations have mostly failed with Nest, Google Glass, its light-selling Pixel smartphone, and its purchase of IP from smart watch maker Fossil having failed to make much of a dent. Its acquisition of Motorola lasted just three years as it sold the company to Lenovo for less than 25% of the price it paid. Fitbit sales were in big trouble, so perhaps the company was right to recast itself as a healthcare and data collection company in catching Google’s eye in what started as a collaboration in April 2018. Let’s see if Google takes a Facebook-like route in linking up wearables data to the wealth of information it holds, using it for purposes we as users might not like, at least those of us who aren’t in Europe where GDPR offers at least some consumer privacy protection. 

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Cleveland’s Global Center for Health Innovation loses its biggest tenant, BioEnterprise, which was also promoting the taxpayer-funded facility that had previously parted ways with its then-largest tenant HIMSS. The developer is trying to figure out how to use the building, with one option being to convert it to meeting space to expand the attached Huntington Convention Center. Taxpayers paid $465 million to build the Center and the convention center.

The Kansas City paper questions whether residents of the declining neighborhoods of south Kansas City are benefiting from the $1.6 billion incentive package that was given to Cerner to build a $4.3 billion campus there on the site of an abandoned mall. They complain that even though 3,000 Cerner employees work on the campus, the only other new development is a single gas station and most employees go straight from the Interstate to the gated Cerner campus and then leave the area after work. The school district loses $2.7 million in annual revenue because of the tax breaks. Local politicians and Cerner had predicted a rejuvenation of the area through new development, but the Walmart remains closed and a neighborhood survey found that the only retail need being met is liquor stores.


People

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Cerner announces in SEC filings the departure of COO Mike Nill and Chief Strategy Officer Joanne Burns in the first quarter of next year. That leaves four executives who were on board when Neal Patterson died in July 2017 – Chief Client Officer John Peterzalek, CFO Marc Naughton, EVP Jeff Townsend, and EVP Donald Trigg. I also noticed that John Glaser has been removed from the executive page even though his individual page as SVP of population health remains, while his LinkedIn shows him as executive senior advisor.

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Denis Zerr (Catholic Health Initiatives) joins Radiology Partners as CIO.


Announcements and Implementations

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The local paper covers the go-live of Kern Medical (CA) on its $30 million Cerner system, showing pride that the hospital, “which had a well-documented history of financial dysfunction,” now has a modern system that is on par with those of competing local hospitals of Dignity Health and Adventist Health.


Government and Politics

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The administrator of Guam Memorial Hospital tells legislators that support for its Optimum system (formerly Keane, then NTT Data, now Cantata Health) will end December 31 but it doesn’t have the money to even start the search for a replacement that could cost $50 million.

CMS is working on Healthcare.gov errors that users experienced on Friday’s first day of open enrollment.


Privacy and Security

The Brooklyn Hospital (NY) says it discovered ransomware in its systems in July 2019 and found that in September 2019 some of its patient data cannot be recovered. Among the lost information is patient name (!!) and cardiac and dental images. The hospital says that recovery efforts are continuing.


Other

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A Newsweek opinion piece by “House of God” author Samuel Shem (aka psychiatrist Joseph Bergman, MD, DPhil) says that “the EMR is essentially a cash register” that was “developed by technocrats as part of the mandate of the Obama administration in 2008” (which is obviously way wrong, but let’s call it creative license). Shem describes a war being waged on both sides of the screen – the hospital’s billing team trying to maximize payment while the insurer’s team tries to minimize it. Shem thinks EHRs should be redesigned to ignore billing requirements like the VA’s VistA (again, good idea, but apropos only in a fictional world, and the VA is dumping VistA for one of those cash registers besides). He closes strong: when someone falls in a theater, does anyone call, “Is there an insurance executive in the house?” Meanwhile, I’ve pre-ordered Shem’s latest book, a “House of God” follow-up that comes out November 12 titled “Man’s 4th Best Hospital.”

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A New York Times essay by UCSF internist, assistant professor, author, and podcaster Emily Silverman, MD says the hospital’s new Epic system amplifies the insecurities of its physician users. She notes:

  • Her first Epic log-in presented a warning that she had “deficiencies,” which she says made her feel like a middle school student whose name was called out in assembly. In contrast, her friends who work at Facebook says the company talks a lot about “voice” in trying to make users feel cared for, with birthday reminders and display of photo memories.
  • Epic has “unintelligible medical notes, filled with ragged vines of superfluous, robot-generated text” and interruptive, mid-documentation demands to choose a patient’s diagnosis from a drop-down list while she is trying to figure out what’s happening with the patient.
  • Entering the chart of a deceased patient, which is often when the physician finds out their patient has died, provides an empathy-free “Deceased Patient Warning” pop-up.
  • She concludes, “A more humane version of Epic would take a different tone. In the absence of a true emergency, its colors and symbols would be neutral, even tranquil. Deceased-patient warnings would recognize the emotional impact of a life lost. Deficiencies and delinquencies would become incomplete tasks, and pop-ups would float into view as small islands of empathy, like the system’s periodic emails. (“Thank you for all of your hard work.”) But until then, the voice of the program itself — urgent, intimidating, and tinged with allegation — will continue to contribute to the profession’s growing sense of despair.”

Cerner SVP John Gresham says the company’s integration with Uber for patient transportation is just one way that Cerner will address social determinants of health, which could include new services such as appointment and prescription reminders that include transportation options, alternatives to ambulance transport that goes beyond Uber’s capability, and prescription delivery.

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Boston Children’s Hospital celebrates the 25th anniversary of its Computational Health Informatics Program (CHIP), which in addition to providing education, created the first personal health record, developed the SMART interoperability protocol, developed HealthMap for visualizing global disease outbreaks, demonstrated the power of analytics and genomics, and spun out several startups. A September 26 symposium reviewed CHIP’s history, then offered panel discussions on what healthcare will look like 25 years from now, including the role hospitals will serve, who will make clinical decisions, how therapies will be developed, and what R&D should be performed now to prepare for the future.

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UCSF hospitalists say moral distress is a root cause of physician burnout and that hospitals should prioritize ethics and the “inherently unethical” healthcare system should be reformed to prioritize patients over shareholder profits. They also urge education in ethics and for doctors to be encourage to advocate for issues that affect their patients, such as gun control and universal health coverage. They cite these specific problems:

  • Pressure to reduce costs in some areas while increasing them in others through profitable prescribing or referrals.
  • Being forced to provide futile or harmful treatments because the patient hasn’t completed an advance directive or family members can’t agree on end-of-life care.
  • Trying to deliver consistently good care despite economic disparities caused by high costs, high insurance deductibles, and a “gutted social safety net.”

Sponsor Updates

  • Health Catalyst and Nordic will exhibit at the CHIME19 Fall CIO Forum November 3-6 in Phoenix.
  • Mobile Heartbeat will host MHUG 2019 November 6-8 in Phoenix.
  • Waystar will exhibit at the Health Management Academy CFO Forum November 6-10 in Laguna Beach, FL.
  • Netsmart will exhibit at the MHCA Fall Conference November 5-7 in Atlanta.
  • Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the HIMSS South Carolina Annual Fall Conference November 1 in Columbia.
  • Experian Health and StayWell will exhibit at the Healthcare Internet Conference November 4-6 in Orlando.
  • PerfectServe will exhibit at the Society of Hospital Medicine Leadership Academy November 4-7 in Nashville.
  • Surescripts will exhibit at the PointClickCare Summit November 3-6 in Dallas.
  • Vocera will exhibit at the Florida Organization of Nurse Executives Fall Conference November 7-8 in Orlando.

Blog Posts


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Contacts

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News 11/1/19

October 31, 2019 News 1 Comment

Top News

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Point-of-care patient education and marketing company Outcome Health avoids prosecution by the DoJ for the fraudulent acts of former executives by agreeing to pay $70 million in restitution to customers and to continue with its remediation efforts.

The Chicago-based company was once valued at $5 billion. Its founders came under fire in 2017 for overcharging drug company advertisers by intentionally inflating the number of waiting room screens running their ads, manipulating third-party ad performance analyses, and creating phony ad campaign screen shots.


Reader Comments

From Rolling it Back: “Re: Walmart Health. Any idea what they are using for an EHR in their new clinic?” I posed that question to Walmart’s PR team, but haven’t heard back so far. Jenn did a a couple of visits to the clinic since the pilot site is in her home town. They told her they’re using Athenahealth, Orchard for labs, and a third system whose name the tech couldn’t recall. They’re also using Zotec for patient self-scheduling. You can read her first-person experience as a patient here.

From Barred Roller: “Re: surveys. Have you done a survey of hospital C-suite leadership about how they use KLAS in making decisions?” I’ve done various KLAS-related poll questions, but respondents are anonymous and thus not limited to verified hospital executives. My experience is that health systems use KLAS more for vendors outside the inpatient EHR realm, since for those, most hospitals will have just two logical choices (not always Epic and Cerner, I should add) and can pick one without help, using factors that go beyond simple user scores. It’s also good to sneak a peek before naming your frontrunner since your executive peers and board members may do that (at the urging of one of the companies that is in the hunt, sometimes) and you need to be ready to explain why you’re buying the #3 product. Lastly you read the comments to make sure you aren’t surprised by a subtle trend, a user-reported issue that hits home, or any good or bad results that were caused by switching to or from your chosen product. All that aside, a health system that is competent and earnest should be able to make their own decision based on references, site visits, and the vendor’s willingness to pay penalties for failing to deliver. That last item is a big one – while health systems sometimes choose a product unwisely, more aggressive contract T&C instead of just signing lawyer-approved boilerplate would flush out a pretender vendor who knows their own weaknesses, but hopes you don’t. List your biggest fears and account for them with required penalties.

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From Stock Picker: “Re: health IT stocks. I don’t understand why people buy shares of second-rate product and service vendors. Can’t they read financial reports?” While share price will eventually reflect company performance — even as shifty executives try to keep the shell moving with slick financial transactions and market-confusing acquisitions – a share of stock is ultimately worth exactly what someone else will pay you to take it. Shareowners don’t necessarily have any more confidence in the long-term performance of a company than skeptics, but rather hope that company news, irrational stock market exuberance, or the possibility of an acquisition will reward their patience. TL; DR: share price is a reflection of many factors, of which hard performance numbers play a minor role (until they don’t).


HIStalk Announcements and Requests

The folks at Definitive Healthcare confirmed a reader’s question about the Meditech replacement at Christus Good Shepherd Medical Center – Longview (TX) as I mentioned Monday. Definitive rechecked and they are indeed  moving to Epic, not Cerner. Thanks for the correction.


Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

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Meditech reports Q1 results: revenue up 2%, EPS $2.44 vs. $0.52, although the net income increase was due to selling a building for $120 million that booked a gain of $89 million. Product and service revenue both increased slightly

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Huron joins virtual hospital company Medically Home Group’s Series B round of funding and becomes the exclusive implementation partner for its hospital-to-home care services.

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Optum acquires remote patient monitoring startup Vivify Health. Founder and CEO Eric Rock also founded EDIS vendor Medhost.

Falconer Pharmacy in New York files a class-action lawsuit against Surescripts, alleging that the company has forced the pharmacy to use its e-prescribing network to avoid higher transaction rates as a “non-loyal customer.” The suit names Allscripts and RelayHealth as co-conspirators.

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Group purchasing organization and consulting firm Premier Inc. acquires Medpricer, a developer of purchased services management technology, for $35 million.


Sales

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  • In England, Alder Hey Children’s Hospital in Liverpool will implement Meditech Expanse.

People

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Cardiologist David Tsay, MD (Columbia University Medical Center) joins Apple’s health team.


Announcements and Implementations

Audacious Inquiry will work with The Sequoia Project to expand availability of the Patient Unified Lookup System for Emergencies (PULSE) during disaster response efforts. The system was initially used by the California Emergency Management Services Authority during wildfires in 2017.

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Livongo adds telemedicine services from MDLive and Doctor on Demand to its digital solutions for patients suffering from chronic conditions.

Geisinger (PA) implements Life Image’s Mammosphere software, giving women the ability to request, store, and share breast health records through its system-wide KeyHIE.

USF Health Morsani College of Medicine (MCOM) at the University of South Florida will partner with Microsoft to create a Medical School of Innovation in the school’s new building that will open soon. Microsoft will provide Teams, Power BI, curriculum-monitoring analytics, and Surface Studios and Hubs. 


Government and Politics

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Finger-pointing ensues after Australian media outlets report that senior Queensland Health officials emailed staff at the region’s hospitals ordering them to avoid performing upgrades to digital systems – including Cerner’s problematic IEMR software – while parliament is in session so as to avoid embarrassing scrutiny from politicians. A Queensland Health representative has since labeled the email inappropriate, adding that planned upgrades will take place with at least a week’s notice and at times that are least inconvenient to patient care.

Beckman Coulter Diagnostics will use a $2.5 million grant from HHS to develop and commercialize a sepsis-detection algorithm for hospitals.


Other

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Popular Science profiles the progress Facebook and the NYU School of Medicine’s Department of Radiology are making with their FastMRI project. Announced a little over a year ago, the knee-focused project aims to develop AI that can generate MRI scans up to 10 times faster than traditional methods. Researchers are preparing to submit their study for academic review. Once submitted, they’ll then study whether AI-created images match what surgeons see when they perform knee surgeries.

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Wolters Kluwer will use a $1 million grant from Ancestry to develop ways providers can interpret and act on the results of genetic testing using its UpToDate evidence-based clinical resource. Ancestry began offering genetic testing alongside its family heritage services earlier this month.

Astria Health (WA) lays off staff and implements a shared services agreement in hopes of emerging from the Chapter 11 bankruptcy it filed in May 2019. It said an unnamed vendor was unable to collect $75 million in patient revenue. The health system implemented Cerner in mid-2018. Its new revenue cycle outsourcer is Gaffey Healthcare.

Medical residents and fellows at Yale New Haven Hospital crash a graduate medical education committee meeting to unfurl a banner reading “Doctors are Humans Too” and to present a Bill of Rights in which they demand working conditions that are safe for patients, elimination of workplace discrimination, adequate supervision, fair evaluations, treating patients the same regardless of their ability to pay, comprehensive health insurance with mental health coverage, and being paid a living wage.

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Wags speculate that the suddenly widespread shortage of black turtlenecks in San Francisco is being caused by their repurposing for Halloween costumes by people who are dressing up as disgraced Theranos CEO Elizabeth Holmes.

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Weird News Andy says this patient can no longer count to 24, but will save on pedicures. Surgeons in China remove the four extra toes on a 21-year-old man’s left foot. He had stopped wearing sandals and has never had a girlfriend because of his insecurity, but his parents had refused to let him have the surgery because the extra digits were a “gift from the heavens” that could always be covered up with shoes (unless they are Vibrams).


Sponsor Updates

  • EClinicalWorks will exhibit at APHA 2019 November 3-5 in Philadelphia.
  • Ellkay and InterSystems will exhibit at the CHIME CIO Fall Forum November 3-6 in Phoenix.
  • Ensocare will exhibit at the ACMA Greater Houston Chapter Annual Conference November 2 in Houston.
  • TriNetX will report its findings about using EHR data for research at ISPOR Europe 2019 November 2-6 in Copenhagen, Denmark.
  • Healthwise and Kyruus will exhibit at the Healthcare Internet Conference November 4-6 in Orlando.
  • Meditech publishes a new case study, “Summit Pacific Increases Reimbursement, Clinic Volumes with Meditech Analytics.”
  • The Chartis Group names Roger Ray, MD (Atrium Health) physician consulting director.
  • Black Book names Nuance the top vendor for end-to-end coding, CDI, transcription, and speech recognition technologies for the seventh consecutive year.
  • Prepared Health CEO Ashish Shah will speak on a panel at the PointClickCare Summit: “Using Data to Build a Bridge to Better Care,” November 5 at 1:45 in Dallas.
  • Google Cloud adds digital clinical assistant startup Suki to its Partner Advantage Program.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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News 10/30/19

October 29, 2019 News 16 Comments

Top News

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Facebook will use the demographics of its users to present them with preventive health information and reminders. It will allow them to search for providers, set appointment reminders, and mark the item as completed.

Facebook claims that it won’t use detailed user information, won’t use the data collected to present targeted advertising, and will store the information securely.

The functionality was developed by Freddy Abnousi, MD, MBA, MSC, a Facebook employee who previously designed a system in which de-identified hospital data provided to Facebook would be re-identified against its own user data to alert hospitals of potentially beneficial interventions. That project was killed off following the Cambridge Analytica scandal.


Reader Comments

From Down Low: “Re: GSI Health. Has been acquired by Medecision.” Unverified. DL left a message on my rumor phone line. GSI Health offers population health management technology and was founded by Lee Jones, MS in 2003. UPDATE: Medecision announced the acquisition Tuesday afternoon. GSI’s platform will become part of Medecision’s Aerial.

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From Minibar Raider: “Re: HLTH. Received this Dilbert by email, which seems apropos. And Livongo has branded the room keys!” HLTH seems to have attracted a lot of expense account-flush C-level vendor and provider executives. Its glitz and VC-funded excess seems right at home in Las Vegas (it is ironic talking about health behaviors within lavish temples that were built on addictive gambling, smoking, overeating, high alcohol consumption, and most likely some sex-related risk factors). I guess I’m just cynical about wealthy C-level executives trying to sound convincing in proclaiming patients and humanity as their primary motivators, although at least a few presenters fit that description. John Halamka tweeted that HLTH is “a perfect hybrid of JPMorgan and Burning Man,” noting an attendance of 6,000. Bizarre: one HLTH attendee’s exhibit hall photo showed a booth consisting of an oversized barber shop with at least five chairs in which attendees were getting actual haircuts. That’s some original booth thinking. UPDATE: the thinking isn’t that original and its very much not the same as the non-commercial Burning Man – HLTH brought in London’s Pall Mall barbers to offer wet shaves and haircuts during conference breaks, which could be sponsored for $40,000 for each break. The same amount of sponsor money would place signage on the Drybar hair styling booth, or you could spend a little more to sponsor a restroom to “capture our attendees’ attention when and where they least expect it.” This is all amusing until you realize who’s paying.


HIStalk Announcements and Requests

I’m amused that stay-at-home people now report their gossip-focused findings (obtained by all-day peering through their windows or listening to scanners) via the new busybody networks of Nextdoor and Facebook neighborhood groups. I can summarize 90% of their poorly written messages as follows: (a) did anybody hear that big noise just now? (b) my power is out, anyone know why or when it will come back on? (c) where were all those police cars going out on the highway? (d) what’s with the traffic backup? Many posters seem incapable of Googling since they ask easily answered questions about business hours and school calendars. Then we have the paranoid neighborhood alerts that someone black, Hispanic, or under 21 was seen “acting suspiciously” (meaning: daring to exist close by). It’s hard to remember that before social media, you only knew how weird or downright disturbing neighbors are when you saw them in the driver’s license office or the ED.


Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

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Reuters reports that Google owner Alphabet has made an offer to acquire Fitbit, which has been attempting to turn itself into a healthcare technology business as its wearables market share slides in the face of stiff competition.

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Revenue cycle technology vendor ESolutions acquires Medidal (Medical Data Logistics), which sells systems to help providers identify missed revenue opportunities in the areas of transfer DRGs, payer eligibility, and pharmacy claims. ESolutions CEO and industry long-timer Gerry McCarthy joined the company in 2018 after serving in executive roles at McKesson Provider Technologies, HealthMedx, and TransUnion Healthcare.

Walgreens will close 40% of its in-store clinics, but will keep the 200 clinics that it runs with health systems. Analysts say the in-store clinics aren’t profitable and face competition from telemedicine services. Walgreens will add Jenny Craig weight-loss sites to 100 stores.

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The HLTH conference’s non-profit foundation acquires CSweetener, a IT executive mentor matching platform for women. The organization’s staff consists of three women named Lisa, with investor and co-founder Lisa Suennen being the most recognizable.

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Albuquerque-based patient engagement app vendor Twistle raises $16 million that it will use to expand its office space, increase headcount, and bring on new employees in Seattle. Founder and CEO Kulmeet Singh was formerly VP of strategic planning for Nuance before starting Twistle in 2010.


Sales

  • Netsmart signs a 10-year deal with pediatric home care provider Aveanna Healthcare, whose 30,000 clinicians and employees across 200 locations in 23 states will use Netsmart’s MyUnity EHR, analytics, and learning management systems.  
  • Adirondack Health Institute chooses Netsmart’s CareManager population health management platform for its New York Health Homes initiative.
  • Primary care house call vendor and DaVita subsidiary provider Vively Health will implement Cerner Millennium, HealtheIntent, and HealtheLife.

People

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Industry long-timer Michael Lovett, MBA (Formativ Health) joins Northwell Direct, Northwell Health’s new direct-to-employer health services business, as COO. 

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Voice- and AI-powered virtual physician assistant vendor Saykara hires Graham Hughes, MBBS (Sutherland Healthcare Solutions) as president.

Rob Anthony (CMS) transitions to director of certification and testing for ONC’s office of technology, where he will oversee health IT certification. He replaces USPHS Captain Alicia Morton, DNP, RN, who will become senior advisor to Deputy National Coordinator Steve Posnack, MS, MHS.


Announcements and Implementations

An InterSystems survey finds that private hospitals in Southeast Asia will dramatically expand their health IT capabilities over the next five years to support value-based care and care coordination. Hospital executives expect to see big gains in the use of analytics and AI as paper records are replaced with their electronic counterparts.

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A new KLAS report on global vendor-neutral archive finds that Philips (via its August 2019 acquisition of Carestream HCIS) and Fuifilm deliver scalability and geographic breadth, while Agfa, Sectra, and Hyland run in region-wide deployments with inconsistent delivery. Customers of GE Healthcare report lack of support and partnership, while those of Siemens (deployed mostly in Europe) complain about third-party implementers and inconsistent customization expertise. Mach7 and Intelerad show promise given limited customer data. KLAS notes, however, that it surveyed each vendor’s list of their own best customers, which may not be representative.

Nuance adds The Sullivan Group’s risk mitigation and safety content to a new Dragon Medical Advisor ED solution.

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Digital-first national medical group Crossover Health will offer self-insured employers the ability to deliver primary care services, care management, and secondary care coordination in its Connected System of Health  program. Crossover supplies the provider team and a proprietary EHR that includes customer relationship management, secure messaging, and project management. Comcast NBCUniversal is the first customer. CEO Scott Shreeve, MD co-founded the company in 2006 after leaving EHR vendor Medsphere, which he also co-founded, in 2006.

Mastercard announces Healthcare Solutions, extending the capabilities of its healthcare account payment cards to help hospitals offer more effective billing methods for a given patient, for payers to identify potentially fraudulent claims, and to provide biometric mobile access to accounts.


Government and Politics

The Federal Bureau of Prisons issues an RFI for an EHR and patient management system, 


Other

The Verge notes that California’s electricity blackouts are forcing hospitals to decide which equipment – such as refrigerators vs. EHRs – to run on backup generators. That is a real-life example from FQHC Winters Healthcare, which decided to keep some lights on and its EHR running for a planned outage that could last anywhere from one to five days. Hospitals switching to generator risk lengthy system reboots, equipment damage, and potential patient harm caused by drug dispensing cabinet downtime, patients stumbling in the dark, and in influx of patients from homes and skilled nursing facilities without power who use medical equipment such as ventilators and IV pumps. The executive director of Winters Healthcare headed out once power was restored to buy more emergency lighting and another generator since he is worried that power outages could be “the new normal.”

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Beijing-based Lepu Medical — which offers an FDA-approved, $2-per-day heart attack risk warning system that was trained on the publicly available data of 500,000 hospitalized patients in China – says its system isn’t selling well in the US because hospitals that are paid well for visits and surgeries see it as a threat to their profits. He also blames malpractice fears and the expensive, time-consuming process of researchers who conduct studies and wait for the results to be published. The company is basically giving up on US hospital sales and will instead work with an online medical visit provider and an ECG company.

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Former college offensive lineman T. J. Abraham, DO was forced to finally retire from his OB-GYN practice when his football-related chronic traumatic encephalopathy left him unable to prescribe drugs or perform surgeries without first covertly checking an app.

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A hospital in China suspends several nurses and employees who were captured on video lining up to pose on the bed formerly occupied by a celebrity singer from Singapore. Afterward, someone listed his used IV bag and syringe for sale online.


Sponsor Updates

  • OptimizeRx integrates its solutions into a single platform, including those from its recent acquisition of digital therapeutics vendor RMDY Health and its partnership with e-prescribing software vendor NewCrop.
  • Pivot Point Consulting, A Vaco Company is named to Consulting Magazine’s 2019 list of fastest-growing firms, rising to #15 in its fifth consecutive appearance.
  • Also on Consulting Magazine’s fastest-growing firms list: Impact Advisors.
  • Surescripts recognizes a dozen leading health system, pharmacy, and EHR vendors with its White Coat Award for their improvements in e-prescription accuracy.
  • Spok’s Connect 19 Conference provides attendees with insights into healthcare communication in the cloud.
  • AdvancedMD will exhibit at the APTA PPS event October 30-November 2 in Orlando.
  • Divurgent launches an internal department that will focus on expending into new markets and nurturing client and consultant relationships.
  • Arcadia publishes a new white paper, “Measuring Care Management: Maximize the Value of Your Care Management Program.”
  • Datica releases a new edition of its 4×4 Health podcast, “International Health IT.”
  • Cumberland Consulting Group will exhibit at the CHIME19 Fall CIO Forum November 3-6 in Phoenix.
  • Dimensional Insight will exhibit at the ACHE Fall Conference November 1 in Needham, MA.

Blog Posts


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Contacts

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Monday Morning Update 10/28/19

October 27, 2019 News 17 Comments

Top News

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From the Cerner earnings call:

  • Chairman and CEO Brent Shafer says Cerner’s partnership with Amazon Web Services will create “advancement in the overall user experience” and will increase Cerner’s profitability.
  • The company blames a lack of growth in managed services and support revenue on former Siemens Health Services customers who had decided to leave years ago and are finally doing so, although the retention rate in that business is still 80%.
  • The termination of Adventist Health’s revenue cycle outsourcing agreement, which Cerner says was a joint decision, will reduce Cerner’s annual revenue by $170 million and triggered a $60 million charge this quarter. The company says it will become more selective in future RCM outsourcing deals based on potential margin and probably won’t offer full outsourcing going forward.
  • The Coast Guard will begin its Cerner implementation this quarter.
  • Cerner’s acquisition of government contractor AbleVets will involve a $75 million cash consideration and will contribute $90 million to 2020 revenue.
  • Positive feedback on its attempts to fix its revenue cycle management problems has led several large clients to initiate a move to Cerner revenue cycle.
  • An unnamed, previously dissatisfied Cerner academic system customer has become a top Cerner reference site and will convert 125 of its clinics from Epic to Cerner.
  • The company believes non-US markets will remain attractive.
  • 80% of Cerner’s clients are hosted.
  • The first Cerner product to move to AWS will be HealthIntent in the first half of 2020.

Reader Comments

From Daddy Shark: “Re: health system CIOs. We just had a deal killed off by an overly aggressive CIO who I think just wanted to flex their power over the medical staff.” Here’s why CIOs and IT governance committees reject user requests for new software, just like parents often say “no new puppy” to their pleading / demanding children even if they promise to take care of it:

  • It’s not in the IT budget. It doesn’t matter that the requesting department “has the money” as they always say – if IT is underfunded and departments have budget surpluses that allow them to make their own IT decisions, then the C-level people aren’t looking at IT strategy and costs correctly.
  • Nobody has analyzed how much money and resources the project will consume over a 10-year useful life.
  • The product is technologically risky, hard to support, or requires hard-to-find expertise.
  • The vendor’s expertise or likely survival is questionable, the proposed contract terms and conditions are unacceptable, or the company has a reputation for under-delivering after the contract is signed.
  • The software requires other departments that weren’t involved in the decision to do more work or spend more money.
  • The user department has stars in their eyes from a vendor-provided, unrealistic vision of post-implementation bliss, forgetting that their department is resistant to changing processes, has failed to successfully manage previous projects, doesn’t optimally use the systems they already have, or are unlikely to be able to juggle the demands of a new implementation with routine departmental operations.

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From Bob: “Re: old LP album. Found this in my mom’s collection. Health IT vendors used to commission albums of smooth background piano music.” Wow, that’s cool. The 1985 album, distributed by then-health IT vendor McDonnell Douglas Physician Systems Company, features space pop composer and pianist Charles Albertine, who died the following year at 57. Copies are available on Amazon and Ebay, but you can stream the whole thing on YouTube. It’s pretty good for what it is.

From Impending Doom: “Re: racial bias in AI. How is that even possible?” It’s the data or the process used to interpret it that is biased. AI simply creates a model that describes the data humans give it, so any bias that is implicit in the data or the process that created it will be faithfully replicated by AI. It’s the job of humans to fully understand the characteristics and limitations of available data before applying AI inappropriately. It’s also the job of AI scientists to watch for bias and to understand how the machine has reached its conclusions, which isn’t easy given the “impenetrable black box” nature of some AI / ML projects, especially the proprietary ones. I hope the technology companies that are pushing AI realize that their clinically focused products won’t get much traction unless they are willing and able to articulate how their algorithm works under the covers, since those who are using it are placing their professional licenses at risk.

From Racing for the Cure: “Re: breast cancer awareness. Lots of pink this time of year.” Working for health systems has jaded me to the gulf between individual human empathy and the corporate interests embedded within every aspect of healthcare, but I’ll at least acknowledge that good people are trying to show their support while having fun. Still, I can’t forget that a lot of companies and people wouldn’t be wallowing in cash if it weren’t for exceptionalistic Americans who think we just need to fight harder and give big corporations more money so we can rule the world and triumph over our own mortality.


HIStalk Announcements and Requests

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Poll respondents place KLAS just head of “none of the above” for offering the most meaningful industry award. Next was the HIMSS Davies Award and it got ugly fast, with the HIT 100 (I don’t recall exactly what that is since I copied it over from a years-ago poll I ran) finishing dead last at 0.65%. The list was little changed from mid-2017, including the same top two finishers and the same last-placer.

New poll to your right or here: what are your HIMSS20 plans? I run this every year right about now, trying to get a general handle on how conference attendance is looking.

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I finally decided to do something about the drawer full of memory cards that span many years and digital cameras. Solution: a 2-terabyte, USB 3.0 Western Digital Easystore portable hard drive that is nearly as fast as a flash drive and requires only the USB connection with no power cord. I just plugged it in and started copying 25,000 photos from an old Windows 8 laptop that was the temporary home of a bunch of these cards from a similar project that I abandoned previously. I hadn’t done the space calculation in my head, so I was surprised that the space consumed was barely a blip of the 2 terabytes. The next step is to move photos into individual folders for each month and year and then copy over the individual memory cards as I try to decide how to handle duplicate files, which with this much cheap storage may mean that I don’t even try to de-duplicate. I paid $59.99 on sale and shipping was free. The drive includes some seemingly well-designed backup software that I don’t need. The old memory cards will provide a backup since their capacity and speed make them obsolete.


Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

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Vocera announces Q3 results: revenue up 6%, adjusted EPS $0.23 vs. $0.20.

Canada-based mobile healthcare system VitalHub acquires startup Oculys Health Informatics, which offers a hospital operations dashboard, for $4.2 million.

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I notice that NantHealth shares are trading at $0.75, down an eye-popping 96% since the company’s splashy mid-2016 IPO and valuing the company at just $83 million. Related company NantKwest shares are at $1.19, down 97% from their IPO-day spike in July 2015. I also noticed that NantHealth’s 10-member executive team is all male except for the VP of human resources, while six of seven executives of NantKwest are male.

CNBC profiles Heal, which offers on-demand doctor house calls for $159 in nine cities. The company has raised $75 million from backers that include former Florida Governor Jeb Bush and singer Lionel Richie. I’m always fascinated by companies that pay professionals X but bill them out at multiples of X while adding what seems like minimal value.


Sales

  • Beaumont Health will implement Mobile Heartbeat’s MH-Cure clinical communications platform in a partnership agreement that includes GE Healthcare.
  • Children’s National Research Network will expand its implementation of the TriNetX global health research network to Children’s National Hospital (DC).

Decisions

  • Huron Regional Medical Center (SD) will replace CPSI Evident with Cerner in 2020.
  • Centra Southside Community Hospital (PA) will replace Omnicell automated dispensing machines with Cerner RxStation.
  • Advocate South Suburban Hospital (IL) will implement Epic’s Beaker laboratory information system in November 2019, replacing Sunquest.
  • Christus Good Shepherd Medical Center – Longview (TX) will replace Meditech with Cerner in 2020. CORRECTION: Definitive Healthcare rechecked with the client and verified that a reader’s report is correct – Christus is moving to Epic, not Cerner.

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


People

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Cone Health (NC) promotes Ben Patel, MS, MBA to EVP/CIO.

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Lisa Maki (PokitDok) joins Microsoft as GM of health alliance formation.


Other

A hospital in China goes live on blockchain-powered patient billing, in which patients can pay their QR-coded bill using the WeChat app. 

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This is depressing. A high school volleyball team’s bake sale raises $1,650 to help Santa Ynez Valley Cottage Hospital (CA) buy a 3D mammography system. Clinical benefit to patients is questionable, but the financial benefit to the hospital is a sure thing. Also depressing is that according to tax filings, the donation would cover about three hours of pay for Cottage Health’s CEO. I wonder how many parents of these kids could afford a visit to the hospital’s ED with a volleyball-caused sprain?


Sponsor Updates

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  • StayWell partners with the California Department of Human Resources to sponsor 7,695 meals for the California Association of Food Banks.
  • Glytec will exhibit at Becker’s CEO + CFO Roundtable November 11-12 in Chicago.
  • A UCLA study finds that use of Healthwise’s shared decision-making tools in primary care clinics increased the participation of prediabetic patients in diabetes prevention programs.
  • Netsmart and Vocera will exhibit at the LeadingAge Annual Meeting and Expo October 27-30 in San Diego.
  • Mobile Heartbeat will exhibit at SC HIMSS November 1 in Columbia.
  • Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the Maternal Health & Perinatal Safety Symposium November 1 Tenafly, NJ.
  • PracticeSuite selects Relatient to power patient reminders, intake, surveys, secure messaging, and self-scheduling for 57,000 medical professionals.
  • T-System and Wellsoft will exhibit at the 2019 ACEP19 Scientific Assembly October 27-30 in Denver.
  • Over 100 top US health systems attend the 2019 Strata Decision Technology Summit to help bend healthcare’s cost curve.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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News 10/25/19

October 24, 2019 News 2 Comments

Top News

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Cerner reports Q3 results: revenue up 7%, adjusted EPS $0.66 vs. $0.63, meeting analyst expectations for both.

The company issued mixed Q4 guidance.

Cerner shares dropped a few percentage points in after-hours trading following the earnings announcement.


Reader Comments

From AZ: “Re: Care Innovations, the Intel and GE joint venture. Heard they are in trouble and almost closed their doors a couple of months ago.” Unverified. The joint venture, formed in 2011 if I recall correctly, hasn’t had much to say beyond touting a remote patient monitoring system.


Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

NextGen Healthcare reports Q2 results: revenue up 3%. adjusted EPS $0.24 vs. $0.24, beating earnings estimates but falling short on revenue.

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InterSystems will expand its work with partners in China after seeing revenue there increasing 18-20% annually as that country’s economy grows and its healthcare sector undergoes digital transformation. 

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Viz.ai will use a new $50 million Series B investment to expand the availability of its AI-powered stroke detection software.

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Amazon will offer newly acquired Health Navigator’s symptom-checker and triage chatbot service to its employees as part of its Amazon Cares virtual clinic pilot. Health Navigator founder and CEO David Thompson, MD is also know for his co-development of a set of globally-used telephone triage protocols.

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Belgium-based digital imaging company Agfa is reportedly accepting bids for its health IT business. The company announced its intent to divest the enterprise imaging and integrated care business in 2017.


People

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Pivot Point Consulting (The Christ Hospital Health Network) names Mauraan Schultz VP of delivery.

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TriCore Reference Laboratories gives CIO James Brown the additional role of CEO of its Rhodes Group LIS and consulting subsidiary.


Announcements and Implementations

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Northwell Health works with health IT vendor MphRx to develop an app that lets patients schedule blood draws from their home or office. The LabFly app comes with a $20 convenience fee and adds payment processing, lab-tech tracking, and access to lab results.

Verily will work with the VA health system in Palo Alto, CA and Atrius Health in Massachusetts on population health projects that will focus on improving care and outcomes for patients undergoing knee replacements, going through alcohol withdrawal, and recovering from heart attacks.

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Nordic completes its move to a new Madison, WI office, doubling its square footage to 50,000 and giving employees views of the University of Wisconsin Arboretum through 12-foot-tall windows. 

Strata Decision Technology announces StrataJazz OnePlan, an advanced planning platform that streamlines budgeting and planning.

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A new KLAS survey of 30,000 physicians via its Arch Collaborative finds that while physicians in some specialties (hospital medicine, pathology, pediatrics) are more satisfied with their EHR than others (plastic surgery, cardiology, orthopedics), it is not consistent and may be driven more by the quality of their initial training. Still, physicians in some specialties say the EHR is too bulky for their limited needs, while others report its inability to accept their drawings or images. More Epic-using specialists say they have the functionality they need vs. Cerner users, but users of both products report deficiencies in their ophthalmology and dermatology capabilities. The report concludes that the quality of initial training, availability of follow-up training, and assistance with personalization can improve satisfaction across all specialties. It would be interesting to see how physician personality type, age, and employment status drove the individual specialty scores.


Government and Politics

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The HHS Office for Civil Rights fines Jackson Health (FL) $2 million for a three-year string of HIPAA violations related to losing paper records, failing to notify authorities in a timely manner about the loss, staff improperly accessing patient medical records and then posting PHI on social media, and a separate incident in which an employee attempted to sell PHI, among other privacy failures. Jackson Health is the same organization linked to an ESPN reporter’s posting of NFL player Jason Pierre-Paul’s medical chart on Twitter, with the report that he had blown off his finger with fireworks on July 4, 2015 derailing his $60 million contract negotiations with the New York Giants.

Texas Health Resources reports that 82,000 people have been impacted by a billing system error that led to it accidentally mail patient information to the wrong recipients.


Privacy and Security

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A Health Services Research study finds that mortality rates among heart attack patients increase at hospitals that have experienced a data breach, with as many as 36 additional deaths per 10,000 heart attacks occurring annually at the hundreds of hospitals studied. The study’s authors found that it took an extra 2.7 minutes for a patient to receive an ECG at a hospital that had experienced a breach, with the lag time remaining as high as 2 minutes up to four years after the hack. Though the researchers didn’t analyze what, if any, additional cybersecurity controls were installed at the hospitals, they have surmised that increased software log-in and access times at these facilities have had a direct impact on heart attack mortality rates.


Other

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An AP article questions the role stethoscopes have left to play in healthcare in light of their higher-tech counterparts. The advent of app-based, handheld devices that use ultrasound and artificial intelligence seem to slowly be edging out the traditional instrument invented by French physician Rene Laennec in 1816. While celebrity MDs like Eric Topol consider it to be obsolete, others working in the trenches of daily care have yet to be fully swayed by shiny new objects that come with considerably higher price tags.

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And speaking of Eric Topol, he responds to Time’s latest cover story on the robot-ization of healthcare.


Sponsor Updates

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  • Glytec becomes the third largest corporate fundraiser for the American Diabetes Association’s Step Out Walk to Stop Diabetes – Boston.
  • Healthcare Growth Partners advises hospital laboratory consulting firm Accumen during its acquisition of 3DR Laboratories.
  • EClinicalWorks will exhibit at the 2019 AAP National Conference & Exhibition October 25-29 in New Orleans.
  • Ensocare will exhibit at the ACMA Oregon Chapter Annual Conference October 26 in Welches, OR.
  • The Tampa Bay Business Journal names Greenway Health Senior Director of Organizational Effectiveness and Transformation Kirsten Schreiter a 2019 People First honoree.
  • Hayes Management Consulting will exhibit at the HCCA Clinical Practice Compliance Conference October 25-27 in Nashville.
  • KLAS Research ranks InterSystems among the top interoperability vendors of 2019.
  • Kyruus and Prepared Health will exhibit at the HLTH Conference October 27-30 in Las Vegas.
  • Redox publishes the results of its “Mobile Health Survey.”
  • ZeOmega names five healthcare leaders to its Advisory Board.
  • Pivot Point Consulting names Joe Clemons (Vancouver Clinic) director of advisory services.
  • Spok publishes a new e-book, “Contact centers in healthcare.”
  • Meditech publishes a new case study, “Physicians at Halifax Health Go Mobile with Meditech Expanse.”
  • Optimum Healthcare IT publishes a white paper titled “ERP System Selection – Evaluating Options and Building Consensus.”

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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News 10/23/19

October 22, 2019 News 9 Comments

Top News

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Recruitment and consulting firm Ettain Group acquires Leidos Health, announced in parallel with Ettain parent company NMS Capital’s sale of its Ettain stake to A&M Capital.

Leidos Health, formed by the merger of Vitalize Consulting Solutions and MaxIT Healthcare, will be renamed Ettain Health.

I confirmed and published a reader’s accurate rumor report on September 18. Leidos said at that time that 850 employees will transfer to the new company.


Reader Comments

From NI: “Re: informatics nurses. How are they perceived in health systems?” Very well, in my experience of having had those folks report to me. Physician informatics is a tougher job because it’s a small number of people, often just one, and peers are suspicious of a doctor who has crossed over to the “dark side.” This is often amplified by specialty rivalry, in which big-ego specialists scoff at the idea that an informatics doc from a different specialty can understand their needs. In contrast, nurses seem to appreciate their peers who have moved into nursing (applied) informatics, with no feelings of resentment that I’ve ever seen (they are still respected nurse colleagues regardless of job description). It helps that health systems wisely choose informatics nurses who are  experienced process change leaders and patient care advocates. They also benefit from their greater team numbers and their deeper process knowledge since they are usually hired from within. Lastly, they love patients more than computers and thus aren’t seen as token IT geeks stumbling around blindly on the floors. Informatics nurses are the unsung heroes of any health system’s IT successes, with “unsung” meaning that clueless doctors, ancillary departments, and executives often override them just because they can. I blame organizational culture and some degree of bias in that 90% of nurses are female in a male-dominated culture, they were not taught in nursing school to be Type A backstabbers and gunners, and they are usually less interested in organizational politics and ladder-climbing than they are in patient care. As I often say, without skilled bedside nurses, a hospital is just a consumer-hostile, poorly run, but fabulously profitable hotel.

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From Rich Mandarin: “Re: grammar peeves. One of my favorite aspects of HIStalk is hearing your latest. As it’s been a while since you’ve posted some, are any currently at top of mind?” First, I promise that I didn’t make this comment up just to pontificate. I’m not a mistake-free grammar zealot who corrects others individually for their casual writing, but rather someone who respects the time and intelligence of business readers who don’t necessarily know me personally, which is why I might open Christmas presents wearing rumpled sweatpants and a King Crimson tee shirt that wouldn’t be my first choice around first-impression strangers at work or a conference. Good business writing should be concise and barely noticeable, free of distracting mistakes and quirky style. Peaking my peeve-meter lately, although not specifically limited to grammar, are these:

  • Using the trendily pompous word “curate.”
  • The possessive “its” being misused as “it’s” about 90% of the time, which I fear is a lost cause since social media has emboldened poor writers to just defiantly throw their mistakes and half-baked thoughts out there, often dictated into speech recognition apps without review.
  • Starting sentences with “know” in an awkward attempt to convey phony corporate emotion, as in, “Know that we care about your health” instead of the identical “we care about your health.”
  • Starting sentences with “so,” a Millennial-common writing crutch that turns everything into a bar story, as in, “So my grandmother died last week …”
  • The informal usage of “Dr. John Smith” instead of the correct listing of John’s specific doctorate.
  • Not using the serial (Oxford) comma, thus saving yourself one keystroke while forcing your reader to re-read your messy sentence. 
  • Non-experts using “pop health” to make themselves sound like insiders, which is even sillier when what they really mean is “population health management,” or in most cases, “population health management technology.”
  • The word “utilizes,” which is just a puffed-up way of saying “uses.” Ditto “leverages.” You’re trying too hard to sound smart.
  • FHIR puns that weren’t even clever the first thousand times.

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From HIMSS20 Keynote Speakers – Again?!: “Re: Alex Rodriguez. I just received an email that he will be the Friday afternoon HIMSS20 keynote speaker. What’s your take on the announcement?” High school graduate, stick-and-ball gazillionaire, and admitted steroid user (in between lying through his teeth about it) A-Rod commands a speaking fee of “$100,000 to $1 million” in yet another example of someone being paid exorbitantly for providing minimal societal benefit. Financially struggling patients must be thrilled to be underwriting the chance for the highly-paid executives of their local non-profit hospital – at least that handful that stick around until Friday afternoon — to jock it up in A-Rod’s celebrity glow as he opines on analytics (I’m pretty sure he’s no Billy Beane given that he never managed anyone other than himself in baseball, and even did that questionably except for mastering the art of saying “I’m sorry” while continuing to do what he was sorry for). This anemic HIMSS20 keynote lineup isn’t what the conference needs to stanch its attendance bleeding.


HIStalk Announcements and Requests

I need to replace my old Timex Expedition watch, but so many Amazon watch reviewers have complained that they were stiffed with a damaged or cheaper model or one that isn’t authorized for US sale. Amazon does little to police bait-and-switch sellers or those who create phony reviews even when it’s obvious and sometimes its reviews for several product variants are dumped into a single set of shared reviews, to the point that I’m beginning to look elsewhere for many items, the same problem that drove me from Ebay.


Webinars

October 24 (Thursday) 1:00 ET. “The power of voice: Will AI-drive virtual bedside assistants become mainstream?” Sponsor: Orbita. Presenters: Nick White, co-creator of DeloitteAssist and principal in Deloitte’s Smart Healthcare Solutions practice; Bill Rogers, CEO and co-founder, Orbita. Conversational AI and virtual health assistants are bringing new opportunities to care facilities to improve patient journeys and yield radical workflow efficiencies. Will the hospital rooms of the future continue to provide traditional bedside call buttons? Or will these be replaced with digitally reimagined, AI-driven, voice-powered agents? Learn from the expert who created today’s industry-leading, market-proven, virtual bedside assistant.

Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

Clinical trials platform vendor SignalPath raises $18 million in a Series B funding round.


People

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Blain Newton (HIMSS Analytics) joins electronic aircraft systems vendor Beta Technologies as CFO/COO.

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Nuance promotes Jonathon Dreyer to VP of solutions marketing.

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Hill-Rom promotes Trey Lauderdale to VP/GM of care communications.


Announcements and Implementations

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USPTO awards Medicomp Systems a patent – its fourth since 2016 – for its Quippe platform technology that identifies and filters relevant clinical data for presentation to clinicians at the point of care.

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Strata Decision Technology announces StrataSphere, a cost benchmarking platform that aggregates information from 1,000 hospitals that use the company’s StrataJazz product (financial planning, analytics, and performance) for gaining insights into best practices. Strata customers can opt in at no cost.


Privacy and Security

The Washington Post investigates a reader’s complaint that the privacy policy of the Allscripts Follow My Health portal of George Washington University’s faculty practice allows it to use patient information for marketing, including by “marketing partners.” She found no opt-out agreement. The paper contacted Allscripts, which says the company doesn’t disclose identifiable patient data to third-party marketing companies even though its privacy policy reserves the right to do so. The paper seemed surprised to learn that HIPAA doesn’t cover technology vendors, apparently as confused as laypeople in general in thinking that the badly aging HIPAA is a broad-coverage patient privacy law instead of a requirement only of covered entities and their business associates, all of which enjoy broad leeway under the guise of “treatment, payment, and operations.”


Other

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The Dallas paper observes that not only is Children’s Health in Dallas paying $2.5 million for a high school football stadium’s naming rights, it will contribute nearly $3 million in other benefits to the school over the next 10 years. Reason: the high school is in a high-income, high-growth area that a competing health system is eying. It’s hard to believe, but there was a time when non-profit hospitals acted like charities instead of aggressive businesses that strong-arm patient collections for excessive bills while not paying taxes. No wonder private equity firms are buying all the healthcare businesses they can find – the system is now too big and politically well connected to fail.

Kaiser Health News finds that hospital and doctors are pushing 3D mammograms that haven’t been proven any better than traditional ones despite costing $50 more. Manufacturers (Hologic, GE Healthcare, Siemens, and Fujifilm) have paid doctors $9 million for promotional activities and most of the journal articles were written by doctors who have financial ties to the industry. The manufacturers are also spending big money for consumer marketing, paid celebrity tweets, and lawmaker lobbying that has successfully forced insurers in many states – both private and Medicaid — to cover the screening. The National Cancer Institute will spend $100 million of taxpayer money to determine whether the tests help or hurt the women who receive them, the burden of proof of which should have been on those companies that are raking in cash from their sale. 

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The Lansing State Journal notes that a company has created dozens of 40 Facebook-promoted, politically one-sided websites whose names and appearance attempt to fool readers into thinking they are published by local newspapers or business publications. The same firm also publishes “FDA Reporter,” “FDA Health News,” and “Patient Daily.” The latter’s top story opines that it is time to modernize HIPAA, written by fresh college graduate who obediently quoted Joel White of the health IT vendor lobbying group Health Innovation Alliance (in which the kid wrote “HIPPA” five times vs. “HIPAA” once).

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You might expect a journal’s PR company to spell the name of its editor-in-chief correctly (that being John Halamka, MD, MS), but I see quite a few other mistakes in the self-congratulatory press release (I count at least seven errors in the 16-word sub-headline alone). Publisher Partners in Digital Health has also come up with the most unwieldy and contrived conference name I’ve seen — ConVerge2Xcelerate.


Sponsor Updates

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  • The Collective Medical team assembles 1,800 pantry packs and 1,500 trauma kits for a local school district in under an hour.
  • AdvancedMD will exhibit at the American Medical Billing Association conference October 24-25 in Las Vegas.
  • Apixio, Datica, Clinical Architecture, and Diameter Health will exhibit at the HLTH Conference October 27-30 in Las Vegas.
  • Artifact Health will exhibit at the CA ACDIS Conference October 25 in Davis, CA.
  • Gartner includes Atlantic.Net in its “2019 Market Guide for Cloud Service Providers to Healthcare Delivery Organizations.”
  • CompuGroup Medical will exhibit at the Louisiana Primary Care Association Annual Conference October 23-24 in Baton Rouge.
  • Dimensional Insight will exhibit at the DV/NJ HIMSS 2019 Fall Conference October 23-25 in Atlantic City.
  • EClinicalWorks congratulates customer The Family Clinic on winning the 2019 CPC+ Practice of the Year award.
  • Optimum Healthcare IT publishes a Q3 healthcare data breaches infographic.

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Contacts

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Monday Morning Update 10/21/19

October 20, 2019 News No Comments

Top News

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Cerner acquires healthcare security-focused government IT contractor AbleVets. Terms were not disclosed.

The company — formed by former Navy oncologist Wyatt Smith, DO in 2012 — reported $96 million in annual income and 345 employees for 2018. It counts among its clients DoD, VA. and HHS.

Cerner will operate the company as a wholly-owned subsidiary. AbleVets is a subcontractor for Cerner’s VA project.

Smith has an extensive health IT background, having served as VP of healthcare for Agilex, a consultant to ONC, deputy CIO for the Military Health System, and manager of the DoD’s AHLTA EHR. He is board-certified in internal medicine, hematology, oncology, and pathology.

The US Digital Service recommended in March 2019 that private-care eligibility software developed by AbleVets for the VA be scrapped because of flaws that were introduced by a rushed timeline.

Cerner previously hired David Waltman — who had led the VA’s VistA modernization program for two years before moving to AbleVets for a few months — six weeks after the VA chose Cerner in a $10 billion, no-bid contract.

CERN shares dropped 0.5% Friday following the announcement.


HIStalk Announcements and Requests

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Most poll respondents would be wary about seeking treatment from a hospital that is known for suing patients over unpaid bills.

New poll to your right or here: Which industry awards do you find meaningful? I ran this same poll a couple of years ago, so it will be fun to compare results. I also added an “enter your own answer” option in case your favorite award wasn’t listed.

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I saw someone on the new season of “Goliath” who looked a bit like Dennis Quaid, but quite different than the lithe, beaming HIMSS09 keynoter. It actually was Dennis, now 65 and no longer married to third wife Kimberly, who was the mother of the heparin-overdosed twins (born by surrogate in 2007 – Meg Ryan was wife #2) who were the subject of their medication error lawsuit against Cedars-Sinai that questionably earned him the HIMSS speaking spot. Cedars and its employees made all the mistakes, but Quaid went after the deep pockets instead in suing the manufacturer of the drugs and eventually settling with them (Cedars also paid $750,000 after the Quaids hinted that they were considering litigation). He formed a patient safety foundation, merged it almost immediately afterward with the Texas Medical Institute of Technology (it, too seems to have faded), made a couple of related documentaries, and hasn’t shown much patient safety interest in years. HIMSS gave his foundation a $10,000 check on stage back in 2009 in addition to whatever speaking fee he required. These days, Dennis is ripped like crazy, frolicking on the beach with his 26-year-old girlfriend (now fiancé, just announced), and always pictured by me as the swaggering Gordo Cooper in “The Right Stuff” in an acting tour de force that Tom Cruise can only wish he had delivered in “Top Gun.”


Webinars

October 24 (Thursday) 1:00 ET. “The power of voice: Will AI-drive virtual bedside assistants become mainstream?” Sponsor: Orbita. Presenters: Nick White, co-creator of DeloitteAssist and principal in Deloitte’s Smart Healthcare Solutions practice; Bill Rogers, CEO and co-founder, Orbita. Conversational AI and virtual health assistants are bringing new opportunities to care facilities to improve patient journeys and yield radical workflow efficiencies. Will the hospital rooms of the future continue to provide traditional bedside call buttons? Or will these be replaced with digitally reimagined, AI-driven, voice-powered agents? Learn from the expert who created today’s industry-leading, market-proven, virtual bedside assistant.

Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Sales

  • England’s Kettering General Hospital NHS Trust signs a 10-year contract with System C for an integrated clinical record and administration system. McKesson acquired System C in early 2011 for $140 million, then sold it and its other UK health and social care businesses to a private equity firm in mid-2014 for undisclosed terms.

People

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Oracle CEO Mark Hurd died Friday of unspecified causes at 62 following a month-long, health-related leave of absence. He was also CEO of HP from 2005 to 2010.

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Google hires former National Coordinator Karen DeSalvo, MD, MPH (Dell Medical School) to the newly created position of chief health officer. She will report to former Geisinger CEO and David Feinberg, MD, MBA (VP, Google Health) and will join another recent Google / Alphabet hire, formed FDA Commissioner and Duke University vice-chancellor Robert Califf, MD, who will head up Google’s medical strategy and policy. DeSalvo and Califf will start their new jobs later this year.


Announcements and Implementations

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Medical expert opinion software vendor Purview provides financial support to allow cancer patients to obtain a remote second opinion from Memorial Sloan Kettering Cancer Center, with medical records sharing facilitated by medical support services vendor PinnacleCare. Purview’s grant supports the Mike Shane Memorial Fund and will initially focus on bile duct cancer diagnosis. Purview investor Mike Shane died of the disease earlier this year.

EClinicalWorks announces that it supports interoperability with both Carequality and CommonWell.


Government and Politics

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A CBS News poll finds that Americans are more worried about healthcare costs than whether everyone has health insurance. Less than half worry about the quality of care and 79% say they are satisfied with the care they receive. Nearly half say big changes are needed to the US healthcare system, while another 30% think it should be rebuilt from scratch.


Privacy and Security

NHS gives Google access to five years’ of patient data from several hospitals. Five of six trusts that had signed data-sharing deals with Google-acquired DeepMind have signed new agreements now that the company’s projects have been placed under Google Health. Critics say such agreements were previously ruled illegal, the hospitals won’t say how much Google is paying them, and patients aren’t aware that their data is being shared with a for-profit company.

HCA-owned Mission Health (NC) notifies an unspecified number of consumers that its online store contained malicious code that was sending their information elsewhere from March 2016 through June 2019. 


Other

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Indiana University will use a $60 million donation from alumnus Fred Luddy —  founder of help desk software vendor ServiceNow – to establish an artificial intelligence institute whose initial focus will be digital health.

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Yale clinicians describe their work to embed clinical decision support for ED prescribing of buprenorphine for opioid use disorder with its Epic system, after reviewing Epic’s capabilities and finding them insufficient. They created an EHR-integrated web app using Epic Active Guidelines (since Epic did not support SMART on FHIR at that time). The eventual integration was seamless, launched from the patient chart navigation bar in an iframe with direct, secure communication. The authors note that such a project involves challenges and recommends that customers focus on updating interoperability standards to support services such as Enterprise Clinical Rules Service.

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EClinicalWorks held its national conference in Orlando this past weekend, October 18-20, as it celebrated its 20th anniversary. 

A ResMed-commissioned survey of 3,000 Americans finds that 56% monitor their health with at least one digital tool; 60% attempt to diagnose themselves via the Internet; and half want technology to improve communication with their PCP, specifically to be able to share information with them. The survey didn’t mention which tools that more than half of consumers are supposedly using, so I’ll remain skeptical in the absence of detailed methodology.

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The Arkansas Department of Human Services shuts down parts of its claims portal following the arrest of an optometry practice’s office manager who discovered that she could “input any number she chose” without the system flagging questionable values. The woman, who is the wife of one of the practice’s optometrists, is charged with filing $600,000 in fraudulent manual Medicaid claims in cases where a patient was insured by both Medicare and Medicaid. Fun fact – the attorney general’s investigator who signed the charging affidavit is named Rhonda Swindle.


Sponsor Updates

  • Lightbeam Health Solutions, Health Catalyst, Waystar, Recondo Technology, Prepared Health, Redox will exhibit at the HLTH Conference October 27-30 in Las Vegas.
  • Mobile Heartbeat will exhibit at The Future of Nursing New York State Action Coalition event October 21.
  • Netsmart will bring training opportunities to its home health customers to help them prepare for new regulatory requirements related to the Patient-Driven Groupings Model.
  • Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the 10th Annual Nebraska Fall Conference October 22 in Omaha.
  • OmniSys will exhibit at the McKesson Prescription Technology Solutions Customer Conference October 22-23 in Pittsburgh.
  • SailPoint acquires Orkus and OverWatchID to deepen governance of cloud applications and infrastructure.
  • TriNetX and Trialbee partner to accelerate patient-centric clinical trials.
  • Vocera will exhibit at the New England Society of Clinical Engineering Symposium Vendor Expo October 22-23 in Framingham, MA.
  • The Dallas Business Journal profiles ZeOmega.

Blog Posts


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Reader Comments

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