News 4/7/17

Top News

23andMe receives approval from the FDA to market its genetic health risk tests for 10 diseases, including celiac, Parkinson’s, and late-onset Alzheimer’s. The approval – the first for a home DNA test – is no doubt being celebrated by the Google-backed startup, which stopped giving consumers health analysis information in 2013 after an FDA slap on the wrist. The company received approval two years later to disclose a person’s carrier status, and has since been largely providing results to consumers seeking answers about their ancestry.

HIStalk Announcements and Requests

This week on HIStalk Practice: The AAFP creates the Center for Diversity and Health Equity to study social determinants of health. The National Governors Association selects seven states to participate in rural health collaborative. MTBC debuts analytics for ACOs. Arizona Connected Care selects referral management tech from Fibroblast. CVS Health awards $1 million to 33 health centers. New report sheds light on physician compensation. American Society of Sleep Medicine studies patient receptiveness to virtual consults. Nancy Gagliano, MD helps readers strategize for MACRA.

Webinars

April 26 (Wednesday) 1:00 ET. “SSM Integrated Health Technologies Clinical Data Migration: Functional and Technical Considerations.” Sponsored by Galen Healthcare Solutions. Presenters: Sandy Winklemann, MHA, RHIA, project manager, SSM Integration Health Technologies; Tyler Mawyer, MHA, managing consultant, Galen Healthcare Solutions; Kavon Kaboli, MPH, senior consultant, Galen Healthcare Solutions. GE Centricity and Meditech to Epic EHR transition. Join us for a complimentary webinar as present the decisions that are important to consider when performing a clinical data migration from the point of view of  the healthcare organization program manager, the clinical analyst, and the technical implementation team. Our expert panel will survey data migration considerations, best practices, and lessons learned. The webinar will present a unique client perspective, offering insight into considerations surrounding staffing, clinical mapping, legacy application support, and validation and testing.

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

Acquisitions, Funding, Business, and Stock

PHI protector CloudVault Health closes a $2.6 million Series A funding round led by investors that include Rudish Health Solutions. President Richard Nelli came to CloudVault in 2015 after a two-year stint at Streamline Health.

Data analytics company Intermedix acquires Nashville, TN-based WPC Healthcare, bolstering the predictive analytics division it created in 2015. WPC CEO Ray Guzman will join Intermedix, also based on Nashville, as SVP of strategy.

Predictive analytics investments continue … Boston-based OM1 secures $15 million in a Series A round led by venture capital firm General Catalyst.

TeleTech Holdings – a global company that specializes in the vague (but presumably profitable) business of customer experience and growth – acquires Connextions from OptumHealth for $80 million. Connextions, which offers tech-enabled member acquisition and retention services, will be folded into TeleTech’s Customer Management Services division.

Drchrono raises $12 million in a Series A funding round led by Runa Capital.

Efforts to eschew becoming a healthcare company don’t stop Alphabet from hiring healthcare tech talent. Job listings for subsidiaries including Sidewalk Labs, Calico, and Verily indicate strong interest (and compensation packages) in computational biologists, robotics experts, and researchers. The Google parent company has already pulled Tom Insel, MD away from heading up the National Institutes of Mental Health, and Jessica Mega, MD from Harvard Medical School.

Redox receives an additional $1 million from the Healthbox-managed Intermountain Healthcare Innovation Fund, bringing its total Series B round to $10 million. The healthcare API vendor took part in the Healthbox Studio Program several years ago, and will now help Intermountain integrate digital health apps with its Cerner system. (Thanks to the reader who reminded me they were on Cerner, not Epic.)

Sales

Sinai Hospital (MD) will roll out predictive analytics from PeraHealth this summer.

Appalachian Regional Healthcare (KY) will begin implementing Meditech’s Web EHR later this year.

People

Stuart Long (Monarch Medical Technologies) joins InfoBionic as CEO.

I2I Population Health names Dawn Berg (Assist Consulting Group), Scot McCray (CamCare) (not pictured), and Jay Wilkes (RyMir Consulting) to its sales team. Adam Ackerman (Relatient) joins the company as director of client development.

Medecision hires Donald Casey, Jr. MD (Alvarez & Marsal) as chief clinical affairs officer, and Ian Chuang, MD (Netsmart) as SVP and chief analytics officer.

Erik Phelps (Epic) joins genetic testing and data analysis startup Tempus as EVP and general counsel.

Announcements and Implementations

Sylvester Comprehensive Cancer Center (FL) selects oncology data-sharing technology from Syapse as part of a new precision medicine initiative.

The NJSHINE HIE connects to the Camden Coalition HIE, launched in 2010 by the New Jersey-based Camden Coalition of Healthcare Providers.

Adirondack Health (NY) will equip local public health agencies and their patients with remote monitoring and videoconferencing services with help from Health Recovery Solutions and the Hixny HIE.

Iowa-based Mercy ACO selects Innovaccer’s Datashop data warehouse to aggregate health data from 65 participating facilities including ambulatory sites, hospitals, and payers.

Government and Politics

FDA Commissioner nominee Scott Gottlieb, MD pledges to uphold the agency’s “gold standard of safety and efficacy” during his confirmation hearing before the Senate HELP Committee. He also stressed that there are ways of modernizing and expediting clinical trials without compromising safety, adding that addressing the opioid crisis and speeding generic drugs to market will be two of his top priorities if confirmed.

Efforts in Missouri to implement an opioid prescription drug monitoring database take one step forward then two steps back when vocal PDMP senatorial holdout Rob Schaaf announces he will finally support a bill authored by proponent Rep. Holly Rehder on the condition that physicians must register on it. The Missouri State Medical Association, however, was quick to tweet its opposition.

Privacy and Security

From DataBreaches.net:

• Behavioral Health Center (ME) discovers that 4,500 records from between 3,000 and 3,500 patients have been stolen and sold on the dark Web.

Research and Innovation

The Washington Post sensationalizes a Mayo Clinic study published in the Journal of Evaluation in Clinical Practice that found 20 percent of patients who asked for a second opinion had been misdiagnosed by PCPs – a result the WaPo author admits is “generally similar to other research on diagnostic error.” The retrospective study of 286 patients found the second diagnosis to be “distinctly different” from the first in 62 cases, the same in 36 cases, and partly correct in the remaining 188.

Technology

Medable develops Cerebrum, machine-learning technology that aggregates health data from a variety of sources to better power smartphone apps like Apple’s HealthKit and CareKit with disease predictions and treatment.

Other

After a recent hospital stay filled with slamming doors and beeping medical equipment, ambient electronic musician Yoko Sen proposes using sound design to reduce alarm fatigue and make hospitals calmer places for patients. She has created a “tranquility area” at Sibley Memorial Hospital (Washington, DC) that offers staff green tea, reclining chairs, soothing music, lavender scents, and projected images. A similar area for patients is under consideration.

@HuffPostComedy urges tweeters to share #AHCASequelTagLines. Legislators seem unlikely to reach any sort of compromise on the rumored resurrection of repeal and replace efforts before they adjourn for a two-week recess.

Sponsor Updates

• Intelligent Medical Objects will exhibit at the Allscripts Northeast Pro ARUG April 7 in Hartford, CT.
• MedData introduces an app to help providers keep better tabs on patients suffering from binge-watching illness.
• The American College of Radiology features National Decision Support Co.’s latest case study, “Homing in on Quality.”
• The Atlanta Journal-Constitution recognizes Navicure with its Atlanta Metro Area 2017 Top WorkPlaces Award.
• Netsmart is the first and only behavioral health EHR vendor to achieve ONC 2015 Edition Health IT Module Certification.
• Nordic Consulting presents what employees love most about the company.
• CloudWave will exhibit at the HIMSS New England Conference April 11 in West Lebanon, NH.
• Experian Health will exhibit at the HFMA NorCal Spring event April 12-14 in Sacramento, CA.
• Sutherland Healthcare Solutions publishes “Digital Reinvention in Healthcare: How Lawrence General Re-Engineers Their Patient Experience.”
• GE Healthcare adds the CareFinity business continuity and archiving solution from EMedApps to its Centricity Partner Program.

Blog Posts

• Iluminate: 3 Key Takeaways from the HIMSS17 Health IT Conference (Ilum Health Solutions)
• Health Information Technology Opportunities for Patient Safety (Impact Advisors)
• Apply Design Thinking to Healthcare Marketing (Influence Health)
• Call Center Patient Experience: The Impact of Outdated Provider Directories on Patient Access (Kyruus)
• Big Data Analytics Tools for Improved Data Management (Liaison Technologies)
• CMS Emergency Preparedness Regulations: What You Need to Know Now (LiveProcess)
• Winding down from Liberation 2017, gearing up for transformative year (Medecision)
• What MACRA Means for Health Plans (NTT Data)
• Meditech 6.1x Implementation Phases: Part 1 Planning (Parallon Technology Solutions)
• What to Look for When Evaluating Charge Capture: Charge Lag Statistics (PMD)
• 3 Secrets to Getting C-Suite Sales Prospects on the Phone (Salesforce)
• Will 2017 Be the Year for Major Healthcare Price Transparency Reform? (The SSI Group)
• Are You Getting the Most From Your Patient Portal? (Solutionreach)
• Local Digital Roadmaps “We Can Work It Out” (Summit Healthcare)
• Designing informatics for genetic diagnostics: four key questions (Sunquest Information Systems)
• Technology Can Close Critical Gaps in Medication Reconciliation (Surescripts)
• Non-technical Considerations Before Beginning an Epic Connect Project (Culbert Healthcare Solutions)
• Healthgrades names ‘Best Hospitals’ for 2017 (Infor)
• How to Survive Your Next Home Care Audit (Meditech)
• What Keeps Nurses Up At Night? (Spok)

Contacts

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

News 4/5/17

Top News

The VA confirms that it remains on track to make a decision about the future of VistA by July 1. It also raises the possibility of continuing to use VistA, but as a vendor-hosted service.

VA Secretary David Shulkin committed to the July 1 date last month. He has also said that the VA made a mistake in not working with the Department of Defense — which chose Cerner for its MHS Genesis project – to buy a single, integrated system.

Acting VA CIO Rob Thomas says a commercial solution remains an option, specifically mentioning Cerner.

The VA has hired consulting firm Grant Thornton to create a business case for four possible actions, one of which is to turn VistA over to a vendor that would then provide it as a service.

Reader Comments

From CIO Uptime Monitor: “Re: BIDMC/Harvard Medical School job posting. Says the CIO is retiring this spring. Is that John Halamka?” No. That job posting is for the Harvard Medical School CIO position held by Rainer Fuchs, PhD, who has been at HMS since 2012 and who is indeed retiring.

HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor Docent Health. The Boston-based company provides health systems with the people, technology, and insights they need to improve and personalize the patient experience, giving each person a set of customized touch points to cover their journey. Its consumer-centric approach drives higher satisfaction scores by satisfying the human need of patients to understand and to be understood. The company provides on- and off-site liaisons – or docents – who coordinate with patients before, during, and after their clinical experience and who participate in nursing huddles and rounds to make sure the non-clinical needs and preferences of patients are met and to empower clinical staff to deliver empathetic care. Health systems get operational patient data dashboards and executive reporting to spot service gaps and identify community health needs. Doing the right thing also drives measurable return on investment via more loyal customers, better satisfaction compensation, and long-term savings. I interviewed CEO and industry long-timer Paul Roscoe a few days ago, obviously catching him off guard with my spur-of-the-moment question wondering whether “data-driven empathy” is an oxymoron. Thanks to Docent Health for supporting HIStalk.

We funded the DonorsChoose grant request of Mrs. S in Missouri, who says her high school pre-calculus students are learning from the Breakout EDU problem-solving kit we provided. She says, “This donation to my classroom has completely engaged students. They are thinking critically and creatively while also practicing the content. I am so proud of my students during these challenges and their willingness to persevere and solve the problem. It is truly a learning environment any teacher would be thrilled to witness and it is all thanks to your generosity!”

Webinars

April 26 (Wednesday) 1:00 ET. “SSM Integrated Health Technologies Clinical Data Migration: Functional and Technical Considerations.” Sponsored by Galen Healthcare Solutions. Presenters: Sandy Winklemann, MHA, RHIA, project manager, SSM Integration Health Technologies; Tyler Mawyer, MHA, managing consultant, Galen Healthcare Solutions; Kavon Kaboli, MPH, senior consultant, Galen Healthcare Solutions. GE Centricity and Meditech to Epic EHR transition. Join us for a complimentary webinar as present the decisions that are important to consider when performing a clinical data migration from the point of view of  the healthcare organization program manager, the clinical analyst, and the technical implementation team. Our expert panel will survey data migration considerations, best practices, and lessons learned. The webinar will present a unique client perspective, offering insight into considerations surrounding staffing, clinical mapping, legacy application support, and validation and testing.

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

Acquisitions, Funding, Business, and Stock

Healthcare payments system vendor Ability Network acquires ShiftHound, which offers staff scheduling and credentialing systems.

Attorneys for Chicago-based Tronc (the former Tribune Publishing) file a letter with the SEC in response to a complaint by NantHealth’s Patrick Soon-Shiong, who made a $70 million investment in the company last year to help thwart a hostile takeover attempt by Gannett. The company says that before investing in Tronc, Soon-Shiong first suggested that Tronc invest in NantHealth’s IPO, and after being rebuffed, then insisted that Tronc Chairman Michael Ferro make a personal investment in NantHealth is an “implicit threat” to pulling out of the deal. Tronc says Ferro took a $10 million stake in NantHealth to pacify Soon-Shiong. Tronc has removed Soon-Shiong for board member re-election and has capped his ownership stake, leading to accuse the company of intentionally squeezing him out. Tronc also claims that Soon-Shiong is demanding payments for Nant-provided technology he made available to Tronc to monetize its online content even though the technology turned out to be unsuitable.

Doctor search website Amino raises $25 million in a Series C funding round, increasing its total to $45 million. The company makes money selling customized versions of its search function to employers and health plans and by offering access to its insurance claims database.

Orion Health Group shares drop sharply after the New Zealand company’s trading update predicts lower revenue. They’re down 61 percent in the past year with a market cap of $226 million. The company says it still hopes to swing to profitability in 2018.

McKesson completes its $1.1 billion acquisition of CoverMyMeds.

Sales

Pomona Valley Hospital Medical Center (CA) chooses Cerner Millenium to replace Cerner Soarian Clinicals and NextGen ambulatory. It will continue to use Cerner Soarian Financials.

Bon Secours Virginia Health System will implement Tonic Health to automate its intake and payments processes.

Skagit Regional Health (WA) and San Joaquin General Hospital (CA) choose MPI clean-up services from Harris Healthcare’s QuadraMed Patient Identity Solutions as they move to Epic and Cerner, respectively.  

People

Nadine Hays (Verscend) joins OmniClaim as chief growth officer.

Texas Health Resources promotes Debbie Jowers to VP of ambulatory ITS services.

Announcements and Implementations

Baystate Health’s Techspring innovation center launches a software development and testing environment for its partners, built on the InterSystems HealthShare interoperability platform.

Rock Health releases its Q1 2017 digital health report, indicating that providers and health plans are delaying expenditures based on regulatory uncertainty but key players remain cautiously optimistic and feel well positioned to navigate any regulatory changes. In Q1, they counted 71 digital health deals totaling over $1 billion. The top six categories by deal volume were Analytics/Big Data, Care Coordination, Telemedicine, Hospital Administration tools, Consumer Engagement, and Wearables/Biosensing.

A small Spok survey finds that health systems rarely apply strategic hospital initiatives to their mobile strategy and don’t often include clinicians in their planning teams.

Change Healthcare releases InterQual 2017.  

Government and Politics

The revised ACA replacement apparently being pushed for quick approval would allow individual states to permit insurers to offer less than the current “essential health benefits” and to charge higher premiums for people with pre-existing conditions. Both were the pre-ACA norm, when less-expensive insurance bought directly from insurers (rather than via an employer) often didn’t cover pregnancy or drug addiction treatment and denied policies to those with relatively minor medical conditions.

Privacy and Security

A review of significant hospital data breaches finds that major teaching hospitals were more commonly involved than smaller or non-teaching hospitals from 2009 to 2016, possibly because they allow more employees to view patient data.

Hackers breach the systems of the International Association of Athletics Federations, exposing the information of athletes who have applied for exemptions that would allow them to use drugs contained on anti-doping lists. The Fancy Bears hacker group, which claims responsibility, previously published the medical records of mostly American and British Olympic athletes after the IAAF accused Russia of state-sponsored doping and banned their teams from competition. 

ABCD Pediatrics (TX) is hit with ransomware, and though it was able to restore from backups without paying the hacker, it found evidence that its systems had been compromised for some time.

HHS OCR warns healthcare organizations that use HTTPS security that malware-detecting HTTPS interception products may not pass along any warnings or errors, allowing the organization to validate only the connection between themselves and the interception product’s certificate rather than all the way to the server.

Other

Ambulatory practice physicians in a community-based health system spend about as much time practicing “desktop medicine” as they do in face-to-face office visits, an analysis of time-stamped EHR records finds. Physicians are spending an increasing amount of time communicating with patients via the  patient portal, managing prescription refills, ordering tests, communicating electronically with staff, and reviewing test results, none of which are billable activities. Work that isn’t logged in the EHR made up the remaining 20 percent of the average doctor’s day. The authors suggest using scribes to manage progress notes, which they estimate would free up one-third of the physician’s time.

World Wide Web creator Sir Tim Berners-Lee wins the Turing Award (computing’s Nobel Prize) for that 1989 accomplishment, but his concern for net neutrality and an overly centralized, commercialized Web storage model that threatens individual privacy has led him to create Solid. Users would be able to decide where their data is stored and how it is shared. He’s also concerned that the web has been turned into a “purveyor of untruth” by an ad revenue model that rewards click-baiting rather than accuracy.

A study finds that ABIM’s Choosing Wisely campaign that encourages both clinicians and patients to skip low-value services had a small but statistically significant reduction in back pain imaging, for which patients often must pay out of pocket. It concludes that the 4-5 percent reduction indicates that consumer incentives may be ineffective for reducing low-value medical care.

A study finds that chargemaster prices not only vary widely among hospitals, they correlate to the price actually paid by insurers and patients. Not surprisingly, list price was not correlated with hospital quality. The authors conclude that hospital list prices are neither irrelevant nor indicative of price gouging, but are rather a subtle method hospital use to get favorable deals from insurers, leaving uninsured patients stuck with paying the made-up high prices in cash while everybody else gets negotiated discounts.

Doctors at Lancaster General Health publish a medical staff newsletter retrospective on its 10 years of using Epic. It refreshingly includes negatives as well as the expected positives – its larger-than-expected $100 million cost, the extra time some doctors spend documenting after hours, and its contribution to physician burnout. One surgeon says Epic is struggling to fulfill its potential because he has to look in other systems to review images, operative reports, and pathology reports, while also noting that EHRs are designed to optimize billing and therefore relevant clinical information is “buried in giant pile of clinically unimportant information.”

Cambridge Mobile Telematics, which offers brilliant smartphone driving apps to educate drivers and allow auto insurance companies to set rates based on driving habits, analyzes its user records to determine that drivers were distracted by their phones in 52 percent of trips that ended in crash, with an alarming one driver in four using their phone within 60 seconds of their crash. The company also found that distraction was just as bad in states with laws against using phones while driving. Users of the company’s DriveWell program reduce their phone distraction by 40 percent within two months.

In England, a newspaper’s undercover investigation of the NHS 111 non-emergency hotline call center finds that workers sleep at their desks, send text messages while pretending to listen to callers, and put suicidal callers on hold until they hang up because “after a while you can’t talk to them no more – it just gets awkward.”

In England, an Iran-born doctor referred to by co-workers as “Little Hitler” loses his medical license after being found guilty of several bizarre outbursts in which he used vulgar terms to describe patients who didn’t bring him gifts, called his receptionist a “fat blob,” referred to a colleague as a cockroach that he hoped would die, and described to female co-workers his vacation adventure in which he “inserted his private parts into a hole in the wall at a nightclub.”

Sponsor Updates

• Crossings Healthcare Solutions posts its most recent newsletter.
• Daw Systems will integrate CoverMyMeds electronic prior authorization into its ScriptSure e-prescribing system.
• Bernoulli’s John Zaleski and Jeanne Venella, RN co-author an article in the Spring 2017 issue of AAMI Horizons.
• Besler Consulting releases a new podcast, “How much revenue is your chargemaster costing you?”
• Black Book honors top cybersecurity firms at InfoSecWorld Conference and Expo.
• Dimensional Insight will exhibit at the Cannabis Business Expo April 12-14 in Phoenix.
• Healthgrades announces Outstanding Patient Experience and Patient Safety Excellence Award recipients.

Blog Posts

• 5 Top-Level Strategic Objectives of CMS’ MACRA Quality Payment Program – Part 1 (Forward Health Group)
• Grab a seat at the strategy table: Learn more about 3 leading CEO strategies—and their IT implications (Advisory Board)
• What Zombies can Teach you about Success in MACRA (Optimum Healthcare IT)
• #JoinTheConversation with Frank Abagnale, Authority on Cybersecurity, Privacy and Identity (Experian Health)
• Telemedicine: Celebrate the possibilities of expanded patient care (AdvancedMD)
• Medicare ACO Performance: Updated for 2017 (Arcadia Healthcare Solutions)
• FHIR Fuels Transformation at Hospitals (Datica)
• 3 Ways Physicians Can Use Social Media for Business Growth (CareSync)
• Top 12 Strategies for a Successful Implementation, Part 1 (Casenet)
• When Was the Last Time You Backed Up Your Data? (CTG)
• Connecting the Dots – The Value of SSOT Crosswalk Documents (Culbert Healthcare Solutions)
• Take Time to Assess Your Career (Direct Consulting Associates)
• ACOs: Is There Room for Medicaid? (ECG Management Consultants)
• 4 Opportunities Analytics can Provide (Hayes Management Consulting)
• EMR Go-Live: 5 Tips for Building a Useful RFP (The HCI Group)
• Building Patient Loyalty, One Word at a Time (Healthgrades)
• Can you and your patients have it all? Why you should personalize and standardize care plans (Healthwise)

Contacts

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

Monday Morning Update 4/3/17

Top News

HHS quietly hires Don Rucker, MD, MBA, MS as National Coordinator, as evidenced by his new entry on the HHS employee list.

Rucker holds a Penn MD and Stanford master’s degrees in business and informatics. He is an adjunct professor in biomedical informatics at Ohio State, but is best known as being chief medical officer for Siemens Healthcare from 2000 to 2013.

Apparently reporting to Rucker is former Rep. John Fleming, MD (R-LA), who said previously that he thought his newly created position of HHS deputy assistant secretary for health technology reform was equivalent to National Coordinator.

Reader Comments

From Lisa Buller:”Re: Skagit Regional Health’s Epic project. As the project director of this implementation, I can tell you the post regarding our EHR project is not only unverified – it is untrue. We are very happy with our selection of Epic and look forward to our on-time go live of October 1, 2017 and the improvement in quality, safety, and efficiency that it will bring to the care we provide our communities.” Lisa referenced the original Epic announcement that indicated a mid-2017 go-live date. Publicly available information suggests that the IT department added 53 positions with 20 more planned to implement Epic (although those employees are often rolled back to their previous jobs after go-live) and CIO John Dwight moved to EvergreenHealth in February. Both items were mentioned by the rumor reporter whose main point was that budget overruns of the $72 million project, if they exist, have not been publicly acknowledged. UPDATE: Lisa provides additional information: “Our project is on time for go live on October 1, 2017 across our organization, including two hospitals and 18 clinics. The project cost is $72 million. We moved our go live from July to October 1, 2017 to ensure adequate time for project build, test, and training. We currently have 23 consultant-employed FTEs – not 60 as was reported in the unverified post. The pay rate referenced in the post is also false.”

From Steve: “Re: NTT Data’s divestiture of its healthcare software division. The acute EHR/RCM products are so far behind any of the competitors, have next to no market share, don’t show up in any industry reports, and NTT Data lost so many clients. I will be curious to see if they recover under the new company. It’s the same leadership that ran that division at NTT Data, so chances are probably pretty slim.” I’m thinking the prize there is the NetSolutions long term care software product line, which runs in 1,700 facilities.

HIStalk Announcements and Requests

Nearly three-fourths of poll respondents have a negative reaction to the White House’s recent HHS appointees.

New poll to your right or here: When will blockchain have a significant healthcare impact?

We bought three Chromebooks for Mrs. J’s first grade class in South Carolina. She reports, “Our class LOVES our Chromebooks. They are a fundamental part of the reading process in our classroom. Students use them almost daily for taking AR quizzes, reading online information, playing learning games, and practicing math facts. They are really enjoying being able to access the tools they need. I’m so thankful that donors like you continue to make a difference through DonorsChoose. It makes teachers like me and students like mine extremely grateful.”

This infuriatingly common mistake bugs me. Is it really so hard to match a singular subject to a singular verb? As the headline writer might say, the grammatical sloppiness of Americans are driving me crazy.

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

This Week in Health IT History

One year ago:

• The Department of Defense names its Cerner-centered EHR project MHS Genesis.
• A study finds wide clinical variation in how patient visits are conducted by six virtual visit companies.
• Southcoast Health lays off 95 employees after running over budget on its $100 million Epic implementation.
• Massachusetts General Hospital and other Partners HealthCare sites go live on Epic.

Five years ago:

• CSC announces plans to launch iSoft in the US after poor performance in England’s NPfIT.
• 3M acquires CodeRyte.
• HHS awards $50,000 to the designers of THUMPr, a web-based heart health consumer profile tool.
• HIMSS lists the HIT-related affects that would arise from a Supreme Court finding that some or all of the ACA is unconstitutional.
• Seven-month-old hospice management software vendor Hospicelink predicts that it will hit $50 million in sales by the end of the year.
• TriZetto announces plans to build a $40 million headquarters building in Denver.

Weekly Anonymous Reader Question

Last week I asked readers to describe their proudest moment in health IT, with these responses:

• Getting the result interfacing going from our lab to the local cancer treatment facility. It had been a months-long project with many fits and starts, but seeing it actually happen was amazing. They went from needing up to a week to get results to make changes to chemotherapy regimens to being able to make changes in a few hours. They can actually correlate some improved survival rates to being able to respond faster to changes in their patients’ health.
• Being the first (and maybe only?) IT person to receive the Employee Recognition Award at the health care organization I worked for.
• When I first started out in health IT, I was part of a SWAT team who would swoop into troubled sites. I was disheartened about six months into the job. I then went to my fifth or sixth site and sat with a doctor who was visibly frustrated. A few tweaks, 30 minutes of coaching and training, and customizing the program and all was better. I went back about three months later and the doctor gave me the biggest hug and looked at me with tears in his eyes and said "I’m no longer stuck in the dictation room until 7, 8, 9:00 at night. I leave the hospital at 6:00 at the latest every day since you came. I’ve made it to all of my son’s tee-ball games this season, my wife and I eat dinner together, I sleep better, and my nurses have all noticed a change in my patient care. Thank you so much. You have made me want to stay in medicine and keep doing what I was put on this Earth to do." Cue me totally getting all teary right ahead of a big executive meeting 🙂 But I remember that doc, and all the other docs on days where it’s kinda crappy. End of quarter, forecast calls, dealing with code issues, trying to keep customers… It’s all kinda crappy, but if I can do one thing each day where I help one person be able to go out there and do better at keeping people healthy and alive, that’s good enough for me.
• Around 10 years ago, I was a sales executive working with small independent medical groups trying to help them move to our network-enabled rev cycle service. There was a wonderful physician I was working with who provided great family practice services to an undeserved population, but struggled to run her practice. I was fortunate enough to help her make the leap of faith to join our network. A year later, I called to check in. The physician started tearing up over the phone. (full disclosure: I went into panic mode once I heard her voice crack). I asked what was wrong and she said, "Wrong? Nothing’s wrong. Yesterday I was able to pay my daughter’s tuition in full for the first time and I owe that to your company.” Thinking about that moment still makes the hair on the back of my neck stand up.
• When the first customer I helped acquire their eICU program verified the clinical, operating, and financial results we had promised. The icing on the cake is when one of the practicing intensivists also reported that for the first time in years he was sleeping through the night uninterrupted, and he felt more alive and happy than he had in years.
• I designed and helped build a bedside critical care CIS that at one site operated nonstop for four-plus years without a server reboot. It was the only system in the data center that kept operating when all the others went down during a hurricane.
• In a meeting, a frustrated physician, who felt burdened and attacked, retorted, "What’s the point? Nothing ever changes here anyway." After the meeting, I compiled a list of the changes that we had made in the past year. Some were IT, some were process, some were new initiatives. In all, I listed 24 accomplishments that we had completed in the previous 12 months. I leaned back in my chair, kicked my feet up on my desk, and raised my hands behind my head. In the silence, I swore I could hear a faint echo of applause.
• In the late 1970s, I wrote a master’s thesis on clinical decision systems, which I defined (simplistically for research) as a physician, nurse, and patient. Key to the triad is the patient as an equal member of the decision team. IT wasn’t until a decade or so into the 21st century that the patient was recognized as a key decision-maker in his/her care. I was proud in retrospect that I had identified the key role a patient plays in their care, based on the different kinds of information which they hold and on which only they can act. Similarly with the differences among physicians and nurses and their unique and special knowledge and decision characteristics.
• One thank you note from a former customer: “The richness of your experience and knowledge is a true asset to the HIT community and it’s always a pleasure to shine the spotlight on you. You never disappoint!”
• Leading an EMR conversion and receiving Joint Commission accreditation 16 days post-EMR conversion with zero nursing citations at a hospital that had never passed Joint Commission without citations previously.
• I was at the Magnet nursing conference doing a demo in our booth and a random attendee walked up and interrupted the demo and said, "I use your product every day and I love it" and then she just walked away.
• Seeing a presentation about better care of patients by a customer using a tool I was integral in designing and testing. It’s pretty awesome to see someone talking about things that were were not possible prior to the existence of something I helped create.
• Oddly, a proud time was spending New Year’s Eve 1999 on call and having almost nothing to do because the years of Y2K preparations were done right. Management invested appropriately and early enough to the work done, people worked hard to address all the issues, and the results were there. We were also prepared for what didn’t happen. I can’t recall another go-live that went as well.
• Hearing a doctor exclaim, "Look, it’s right here!" as she pulled up a hospital discharge report in real time while the patient was in her office for a follow-up. No calls to the hospital chasing paperwork, no checking billing office inboxes or wire baskets — everything ready to go while the patient was in front of her.
• Chair of an AMC department walking through exhibits at a conference, taking a few steps backward, turning to me at the booth and saying, "I may not have said this before, but your system has changed the way (our specialty) is practiced in America. Thank you."
• Teaming with Kaiser Permanente in Southern California in a partnership to build and deploy an application integrated with Epic that used NLP to automatically calculate the E&M code at the point of care. This was an early (2005) commercial use of AI. The end result was an a operational success for Kaiser and a commercial success for our small company. The technology is now owned by Nuance.
• Being the first hospital to activate the first commercially available EMR 19 years ago and it’s still running fine. And it only cost $16 million for an 800-bed hospital.
• I don’t really have one other than doing a great job every day before the Big Vendor came along and there needed to be 8-10 of me.
• My first invitation to Histalkapalooza.

The question this week: What is your favorite moment from any past HIMSS conferences?

Last Week’s Most Interesting News

• An IBM report finds that the number of healthcare records exposed via breach dropped 88 percent for 2016 vs. 2015, with just 29 percent of incidents involving outsiders.
• The FBI warns healthcare organizations that hackers are targeting FTP servers configured to allow anonymous access.
• The White House appoints Roger Severino as director of HHS’s Office for Civil Rights.
• A review of UCSF’s virtual glucose management service finds significant improvement in glucose control.

Webinars

April 26 (Wednesday) 1:00 ET. “SSM Integrated Health Technologies Clinical Data Migration: Functional and Technical Considerations.” Sponsored by Galen Healthcare Solutions. Presenters: Sandy Winklemann, MHA, RHIA, project manager, SSM Integration Health Technologies; Tyler Mawyer, MHA, managing consultant, Galen Healthcare Solutions; Kavon Kaboli, MPH, senior consultant, Galen Healthcare Solutions. GE Centricity and Meditech to Epic EHR transition. Join us for a complimentary webinar as present the decisions that are important to consider when performing a clinical data migration from the point of view of  the healthcare organization program manager, the clinical analyst, and the technical implementation team. Our expert panel will survey data migration considerations, best practices, and lessons learned. The webinar will present a unique client perspective, offering insight into considerations surrounding staffing, clinical mapping, legacy application support, and validation and testing.

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

Acquisitions, Funding, Business, and Stock

NTT Data sells its hospital and long term care software suites to newly created and PE-backed Cantata Health. Those products involve Optimum (hospital clinical and RCM) and NetSolutions (for skilled nursing, assisted living, and independent living). The PE backer is GPB Capital Holdings. NTT Data acquired the software with its acquisition of Keane in October 2010 at a rumored $1.2 billion. Cantata Health will be led by former NTT Data healthcare technologies division executives Mike Jones (CEO) and Rich Zegel (CTO).

NantHealth reports Q4 results: revenue up 18 percent, EPS –$0.19 vs. -$0.10, beating earnings estimates but falling short on revenue, sending shares down 3 percent Friday. The company lost $184 million in the fiscal year, doubling its 2015 losses.

Decisions

• Community Health Systems (TN) chooses Infor for enterprise financial management and will begin rollout this year.
• University of California Irvine Health System (CA) will go live with Oracle PeopleSoft ERP in 2018.
• Charlton Memorial Hospital (MA) will go live with Oracle PeopleSoft HR this year.

These provider-reported updates are provided by Definitive Healthcare, which offers powerful intelligence on hospitals, physicians, and healthcare providers.

Other

Public radio profiles Kaiser Permanente’s opioid prescribing program, implemented in 2009 after clinical leaders noted that OxyContin was among its most-prescribed drugs, patients were on the medication for long periods with ever-increasing doses, some of the prescriptions were for 1,000 or more pills, and doctors were specifying brand name drugs that weren’t covered by insurance but that command a higher street value. KP studied its opioid use from its Epic data, sent reps to counter pharma sales pushes to use more, programmed Epic to help guide physician decisions, and implemented “The Difficult Pain Conversation” to encourage patients to stop demanding opioid prescriptions.

The VA complains about employee-friendly laws that force it to keep paying workers it’s trying to fire, with the latest example being an employee who was caught watching pornography while with a patient who the VA has to keep paying for at least 30 days while the bureaucracy-laden termination process is followed.

A heart surgeon who sued former employer Memorial Hermann (TX) for using peer review and quality data to discredit him after he complained about quality problems wins $6.4 million in a jury award.

Epic’s April Fool’s web page makeover included these stories:

• Introduction of TinDR, an Epic app that allows doctors and patients to choose each other via a right or left swipe, quoting a doctor user as saying, “I didn’t do great in med school, but I hit the gym six days a week, and that’s finally paying off.”
• The meeting of AI systems IBM Watson and Epic Bruce, in which Bruce sent Watson a 2 a.m. messaging questioning, “You up?”
• The release of Chirp, a clinical notification app for the Apple iRing that displays college insignia or birthstones in the absence of pending notifications.

A hacker defeats the facial recognition security of the just-released Samsung Galaxy S8 smartphone by copying the registered user’s Facebook photo and then just sticking it in front of the phone’s camera.

A med student’s interesting article says that the broken medical residency electronic match program is leaving half of new graduates without a residency slot. The author says the electronic application process encourages blasting out applications en masse, overwhelming the ability of the residency programs to evaluate their candidates wisely. He concludes that pen and paper applications might force applicants to be more selective in expressing their true interests, adding that the number of electronic applications per student could also be limited but that’s not likely because the AAMC-owned system makes a lot of money per application.

California-based surgery collaboration app vendor Casetabs (which describes itself pointlessly as “the Uber of surgeries”) runs a Craigslist ad (where apparently all the health IT experts look for work) for a sales development rep with some fun requirements:

• “Sales sniper with a proven track record of crushing sales quotas.”
• “Extreme comfort in cold-calling (70-100 calls/day).”
• “Water Garden office complex in Santa Monica (sofas, fire pit, B-ball, football, corn hole, Foosball, etc.)”
• “High performance, high pay environment (eat what you kill).”

Here’s Part 2 of the top 10 HIS vendors report from Vince and Elise.

Dr. Weird News Andy would like to order a vodka drip, stat. Veterinarians save a cat that poisoned herself by licking spilled brake fluid off her fur by administering IV vodka to counter the effects of ethylene glycol. Princess the cat is recovering at home, which by WNA’s calculation leaves her with eight remaining lives.  

Sponsor Updates

• Clinical Computer Systems, Inc., developer of the Obix Perinatal Data System, celebrates its 20 years in healthcare.
• ZeOmega will exhibit at NAACOS Spring 2017 Conference April 5-7 in Baltimore.

Blog Posts

• Reigning in Hospital Supply Costs and Physician Preference Item Spending (Definitive Healthcare)
• Improving Workflow AND the Patient Experience (Access)
• #JoinTheConversation on Patient Engagement (Experian Health)
• Enabling Hybrid IT with the Right Network Connectivity (TierPoint)
• From the HEDIS 2017 trenches: tracking your retrieval and abstraction efforts (Verscend)
• Eliminate the Wait: Self-Rooming at Aurora’s Children’s Health (Versus Technology)
• To Build or Buy an Analytics Solution? (Part 2) (Vital Images)
• Partnering for science. (Voalte)
• Managing Stakeholder Interactions – the Key to Success with Value-based Reimbursement Programs (ZirMed)
• Simplifying the “Rules of the Road” for Patient Education (Zynx Health)

Contacts

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

News 3/31/17

Top News

An IBM security report finds that healthcare is the #5 most-hacked industry sector, with just 29 percent of the incidents involving outsiders.

“Inadvertent actors” — such as employees who fall for phishing or malware scams — made up nearly half the total number of incidents, while malicious insiders were behind just about as many attacks as external hackers.

Many successful healthcare attacks involved smaller organizations, resulting in an 88 percent drop in exposed records in 2016 vs. 2015.

The report estimates that criminals made $1 billion from ransomware in 2016 and that 44 percent of spam email contains malicious attachments, most of it ransomware.

IBM warns that the success of hackers has driven down the black market value of structured data, adding that “unstructured data is big-game hunting for hackers and we expect to see them monetize it this year in new ways.”

Reader Comments

From Jake Serpent: “Re: ransomware. The FBI is investigating a case where PCP’s clearinghouse account was hacked and $86,000 in insurance payments were routed to other bank accounts. Interestingly, the FBI advised them not to disclose to their EHR/PM vendor’s IT support that they had been hacked until they had learned more. This is a new hole in the cash flow for thieves to exploit.” Unverified.

From Jigger: “Re: NantHealth. Allscripts invested $200 million in the company in mid-2015 before the NH IPO, while NantHealth’s Patrick Soon-Shiong personally invested $100 million in Allscripts. How have they fared?” The best I can tell, Allscripts spent $200 million to acquire shares that are now worth $74 million, so they are down $126 million. Soon-Shiong’s $100 million investment in Allscripts shares is now worth around $92 million. In the past year, MDRX shares are down 7 percent, while those of NH have shed 73 percent since they began trading in June 2016.

From Oleander: “Re: Aventura. Has ceased operations and closes Friday.” Unverified, but folks in the know say they’re winding it down. It’s highly unusual for a company that sells a product (rather than a service) to just walk away instead of selling out for whatever price the market will bear. I expect to have more details soon.

From Lugubrious Lad: “Re: Missouri’s lack of a prescription drug monitoring program. From reports I’ve read, it’s a small group led by a powerful state legislator that has blocked a statewide program. State Senator Rob Schaaf once said people who die of overdoses remove themselves from the gene pool.” Senator Schaaf is a doctor, with his obvious lack of empathy perhaps validating that he’s better suited for power-brokering than attending to patients. Schaff’s PDMP objections involve patient privacy – he proposes his own bizarre system in which doctors would send the state the names of patients for whom they are considering issuing prescriptions for narcotics and then the state would let the doctor know of any concerns (given that they have no medical information to review and that such a system wouldn’t work with that of any other state, including those that border Missouri). Schaaf says he will filibuster any attempts to implement a PDMP other than his own: “I’d just as soon not have a PDMP. Would they rather have a database that protects privacy or no database at all?” On the other hand, his skimpy legislative body of work includes designating Jumping Jacks as the official state exercise.

From Tip Toe Through the Tulips: “Re: Skagit Regional Health (WA). The 185-bed system’s consultant and another consulting firm that was being paid $500 per hour contracted for Epic for $72 million to replace Meditech and NextGen, more than larger sites have paid. The cost is now over $100 million and the IT department has gone from 53 FTEs to 113 plus 60 consultants. They are missing deadlines, dates have been pushed back, the consultant-turned-CIO has gone, and they are continuing without a CIO. This coupled with a money-sucking HIE they own with Island Health that is in disarray, for which they have hired another expensive consulting group to review. Time will tell whether this system survives a $1 million per bed Epic project.” Unverified.

HIStalk Announcements and Requests

We funded the DonorsChoose grant request of Mrs. V in Texas, who asked for a 8×10 carpet for her first grade class’s reading area. What won me over was her eloquent description of its importance to her classroom in replacing the worn out one they had been using for years: “We start from only knowing mostly sounds and basic words to reading chapter books. We will basically summit a knowledge mountain this year to be prepared for our future. I do my job so that someday these students will have the opportunity to have a career of their own. The carpet is the heartbeat of our classroom. We share all of our lessons there. We share joy, excitement, heartbreak, breakthroughs, and growth on that piece of cloth. The battle of education is fought and won in one spot in the classroom and that is on that carpet.”

The government’s Internet privacy protections rollback revived my interest in using a private VPN service for web browsing (though to be fair, those protections hadn’t taken effect yet anyway, so nothing has changed.) My requirement of a free trial led me to VyprVPN at $45 per year. Speedtest shows no slowdown and it’s painless to install and use. A VPN also protects you when using public WiFi, but even more intriguingly, it apparently can save money on Internet purchases, where price is often set by the user’s location — VyprVPN priced the same SYD-LAX flight on Kayak by connecting through servers in several countries and it ranged from $2,900 to $5,400. VyprVPN runs great on the laptop and iPad, although it didn’t work on my Chromebook because of router settings that I didn’t bother changing because it wasn’t really important.

This week on HIStalk Practice: Congratulatory AHCA ads fly fast, furiously, and prematurely. Facial recognition software helps physicians diagnose rare pediatric disease. Wisconsin MDs prepare for mandatory PDMP reporting. Eastern Shore Psychological Services implements MediWare EHR. EPatientFinder’s Lance Hayden offers inexpensive steps to better practice cybersecurity. IHealth acquires AllDocuments. Mecklenberg County health officials accidentally release PHI. Navicure’s Jim Denny eases providers into care cost transparency practices.

Webinars

April 26 (Wednesday) 1:00 ET. “SSM Integrated Health Technologies Clinical Data Migration: Functional and Technical Considerations.” Sponsored by Galen Healthcare Solutions. Presenters: Sandy Winklemann, MHA, RHIA, project manager, SSM Integration Health Technologies; Tyler Mawyer, MHA, managing consultant, Galen Healthcare Solutions; Kavon Kaboli, MPH, senior consultant, Galen Healthcare Solutions. GE Centricity and Meditech to Epic EHR transition. Join us for a complimentary webinar as present the decisions that are important to consider when performing a clinical data migration from the point of view of  the healthcare organization program manager, the clinical analyst, and the technical implementation team. Our expert panel will survey data migration considerations, best practices, and lessons learned. The webinar will present a unique client perspective, offering insight into considerations surrounding staffing, clinical mapping, legacy application support, and validation and testing.

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

Acquisitions, Funding, Business, and Stock

San Francisco-based primary care practice Carbon Health raises $6.5 million in a seed funding round to expand use of its patient app that offers appointment scheduling, payments, and prescription refills.

Health kiosk vendor Higi receives an unspecified Series B investment from BlueCross BlueShield Venture Partners and acquires EveryMove, which offers a health rewards system to health plans.

Sales

Three Ontario hospitals will implement Meditech 6.1 Web EHR, hosted by Markham Stouffville Hospital.

People

Evariant names Clay Ritchey (Imprivata) as CEO.

Leidos Health hires Bill Kloes (Nuance) as VP of operations integration of its health group.

Terri Ripley, MIT (Inova Health System) joins OrthoVirginia as CIO.

The Strategic Health Information Exchange Collaborative hires Pam Mathews, RN, MBA (Pam Mathews & Associates) as interim executive director.

Solutionreach promotes Paul Kocherans to SVP of sales; Justin Everette to VP of marketing; and Lance Rodela to VP of product management.

Announcements and Implementations

IBM will incorporate SNOMED CT terminology in its Watson Health offerings.

CMS approves Forward Health Group’s PopulationManager as a qualified registry for the 2017 performance year.

The World Health Organization launches a global initiative to reduce severe, avoidable medication error harm by 50 percent over the next five years. It will offer guidance, strategies, plans, and tools.

Healthwise provides a $2 million grant to fund the Informed Medical Decisions Program at Massachusetts General Hospital’s Decision Sciences Center. Michael J. Barry, MD, Healthwise chief science officer, will return full time to MGH to direct the center, which will study how to incorporate the patient’s voice in making healthcare decisions.

The Connecticut Hospital Association and Bayer will create a statewide database to track patient exposure to radiation from CT scans.

Government and Politics

Senators Lamar Alexander (R-TN) and Bob Corker (R-TN) introduce legislation that would allow Americans who live in a county where no insurers offer ACA plans in 2018 to apply any federal subsidy they receive to plans they buy directly from insurers. The challenge, which they didn’t mention, is that those same counties may well have no insurers willing to sell individual policies either, meaning that those who can’t get insurance through an employer can’t obtain it at any price.

Meanwhile, Sen. Corker responds to the comments of fellow Republican and House Speaker Paul Ryan (R-WI), who expressed concern in a TV interview that President Trump will reach out to Democrats to get healthcare legislation passed instead of twisting the arms of party loyalists to repeal ACA in purely partisan fashion. A new poll finds that 62 percent of Americans think President Trump has mishandled healthcare reform, sending his record-low approval rating even lower to 35 percent following last week’s AHCA drama.

The Texas Senate appears to have ended the state’s relentless efforts to stifle the use of telemedicine.

Privacy and Security

Thieves hoping to steal petty cash from a clinic of CoxHealth (MO) also grab patient fee slips from the state, triggering the requirement that the incident be reported as a breach to HHS.

Other

A New York Times Magazine article describes the expensive industry created around “coder vs. coder” billing code jockeying that occurs among hospitals, insurers, and auditors that often leave patients holding an indecipherable bills from multiple providers involved in a single episode of their care that may bankrupt them despite their best intentions. Some excerpts:

Individual doctors have complained bitterly about the increasing complexity of coding and the expensive necessity of hiring their own professional coders and billers … But they have received little support from the medical establishment, which has largely ignored the protests. And perhaps for good reason: The American Medical Association owns the copyright to CPT, the code used by doctors …  when Medicare announced that it would pay only a set fee for the first hour and a half of a chemotherapy infusion — and a bonus for time thereafter — a raft of infusions clocked in at 91 minutes … Today many medical centers have coders specializing in particular disciplines … The Business of Spine, a Texas-based consulting firm with a partner office in Long Island, advises spine surgeons’ billers about what coding Medicare and commercial insurers will tolerate, what’s legal and not, to maximize revenue. The evolution of this mammoth growth enterprise means bigger bills for everyone.

Colorado’s new Medicaid payment system for developmental disability services is rejecting provider claims due to coding errors that the state blames on users who didn’t pay attention to its communication about the changes over the past 18 months. Speech therapy clinic operator Jill Tullman says she bills up to $12,000 per week to Medicaid, but has been paid only $288 in the past month. She also spent 2,500 minutes trying to get help from the state’s call center, run by Hewlett Packard Enterprise, which still has 90-minute wait times even after fixing software and connectivity problems. The state has paid 48 percent of submitted claims in the first month. 

A Florida State University psychology researcher studies the EHR data of 2 million patients to create a machine learning method that can predict whether someone will attempt suicide within the next two years with 80-90 percent accuracy.

The University of Texas system regents will pay Ron DePinho, MD — the just-resigned president of MD Anderson Cancer Center — over $1 million per year to serve as a professor of cancer biology, placing his compensation at nearly triple that of his boss, the cancer biology chair. He will also receive $1 million per year to fund his research projects. Cynics might presume that his resignation was neither voluntary nor unchallenged.

Sponsor Updates

• Consulting Magazine profiles Peter Smith of Impact Advisors.
• Imprivata will exhibit at the VHHA Spring Conference April 5-7 in Williamsburg, VA.
• Philly.com profiles InstaMed.
• InterSystems will exhibit at the HIMSS Population Health Forum April 3-4 in Boston.
• Intelligent Medical Objects will exhibit at AORN International Surgical Conference & Expo April 1-5 in Boston.
• Kyruus hosts NewCoBos April 5-6 in Boston.
• NTT Data’s Lisa Woodley presents at the LOMA 2017 Customer Experience Conference March 30 in Las Vegas.
• Point-of-Care Partners will exhibit at the HL7 Mini-Connectathon April 10-12 in Chicago.
• Protenus hosted its inaugural Privacy and Analytics Conference last week at its headquarters in Baltimore.
• SK&A publishes “Physician Office Usage of EHR Software.”
• PatientSafe Solutions will demonstrate new Rounding and Early Warning System worfklows of its PatientTouch platform at AONE/ANIA.

Blog Posts

• Understanding What is Required Under the Stark Law, with infographic (Optimum Healthcare IT)
• Which MIPS path is right for you? (Encore, A Quintiles Company)
• ILÚMinate: 3 Key Takeaways from the HIMSS17 Health IT Conference (Ilum Health Solutions)
• Thought leader podcast series: Big Data (Meditech)
• How Hospitals are Using Analytics to Drive Improvements in a Value-Based World (Dimensional Insight)
• Health Information Technology’s Opportunities for Patient Safety (Impact Advisors)
• Healthcare organizations report thousands of hours and millions of dollars saved with SSO and VDI (Imprivata)
• How to Choose and Navigate Social Channels in Healthcare Marketing (Influence Health)
• Rearrange Activities with Ease (Learn on Demand Systems)
• 2017 HIPAA Compliance Checklist: 4 Items to Expect from a Vendor (Liaison Technologies)
• CMS Delays Bundled Payment Expansion. What does it mean for you? (Medecision)
• 6 Questions with Dr. Colin Banas, CMIO at VCU Health (Spok)
• Are Your Payments Walking Out the Door? (Navicure)
• The Meditech Scheduling Module: Tips and Benefits When Upgrading to 6.1 (Parallon Technology Solutions)
• Leading the Way Through Healthcare Fee for Value Transformation (Experian Health)
• Where We Are, and Where We Aren’t, in Healthcare IT (PatientKeeper)
• Information Governance Programs Harness the Power of Data (Sagacious Consultants)
• A Connected Care Journey for Patients (Salesforce)
• Burden of Prior Authorization Affects Providers: Coalition Seeks Reform (The SSI Group)
• 3 Ways to Make Your Practice Appeal to Patients (Solutionreach)
• The Way Technology has Revolutionized our World Today (Summit Healthcare)
• To the Tech-Minded Physician on National Doctor’s Day, We Thank You (Surescripts)

Contacts

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

News 3/29/17

Top News

The FBI’s Cyber Division warns medical and dental facilities that hackers are launching cyberattacks by exploiting FTP servers that have been configured to allow anonymous access.

The alert cited a 2015 University of  Michigan review called “FTP: The Forgotten Cloud” that warned of security flaws in the nearly 50-year-old protocol and the 1 million FTP servers that are not password protected.

Reader Comments

From Gilded Lily: “Re: list of ‘100 great healthcare leaders to know.’ More crapware.” Asking fresh liberal arts grads to create such a list ensures reliance on Googling. At least they claim nothing more in leaving their methodology unstated. Or as one of their readers astutely observed and boldly commented on the site, “This rings about as true as a Best Hospitals list that’s based largely on reputation. Oh, well. It will drive clicks and traffic to the website.”

From Jelly Roll: “Re: Qventus expanding to the periop environment. That’s kind of BS since the company started in periop when they were AnalyticsMD. They didn’t get much traction, so they explored the ED and other areas and are now making this announcement to get some press after raising a bunch of capital. Read some of their early blog posts – they talk about OR solutions and exhibited at periop-oriented conferences three years ago.” I pulled up a cached copy of AnalyticsMD.com from 2013 and they were talking about OR deployment then, along with “in-patient wards” (that’s almost as bad as the health IT site whose young reporter creatively but incorrectly expanded the press release’s term “OR” into “operative room.”) Qventus raised $13 million in November 2016.  

HIStalk Announcements and Requests

I’m enjoying the upbeat stories being sent in my “Proudest Moment” survey. It’s good to occasionally take a break from never-ending pressure and negativity and reflect on the big-picture positive work we do. Some of the reports I’ve received (and will list in Monday’s HIStalk) are moving. What’s going to be on your HIT career tombstone?

We provided iPad modules for art, math, and coding for Mrs. F’s middle school class in California. She reports, “My students are enjoying integrating technology and art into our core curriculum. They love being able to take photographs, create sketches, and animate their creations. My students also love using Osmo Numbers during math center time to increase their comprehension of number sense and operations with decimals.”

Webinars

March 29 (Wednesday) 1:00 ET. “Improving patient outcomes with smartphones: UW Medicine Valley Medical Center’s story.” Sponsored by Voalte. Presenters: James Jones, MBA, MSN, VP of patient care services and nursing operations, UW Medicine Valley Medical Center; Wayne Manuel, MBA, SVP of strategic services, UW Medicine Valley Medical Center. UW Medicine Valley Medical Center dramatically improved patient outcomes after moving to a smartphone-based platform for clinical communication and alarm and alert notification. Before-and-after analysis shows a reduction in hospital-acquired pressure ulcers and skin integrity events, fall and slip events, and medication errors. By limiting overhead paging, the medical center also created a calmer, quieter environment and improved engagement among nursing and hospitalists. Hospital executives will describe their experience and vision for the future in addressing quality, cost, and the patient-caregiver experience.

April 26 (Wednesday) 1:00 ET. “SSM Integrated Health Technologies Clinical Data Migration: Functional and Technical Considerations.” Sponsored by Galen Healthcare Solutions. Presenters: Sandy Winklemann, MHA, RHIA, project manager, SSM Integration Health Technologies; Tyler Mawyer, MHA, managing consultant, Galen Healthcare Solutions; Kavon Kaboli, MPH, senior consultant, Galen Healthcare Solutions. GE Centricity and Meditech to Epic EHR transition. Join us for a complimentary webinar as present the decisions that are important to consider when performing a clinical data migration from the point of view of  the healthcare organization program manager, the clinical analyst, and the technical implementation team. Our expert panel will survey data migration considerations, best practices, and lessons learned. The webinar will present a unique client perspective, offering insight into considerations surrounding staffing, clinical mapping, legacy application support, and validation and testing.

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

Acquisitions, Funding, Business, and Stock

Tesla and SpaceX founder Elon Musk forms Neuralink, which will develop an implantable brain-computer interface.

The US Supreme Court is reviewing whether church-affiliated health systems are exempt from federal laws that protect employee pensions. Advocate Health Care says it shouldn’t have to follow ERISA laws that require its pension plan to be funded and insured, saying it could owe billions of dollars in retroactive penalties if the court says it intentionally disobeyed the law.

Sales

UAE-based Emirates Hospital Group will implement InterSystems TrackCare in all its facilities.

People

Ries Robinson, MD (Medici Technologies) joins Presbyterian Healthcare Services (NM) as SVP/chief innovation officer.

Spok hires Mike Wallace (Intermedix) as CFO.

Real-time patient safety solution vendor Bernoulli hires as consultants Neil Halpern, MD (Memorial Sloan Kettering Cancer Center) and Amar Setty, MD (AnesthesiaStat).

Modern Healthcare’s health IT writer Joe Conn, who is a rarity in actually understanding the topic he covers, retires. I trusted what he wrote and admire that he didn’t let his ego interfere with his reporting.

Chris Edwards (Validic) joins Conversa Health as chief marketing and experience officer.  

Weber State University (UT) honors Associate Professor of Computer Science Richard Fry, PhD with its faculty and staff award. His accomplishments include a long career in the Air Force, developing technology to help orphaned children in Thailand learn English, converting paper medical records into an EHR in Ghana, developing an open source web application to help New Zealand document the lack of health services in rural communities, and creating an order queuing system for a local Air Force base to support its special needs employees.

Don Fisher, PhD, president and CEO of the American Group Medical Association since 1980, dies of cancer at 71.

Announcements and Implementations

Kyruus releases a new version of its ProviderMatch Analytics that helps health systems track patient access channel trends and optimize their provider networks.

Cerner and Nevada, MO will launch a county-wide prescription drug monitoring program as part of their Healthy Nevada program, trying to fill the gap left by the clueless Missouri state government that keeps finding excuses to remain the only state that can’t muster enough consensus to launch its own program.

Health Catalyst launches Leading Wisely, an executive decision support system.

Allscripts will resell abstracting and physician query solutions from Streamline Health Solutions.

Government and Politics

Days after President Trump declared that he was moving on to other priorities and leaving the Affordable Care Act intact after failing to win enough votes to repeal it, the White House and House Republican leaders have restarted negotiations. “We are going to work together,” declared House Speaker Paul Ryan (R-WI), with “we” being his fellow Republicans alarmed at the President’s hint that he might actually get some Democrats involved after his party failed to support him in sufficient numbers.

House Republicans vote to eliminate privacy rules imposed by the FCC last year, allowing broadband providers to sell the browsing data of their customers without asking permission. All that remains is for the law to be signed by President Trump, who indicates he will do so.

Privacy and Security

From DataBreaches.net:

• A Kentucky chiropractic practice notifies 5,000 patients that its systems were attacked by ransomware.
• Urology Austin (TX) notifies 280,000 patients of a ransomware attack.
• A study finds that 40 percent of used electronic devices listed for sale contain still-readable personal information.
• Med Center Health (KY) says a former employee obtained the billing information of 160,000 patients in 2014-2015.
• Washington University School of Medicine in St. Louis notifies an unstated number of patients that their information was exposed by employees who fell for a phishing scam.

Innovation and Research

UCSF’s virtual glucose management service – in which diabetes specialists remotely review abnormal glucose lab values and make recommendations as an Epic care note – reduced the number of hyperglycemic patients by 39 percent and the number of severe hypoglycemic events from 40 to 15.

Other

An American College of Physicians position paper says doctors are overloaded with administrative responsibilities, one of them being EHRs that were designed for patient care but that have been co-opted for non-clinical purposes to the point that EHR vendors have little time left to improve their patient care capability. ACP recommends that EHRs support the “write once, reuse many times” philosophy; embed tags to show where information originated; and allow clinicians to search available data when writing notes and allow them to link to it or copy/paste using tags. It also suggests that stakeholders use the same data elements and reporting formats, that clinical decision support replace non-real time data exchange such as prior authorization, and that agencies used shared registries to query for whatever information they need.

Pharma data technology companies QuintilesIMS and Veeva sue each other over the use of prescriber databases for drug marketing. Veeva says QuintilesIMS is engaging in anti-competitive practices by refusing to let Veeva customers load QuintilesIMS data into its network, while QuintilesIMS says it won’t provide the information because Veeva won’t guarantee that it will be protected following reports of unauthorized access.

STAT reports that Patrick Soon-Shiong and his Nant companies may have violated FDA regulations by talking about curing cancer in referring to drugs not yet approved by the FDA. Soon-Shiong, NantKwest, and NantHealth – stung by two critical STAT reports – have ramped up their feel-good social media PR campaign. After STAT’s inquiries, videos were deleted that had referred to the company’s treatments as a “breakthrough” that can “kill cancer.” A physician with drug promotion expertise summarized the 12-patient, modest results study referred to by Soon-Shiong as a breakthrough as, “The data is blatantly not supporting that statement, and the video blatantly uses emotion, not science, to make the case that this drug deserves a try.”

The Supreme Court hears a class action lawsuit brought against SAIC (now Leidos) by six retirement and pension funds for “the single largest fraud ever perpetrated on the city of New York.” Leidos says it has improved compliance efforts and noted its successful DoD EHR bid in defending SAIC’s performance in developing a city payroll system that was budgeted at $63 million that ended up costing $760 million and that resulted in long prison stretches for three consulting firm employees. SAIC paid $500 million to avoid federal prosecution, sending shares down and triggering the investor lawsuit that claims the company misstated information in its SEC filings.

Two second-year Mass General internal medicine residents die in an avalanche in Canada. Lauren Zeitels earned a MPhil in medical genetics at University of Cambridge and an MD/PhD in human genetics from Johns Hopkins and planned to purse a career in rheumatology. Cornell graduate Victor Federov, MD, PhD hoped to specialize in hematology-oncology.

Late-breaking April 1 news from an obviously tyred Weird News Andy, with whom I’ll need to have a natter: Cerner changes the name of its British Isles operation to Cernre to better reflect traditional UK spelling habits. "Having Cerner spelled one way and Centre spelled the other confused many people when they came to front door of our building in London. With this change, we believe we will blend in with the local flavour," according to a spokesperson from Cernre.

Sponsor Updates

• DrFirst wins two awards for its company culture and employee-centric work environment.
• Audacious Inquiry publishes a series of white papers called “21st Century Cures Act: Compliance for HIOs.”
• Optimum Healthcare IT creates an infographic titled “How to Navigate an EHR Implementation Lifecycle.”
• Spok will present and exhibit at the Becker’s Hospital Review 8th Annual Meeting April 17-20.
• Aprima and Healthwise will exhibit at the ACP Internal Medicine Meeting March 30-April 1 in San Diego.
• Arcadia Healthcare Solutions will exhibit at the NAACOS 2017 Spring Conference April 5 in Baltimore.
• Besler Consulting will exhibit at the Hudson Valley HFMA Annual Institute April 6 in Tarrytown, NY.
• CompuGroup Medical will exhibit at the COLA Annual Symposium April 5-8 in Las Vegas.
• CoverMyMeds will exhibit at Computer-Rx Idea Exchange 2017 March 31-April 1 in Oklahoma City.
• Direct Consulting Associates will exhibit at the Central & Southern Ohio HIMSS Springs Conference April 5 in Dublin.
• ECG Management Consultants will present at the 2017 ACHE Congress March 29 in Chicago.
• Elsevier Clinical Solutions announces a reseller agreement with PolicyMedical.
• EClinicalWorks will exhibit at the Pediatric Urgent Care Conference March 30-31 in New Orleans.
• FormFast will exhibit at ANIA 2017 March 30-31 in New Orleans.

Blog Posts

• Nordic is hitting the road (Nordic)
• The EHR Payoff (AdvancedMD)
• The Final Word: Quality (Arcadia Healthcare Solutions)
• Money Matters: A Heart of CareSync Story (CareSync)
• Happy People Produce Quality (CTG)
• Why I Talk About the Flint Water Crisis on Go-Live Day (Culbert Healthcare Solutions)
• Smartphone Apps That You Will Want to Download (Dynamic Computing Services)
• MACRA Mania – Breaking Down the Rule & Answering “What Now?” (Divurgent)
• Code City: Chicago is Becoming a City of Coders (GE Healthcare)
• 7 Tips to Cultivate Your Trainer, Part 2 of 2 (Hayes Management Consulting)
• Why Patient Education is a “Need-to-Have” for Successful Care Coordination (Healthwise)

Contacts

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

Monday Morning Update 3/27/17

Top News

The Trump administration appoints Roger Severino as director of HHS’s Office for Civil Rights, which enforces HIPAA. He was previously director of the DeVos Center for Religion and Civil Society of conservative think tank The Heritage Foundation.

Severino is on record as opposing the ACA-mandated LGBT anti-discrimination laws that he will be charged with enforcing. He says those laws create conflicts of interest in providers who don’t want to provide gender reassignment surgeries. 

HHS must have been in a hurry to run his bio on its leadership page since it not only is missing his flag-backed photo, but it incorrectly lists his new position as, “Director, Office of Civil Rights.”

Reader Comments

From Mideast Business Analyst: “Re: GE. Can anyone confirm that they are contemplating getting back into the HIS business? I heard many reports from contacts in the Middle East claiming that GE has bought (or is in the process of acquiring) a local HIS company with an existing client base in Saudi Arabia. While this might look like a smart move, I expect that it will take them a long time before they can fix the countless problems of the solution (in case it was the same one I know) and make their customers happy.”

From Skip Church: “Re: the usual HIMSS publication. Their Twittarrhea is always annoying in recycling the same old non-news, but this weekend’s automatically scheduled tweets included a bunch of articles written before AHCA voting was cancelled.” I assume they didn’t realize that lame stories posted before the AHCA vote were going to look pretty stupid when hurled up afterward on Twitter regardless of the schedule vote’s outcome. Most puzzling, however, is why the site thought their readers needed their cheap-seats rehash in the first place. Actual news sites were already amply covering AHCA voting, deploying real reporters with inside sources to write their lead story that the site simply re-worded from “published reports” in a cheap grab for eyeballs. It’s also not really a health IT story.  

Meanwhile, this is a refreshingly honest “primary accountability” from the job description of a HIMSS associate editor.

From Robert Lafsky, MD: “Re: cybersecurity. This Slate article is interesting.” The article says that technology companies have transformed cybersecurity from a “people problem with a technology component” into the opposite. A snip:

The tech industry has become such a colossus it has achieved a strange, self-interested triple role: as producer of flawed products and services, town crier about the gravity of these same vulnerabilities, and confidence man peddling the solution to the problem.

HIStalk Announcements and Requests

Most poll respondents have access to the patient portal of their most recently visited provider and most of them used it, but more importantly, 75 percent of those who used it liked it. HITgeek says it’s silly that providers have “their” portal instead of each of us having our own that those providers populate, questioning why the health data of individuals can’t be as integrated as their bodies are.

New poll to your right or here: Is your reaction to recent HHS appointments (Price, Verma, Fleming, Bardis, Severino) overall positive or negative?

We provided eight tablets for Ms. B’s Missouri kindergarten class in funding her DonorsChoose grant request. She reports, “Words do not even express how much gratitude my students and myself have for your generosity. We received our donation and opened the package as a class. The light in my students eyes’ when they saw the tablets was irreplaceable. These tablets have helped with both literacy and math. Each day, we have literacy small groups as well as math groups. Students rotate around the room and have a chance to use the tablets at this time. We use instructional apps on the tablets that the students are able to utilize on their own. It is another reinforcement for the students to practice what we are learning in class.”

This Week in Health IT History

One year ago:

• MedStar Health’s systems are brought down by a ransomware attack.
• Dell sells its IT services business to NTT Data for $3.05 billion to raise cash for its acquisition of storage vendor EMC.
• Epic updates its employment contracts with a mandatory arbitration clause to prevent lawsuits claiming unpaid overtime.
• Orion Health announces that it will lay off 36 US-based employees.
• Valence Health lays off 75 employees.
• Sandlot Solutions shuts down.

Five years ago:

• Newt Gingrich’s Center for Health Transformation closes and files Chapter 7 bankruptcy, listing several health IT vendors as creditors. 
• VA CIO Roger Baker says the $4 billion joint VA-DoD iEHR system built by Harris Corp. could be available by 2014.
• Vocera shares gain 40 percent on their IPO day.
• BlackBerry maker Research in Motion reports sagging sales and an executive housecleaning.
• Several medical device manufacturers conduct large layoffs to offset the 2.3 percent tax levied by passage of the Affordable Care Act.
• The Coast Guard prepares for its go-live on Epic.

Weekly Anonymous Reader Question

Last week I asked readers for the most hilariously clueless one-sentence statement made by an executive in their organization.

• Consulting firm CEO: “It’s not my job to provide a vision. People just need to do their damn jobs.” (at a leadership retreat where the goal was setting a 3-5 year trajectory), The company closed less than six months later.
• "This is a go-live. No support tickets should be submitted with a priority less than high."
• Regarding a chronically unhappy (with good reason) customer who was a 15-minute drive from company HQ: "Its not worth the time for one low-volume family doctor." Turns out that low-volume family doctor was good friends with a board member of a large medical group the company was trying to sell to.
• CEO was upset that vendor had no way to upgrade the entire software with no downtime. Would have been content with a plan in near future for the vendor to do so. It only would have required re-writing the entire EMR from the ground up. Not to mention that certain upgrades require database engine and/or OS upgrades, which on their own also require downtimes. Even a failover to another instance requires a small downtime (OpenVMS folks, please stifle yourselves).
• “We embrace failure.”
• Our nurse recruiter said to me, "It’s not important for RNs to have EHR credentials — they do not need that to work at our facility.”
• “Our quality scores are lower because, as an academic medical center, our patients are sicker.”
• “We’re working on it.”
• “We need a button in there that does some science.” (executive feedback to an application developer).
• On "voluntarily leaving" after several years of poor performance and multiple rounds of layoffs: "I’m going to spend the next few weeks recharging my batteries and figuring out what’s next."

This week’s question: What is the proudest moment of your health IT career?

Last Week’s Most Interesting News

• The White House and House Speaker Paul Ryan cancel voting on the American Health Care Act at the last minute after failing to gain the votes needed for its passage.
• A study concludes that mortality and morbidity is increasing among white, non-Hispanic, low-education American men due to drug overdoses, suicide, and alcohol-related liver disease, while life expectancy among those with higher educational levels is increasing.
• GE Healthcare announces plans to invest $500 million and hire 5,000 software developers over the next three years.
• President Trump appoints former Congressman John Fleming (R-LA) to the newly created position of HHS deputy assistant for health technology, after which Fleming expressed uncertainty about what the job entails because he thought he was interviewing for National Coordinator.
• Theranos offers investors additional shares if they agree not to sue the company or founder Elizabeth Holmes.

Webinars

March 29 (Wednesday) 1:00 ET. “Improving patient outcomes with smartphones: UW Medicine Valley Medical Center’s story.” Sponsored by Voalte. Presenters: James Jones, MBA, MSN, VP of patient care services and nursing operations, UW Medicine Valley Medical Center; Wayne Manuel, MBA, SVP of strategic services, UW Medicine Valley Medical Center. UW Medicine Valley Medical Center dramatically improved patient outcomes after moving to a smartphone-based platform for clinical communication and alarm and alert notification. Before-and-after analysis shows a reduction in hospital-acquired pressure ulcers and skin integrity events, fall and slip events, and medication errors. By limiting overhead paging, the medical center also created a calmer, quieter environment and improved engagement among nursing and hospitalists. Hospital executives will describe their experience and vision for the future in addressing quality, cost, and the patient-caregiver experience.

April 26 (Wednesday) 1:00 ET. “SSM Integrated Health Technologies Clinical Data Migration: Functional and Technical Considerations.” Sponsored by Galen Healthcare Solutions. Presenters: Sandy Winklemann, MHA, RHIA, project manager, SSM Integration Health Technologies; Tyler Mawyer, MHA, managing consultant, Galen Healthcare Solutions; Kavon Kaboli, MPH, senior consultant, Galen Healthcare Solutions. GE Centricity and Meditech to Epic EHR transition. Join us for a complimentary webinar as present the decisions that are important to consider when performing a clinical data migration from the point of view of  the healthcare organization program manager, the clinical analyst, and the technical implementation team. Our expert panel will survey data migration considerations, best practices, and lessons learned. The webinar will present a unique client perspective, offering insight into considerations surrounding staffing, clinical mapping, legacy application support, and validation and testing.

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

Acquisitions, Funding, Business, and Stock

Reuters reports that Advisory Board Company and Evolent Health are considering a merger of some or all of their businesses but ABCO has other bidders, among them Press Ganey. Advisory Board and UPMC created Evolent in 2011 and it went public in 2015, with Advisory Board owning 13.7 percent of the shares.

Announcements and Implementations

Docent Health expands its in-person patient experience program with digital and phone-based services.

Other

Vince and Elise kick off their annual series covering the top 10 HIS vendors.

Sponsor Updates

• Children’s Hospital of the King’s Daughters (VA) reports a fourfold investment return in 24 months from working with Influence Health to book procedures to correct a rare pediatric chest wall deformity.
• ZeOmega will exhibit at the Population Health Colloquium March 27-29 in Philadelphia.

Blog Posts

• Think, Act, Adapt with Urgency (Nordic)
• Leading the Way Through Healthcare Fee for Value Transformation (Experian Health)
• RISE to the occasion: quality, risk adjustment, payers, and providers converge (Verscend)
• To Build or Buy an Analytics Solution? (Part 1) (Vital Images)
• Beyond bells and whistles. (Voalte)
• 5 Major CX Considerations to Think Through Now (West Corp.)
• Back to the Future in Mobile Technology (Conduent Health)
• Getting Paid in a Value-based World (ZirMed)

Contacts

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

News 3/24/17

Top News

A study in progress postulates that rising mortality and morbidity in midlife, non-Hispanic Americans is due to the “cumulative disadvantage” of poor job prospects for those with low levels of education, leading to “deaths of despair.” 

In contrast, mortality rates in Europe are going down overall, decreasing even more rapidly for those without higher education.

The authors note a startling statistic – whites aged 50-54 had a 30 percent lower mortality rate than blacks in 1999, but the white mortality rate is now 30 percent higher. It also notes that overprescribing of opioids for pain has made things much worse.

People will be less-healthy at age 65 than those who preceded them, which has significant implications for Medicare.

Reader Comments

From If You Can’t Spell It: “Re: Smart Source press release. Misspelling HIPAA doesn’t give me the warm and fuzzies about my data being protected.” I’m thinking about trademarking “HIPPA” and printing off standard Office Depot certificate blanks with the names of companies who can then brag that they are “HIPPA compliant” without really doing anything more than sending me a check.

HIStalk Announcements and Requests

We provided building bocks for Mrs. K’s class in New York in funding her DonorsChoose request. She says, “My students are having so much fun with these blocks and they don’t even know they are learning. They are really discovering what happens when the blocks are stacked certain ways. The ability you have given them to explore and experiment with the blocks is wonderful. I really want my students to love coming to school and this has helped them tremendously.”

Someone posted on Facebook that their kid pointed out that SNOMED spelled backwards is DEMONS, which I hadn’t noticed.

This week on HIStalk Practice: RevMD opens first office in Puerto Rico. Blockit raises seed funding for appointment scheduling tech. The LA County Dept. of Health Services selects care coordination software from Eccovia Solutions. Navigating Cancer adds virtual consult capabilities. Mobile health holds promise for pediatric healthcare interventions. Biotricity CEO Waqaas Al-Siddiq explains how AI will soon disrupt the traditional physician practice. GE Healthcare announces plans to double its engineering workforce. Salus Telehealth offers free virtual grief counseling to military family members.

Webinars

March 29 (Wednesday) 1:00 ET. “Improving patient outcomes with smartphones: UW Medicine Valley Medical Center’s story.” Sponsored by Voalte. Presenters: James Jones, MBA, MSN, VP of patient care services and nursing operations, UW Medicine Valley Medical Center; Wayne Manuel, MBA, SVP of strategic services, UW Medicine Valley Medical Center. UW Medicine Valley Medical Center dramatically improved patient outcomes after moving to a smartphone-based platform for clinical communication and alarm and alert notification. Before-and-after analysis shows a reduction in hospital-acquired pressure ulcers and skin integrity events, fall and slip events, and medication errors. By limiting overhead paging, the medical center also created a calmer, quieter environment and improved engagement among nursing and hospitalists. Hospital executives will describe their experience and vision for the future in addressing quality, cost, and the patient-caregiver experience.

April 26 (Wednesday) 1:00 ET. “SSM Integrated Health Technologies Clinical Data Migration: Functional and Technical Considerations.” Sponsored by Galen Healthcare Solutions. Presenters: Sandy Winklemann, MHA, RHIA, project manager, SSM Integration Health Technologies; Tyler Mawyer, MHA, managing consultant, Galen Healthcare Solutions; Kavon Kaboli, MPH, senior consultant, Galen Healthcare Solutions. GE Centricity and Meditech to Epic EHR transition. Join us for a complimentary webinar as present the decisions that are important to consider when performing a clinical data migration from the point of view of  the healthcare organization program manager, the clinical analyst, and the technical implementation team. Our expert panel will survey data migration considerations, best practices, and lessons learned. The webinar will present a unique client perspective, offering insight into considerations surrounding staffing, clinical mapping, legacy application support, and validation and testing.

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

Acquisitions, Funding, Business, and Stock

Several dozen employees sue Merion Matters, the company that publishes the Advance-branded healthcare magazines (Advance for Health Information Professionals, Advance for Nurses, etc.), claiming they were not paid properly and that the company didn’t make contributions to their health plan. Glassdoor reviews are scathing, with some indicating that the company has closed, which may be why their tweeting stopped at the end of February. They used to have a health IT publication called Advance for Health Information Executives, but shut that down in 2010. Google-stalking suggests that the couple who own the business have some nice houses – a 14,000 square foot one in Malvern, PA and a $4 million oceanfront spread in New Jersey, although they sold their $2 million Florida condo a couple of years ago.

Theranos will give its investors more stock if they promise not to sue the company or CEO Elizabeth Holmes, with the shares coming from the personal holdings of Holmes, who would then cease to be the majority shareholder. The company will also buy back Rupert Murdoch’s shares for which he paid $125 million in 2015 for $1, apparently at his request so he can take a tax-saving loss in the absence of any other buyer for his stake.

GE will invest $500 million over the next three years in its GE Healthcare unit to digitize operations, hire 5,000 more software engineers, and possibly to fund a data analysis acquisition.

Sales

Maury Regional Health (TN) chooses Cerner, which will replace Meditech inpatient and NextGen outpatient.

An unnamed customer of Craneware extends its contract.

People

Brita Hansen, MD (Hennepin County Medical Center) joins LogicStream Health as chief medical officer.

Announcements and Implementations

HL7 publishes FHIR Release 3, which expands clinical workflow functionality and supports clinical decision support and CQMs.

Qventus expands its AI-powered real-time decision management system to the perioperative environment.

Epic embeds Nuance’s computer-assisted physician documentation into its NoteReader clinical documentation improvement solution to provide real-time feedback to doctors.

Health First (FL) goes live with First Databank’s recently acquired Meducation medication instructions systems, integrated with Allscripts Sunrise.

USAA Life Insurance Company says it can provide life insurance quotes 30 days faster now that it’s using Cerner HealtheHistory to retrieve EHR information electronically instead of by making manual requests to providers. It works for people who use the patient portals of the VA, DoD, or Kaiser Permanente.

Zynx Health and Healthwise will integrate their care plans and patient education content, respectively.

Government and Politics

Former MedAssets CEO John Bardis is appointed HHS assistant secretary for administration, which oversees business management, the CIO function, human resources, security, and program support. 

Privacy and Security

A systems administrator who was fired by an unnamed Pennsylvania healthcare facility after three weeks on the job is charged with criminal hacking over the following two-year period, which he accomplished by using his logon credentials that were not inactivated when he left. The Justice Department says Brandon Coughlin disabled all other administrator accounts, inactivated the credentials of users, tried to buy $5,000 worth of iPads using the organization’s account at Staples, and deleted patient records.

The Senate votes to overturn FCC privacy rules that were enacted last year. If the resolution is passed by the House, Internet and wireless service providers will be allowed collect and sell the personal information of their users – including browsing history — to third parties.

Other

Half of surveyed HIE executives say EHR vendors routinely engage in information blocking, although the #1 most common form of it they reported is not enhancing their products to support interoperability, which to me doesn’t really meet the definition. Likewise, respondents say the most common way health systems block information is by coercing providers to use a specific EHR. Also confusing is that the survey asked how frequently information blocking occurs, such as the 33 percent of respondents who say EHR vendors block information “occasionally,” whatever that means. Respondents suggested prohibiting gag clauses, assessing interoperability in the field, and creating stronger state and federal infrastructure, policies, and standards. I’m not convinced that HIE executives are in the best position to identify information blocking or to recommend solutions for it, so I’m not finding a lot of value in this research.

A National Academy of Medicine article published in JAMA says the US healthcare system needs an overhaul, calling out massive costs, fragmented care delivery, and income-based health disparity that has caused the first drop in life expectancy in 20 years. It suggests priorities of paying for value, empowering people, activating communities, and connecting care with digital interfaces. Suggestions specific to interoperability are to use HHS’s regulatory and payment clout to enforce interoperability standards, have HHS sponsor creation of standards for APIs, streamline privacy policies, and push for patients to own their data.

The dean of medical education at the Icahn School of Medicine writes a NEJM essay on the suicide of a fourth-year medical student:

From their very first shadowing experience to their first foray in the lab; from high school advanced-placement courses and college admissions tests to grade point averages and the Medical College Admissions Test (MCAT); with helicopter parents, peer pressure, violins and varsity soccer, college rankings, medical school rankings, medical licensing exams, and the residency Match, we never let up on them — and it’s killing them.

In India, a cardiologist whose hospital employer had fallen several months behind in issuing paychecks kills himself.

In England, a four-year-old boy whose mother had passed out at home presses his mom’s thumb onto her iPhone’s fingerprint sensor to unlock it and then asks Siri for help,  which triggers a call to 999 (England’s version of 911) that brings paramedics to revive her.

Sponsor Updates

• Optimum Healthcare IT CMIO Sheryl Bushman, DO is profiled in American Health Leader.
• Spok publishes a white paper on the implementation of Care Connect at Parkland Health & Hospital System (TX).
• Iatric Systems will exhibit at the HCCA Compliance Institute March 26-29 in National Harbor, MD.
• PatientSafe Solutions; PerfectServe; QuadraMed, a division of Harris Healthcare; and Sunquest Information Systems will exhibit at AONE 2017 March 29-April 1 in Baltimore.
• PatientKeeper publishes a new ebook, “Healthcare IT 2017-2022: First Comes Change, Then Comes Value.”
• Intelligent Medical Objects will exhibit at the AMIA Joint Summits on Translational Science March 27-30 in San Francisco.
• Kyruus will exhibit at ACHE 2017 March 27-30 in Chicago.
• Liaison Technologies launches an educational microsite to help businesses achieve digital transformation.
• LiveProcess and Meditech will exhibit at AONE’s annual meeting March 29-April 1 in Baltimore.
• MedData will exhibit at the HFMA Texas State Conference March 26-29 in Austin.
• National Decision Support Company will exhibit at the NCCN Annual Conference March 23-24 in Orlando.
• Netsmart will exhibit at the Texas Public Health Association annual meeting March 27 in Fort Worth, TX.
• Crain’s profiles GE Healthcare.
• Obix Perinatal Data System by Clinical Computer Systems Inc. will exhibit at the AWHONN Virginia Section Conference March 25 in Fairfax.

Blog Posts

• Exploring new ways to use FHIR: Infor to sponsor the HL7-AMIA Datathon this weekend  (Infor)
• Recipe for effective strategic healthcare IT consulting (Nordic)
• eForms and BBQ – They Go Hand in Hand (Access)
• Our Proven Cost-Effective Alternative for eCQM Submissions (Parallon Technology Solutions)
• #JointheConversation with Experian Health’s Cindy Dullea at #HIMSS17 (Experian Health)
• #PSA2017 Mobile Care Collaboration: Untethering the EMR to Improve Patient Safety (PatientSafe Solutions)
• 4 Tips to Automate Your Patient Revenue Cycle (Patientco)
• Detailed and Accurate Provider Data Needed to Drive Online Referral Management Efforts (Phynd Technologies)
• Bundled Payments for Care Improvement Initiative? Now That’s a Mouthful (PMD)
• Hacking Incidents Down, While Some Insider Health Data Breaches Took 5+ years to Discover (Protenus)
• New Healthcare Payment Models Require Customer Relationship Management (Salesforce)
• What Does the Future Hold for Independent Ambulatory Surgery Centers? (The SSI Group)
• Why Your Practice Management Systems Isn’t Designed to Manage Patient Relationships (Solutionreach)
• Transformational Leadership: CNO perspectives (Sphere3)
• Looking Back, and Giving Back, at HIMSS17 (Summit Healthcare)
• Improving Patient Safety with the Click of a Button (Surescripts)
• 4 key elements of an advanced analytics plan (Advisory Board)
• Health Maintenance with Epic Healthy Planet (Optimum Healthcare IT)
• EHR Optimization in a Behavioral Health Hospital: Patient Safety Win (Impact Advisors)
• Technology is a Powerful Weapon in the Fight Against Opioid Abuse (Imprivata)
• Before You Redesign Your Hospital Website, Define Your Goals (Influence Health)
• Change and Inadequate Tools Pose New Challenges for Physicians (Ingenious Med)
• And the Award Goes to … Healthcare Payment Innovators! (InstaMed)
• It’s Not a Game: What is Interoperability in Healthcare? (Liaison Technologies)
• Opening the Doors to the New Spok.com (Spok)
• Cybersecurity: 5 Ways to Keep Your EHR Data as Safe as Your Patients (Meditech)
• If You Aren’t Tracking These 3 KPIs, You’re Losing Money (Navicure)
• The Power of Voice (Netsmart)
• Recipe for effective strategic healthcare IT consulting (Nordic)

Contacts

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

News 3/22/17

Top News

President Trump appoints former US Rep. John Fleming, MD (R-LA) as deputy assistant secretary for health technology. That’s apparently a newly created HHS position whose connection to ONC has not been stated.

The 65-year-old Fleming says his understanding of the job is as a champion for innovation, describing his goals of improving EHR productivity, spurring EHR vendor competition, paying doctors to use technology, and reducing physician administrative burden.

Fleming tells Politico that he thought he was interviewing for the National Coordinator job, but says of the one he took, “I think it’s the same or a similar position – I really don’t know.”

Fleming lost his Senate bid in 2016 after an eight-year term as Congressman, finishing fifth in the primary after giving up his House seat to run. He has criticized the Affordable Care Act as “the most dangerous piece of legislation ever passed in Congress.” The former Navy doctor also owns 36 Subway sandwich shops and suggests that he plans to eventually return to Louisiana politics.

Reader Comments

From Not from Monterey: “Re: patient self-scheduling as mentioned in the Jim Higgins interview. I want to turn on patient self-scheduling for our site, which will use Cerner’s own patient portal and integrates with Cerner’s Scheduling product, but I’d love to hear about other sites’ experiences with patient self-scheduling. As Jim mentions, this is a patient satisfier that can easily be botched, both internally and externally. Heck, I’d love to hear from Epic sites about this. Who is doing this well?”

From Bandana: “Re: Welltok. Quietly laid off 100 employees last week from the Silverlink acquisition.” A company spokesperson responded to my inquiry: “I can confirm that this information is factually incorrect. In full transparency, we did transition out a handful of individuals from the company last week. At the same time, we also proactively hired a handful as well. This business decision was made to reduce duplicative roles within our organization and maximize resources so that we can stay focused on our collective mission – to empower consumers to achieve their optimal health.” Consumer health rewards vendor Welltok acquired Silverlink, which offered consumer communications technology, in December 2015.

From Grab Them By the Headline: “Re: your favorite HIMSS-owned publication. I’m sending them a thesaurus to help them find words other than ‘grabs’ and ‘nabs’ for their re-worded press releases about company funding.” I don’t read their site, but Googling makes it obvious that they over-use those annoying, child-like verbs in describing equity investments. It’s not like those companies are stealing a cookie from the plate and running away, nor does health IT need to be a Bat-fight full of “Kapow! Blam! Powie!” I can never tell whether their goal is to attract a less-intelligent audience or to diminish the collective IQ of the one they already have.

From Confused: “Re: blockchain. I’m looking for a layman’s primer, preferably with real-world healthcare examples.” I’ll invite readers to suggest resources they have found useful as an introduction.

HIStalk Announcements and Requests

We funded the DonorsChoose grant request of Mrs. S in South Carolina, who asked for spelling games and an organizer. She reports, “My students were overjoyed to hear that others care about them enough to contribute to their classroom and education without even meeting them. This is such a sweet reminder to them of the good in the world. The rolling cart provides my students with an organized way to access their word work materials and the board games are an excellent addition to that.”

Webinars

March 29 (Wednesday) 1:00 ET. “Improving patient outcomes with smartphones: UW Medicine Valley Medical Center’s story.” Sponsored by Voalte. Presenters: James Jones, MBA, MSN, VP of patient care services and nursing operations, UW Medicine Valley Medical Center; Wayne Manuel, MBA, SVP of strategic services, UW Medicine Valley Medical Center. UW Medicine Valley Medical Center dramatically improved patient outcomes after moving to a smartphone-based platform for clinical communication and alarm and alert notification. Before-and-after analysis shows a reduction in hospital-acquired pressure ulcers and skin integrity events, fall and slip events, and medication errors. By limiting overhead paging, the medical center also created a calmer, quieter environment and improved engagement among nursing and hospitalists. Hospital executives will describe their experience and vision for the future in addressing quality, cost, and the patient-caregiver experience.

April 26 (Wednesday) 1:00 ET. “SSM Integrated Health Technologies Clinical Data Migration: Functional and Technical Considerations.” Sponsored by Galen Healthcare Solutions. Presenters: Sandy Winklemann, MHA, RHIA, project manager, SSM Integration Health Technologies; Tyler Mawyer, MHA, managing consultant, Galen Healthcare Solutions; Kavon Kaboli, MPH, senior consultant, Galen Healthcare Solutions. GE Centricity and Meditech to Epic EHR transition. Join us for a complimentary webinar as present the decisions that are important to consider when performing a clinical data migration from the point of view of  the healthcare organization program manager, the clinical analyst, and the technical implementation team. Our expert panel will survey data migration considerations, best practices, and lessons learned. The webinar will present a unique client perspective, offering insight into considerations surrounding staffing, clinical mapping, legacy application support, and validation and testing.

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

Acquisitions, Funding, Business, and Stock

Ivenix closes a $50 million equity financing round that will allow the company to pursue FDA approval to market its Ivenix Infusion System smart IV pump.

Sales

Coffeyville Regional Medical Center (KS) will upgrade to Meditech’s Web EHR.

People

Laboratory-focused analytics vendor Viewics hires Keith Laughman (TRG Healthcare) as CEO. He replaces co-founder Dhiren Bhatia, who will move to chief strategy officer.

Operations planning platform vendor Hospital IQ hires Paris Lovett, MD, MBA (Thomas Jefferson University) as chief medical officer; Jason Harber (TeleTracking Technologies) as VP of product management; and Cheryle Cushion (OneCloud Software) as VP of marketing.

Announcements and Implementations

IBM announces a public, cloud-based service for creating blockchain networks based on the Linux Foundation’s open source Hyperledger Fabric. The starter plan and beta are free, while the business network subscription costs $10,000 per month for four peers and a certificate authority on IBM LinuxOne. The first customer is Canada-based SecureKey Technologies, which is developing a consumer digital identity network and has as investors Canada’s leading banks.

Mercy goes live on the Visage 7 Enterprise Imaging Platform, replacing nine imaging systems used by over 50 locations in less than six months.

GetWellNetwork launches the Person Engagement Index, an 18-question survey that assigns each patient a score representing their capacity to participate in their care. The score can be used by individual clinicians to decide how to educate and engage patients, by care managers to improve risk stratification, and by marketing people to tailor their communication messages.

AHIMA publishes a good brief on enhancing HIM practices to support LGBT populations that includes:

• Making sure both partners sign provider HIPAA forms.
• Suggesting that partners share each other’s patient portal log-ins.
• Allow patients to submit pre-visit information via the patient portal to alleviate privacy concerns in sharing the information at registration.
• Allow patients to list their preferred name and gender along with the legal versions.
• Allow lab reference ranges to be modified by gender, such as in the case of someone undergoing a female-to-male reassignment.
• Add EHR fields for gender identify, sexual orientation, sex assigned at birth, and organ inventory.

Government and Politics

The government of India responds to complaints about the drug supply chain and illegal Internet sales by proposing to require drug manufacturers to register on a new online portal and enter all of their sales there, including the drug’s batch number, quantity, and expiration date, with the pharmacy receiving the drug shipment also being required create an entry on the site. Pharmacists would also have to record each drug prescription on the site and include prescriber and pharmacist information, and for some drugs, the patient’s information. Hospitals would also have to record all medication dispensing activity, including details of any adverse reactions. 

An opinion piece in The HIll says the American Optometric Association is lobbying hard to support state laws that would prohibit online vision tests, not because they don’t work, but because they don’t provide in-office optometrists a chance to upsell new, high-markup glasses or contacts. AOA spent $1.8 million on lobbying in 2016. The target of much of the optometrists’ wrath is Opternative, which offers a $40, 15-minute online refractive test that includes a prescription for glasses or contacts.

ONC updates its SAFER Guides, best practices driven self-assessment tools and templates that allow medical practices to review their EHRs for patient safety issues.

Privacy and Security

Metropolitan Urology Group (WI) announces that basic, pre-2010 patient information was exposed in a November 2016 ransomware attack.

A journal essay questions why the NHS signed a deal with Google-owned DeepMind for kidney injury alerting, noting that Google gains access to patient information without sufficient controls being spelled out in the contract. It also notes that UK law requires patient consent for sending their data to a third party, and while kidney patients are covered by a patient care relationship, DeepMind was given the data of every patient admitted to Royal Free London NHS Foundation Trust over five years without the consent of those patients. It concludes,

The 2015–16 deal between a subsidiary of the world’s largest advertising company and a major hospital trust in Britain’s centralized public health service should serve as a cautionary tale and a call to attention. Through the vehicle of a promise both grand and diffuse––of a streaming app that will deliver critical alerts and actionable analytics on kidney disease now, and the health of all citizens in the future––Google DeepMind has entered the healthcare market. It has done so without any health-specific domain expertise, but with a potent combination of prestige, patronage, and the promise of progress. Networks of information now rule our professional and personal lives. These are principally owned and controlled by a handful of US companies … If these born-digital companies are afforded the opportunity to extend these networks into other domains of life, they will limit competition there, too. This is what is at stake with Google DeepMind being given unfettered, unexamined access to population-wide health datasets. It will build, own, and control networks of knowledge about disease.

Innovation and Research

The Miami paper describes the health IT project involvement of Miami Children’s Health System (FL), which includes investment, internal development, and pilot projects with accelerator startups.

The American College of Cardiology reports on the multi-center “Genetic InFormatics Trial (GIFT) of Warfarin Therapy to Prevent DVT,” which concludes that dosing the blood-thinning drug based on patient genotype reduced complications by 27 percent vs. the usual method of starting the patient on 5 mg daily and then titrating to INR results. The computer-based, real-time interface estimates the dose and provides recommendations  for adjustment based on other patient factors. The lead author expresses hope that EHR vendors will add genetic and clinical dosing algorithms to their systems to suggest doses early in the ordering process.

Other

Banner Health says the two Tucson, AZ hospitals it acquired in 2015 in absorbing the former University of Arizona Health Network lost $89 million in 2016, will lose $45 million this year, and will require $30 million to be converted to Banner’s Cerner system. The Tucson hospitals went live on a $115 million Epic project in 2013. The 28-hospital Banner, which is Arizona’s largest private employer, is trying to reduce its corporate service department expense by $65 million this year.  

In New Zealand, the health board blames its since-replaced computer system after discovering that critical radiology results that were viewed but not acknowledged would disappear from the physician’s inbox. A woman died of cancer when her doctor took a quick look at a new X-ray showing a lung mass in 2013, but then left for vacation with plans to contact the patient when she returned. When the doctor came back to work, the alert had disappeared and she forgot to follow up. The woman died of cancer in 2015 without having been contacted about her lung mass.

A study finds that hospital death rates drop during the week of unannounced Joint Commission inspections compared to the three weeks before or after. The authors conclude that hospital employees pay more attention to patient care when inspectors are observing them.

Politico ehealth editor and author Arthur Allen writes a nice piece – which may turn out to be a fond eulogy or celebration of life kind of thing – about the VA’s VistA system that seems sure to be mothballed soon in favor of a commercial replacement. I’m intentionally not calling VistA an EHR as I usually do since it does far more than that and maybe that’s important in this context – I’m pretty sure the VA will need more than just Cerner or Epic to replace VistA since has many non-clinical modules. Allen makes the broader point that perhaps the decisions about VistA over the years illustrate “just how difficult it can be for the government to handle innovation in its midst.”  Most fascinating is that the “Hardhats” who built VistA in a skunkworks project were subjected to open hostility from the centralization-obsessed VA, its IT contractors, and unknown folks who fired or transferred them, sabotaged their computers, and at one point, unwittingly symbolically tried to burn their stacks of programming printouts in a computer room by lighting paper medical records on fire.

Forbes publishes its annual list of billionaires, with Epic’s Judy Faulkner coming in at #867 with $2.4 billion. The “healthcare” section is littered with drug company and medical device billionaires, which might suggest where the excess profits generated by sick people accrue. Snapchat’s Evan Spiegel is the youngest self-made billionaire at 26 years old, joined by his Snap co-billionaires and the 20-something guys who started Ireland-based credit card processing firm Stripe.

I’d like to say it could never happen here, but lately I’m not so sure. India sees three examples of the family members of patients attacking clinicians. Family members of patient who later died beat a government hospital doctor with chairs, rods, and scissors when he recommends taking the patient to a tertiary care hospital to see a neurosurgeon. The relatives of a man who died of swine flu attack a doctor and nurse. Finally, a first-year resident is beaten up by the family of a 60-year-old woman who died of chronic kidney disease. Doctors say attack mobs are a problem only in state hospitals since private hospitals don’t accept desperately ill patients and also don’t allow more than one visitor at a time, limitations that state hospitals aren’t allowed to impose.

Sponsor Updates

• Agfa Healthcare releases a video compilation of its time at ECR 2017.
• Arcadia Healthcare Solutions will exhibit at the annual AMGA Conference March 22-25 in Grapevine, TX.
• QuadraMed Patient Identity Solutions, a division of Harris Healthcare, announces that the QuadraMed EMPI has earned the top 2016 EMPI ranking from Black Book Research.
• Besler Consulting’s DeLicia Maynard will speak at the Annual Hospital/Physician Collaborative Meeting March 22 in Lancaster, PA.
• Bottomline Technologies will exhibit at the Health Care Compliance Association Annual Compliance Institute March 26-29 in National Harbor, MD.
• Carevive Systems will exhibit at the NCCN Annual Conference March 23-24 in Orlando.
• CompuGroup Medical will exhibit at CLMA KnowledgeLab 2017 March 26-29 in Nashville.
• The Connecticut Technology Council names Diameter Health Chief Data Scientist Chun Li a finalist for its 2017 Women of Innovation Award.
• ECG Management Consultants will exhibit at ACHE’s Congress on Healthcare Leadership March 25-30 in Chicago.
• EClinicalWorks and Evariant will exhibit at AMGA March 22-25 in Grapevine, TX.
• The NFL and GE partner to advance understanding and treatment of concussions.
• Consulting Magazine recognizes The HCI Group’s Stephen Tokarz as one of the “Rising Starts of the Profession” in the healthcare category for 2017.
• Healthwise exhibits at Ehealth Initiative’s annual conference March 21-22 in Washington, DC.

Blog Posts

• 4 Ways Independent Practices can Thrive with Streamlined Workflow (AdvancedMD)
• #JointheConversation with Experian Health’s Cindy Dullea at #HIMSS17 (Experian Health)
• Welcoming New Arcadia Advisor John Halamka, MD (Arcadia Healthcare Solutions)
• Takeaways from the Gartner Data & Analytics Summit (Dimensional Insight)
• Top 10 Patient Safety Concerns for Healthcare Organizations (Bernoulli)
• FHIR is No Longer Just a Concept (Datica)
• In Case of Emergency: A Heart of CareSync Story (CareSync)
• Medicare, Medicaid, and the Prior Authorization (PA) Process (CoverMyMeds)
• The Perfect Storm (Culbert Healthcare Solutions)
• How Analytics can Help in a Value-based World (Dimensional Insight)
• How can Health Systems Engage Millenial Physicians? (Evariant)
• Halifax Health: Better Communication for Better Patient Care (Vocera Communications)
• 7 Tips to Cultivate Your Trainer, Part 1 of 2 (Hayes Management Consulting)
• HCS at NAPHS Annual Meeting, Focused on Behavioral Health (HCS)
• What New IT Challenges do Healthcare Organizations Face in 2017? (Huntzinger Management Group)

Contacts

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

Monday Morning Update 3/20/17

Top News

Pennsylvania’s mandatory medical error reporting — which requires submitters to indicate if health IT caused the event or contributed to it – shows an increasing number of HIT-related medication errors. Patients were harmed in eight incidents in the state during the first half of 2016.

Interestingly, the most common cause of dose omissions was system downtime, while the most frequent cause of wrong dosage errors being incorrectly entered patient weight, with one frightening example being a 46 kg patient whose Lovenox dose was calculated based on a mistyped weight of 146 kg.

In another example, a doctor ordered 65,610 mg of aspirin, explaining that she ignored the overdose warnings because she was just re-entering the home med (and in doing so, typed 810 tablets instead of 81 mg daily).

CPOE was involved in half of the incidents, with the pharmacy and eMAR systems each being tied to about one-fourth of incidents.

Reader Comments

From SkidMark: “Re: Epic. Continues its expansion into niche markets by partnering with Acumen Physician Solutions, which is part of Fresenius. Acumen offers a specialty EHR for nephrologists who round in dialysis clinics, but who also visit ESRD patients during their frequent hospital stays. What are the chances the Fresenius will also migrate its 2,500 dialysis clinics from Cerner Soarian to Epic’s legacy or emerging EHR for better integration with their nephrologists?” Fresenius announces that the next version of its Acumen EHR will be “Acumen 2.0 powered by Epic.” Fresenius chose Siemens Soarian in early 2005. It would seem to make sense that choosing Epic for nephrologists would improve the chances of replacing organization-wide Soarian with Epic rather than Millennium.

From McChange Pissed: “Re: Change Healthcare’s board of directors. What is McK thinking? They made one bad IT decision after another, starting with Pam Pure, and now she’s back?” Change Healthcare’s board includes Pam Pure, now CEO of HealthMEDX, but she has served on Change’s board since 2012, long before McKesson was involved (when it was Emdeon). Also on the board (for many years, too) is Phil Pead, who was CEO of Eclipsys and chairman of the Allscripts board following its acquisition of Eclipsys, but who later was fired in 2012 after clashing with CEO Glen Tullman, who was fired himself just a few months after. At least Change Healthcare’s management team includes three females among 12 executives (25 percent) vs. just one of eight board members (12.5 percent). 

From Springy Insole: “Re: after-visit summary. Have you seen any organization that has a patient-friendly one? The ones I’ve seen are pretty unhelpful and improvements could make a world of difference.” I’ll open it up to readers to weigh in and hopefully provide examples. Those I’ve seen look like they were uncreatively designed by programmers. The above came from the VA’s Robert Durkin, MD, MS, just to give you a refresher of what we’re talking about. While I like the format, I might suggest these changes:

• Indicate which diagnoses were new vs. existing, or perhaps include a date for each diagnosis. In fact, a problem I see with a lot of AVS is that programmers proudly regurgitate everything they have on file about a patient along with boilerplate reference information from third-party products, creating a bulky document that makes it hard to figure out what’s new (a pervasive problem with EHRs in general).
• Don’t mix diagnoses with health indicators, i.e. “ex-smoker” is not a diagnosis.
• Don’t use medical jargon like “vitals.”
• Indicate either the percentile or the risk of each vital sign listed so the patient doesn’t have to figure out what a BMI of 32 means.
• What I would really like to see on all AVS printouts is a few sentences from the doctor that summarize what he or she found, what the patient should be doing, and what the goals are and when those goals will be reassessed. That should be the first set of items on the document, under the assumption that the patient won’t read all of it and thus should see that first. The purpose of an AVS isn’t to print out the information that already exists in the EHR, except of course in the case where lack of interoperability makes the patient the integration engine in handing it off to their next provider.
• It would also be nice to use the summary as some type of agreement between doctor and patient of how they will work together.
• In fact, maybe that’s my takeaway – the AVS should not be considered an efficient but poor substitute for doctor-patient communication. A pretty printout is fine for a Jiffy Lube oil change summary, but a slam-bam medical encounter that results in a handed-over sheet of paper while discouraging patients to ask questions or seek follow-up isn’t ideal. A doctor visit often reminds me of a church confessional – the parishioner quickly states his or her issues and is sent away equally quickly formulated instructions — except that in medicine’s case, the church only offers the confessional while omitting the other important aspects of the church that might have prevented the need for confession in the first place.

HIStalk Announcements and Requests

I’ll take the glass-half-full viewpoint in celebrating the fact that 25 percent of poll respondents were able to view their records from other providers in their most recent encounter. Clarence is frustrated that his providers all use Epic, but even as a former Epic employee, he can’t convince the clinicians that they can actually retrieve his information from other sites. Greg’s specialist could access his chart and test results, but he had to tell them he’d had new tests. Brittney was impressed that her urgent care clinic records were not only automatically placed into her PCP chart, but that the doctor even asked about the outcome. Susan says we all need to educate patients and support consumer-mediated health exchange because they don’t realize that we aren’t already exchanging information.

New poll to your right or here: what was your patient portal experience from your most recent provider visit?

Mrs. H in Michigan exclaims, “This is amazing!” in describing how her students are using the listening center we provided in funding her DonorsChoose project. She says they listen to stories every day, write about what they heard, share their thoughts with classmates, and then take the physical book home to read on their own.

This Week in Health IT History

One year ago:

• Apple announces the CareKit developer framework for creating iPhone health apps.
• McKesson announces that it will take a $300 million restructuring charge and lay off 1,600 employees.
• NYC Health + Hospitals President and CEO Ram Raju, MD defends the organization’s Epic go-live date and says a CMIO who quit over the patient safety implications is a disgruntled former employee.
• Several hospitals are hit by ransomware.
• Allscripts and a private equity firm acquire post-acute care EHR vendor Netsmart for $950 million.
• New York’s e-prescribing mandate takes effect.

Five years ago:

• Memorial Sloan-Kettering Cancer Center and IBM announce their collaboration to use IBM Watson for oncology decision support.
• Vocera prices its IPO shares.
• Thomson Reuters puts its healthcare data and analytics business back on the market.
• Cerner breaks ground on its new campus at State Avenue and Village West Parkway.
• HHS launches a developer challenge to use Twitter for real-time public health tracking.

Weekly Anonymous Reader Question

Last week I asked readers to describe the dumbest EHR design flaw they’ve seen recently. I’m omitting vendor names since the point was to show the need for improvement as an industry.

• Click on Labs and there’s a New button, but that means to add a new historical lab – you can’t actually order from there.
• It’s impossible to add reference ranges for in-house labs.
• Free-text drug allergy entry is allowed and users do it all the time despite threats to their unborn children.
• The end user can click one wrong button and delete a global template that cannot be recovered.
• Storage of multiple instances of physiologic variables in different parts of the same database – a heart rate entered by a nurse goes one place, one entered by an allied health provider goes into another data element. When reporting on heart rate, which one does one access?
• Cannot store/send more than one ID for an individual patient visit, which is horrendously inadequate for trying to do conversions, file billing data, and file incoming patient data from another system.
• Approving med refill requests makes no entry in the EHR.
• Half of the home screen is taken up with notifications that list only a category and number. I have to open each one and there may be 10-15 at any time. I just want a list, maybe grouped by category, so I can see them at a glance.
• Can’t put isolation status in the patient header.
• The medication ordering drop-down sorts as strings instead of integers, so doses are listed as 1, 10, 2, 20, etc. How easy is it to generate an order for 10 mg of warfarin instead of 1 mg? Easy enough to be very glad a pharmacist caught the mistake before “the computer” killed someone with massive internal bleeding.
• Does not have a unique identifier to send for bi-directional data flow.
• The lack of design generosity for analysts blows my mind. It’s appallingly easy to hit a key and overwrite something – there’s no way to know what had been there, no undo button, and no way to close a record without saving.
• Our appointment reminder system can send only the patient’s scheduled start time, ensuring that we will run behind schedule. Is it so hard for the system to subtract 10 minutes for follow-up patients and 20 for new patients to calculate the arrival time?
• Tiny icons that can’t be enlarged.
• Scanning in individual TIFF files.
• Two of our systems can’t handle the Daylight Saving Time change in the fall and must be shut down for an hour.
• If you click X next to a patient name when entering documentation, there’s no “do you want to save your work” warning like every single other piece of software in existence.
• When discharging an ED patient, I select instructions, discharge meds, follow-up doctor, and instructions. Back on the discharge screen, the Print button prints an instruction with none of the above listed. I have to jump to another part of the application and reload the page. I’ve had patients leave the hospital without the information and we had to deliver it to them. The vendor’s “reload after selecting” workaround has been in place for 2.5 years.
• The provider master file should be its own app with a cert and minimum staffing recommendation.
• A vendor demonstrated their new enterprise system to a large hospital group and discharged the pregnant male demo patient. The risk manager pointed out the flaw.
• A well-known EHR does not port a female patient’s gyn history into the OB episode when she becomes pregnant, requiring employees to re-document the entire history.
• The vendor sets up two direct messaging solutions, one that’s DirectTrust accredited and one that isn’t. As a result, not all users can exchange messages with other accredited HISPs and they may not know if they are on the “right” HISP.
• If an external user sends a Direct message with a C-CDA and PDF, the HISP drops the PDF attachments because the vendor doesn’t support receiving them. Plenty of EHRs have the same problem, but the killer is that there’s no notice back to the sender that only part of their message was delivered.
• No sandbox for hospital users.

This week’s question, just to lighten things up a bit:  What’s the most hilariously clueless one-sentence statement you’ve heard an executive of your organization make?

Last Week’s Most Interesting News

• A GAO report says HHS should question why so many providers say they offer patients access to their electronic information, yet few patients review it.
• Mayo Clinic says its decreasing margins force it to give appointment priority to patients covered by private insurance rather than Medicare and Medicaid.
• ECRI’s #1 patient safety concern for 2017 is EHR information management.
• A House bill would allow employers to require employees to undergo genetic testing and to share their results to earn health insurance premium discounts in corporate wellness programs.

Webinars

March 29 (Wednesday) 1:00 ET. “Improving patient outcomes with smartphones: UW Medicine Valley Medical Center’s story.” Sponsored by Voalte. Presenters: James Jones, MBA, MSN, VP of patient care services and nursing operations, UW Medicine Valley Medical Center; Wayne Manuel, MBA, SVP of strategic services, UW Medicine Valley Medical Center. UW Medicine Valley Medical Center dramatically improved patient outcomes after moving to a smartphone-based platform for clinical communication and alarm and alert notification. Before-and-after analysis shows a reduction in hospital-acquired pressure ulcers and skin integrity events, fall and slip events, and medication errors. By limiting overhead paging, the medical center also created a calmer, quieter environment and improved engagement among nursing and hospitalists. Hospital executives will describe their experience and vision for the future in addressing quality, cost, and the patient-caregiver experience.

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

Decisions

• Henry Ford Allegiance Health (MI) will go live with Epic in August 2017.
• Columbus Regional Healthcare System (GA) switched ERP systems from Infor to Sage in January 2017.
• Bon Secours St. Francis Hospital (SC) moved from McKesson to Cerner in October 2016.

These provider-reported updates are provided by Definitive Healthcare, which offers powerful intelligence on hospitals, physicians, and healthcare providers.

People

The Missouri Health Connection HIE promotes Angie Bass, MHA to president and CEO. I believe she’s the fourth CEO since the organization was founded in 2012.

Privacy and Security

Children’s Hospital of Eastern Ontario notifies 283 people that the medical information of their children was used in a college class taught by one of its employees, who handed out a surgery schedule will full patient information for an in-class exercise.

Houston Methodist Cancer Center notifies 1,400 patients that their email addresses were exposed when an employee used CC: rather than BCC: for a mass email.

A North Carolina radiation oncologist and medical school professor is arrested for issuing fraudulent narcotics prescriptions. Adding insult to injury, State Bureau of Investigation officials who raided his home also arrested his son when they examined his computer and found child pornography. That should create some awkward “remember that day” family conversations.

A Texas woman files a complaint with the state’s medical board and notifies HHS after she says a doctor who performed a “non-surgical tummy tuck” that she complained about on Facebook, after which the doctor allegedly posted near-naked pre-surgical photos and video of her on Facebook and YouTube. The patient claims that Tinuade Olusegun-Gbadehan, MD then threatened her by emailing a link to the video and a message that said, “This video result, when posted as a response to your next slanderous comment about the Dr. O Lift on social media, will be just as damaging to YOUR professional reputation.”

Other

Five VA hospitals create the country’s first 3-D printing network, allowing doctors to design and build prosthetic and orthotic devices as well as to construct anatomic models for study and surgery practice.

A high-profile cardiothoracic surgeon sues Memorial Hermann (TX), which he claims manipulated outcomes data to discredit him after he threatened to move to competitor Houston Methodist Hospital. The doctor – who had served as chair of both the surgery and cardiovascular departments of Memorial Hermann — says Memorial Hermann ordered him to perform surgeries only under the supervision of another surgeon and then presented the information to a roomful of colleagues to smear his reputation even though the underlying data was flawed. “I was coming between administrators and market share,” he concludes, saying he left because Memorial Hermann’s cost-cutting measures were compromising patient care. The hospital stands by its peer review process that uses data from the Society of Thoracic Surgeons.

Adventist Health System’s automated, real-time patient harm trigger system – which attempts to identify patient safety issues by reviewing events such as the ordering drugs that might indicate treatment of unreported patient harm – captures a lot more incidents than manual review. The most frequent harms in order of severity were medication-related hypoglycemia, C. diff infection, medication-related bleeding, venous thromboembolism, and post-surgical respiratory complication. The most dramatic increase was for pressure ulcers, which were detected 112 times by the trigger system vs. 0 as previously reported to the PSI 90 regulatory program.

The FBI charges a man with cyberstalking after he uses Twitter to induce an epileptic seizure in a magazine editor who had written articles critical of President Trump. 29-year-old John Rivello knew that Kurt Eichenwald suffers from epileptic seizures and tweeted him a strobe-like animated GIF with a message, “You deserve a seizure for your post.” Eichenwald had an immediate seizure that left him incapacitated for several days and has since received similar animations from 40 other seriously disturbed Twitter users.

Bizarrely sad: a man plugs his iPhone charger into an extension cord and takes the phone into the bathtub with him, with the resulting water contact electrocuting him. The coroner says he will ask Apple to warn phone-addicted people that bringing a plugged-in phone into the bathtub is little different from using a hairdryer there. The man had plugged the extension cord into a hall outlet, which makes me think that he might still be alive had he instead chosen a GFI-protected bathroom jack. Or, if his bathroom indeed had GFI, whether his bypassing of it was perhaps intentional.

Miami authorities try to build a case against a porn star who also operated a cosmetic center where a woman died in 2013 after a botched butt lift procedure. Vanessa Luna (her professional name, which is subtly clever if intentional since her trademark feature is her posterior and thus a “moon” reference is sly) says her clinic just sold Herbalife and cosmetics, but several witnesses say she oversaw illegal cosmetic surgeries performed there. Ms. Luna says she ran Facebook ads for plastic surgery and sold the resulting referrals to reputable doctors, but didn’t do any procedures herself. It wouldn’t be a South Florida story without Medicare fraud, for which the patient had served prison time.

Sponsor Updates

• Versus Technology will exhibit at AMGA March 22-25 in Grapevine, TX.
• Huron recognizes employee performance with 10 senior-level promotions.
• ZeOmega releases the latest edition of its ZeExchange newsletter

Blog Posts

• Busting myths about clinical claim review (Verscend)
• Real World Success Stories in Enterprise Imaging – Case #1: Pediatric Aneurysm (Visage Imaging)
• What We Learned at HIMSS17: Exploring Japanese Heritage and the Impact on Health IT (Vital Images)
• Scalability is the secret sauce. (Voalte)
• What’s Happening with Value-based Reimbursement in 2017 (ZirMed)

Contacts

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

News 3/17/17

Top News

A GAO report says HHS should investigate why few patients access their electronic medical information even though 90+ percent of hospitals and practices claim to offer such access.

The report suggests that patient portals are the most common method by which patients look up their information, most commonly that of the provider’s EHR vendor. The report notes the limitations of portals:

• Patients must often use multiple portals for their multiple providers, meaning they have to go through the sometimes laborious setup more than once and maintain multiple sets of login credentials.
• Longitudinal data across providers isn’t available.
• User interface design is often poor.
• Each provider’s portal may be set up to display a subset of the available information that may be inconsistent, such as one portal showing prescriptions and another not.
• New information is not always available consistently, such as recent lab results that may not be posted every time depending on which lab processed the sample.
• Portals don’t usually display historical vital signs and weights that the patient could use for trending.

The percentage of patients who review their health information varied widely depending on which EHR the organization used. Of the top 10 vendors (which were not named in the report), the percentage of patients who reviewed their information ranged from 10 percent to 48 percent.

The report suggests that providers provide portal brochures, promote the portal during each interaction, make computers available in the hospital or practice, send reminder emails, reward clinical staff, or offer patients prizes or discounts for using the portal.

Reader Comments

From Inquiring Mind: “Re: Soffet. We’re converting to Cerner Patient Accounting and the reference site mentioned a product called Cerner Charge Integrity from Soffet. We’ve searched HIStalk and haven’t found it. Where can I find this mythical company and product?” Some pretty impressive Googling (if I do say so myself) turned up Softek Solutions, which offers EHR performance and revenue integrity solutions for Cerner sites.

From Shoulda Shorted: “Re: fitness trackers. You wrote in 2015 that fitness trackers had run their course. I sent that comment to my broker when Fitbit was trading at $35, but I should have also shorted shares – they are now at $6.” I also now see that Microsoft has killed off its poorly designed Band tracker that I had panned after trying it, with its demise going unnoticed due to indifference. My take today: the only fitness tracker that will ever be consistently used will be built into your phone, with any required sensors being effortless and invisible. Nobody wants to wander around like Dick Tracy with a big old gadget on their wrist or risk embarrassment after missing a fad shift in still wearing one of those once-ubiquitous but now-defunct Livestrong yellow rubber bands. My weekend poll might ask how many trackers you’ve owned and whether you still use one (my early 2014 survey found that 37 percent of respondents claimed to use their tracker at least five days per week, “use” being loosely defined). The early-market churn as companies rushed supposedly improved products to market and convinced consumers to change brands created the illusion of ongoing demand, but there’s only so much to be gain health-wise by counting steps and most Americans don’t really want to take a lot of steps anyway. At least you can hang clothes from unused treadmills.

HIStalk Announcements and Requests

Readers funded the DonorsChoose grant request of Ms. H in Indiana, whose seventh graders are using the scientific calculators we provided to perform complex experiments in calculating the volume of cylinders using popcorn.

Lorre’s post-HIMSS specials for new sponsors of the site and of webinars ends when March does, so interested companies have a couple of weeks to speak up before we slack off during those lazy, hazy, crazy days of summer.

I was reading a questionably authoritative article that proclaimed that data centers will be obsolete within five years because of the cloud. I think they missed the fact that data centers aren’t going away – they’re just being centralized. What has changed is ownership and the length of the cord attaching the end user. As I often say, the cloud is just someone else’s computer, although that’s a flip response if a vendor really offers a “cloud” – a pool of interchangeable, commodity servers that are physically touched only when installed and discarded and that are managed collectively, spun up quickly via software, scalable, and are sold as a metered service. It would be interesting to know which health IT vendors are truly operating in this type of cloud vs. just parking the same old server in their own building instead of one owned by the customer. And speaking of Dilbert (which I wasn’t, except to include the strip above), Scott Adams is putting together a list of startups that could lower healthcare costs and is seeking submissions in case you work for one of those.

Listening: new from Norway-based but American-sounding Beachheads, jangly, hook-laden power pop that defies your toes to stop tapping even with a pleasant soupcon of the punkish minor chords that I require.

This week on HIStalk Practice: CaptureRx expands, relocates in San Antonio. Southwest Behavioral & Health Services implements EnSoftek IT. Compulink develops EHR for pain medicine providers. Primaria Health launches ACO in Central Indiana. Ingenious Med CEO Joe Marabito calls out lack of vendor support for physicians. Price, Verma reassure governors of their commitment to Medicaid. MGMA takes CMS to task for lack of 2017 MIPS eligibility information.

Webinars

March 29 (Wednesday) 1:00 ET. “Improving patient outcomes with smartphones: UW Medicine Valley Medical Center’s story.” Sponsored by Voalte. Presenters: James Jones, MBA, MSN, VP of patient care services and nursing operations, UW Medicine Valley Medical Center; Wayne Manuel, MBA, SVP of strategic services, UW Medicine Valley Medical Center. UW Medicine Valley Medical Center dramatically improved patient outcomes after moving to a smartphone-based platform for clinical communication and alarm and alert notification. Before-and-after analysis shows a reduction in hospital-acquired pressure ulcers and skin integrity events, fall and slip events, and medication errors. By limiting overhead paging, the medical center also created a calmer, quieter environment and improved engagement among nursing and hospitalists. Hospital executives will describe their experience and vision for the future in addressing quality, cost, and the patient-caregiver experience.

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

Acquisitions, Funding, Business, and Stock

CareDox, which offers a free EHR for K-12 public schools, raises $6.4 million in a Series A funding round, increasing its total to $13.5 million. The company is vague about how it makes money, but it appears to sell de-identified student information and to send care reminder-type advertising messages to parents.

First Databank acquires Polyglot Systems, which offers the Meducation patient medication instructions product line.

FDA-approved EKG app vendor AliveCor raises $30 million to add AI-powered EKG analysis to its service.

Livongo Health, the diabetes monitoring and coaching company led by former Allscripts CEO Glen Tullman, raises $52 million in a Series D round, increasing its total to $143 million.

McKesson is rumored to be selling its San Francisco headquarters building for $300 million. The company previously announced plans to sell and then lease back the 38-story building.

Sales

Hawaii’s leading health plan HMSA selects Sharecare’s consumer health and messaging platform for a statewide rollout and also makes an unspecified investment in the company, started in 2010 by WebMD founder Jeff Arnold and TV’s Dr. Oz. Sharecare acquired the population health business of Healthways in July 2016.

Mount Sinai Health System (NY) will use Salesforce Health Cloud to coordinate and manage care of Medicaid Performing Provider System.

People

Influence Health hires Dave Morgan (Recondo Technology) as CFO and Rupen Patel (NCR) as CTO.

Former Acting CMS Administrator Andy Slavitt (and our HIStalk Industry Figure of the Year) joins the Bipartisan Policy Center as senior advisor.

Announcements and Implementations

Mayo Clinic says that its tighter margins have forced it to start giving appointment priority to privately insured patients over those covered by Medicare and Medicaid. Mayo had a $475 million profit in 2016. What’s most surprising is that Mayo announced publicly what most health systems do privately – market to those with private insurance and, all things being equal, give them smoother passage through the system without affecting clinical outcomes. Perhaps there’s a market for a targeted patient dissatisfaction program to keep the low-paying customers away without actually banning them.

IBM Watson Health licenses AI-powered medical imaging analysis software from Israel-based MedyMatch Technology, which IBM will offer to EDs for assessing patients with suspected head trauma or stroke.

Government and Politics

The White House’s budget proposal, which would cut NIH funding by 19 percent, would also move HHS’s AHRQ into the National Institutes of Health.

Privacy and Security

A phishing employee awareness test by BayCare Health System (FL) creates headaches for the tax collector’s office when appropriately wary workers call to verify the phony government-looking email. The health system expected unsuspecting employees to click on links as the email instructed, which would have automatically presented them with a lesson on why their actions were inappropriate.

Other

A second Dallas death is attributed to a “ghost call” problem in which 911 callers can’t get through because the lines are overloaded by calls from T-Mobile cell users who didn’t actually dial 911. The Dallas-only problem seems happen when someone completes a 911 call, then sometime later the cell service thinks the call didn’t go through and tries again. The city admits that a six-month-old died while his babysitter was on hold with 911 for 30 minutes last week, with records indicating that 360 callers were waiting on hold at one point in the day.

A federal judge dismisses a lawsuit brought against Amtrak by Temple University Hospital that demanded payment of $1.63 million for treating a passenger injured in a May 2015 derailment. The passenger was covered by Medicare but the hospital didn’t submit its claim in time to collect the $269,000 that Medicare would have paid.

I mentioned last time that a new app measures the percentage of time men vs. women speak in a meeting, but here’s one I like better. Woman Interrupted allows measurement of “manterruption,” when a male interrupts a female who is speaking. I’m sympathetic since there’s nothing that drives me crazier (and often into pouty silence) than when someone of either gender repeatedly interrupts me, either in a one-to-one or group setting. It’s usually one of two extreme personality types: (a) an egotist (often the highest-ranking person in a meeting) who thinks they possess super-human insight into what needs to be said; or (b) someone so lacking in self-confidence that they have to talk over someone else to feel validated. I’m pretty sure those interrupters hate being interrupted themselves (since everybody does), so I always wonder if I should just say, “I’m going to leave now since you’ve turned our dialog into monolog and thus rendered my presence superfluous.” For the app, I suggest a Nuance-powered enterprise version that maintains speech profiles on every employee so it can provide a meeting recap indicating: (a) how much time each person talked; (b) how many times they interrupted someone or were interrupted themselves; and (c) who the primary interrupters are on the rudeness leaderboard. Perhaps it could also record which ideas each person argued for or against and then reconvene the groups six months later to see whose thoughts most closely aligned with the eventual reality and then automatically remove the chatty but wrong ones from future invitations.

Sponsor Updates

• Billings Clinic Hospital (MO) goes live with Versus Wi-Fi RTLS asset tracking.
• InterSystems posts its HIMSS17 presentation by Mental Health Center of Denver VP & CIO Wesley Williams, MD.
• Intelligent Medical Objects, Kyruus, Meditech, and PerfectServe will exhibit at AMGA 2017 March 22-25 in Grapevine, TX.
• Liaison Technologies will exhibit at the SCOPE Spring Conference March 19-21 in Atlanta.
• LifeImage publishes a new primer, “Image Sharing: Is It Missing From Your Enterprise Imaging Strategy?”
• Gartner names LogicWorks a leader in its 2017 Magic Quadrant for Public Cloud Infrastructure Managed Services Providers.
• MedData and The SSI Group will exhibit at the HFMA Texas State Conference March 26-29 in Austin.
• Netsmart will exhibit at the NAPHS Annual Meeting March 20 in Washington, DC.
• News: NTT Data awarded contract by the CDC
• NVoq will exhibit at the ACC Annual Scientific Session & Expo March 17-19 in Washington, DC.
• Experian Health will exhibit at HFMA KY March 30-31 in Lexington.
• Reaction facilitates a study on the ways in which independent physician referrals represent millions of dollars in revenue for hospitals.
• Harris Healthcare will exhibit at the NYONEL Annual Meeting March 19-21 in Tarrytown, NY.
• Sagacious Consultants releases the latest edition of Sagacious Pulse.
• Sunquest will exhibit at ACMG 2017 March 22-24 in Phoenix.
• Surescripts will exhibit at the Patient Adherence and Engagement Summit March 21-22 in Philadelphia.
• Sutherland Healthcare Solutions releases a new case study featuring Palomar Health, “Turning ICD-10’s Transition from Anticipated Calamity into a Resounding Success.”

Blog Posts

• How Analytics Can Help in a Value-Based World (Dimensional Insight)
• #JointheConversation on Analytics (Experian Health)
• AIDS Resource Center of Wisconsin – Making a Difference in HIV Outcomes (Forward Health Group)
• Why Aren’t You Leveraging Analytics? (Optimum Healthcare IT)
• Real World Success Stories in Enterprise Imaging | Case #1:  Pediatric Aneurysm (Visage Imaging)
• Technology Evaluation Tools for a Complex Hospital Acquisition Process (Sphere3)
• Epic Workqueues and Revenue Cycle (Impact Advisors)
• What’s in Your Tech Stack? (Influence Health)
• CNO conversation #1: How do you handle overtime? (Infor)
• Certificationology: The Art of Making Healthcare Payment Security Decisions as Conspicuously as You Choose Your March Madness Bracket (InstaMed)
• Key Pharma Industry Trends to Watch for in 2017 (Liaison Technologies)
• Are You Ready for the CMS Emergency Preparedness Final Rule? (Live Process)
• How to Migrate to AWS in 30 Days (Logicworks)
• The Early Bird Gets the Bundled Payment Program Worm (Medecision)
• EHR “Go Live” Isn’t the End … It’s Just the Beginning (Netsmart)
• The Benefits and Challenges of Staff Augmentation (Parallon Technology Solutions)
• Too Big to Succeed? (CloudWave)
• Is the EHR a secret weapon for success under risk? We think so.  (Advisory Board)
• Putting the “Long” in Long-Term EHR Training (PatientKeeper)
• The Path Forward for Enterprise Imaging (Lexmark Healthcare)
• How Pharmaceutical Companies Could be Affected by the AMA’s Prior Authorization and Utilization Management Reform Proposal (Point-of-Care Partners)
• Marking One Year of Success in Financial Services and Healthcare (Salesforce)
• Why It’s OK to be a Dinosaur in Patient Communication (Solutionreach)
• The Growing Need for Notifications (Summit Healthcare)
• How to grow capacity and tame complexity in the genetics lab (Sunquest)
• Using Actionable Intelligence to Improve Patient Safety (Surescripts)

Contacts

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

News 3/15/17

Top News

ECRI Institute lists its “2017 Top 10 Patient Safety Concerns for Healthcare Organizations” that includes:

1. Information management in EHRs
2. Unrecognized patient deterioration
3. Implementation and use of clinical decision support
4. Test result reporting and follow-up
5. Antimicrobial stewardship
6. Patient identification
7. Opioid administration and monitoring in acute care
8. Behavioral health issues in non-behavioral-health settings
9. Management of new oral anticoagulants
10. Inadequate organization systems or processes to improve safety and quality

Reader Comments

From Greek Goddess: “Re: Epic. As you’ve shared, its non-marketing department has done a good job of making operating margin and revenue growth part of the industry narrative, claiming causation with Epic’s EHR. You’ve been a voice of reason here, along with Wall Street and others – stating the obvious that the tide has risen for the entire industry under more reimbursed care under ACA and Medicaid coverage. The proposed Republican plan will cause 14 million people to lose coverage next year per the CBO. It will be interesting to see what Epic’s non-marketing department does to pin those falling margins on the competitors if that happens.” Perhaps Epic’s snazzy charts will show that their clients enjoyed less-dramatically reduced margins than those of their competitors. It’s meaningless anyway since, as is nearly always the case in healthcare, correlation is easy to observe but causation is nearly impossible to prove.

From RIF’ed Me a New One: “Re: Aetna. Several friends were let go yesterday and were told it was because of the failed Humana acquisition. I’m wondering if anyone else was affected?” I assume that if HIStalk readers are reporting it, it probably affected Aetna’s Medicity or iTriage groups. Anonymous reports on TheLayoff.com suggest that both Aetna and Humana have been paring headcount since the federal government turned the hose on their mating ritual.

From Slammed CIO: “Re: HIMSS17 unsolicited follow-ups. Vendors are contacting me claiming that I visited their booth at HIMSS17, ones I didn’t talk to then and have no need to talk with now. Has something changed at HIMSS? I’m curious if other attendees are having this experience.” I’ve received only a handful of emails, and while I don’t recall having visited the booths of a couple of the companies that sent them, I might well have allowed them to scan my badge so I could get a snack or lip balm or something.

From Julian Assuage: “Re: anonymous communications. How can I send you something with full anonymity?” My rumor report form is anonymous other than it captures your IP address, which is inherent in the form tool I use (although I don’t look at the IP address anyway). You could use Guerrilla Mail, which offers both disposable email addresses and the ability to send anonymous email without registering or paying. Either method supports adding attachments if you are inclined to provide supporting evidence.

From Pellegrino: “Re: Elaine Remmlinger of ECG. She was supposed to start a project with us and is retiring, effective immediately. It seems the reported bloodletting of the former Kurt Salmon employees is true.” ECG confirms that Elaine has retired as of Monday, but adds that she will probably be transitioning clients and projects for a few weeks.

HIStalk Announcements and Requests

We funded the DonorsChoose grant request of Ms. A in Illinois, who created a family involvement and social-emotional learning program for her community that is “plagued with low social-economic ills, gang infestation, and violence.” We provided VR headsets, geometry kits, robotics and electronic doodling pens, and other interactive tools to allow “virtual field trips.” 

Aging programmer test – how many of the four long-obsolete programming languages above can you identify without Googling?

Webinars

March 29 (Wednesday) 1:00 ET. “Improving patient outcomes with smartphones: UW Medicine Valley Medical Center’s story.” Sponsored by Voalte. Presenters: James Jones, MBA, MSN, VP of patient care services and nursing operations, UW Medicine Valley Medical Center; Wayne Manuel, MBA, SVP of strategic services, UW Medicine Valley Medical Center. UW Medicine Valley Medical Center dramatically improved patient outcomes after moving to a smartphone-based platform for clinical communication and alarm and alert notification. Before-and-after analysis shows a reduction in hospital-acquired pressure ulcers and skin integrity events, fall and slip events, and medication errors. By limiting overhead paging, the medical center also created a calmer, quieter environment and improved engagement among nursing and hospitalists. Hospital executives will describe their experience and vision for the future in addressing quality, cost, and the patient-caregiver experience.

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

Acquisitions, Funding, Business, and Stock

The Hartford business paper profiles CareCentrix, which manages technology-powered post-acute care services for insurers. The company recorded $1.4 billion in revenue in 2016 in managing 23 million covered lives. CEO John Driscoll was formerly president of Castlight Health and was a Medco executive.

Medical cost containment vendor HMS Holdings will pay $170 million in cash to acquire Eliza Corporation, which offers consumer engagement and automated outreach programs.

A federal court rules that the contracts of medical supply competitive bidding site Medpricer violate anti-kickback law since the company charges fees as a percentage of the dollar volume purchased. The federal judge determined that the company violated the law since federal healthcare programs could eventually be billed for the goods. Medpricer sued medical device maker Becton, Dickinson, and Co. for refusing to pay its 1.5 percent fee for three successful bids even though Becton had inserted language into its bid indicating that it would not pay any fees.

Announcements and Implementations

The National Patient Safety Foundation and the Institute for Healthcare Improvement will merge. IHI President and CEO Derek Feeley will lead the combined organizations.

Henry Mayo Newall Hospital (CA) and Parkview Medical Center (CO) go live with Summit Healthcare’s Provider Alert clinical event notification and data exchange solution.

GetWellNetwork completes integration of its interactive patient care system with the VA’s VistA and other technology platforms.

Government and Politics

The Senate confirms health policy consultant and Medicaid expert Seema Verma, MPH as CMS administrator.

The President nominates Scott Gottlieb, MD to run the FDA. He is a venture partner, investment banker, and hedge funder advisor who sits on the boards of several drug companies and has advocated FDA de-regulation. He was FDA’s deputy commissioner for medical and scientific affairs from 2005 to 2007, director of medical policy development before that, and a member of the Health IT Policy Committee.

Trade association Health IT Now urges HHS Secretary Tom Price and Congress to review ONC’s regulatory role in health IT, citing ONC”s plans to review EHR product safety that are seemingly in conflict with FDA’s role and ONC’s “we’ll know it when we see it” certification process. Health IT is a non-profit group, but incorporated as a 501(c)(4) organization, meaning it can engage in political lobbying, endorse candidates, and make political donations. Health IT Now’s odd lot of members include drug companies and few second-tier healthcare associations, with notable dropouts over the years that I noticed in comparing old vs. new member lists being the American Academy of Nursing, the American Cancer Society, AHIMA, ANA, IBM, and several hospitals.

Technology

A Sweden-based design firm creates GenderEQ, a free iOS app that analyzes the percentage of time males and females speak during a meeting. I like the idea of calling out unintentional gender bias, but the app’s inherent shortcomings are obvious: (a) it may not always identify gender correctly by voice alone, and (b) it is not unreasonable that those of one gender might speak more than the other in a given meeting simply because of who is in the room or what roles they are serving in the meeting. I suggest a companion app that I’ll call TwitEQ, which matches who talked the most with the perception of fellow attendees that their comments were useful. Meeting dynamics encourage everyone to speak up, even those whose comments are of marginal value or relevance, especially in hospitals where too many people are invited and even more show up because they would otherwise feel slighted that decisions would be made without their self-assessed expertise.

Microsoft begins the rollout of Teams, its free workplace collaboration platform and Slack competitor, to Office 365 users. Somehow it’s comforting to see Northwind Traders used as a sample business as Microsoft always does.

Privacy and Security

From DataBreaches. net:

• In New Zealand, a new physician practice system is taken offline when the Ministry of Health discovers that it sends data back to the vendor’s servers in unencrypted sessions.
• A hacker who was previously arrested for stealing and selling 62,000 W2 forms of UPMC employees says he will plead guilty.
• Denton Heart Group (TX) notifies an unstated number of patients that an unencrypted backup drive was stolen from a locked closet, exposing seven years’ of information.
• BJC HealthCare notifies 644 program participants that their information was emailed among its service providers without encryption.

Other

A review of an asthma study conducted using Apple ResearchKit apparently reaches an unexpected conclusion – fickle phone users are just as likely to allow their attention to wander from a clinical study over time as they are their use of any other app, as 6,500 baseline users yielded 2,300 who actively participated and 175 who completed a six-month milestone survey. Still, it’s not easy assembling a study cohort in general, so it’s probably not a bad outcome.

A Slate article ponders whether big data can be applied to predict when someone will die, contrasting the unbiased predictive capability of technology vs. the optimistic, subjective guesses of physicians. A NEJM opinion piece written by a Harvard ED doctor who is working on the technology suggests that the best use of such algorithms is by patients and families who can then make non-healthcare decisions for their remaining time, or as the Slate article concludes, “freeing us from trying to live longer so that we can just live.” 

A tiny study performed in a safety net clinic finds that both doctors and patients benefit when patients are given permission to enter topics of concern into the EHR visit note before their arrival.

Three clinicians from University Medical Center (LA) testify that they don’t know who entered a description of “accidental discharge of a gun” in describing the ED treatment of the wife of slain former pro football player Will Smith of the New Orleans Saints. Smith was driving drunk in New Orleans in April 2016 when he rammed the car of another man who then shot several times into Smith’s car, killing Smith and injuring his wife, Raquel. The attorneys of the shooter hope to use the medical record entry to get their client a new trial in claiming that Raquel Smith told the ED staff that her shooting was accidental. The clinicians say the description might have been entered by a medical billing coder who just chose the first available computer dropdown, noting that Raquel Smith’s chart contains another incorrect entry. When asked what Raquel Smith said when she arrived in the ED, the trauma director replied, “Going from memory, I think it was just, ‘I was shot,’ but that was about 900 gunshot wounds ago."”

Weird News Andy questions the wording of a description of a spontaneous breathing trial, which involves cutting back on ventilator breathing assistance to assess the patient’s ability to breathe on their own. WNA challenges this sentence: “If it is not clear that the patient has passed at 120 minutes the SBT should be considered a failure,” wondering if the purpose of the test is to kill the patient.

Sponsor Updates

• HealthCare Synergy will offer Ability Network’s all-payer claims processing, follow-up, and denial management to its customers.
• Gartner names AdvancedMD to its FrontRunners quadrant for EHRs.
• Spok Chief Nursing Officer Nat’e Guyton, RN, MSN will lead a focus group titled “What Keeps You Up At Night?” at AONE in Baltimore, March 29-April 1.
• KLAS includes Arcadia Healthcare Solutions in its 2016 Population Health Management Performance Report.
• The Milwaukee-Wisconsin Journal Sentinel talks with GE Healthcare CEO of Clinical Care Solutions Anders Wold about the company’s plans to open a new facility in Wisconsin.
• Aprima will exhibit at the AAPM Annual Meeting March 16-18 in Orlando.
• The HIMSS EHR Association recognizes several companies, including GE Healthcare and Medhost, for adopting its new EHR Developer Code of Conduct.
• Besler Consulting releases a new podcast, “Why adjusting wage index now can affect future reimbursement.”
• Direct Consulting Associates will exhibit at the Ohio MGMA Winter State Conference March 17 in Columbus.
• Dimensional Insight launches Version 7.0 of its BI platform.
• Kay Morgan, VP for drug products and industry standards for clinical solutions at Elsevier, receives the Healthcare Distribution Alliance’s 2017 Distribution Management Award for industry leadership.
• EClinicalWorks will exhibit at the 2017 VMGMA Spring Conference March 19-21 in Charlottesville, VA.
• HBI Solutions makes its HIMSS presentations available for download.
• HCS will exhibit at the NAPHS 2017 Annual Meeting March 20-22 in Washington, DC.
• Jacksonville’s Business Journal includes The HCI Group’s Jarrod Germano in its “40 Under 40” list of most promising businessmen and women.
• Healthgrades upgrades its website functionality in a number of areas.
• Huntzinger Management Group offers its HIMSS presentation, “Portal Use Factors – The Keys to Patient Portal Adoption,” for download.

Blog Posts

• Who Composes the Modern Care Team? (Spok)
• IdeaShare is Now Part of the NEST Community (AdvancedMD)
• Shedding Light on the Dark Spaces in Healthcare (CareSync)
• HIMSS 2017: Post-Show Recap (CoverMyMeds)
• 3 tips for Epic interfaces from Senior Consultant Lee Coleman (Nordic)
• Engaging in Process Improvement & Organizational Transformation Prior to a Revenue Cycle System Implementation (Culbert Healthcare Solutions)
• Employers Want Self-Starters (Direct Consulting Associates)
• We are Stronger Together – an Employee’s Mission to Advocate for MS (Dynamic Computing Services)
• HIMSS17 Interoperability Showcase: A Peek into the Future of Interoperability (ECG Management Consultants)
• Managing Denials in a Value-based Reimbursement World (Hayes Management Consulting)
• Now it’s personal. I just got my refill super-fast! (Healthfinch)

Contacts

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

Monday Morning Update 3/13/17

Top News

House bill HR 1313, the Preserving Employee Wellness Program Act — which was approved in straight party line voting in a House committee last week — would allow employers to mandate that their employees undergo genetic testing and share their results to earn insurance premium rebates.

Companies can’t ask for non-voluntary employee genetic analysis today, but the new law would allow employers to require those tests if they are offered as part of a workplace wellness or disease prevention program.

The bill could end up in the second phase of ACA repeal legislation. It is sponsored by Rep. Virginia Foxx (R-NC).

Reader Comments

From Undervalued: “Re: American Board of Internal Medicine. Called me this evening to take part in a paid survey about unnecessary testing. Doctors are paid $50 for participating, except family practice docs get only $40. As fellow PCPs, ABIM should be ashamed for its undervaluation of family practice colleagues.” I wanted to weigh in on ABIM’s insulting approach, but I got distracted by trying to remember which 1970s band had a psychedelic-looking logo like ABIM’s.

From Stats Rat: “Re: HIMSS publication survey. Says 70 percent of HIMSS17 attendees are actively seeking or planning artificial intelligence.” I don’t think I would draw too much insight from a “top story” based on a survey with just 70 responses.

From Bill Gates’ Brother Pearly: “Re: webinars. Could you offer CMEs or other CEUs to participants? Accredited organizations might be willing to help and you could have more topics related to informatics.” I like the idea, but would indeed need external help since I recall from long-ago hospital experience what a pain it is to accredit educational programs for CEUs.

From Trenton Medusa: “Re: Salesforce Health Cloud. You said you liked what you saw at the HIMSS conference. How much of it was real?” I saw just a short demo of one use case. I was mostly intrigued by the possibilities of having a large, technically sophisticated customer relationship management player turn its focus to health system-physician and physician-patient interaction. Health Cloud is a new offering and I’m not sure that either Salesforce or its prospects have a clear vision of how it can be used. I’m also not sure that Salesforce and its reps are prepared to devote the level of hand-holding that health systems have grown to expect in assuming that their vendors will tell them not only how to use their software, but how the health system should conduct its business (we chronically insecure health systems want vendors to share what they’ve learned at other sites). Lastly, the Salesforce model often involves selling third-party products and services to meet particular needs and that will require money and management of additional vendors. My conclusion is that health systems need to determine for themselves how much of the potential of Health Cloud has been realized at a live site and have a clear plan what they’ll do with it. I’m interested in hearing about firsthand experience.

From Pliny: “Re: medication compliance apps. What do you think of them?” Not much, starting with their premise that people are supposed to be obediently “compliant” with orders from their paternalistic doctors. Some patients – especially those on many medications with complicated schedules – could benefit from meds-due reminders, but I suspect the real problem is a lot more complicated than just issuing appropriately timed beeps or alerting the doctor that the pill bottle wasn’t opened at the right time. Examples:

• They don’t understand the purpose of the therapy, question its value, or weren’t given the chance to discuss the expected benefit and outcomes before the prescription was generated.
• They left their rushed encounter without remembering what they were supposed to do.
• They can’t afford the medication.
• They are adjusting their own doses for what may or may not be good reasons.
• Their doctor and/or pharmacist didn’t do a good job explaining how or when the medication should be taken or didn’t develop a trustworthy rapport with them.
• They are experiencing side effects but don’t know what they should do about them.

From Robert Lafsky, MD: “Re: police technology. Note medical parallels – text-based recording, proprietary databases, and enthusiastic adoption of technologies without adequate trials.” A law professor’s editorial says we spend $100 billion per year on public safety without really knowing which police tactics or technologies work and without conducting any sort of cost-benefit analysis. It calls out expensive gunshot sound detection system ShotSpotter, which is being used even though police departments haven’t analyzed whether it has decreased incidents or increased arrests. The article also notes that, as in healthcare, it’s hard to identify causation vs. correlation and it’s even harder to quantify events that were prevented.

HIStalk Announcements and Requests

My not very conclusive poll finds that the health IT business will either get better or will get worse. Perhaps the only takeaway is to avoid making a plan that involves it remaining the same.

New poll to your right or here: In your most recent physician or hospital encounter, were your electronic records from other providers available and reviewed?

Mrs. R’s second grade English as a Second Language class in New Jersey is using the document camera we provided in funding her DonorsChoose grant request to perform their work on the classroom whiteboard, which gives the students confidence and instant feedback from their classmates. It also eliminates teacher photocopying time and expense. I like funding document camera projects because they are high impact, super low cost at less than $200, make it easier for the teacher to make lessons interactive, and help teach students vital presentation and persuasion skills.

Welcome to new HIStalk Gold Sponsor ROI Healthcare Solutions. The Atlanta-based consulting firm, founded in 1999, offers legacy application support, application management services, ERP optimization (as an Infor Global Alliance Partner), supply chain EDI, staff augmentation, and enterprise content management services. The company’s expertise includes Epic, Cerner, McKesson, Allscripts, RelayHealth, and Hyland. The company offers case studies and a client list. McKesson has named the company as a support partner to provide post-sunset support for Horizon Clinicals. President Jim Jancik’s 25-year career includes experience with CGEY and McKesson, while founder and EVP Kathy London spent time at McKesson, Siemens, and Healthcare Systems Management. Thanks to ROI Healthcare Solutions for supporting HIStalk.

Dear health IT site that isn’t owned by HIMSS for a change: API stands for application program interface. You should check out this thing called Google.

Listening: Doro, the German metal queen (formerly of Warlock) who’s still banging heads at 52.

This Week in Health IT History

One year ago:

• The New York Post cites unnamed sources who predict patient harm from the rushed Epic implementation of NYC Health + Hospitals.
• McKesson sells its ambulatory EHR/PM products to E-MDs.
• MD Anderson Cancer Center goes live on Epic.
• New VA leadership announces that it is reassessing whether the VistA EHR fits into its long-term plans.
• CMS pledges to remove Social Security numbers fro Medicare cards starting in April 2018.

Five years ago:

• Former HHS CTO Todd Park is named US CTO, replacing Aneesh Chopra.
• Greenway Medical Technologies announces its first quarterly results as a publicly traded company.
• Wexner Medical Center at Ohio State goes live on Epic.
• Kevin Fickenscher, MD is named president and CEO of AMIA.
• Hotel reservations were opened for HIMSS13 in New Orleans following the conclusion of HIMSS12 in Las Vegas.

Weekly Anonymous Reader Question

Here are the reader responses I received to last week’s question: describe an unethical decision your employer made in the past year:

• Brazen, intentionally fraudulent overcoding seems to be acceptable, according to publicly available Medicare data. Explain why some of your local doctors have 100 percent of visits billed at 99215, which is impossible since there’s not enough time in the appointments and not every patient qualifies for a level 5. Medicare turns its back, ACOs permit it, the press doesn’t care, and it’s too complex for patients to understand, so Medicare keeps paying and healthcare costs keep going up.
• My former employer pushed sales of a broken piece of software REALLY hard. We also didn’t have the resources to implement it in any sort of reasonable timeframe. Alternately, they fired a woman in the middle of a long fight with brain cancer.
• Awarded bids to vendors on sole source contracts when an RFP is the rule.
• Hired his daughter to work in our group. So uncomfortable for everyone.
• Actively would not admit to customers that we knew we were going to miss contractual deadlines because sold product offerings hadn’t even been agreed to or started, and that left staff hanging in front of execs and colleagues at customer site in a state of lying through omission or avoidance. It was very trust abusive practice of what was explained to me as "incremental disclosure."
• Should we continue to bill for a physician who is billing for telemedicine visits as office visits?
• The CEO of the hospital pressuring physicians to write narcotics for patients who would complain if they did not get them when they were not warranted . All for patients satisfaction scores and money.
• Moved an outpatient IV treatment center to inpatient AO center just because they could charge way more despite increased co-pay and inconvenience for patients.

This week’s reader-suggested question: what’s the dumbest EHR design flaw you’ve seen recently? Inpatient or outpatient, as a user or as a vendor, tell us what you’ve seen.

Last Week’s Most Interesting News

• Google’s DeepMind Health announces plans to create a blockchain-like patient record and auditing tool.
• The Republican ACA repeal bill makes its way through the House, with opposition express by several healthcare groups.
• VA Secretary David Shulkin tells a House committee that the VA should move to commercial software products rather than build its own.
• Shares of NantHealth drop sharply after a report described founder Patrick Soon-Shiong’s $12 million donation to the University of Utah that required it to purchase $10 million of NantHealth’s services, also allowing the company to inflate the success of its GPS Cancer screening test.
• India-based Tech Mahindra announces that it will acquire The HCI Group for $110 million.
• The Advisory Board Company settles its differences with an activist investor.

Webinars

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

Acquisitions, Funding, Business, and Stock

ZirMed will lay off 60 employees, about 9 percent of its workforce, as consolidation and acquisition of physician practices reduce its customer count and the need for support technicians for obsolete products. The layoffs will be equally spread among offices in Louisville, Chicago, and Culver City, CA.

NantHealth’s share price slide continued through last week, closing at $4.33, down 77 percent from their first day of trading in June 2016.

Decisions

• Gordon Hospital (GA) will go live with Oracle PeopleSoft In October 2017.
• Fairview Maple Grove Hospital (MN) will go live with Omnicell’s automated dispensing cabinet System in 2018.

These provider-reported updates are provided by Definitive Healthcare, which offers powerful intelligence on hospitals, physicians, and healthcare providers.

People

Navicure hires Kermit Randa (PeopleAdmin) as chief growth officer.

Privacy and Security

Several employees of community physician groups and one employee of a contracted vendor are fired after inappropriately accessing the medical records of pediatric patients of VCU Health System (VA). 

A reader-forwarded email suggests that a GetWellNetwork payroll employee has fallen for the now-common W2 phishing scam where an unknown hacker impersonating the CEO sends an email asking for a file of year-end employee tax records. Above is an example of an authentic-looking email intended to harvest the information needed to obtain fraudulent tax refunds.

Other

Epic’s Judy Faulkner has made herself uncharacteristically available for interviews lately. She tells Modern Healthcare that physician burnout started 20 years ago when they lost their fight for healthcare control and government and big business took over. She says her focus is on making the company’s software a “joy to use,” helping derive value from data, and emphasizing collaboration. The 73-year-old Faulkner says she doesn’t see her role at Epic changing over the next five years.

Neurosurgeon Johnny Delashaw, MD — chair of the Seattle-based Swedish Neuroscience Institute — resigns three weeks after the local paper publishes an expose of internal complaints about the organization’s culture of retribution, inappropriate care, and the lack of participation by Delashaw in surgeries for which he generated $86 million in his first 16 months on the job. He left OHSU in 2012 as Oregon’s highest-paid state pensioner at $663,000 per year, earning more than even the former University of Oregon football coach.

Weird News Andy says he should at least have gone to a branch office before mouthing off. A Wyoming ski instructor who cut his jump between two trees too close has his lip pierced by an 18-inch tree branch, after which he called out to his friend, “Hey, look, I just got a new piercing.” The hospital removed the stick, after which the ski dude was happy because he could drink beer through a straw. His GoFundMe campaign raised enough money to cover his $1,250 insurance deductible, although many commenters weren’t sympathetic that he wasn’t willing to pay for his own mistake while another added, “The bigger problem with America is that it costs $1,000 to pull a stick out of someone’s face.”

Sponsor Updates

• Salesforce earns the number eight spot on Fortune’s list of 100 Best Companies to Work For.
• The SSI Group will exhibit at the 2017 NCHFMA Annual Meeting March 12 in North Carolina.
• The Utah Business Insider podcast features Solutionreach CEO Jim Higgins.
• ZeOmega will exhibit at the Women Leading Business Healthcare Summit March 15-17 in Las Vegas.

Blog Posts

• 6 Things You Missed at ‘HIMSS17 (Salesforce)
• Two Big Reasons You Should Be Texting Your Patients (Solutionreach)
• Should the Fax Machine Disappear from the Healthcare Market? (Summit Healthcare)
• Keeping IT Patient-Centered: Top Takeaways and Tech Trends from HIMSS17 (Surescripts)
• “Spring Clean” Your IT (TierPoint)
• The art and science of handling Medicare risk adjustment coding “gray areas” (Verscend)
• Care team communication comes of age. (Voalte)
• #BeBoldforChange (Conduent Health)

Contacts

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

News 3/10/17

Top News

Two House panels approve the Republican ACA repeal bill, sending it to the House floor. The Ways and Means committee required an 18-hour session to endorse the American Health Care Act, while the Energy and Commerce Committee’s marathon hearing lasted more than 27 straight hours before ending with a straight party line vote.

President Trump immediately began pitching the bill, while House Speaker Paul Ryan brought out a PowerPoint presentation hoping to gain support while declaring that the bill is a “binary choice” that suggests taking it or leaving it, now or never, with no significant changes. Sources indicate that the President told a conservative group that if the bill isn’t passed, he will allow the Affordable Care Act to fail and then blame Democrats.

The American Health Care Act has yet to be scored by the Congressional Budget Office to estimate its cost and the number of uninsured Americans before and after its implementation. On record as opposing the bill in its present form are the American Medical Association, the American Hospital Association, the Association of American Medical Colleges, the American Nurses Association, AARP, and a surprisingly bold Medicaid Chief Medical Officer Andrey Ostrovsky, MD. {correction: I originally wrote that Ostrovsky was appointed by the Trump administration, which is incorrect. He joined CMS in September 2016).

Reader Comments

From Pixelator: “Re: Epic’s App Orchard. It follows the Apple App Store model from what I can tell. Apple doesn’t look at or copy code from apps, but it also doesn’t want to be sued by a developer of a minor app if it expands its own product into similar territory. I doubt any EHR vendor gives unfettered access to their APIs or data models that allows a vendor to sell derivative works without any control by the EHR vendor, but I’m interested in the first-hand experience of others with Cerner, Allscripts, etc.“

From Squidward Tentacles: “Re: single-payer system. I’m interested in your thoughts after reading this article in a left-leaning publication.” I’m in favor of universal healthcare, I say after years of arguing otherwise. The US is the stubborn outlier among developed countries and we’re spending ourselves into bankruptcy (both as individuals and as a nation) while lagging the pack on health indicators. Universal healthcare doesn’t necessarily mean a government-run program or one that gives citizens a blank check for their every healthcare need. Unfortunately, we’ll probably continue to out-spend and out-die our peer nations since we’ve allowed healthcare to become a political and economic class football. Our system is mediocre to good for those with means, bad for those without, and worse still for those who have income and assets that can be wiped out with a single, inevitable medical event.

HIStalk Announcements and Requests

Reader donations funded the DonorsChoose grant request of Ms. P in Oklahoma, who asked for hands-on learning stations for her class of learning-disabled kindergartners. She says the kids love the sight word mats, are having fun with watercolors, and are using the chalkboard for practice work.

I was thinking that it’s probably time to buy a new laptop since the $300 one I use as my only computer (other than my Chromebook) is several years old. I’m discouraged that the laptop market seems dull, with prices higher than I expected and poor customer reviews. I’ve been scouring ads from BestBuy and the office supply stories for weeks with nothing rising above the pack. I was thinking it that it makes sense to upgrade when buying something new, like getting 16GB of memory and maybe a solid state drive, but I don’t want to spend $1,000 to replace a $300 device, especially when I don’t need or want a touchscreen or a two-in-one laptop. I thought sure I would feel outclassed and then be overcome with tingly anticipation upon seeing what has improved in the intervening years, but I haven’t missed much.

This week on HIStalk Practice: GuideWell acquires PopHealthCare. The Bronx RHIO selects population health reporting tools from Imat Solutions. CMS opens up 2018 Next Generation ACO applications. First Stop Health raises $1.6 million. Fitbit rethinks its product lines. PCPs in Maryland form the Chesapeake IPA. Health Fidelity’s Chris Gluhak offers HIPs tips for MIPS. Alternative Family Services selects Core Solutions EHR. A Helping Hand of Wilmington implements Mediware’s AlphaFlex. This month’s Winners Circle features Albert Wolf, MD and Todd Wolynn, MD of Kids Plus Pediatrics in Pittsburgh.

Webinars

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

Acquisitions, Funding, Business, and Stock

San Francisco-based online medical clinic Virta Health, which launched this week with $37 million in funding, says it hopes to reverse type 2 diabetes in 100 million people by 2025 using individualized nutritional analysis and artificial intelligence-powered continuous monitoring and coaching. Founder and CEO Sami Inkinen also co-founded real estate site Trulia.

Investors in China are souring at the prospects of the country’s 2,000 mobile health apps that offer consumers alternatives to overcrowded hospitals. At least three apps — of the several hundred that have attracted investments — have hit $1 billion in valuation, but investors are beginning to question whether they will ever make money since the only revenue source for the apps is advertising. The most-used medical app, insurer-owned Ping An Good Doctor (which offers free doctor consultations), raised $500 million in a Series A funding round last spring that valued the company at $3 billion. Search giant Baidu shut down its mobile health unit and at least 27 medical app vendors have closed after burning through their investor-provided cash. The surviving app vendors are trying to pivot in working with hospitals or insurance companies.

Telemedicine platform vendor GlobalMed acquires competitor TreatMD.

India-based offshore medical coding vendor Omega Healthcare Management Services acquires North Carolina-based analytics vendor WhiteSpace Health, which has development offices in India. WhiteSpace Health co-founder Sy Yellamanchali was previously SVP with MModal.

PokitDok raises an unspecified strategic investment to further develop its APIs and blockchain solutions, increasing its total funding to $48 million.

Cerner opens the first two towers of its Innovation campus, its seventh in the Kansas City area.

Sales

Mount Sinai Health System (NY) chooses patient-provider matching from Kyruus for its Physician Access Services team that handles referrals for 700 providers.

Adventist Health System chooses Premier’s pharmacy clinical surveillance and analytics for medication management and antibiotic stewardship programs. Premier acquired the former TheraDoc from Hospira for $117 million in August 2014.

People

MD Anderson Cancer Center President Ron DePinho, MD resigns, explaining that the organization needs someone who can inspire unity and apply operational focus. MDACC has struggled with a deteriorating financial position that it blames on its Epic implementation, among other factors, and has stumbled in its $62 million failed attempt to use IBM Watson for cancer care.

CareCloud hires Greg Shorten (Validic) as chief revenue officer.

Announcements and Implementations

Medecision launches Aerial Bundled Episode Manager, which helps IDNs working under bundled payment arrangements to better identify and care for high-risk patients.

Google’s DeepMind Health subsidiary will implement a blockchain-like Verifiable Data Audit to provide hospitals with an audit log of how the information of their patients was handled. The company says its method is different from blockchain because it will not require heavy duty computing and will be able to call out changes to any part of the stored data. According to the company,

We’ll build a dedicated online interface that authorized staff at our partner hospitals can use to examine the audit trail of DeepMind Health’s data use in real-time. It will allow continuous verification that our systems are working as they should, and enable our partners to easily query the ledger to check for particular types of data use. We’d also like to enable our partners to run automated queries, effectively setting alarms that would be triggered if anything unusual took place. And, in time, we could even give our partners the option of allowing others to check our data processing, such as individual patients or patient groups.

Government and Politics

VA Secretary David Shulkin tells the House Veterans Affairs Committee, “I’ve come to the conclusion that VA building its own software products and doing its own software development inside is not a good way to pursue this. We need to move toward commercially-tested products.”

Conan O’Brien creates a modestly funny ad that lampoons this week’s comments by Rep. Jason Chaffetz (R-UT), who lauded removing the ACA’s individual mandate and said that Americans should invest in their healthcare instead of the latest iPhone. The video also made me think of the digital heath evangelists whose never-ending parade of questionably useful apps are their hammer in search of a nail. Meanwhile, Chaffetz’s comment led family physician Kathryn Allen to immediately file paperwork to run against him.

Other

Debt rating services revise the credit outlook of Partners HealthCare (MA) from stable to negative following its $108 million fiscal year operating loss. Analysts are worried most about continuing losses in the company’s Medicaid insurance business, adding that they aren’t worried about the temporary bottom line hits from its Epic implementation and office consolidation project.

In Minnesota, Fairview Health Services and HealthEast Care System announce plans to merge.

Western Missouri Medical Center (MO) outsources its patient billing after patients complain about the confusing bills sent by its Cerner billing system.

Cancer researcher Carlo Croce, MD, who has been awarded $86 million in federal research grants, has been the subject of several allegations and whistleblower complaints regarding falsified data that include Photoshopped western blots, according to a New York Times investigation. Journals have updated 20 of his papers with corrections, retractions, and editors’ notices, but Ohio State University – the recipient of $8.7 million from his grants – has repeatedly cleared him of wrongdoing. Croce had previously joined a scientific advisory board of a tobacco producer-funded group that tried to convince the public that smoking doesn’t cause cancer. It’s interesting to me is that he’s an art collector, with 400 paintings by Italian masters displayed in the 5,000-square-foot gallery he added to his $3 million mansion. Cancer has bankrupted a lot of people, but some have become wealthy from it.

Add this to the long list of reasons that “semi-private” hospital rooms make no sense at all. An inpatient returns to his bed after undergoing tests and finds that his credit cards and cellphone have been stolen from his bedside drawer. Authorities later investigating fraudulent charges on his card arrest the perpetrator – the guy who shared his hospital room.

The family of a South Carolina man who died of a severe allergic reaction sues Union County Medical Center (SC), claiming that when its locum tenens ED doctor wasn’t able to intubate him, the doctor then viewed a YouTube video on performing a cricothyrotomy, which also failed. Police arriving to investigate found the video still up on the doctor’s computer screen.

Weird News Andy exclaims with his best Monty Python accent that “I’m not dead yet” in describing the findings of ICU doctors in which patients showed brain activity after being declared clinically dead.

Sponsor Updates

• PokitDok launches its API developer tools on AWS Marketplace with bundled plans for patient check-in, health insurance administration, and out-of-pocket estimates. 
• The FutureofEverything.io features Impact Advisors Principal Eric Gerard in “What’s the Future of Healthcare?”
• Imprivata presents at the Massachusetts Health Data Consortium’s event on healthcare’s identity crisis.
• Ingenious Med’s Practice and Enterprise charge capture and care coordination technology earn HITRUST CSF Certification.
• InterSystems shares its show-floor presentation from HIMSS17 featuring Laura Adams from the Rhode Island Quality Institute.
• Intelligent Medical Objects will exhibit at the Cerner UK Collaboration Forum March 13-16 in London.
• Ovum Report recognizes Liaison Technologies as a leading B2B integration managed services provider.
• Gartner names LogicWorks a leader in the 2017 Magic Quadrant for Public Cloud Infrastructure Managed Service Providers, Worldwide.
• Meditech will host its Certificate Program in Clinical Informatics as a distance learning course March 21 through May 25 at MassBay Community College, Rowan College at Burlington County, and the Deborah Heart and Lung Center.
• NVoq will exhibit at the AAOS Annual Meeting of Orthopedic Surgeons March 14-18 in San Diego.
• Obix Perinatal Data System will exhibit at the AWHONN West Central Michigan Chapter Conference March 15 in Grand Rapids.
• Experian Health will exhibit at HFMA Western PA March 13-14 in Washington, PA.
• PerfectServe will exhibit at the Renal Physicians Association Annual Meeting March 17-18 in Nashville.

Blog Posts

• Bringing Together Multiple Physician On-Call Schedules: Spok & QGenda (Spok)
• Epic Workqueues and Revenue Cycle (Impact Advisors)
• [International Women’s Day] Four things everyone can do to #BeBoldForChange (Nordic)
• Our takeaways from the year’s biggest health IT conference, HIMSS17 (Advisory Board)
• HIMSS17: Solving Interoperability Challenges with Workflow Integration (Iatric Systems)
• 9 Digital Marketing Tactics Underused by Healthcare Marketers (Influence Health)
• 5 Things Healthcare Can Learn from Zappos and Starbucks (InstaMed)
• #HIMSS17 Visible progress in our evolutionary world of healthcare (Liaison Technologies)
• Insights from HIMSS17 (LifeImage)
• Are You Already On Your Way to Success with Bundled Payments? (Medecision)
• Back to Basics – Denials Management: Reduced claim denials for the win (Navicure)
• Back from #HIMSS17 – A Recap (Netsmart)
• Achieving Integrated Care as the Foundation of Pop Health Mgmt: The Drivers for Change, Part 2 (Orion Health)
• Meditech 6.1x Registration: 5 Things to Consider (Parallon Technology Solutions)
• Leverage Your HIS Investment with the Right Payments Infrastructure (Patientco)
• Are We There Yet? (PatientKeeper)
• Who’s Afraid of the Big Bad Cloud? (Lexmark Healthcare)
• Congratulations Ochsner (PeriGen)
• Why Accurate Provider Data is Critical to Online Provider Search and Referral Management (Phynd Technologies)
• Why Pharmaceutical Companies Need to Invest in Population Health Management (Point-of-Care Partners)
• A/B Testing Patient Statements and Payment Portals (Sagacious Consultants)

Contacts

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

News 3/8/17

Top News

House Republicans unveil their plan to repeal and replace the Affordable Care Act, which they have named the American Health Care Act. It would:

• Roll back the Medicaid expansion that insures 10 million people
• Eliminate the requirement that people carry health insurance
• Allow large employers to opt out of providing coverage to their full-time employees
• Penalize those who let their insurance lapse and then sign up again
• Replace premium subsidies with income tax credits
• Allow insurers to charge much higher rates to older people
• Change Medicaid from an open-ended entitlement to a per-person block grant to each state
• Repeal the ACA-imposed tax surcharges on insurance companies, drug and device manufacturers, and citizens who earn more than $250,000.

The proposal would continue to prohibit denial of coverage for pre-existing conditions and lifetime caps and would allowing parents to keep children through age 26 on their insurance. It would eliminate ACA-mandated basic coverage provisions, allowing insurers to issue catastrophic-only plans as they did pre-ACA.

Two House committees plan to vote on the legislation without first asking the Congressional Budget Office to perform a cost estimate or to project how many Americans would become uninsured with the changes.

Reader Comments

From Under My Wheels: “Re: Epic’s App Orchard. A former Epic executive tells me that the legal terms of participating give Epic all intellectual property rights to the app. It might seem that they are protecting themselves in case they decide to create functionality that would compete with an App Orchard app. But another perspective is that Epic is taking customer heat for lack of innovation and App Orchard gives Epic a way to look over another company’s innovation and then squash it. It also makes customers happy because they might think they can monetize what they’ve been giving Epic for free. Judy made some big statements about openness through cozy journalists at HIMSS, but App Orchard isn’t as open as Epic would like everyone to believe.” Unverified.

HIStalk Announcements and Requests

Welcome to new HIStalk Gold Sponsor Saturn Care. The company’s clinician-developed, patient-centric CDMP (Chronic Disease Management Program) supports value-based diabetes management for primary care by bringing together EHR and patient data into a single view with risk scoring and decision support tools, allowing care teams to improve both clinical (HbA1c) and behavioral (diabetes stress) outcomes. Patients provide behavioral data via mobile and other tools that the primary care team then reviews via CDMP to improve visit and care management efficiency. The company’s technology was developed with organizations such as UPMC, the VA, and Joslin Diabetes Center and has been clinically validated in an NIH study. It was designed to work within programs such as CPC+ and MACRA, which require measuring quality and cost metrics and for which the ADA guidelines are the best evidence-based means to improve outcomes. Practices can choose between a per-patient, per-month licensing structure or a turnkey services solution. Sign up for their April 12 webinar for more information. Thanks to Saturn Care for supporting HIStalk.

We funded the DonorsChoose grant request of Ms. M in Minnesota, who asked for STEAM-related books for her fourth grade class to use in a book club-like small group exercise. She declares them to be “awesome,” as they are being used in “lit circles” in the class’s unit on sustainability, environmentalism, and conservation.

Interest has been muted (non-existent, to be precise) in my quest for contributors in these areas that I mentioned in Monday’s post. Contact me if you are interested – compensation and anonymity issues can be worked out.

• Experts in nursing, laboratory, and pharmacy IT to provide updates in their respective subject areas at least quarterly
• Someone to write a digital health summary every so often
• An expert in non-US healthcare IT to write a regular summary of what’s going on outside the US
• A leader, provider, or technologist in their 20s or 30s who can represent that point of view

Webinars

March 9 (Thursday) 1:00 ET. “PAMA: The 2017 MPFS Final Rule.” Sponsored by National Decision Support Company. Presenter: Erin Lane, senior analyst, The Advisory Board Company. The Protecting Access to Medicare Act of 2014 instructed CMS to require physicians to consult with a qualified clinical decision support (CDS) mechanism that relies on established appropriate use criteria (AUC) when ordering certain imaging exams. Providers must report AUC interactions beginning January 1, 2018 to receive payment for Medicare Advanced Imaging studies, with the CDS recording a unique number. Outliers will be measured against a set of Priority Clinical Areas and interaction with the AUC. This webinar will review the requirements for Medicare Advanced Imaging compliance and will review how to ensure that CDS tools submit the information needed for reimbursement. 

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

Acquisitions, Funding, Business, and Stock

Talent management software vendor HealthcareSource will acquire Centricity Contingent Staffing (formerly API Healthcare’s Clearview) from GE Healthcare.

Shares in NantHealth fell 23 percent Monday and another 10 percent Tuesday following a STAT report that describes a high-profile, $12 million gift to University of Utah from founder Patrick Soon-Shiong, MD that came with strings attached – the university had to buy $10 million worth of genetic sequencing services from NantHealth in a “partnership” and also provide patient data to help the company develop a new product. The article also claims that NantHealth misled investors in its November earnings call in claiming that one-third of its GPS Cancer screening tests were purchased by the university, which the university says isn’t true since it only ordered standard genetic sequencing tests that have nothing to do with GPS Cancer. Independent attorneys asked by STAT to review the agreements questioned why the university would sign such an agreement whose wording attempted to avoid the implication of indirect self-dealing, although one was blunt in concluding, “They’re laundering the funds through the University of Utah.” Shares in NH, which closed at $18.59 on their first day of trading last June a few weeks before the University of Utah announcement, have shed 73 percent since, valuing the company at $598 million.

Announcements and Implementations

Allscripts Sunrise, CareInMotion, and 2bPrecise solutions are accepted into NHS London’s procurement program.

WebMD adds health-related topics to Amazon Alexa-powered devices. I tried it today on the Echo – just say, “Alexa, enable WebMD skill.” It’s interesting, although it doesn’t always recognize drug generic names even when it knows the brand names.

Other

A Rand medical claims analysis concludes that employer-offered telemedicine services such as Teladoc offer convenience to users with respiratory infections, but actually raise employer healthcare costs because most of their employees would not have sought care for their self-limiting conditions otherwise.

A new searchable IRS database reveals that non-profit organizations paid 2,700 employees $1 million or more in 2014, with hospital operator Ascension leading the pack in providing $17.6 million in compensation to CEO Anthony Tersigni.

In England, a man who previously served as chair of two NHS trusts and CEO of a hospice is sentenced to two years in prison for falsifying his work history and claimed doctorate, with authorities finally discovering that his job experience was as a probation officer and a builder. The moral of the story is to always verify educational credentials, not so much because having them may or may not be a critical success factor for the job, but rather that you don’t want to hire someone who is willing earn a job by lying.

Sponsor Updates

• The Intelligent Health Association recognizes NantHealth CEO Patrick Soon-Shiong, MD with its Special Recognition Award.
• Meditech participates in the Northeastern University Nurse Innovation and Entrepreneurship Advisory Board, on which EVP Hoda Sayed-Friel serves.
• Besler Consulting releases a new podcast, “Practical steps toward MACRA implementation.”
• Carevive CEO Madelyn Herzfeld, RN discusses the challenges practice face when implementing new patient engagement tech in a new video series.
• CoverMyMeds will sponsor the SPCMA Business Forum 2017 March 8-9 in Orlando.
• The Relentless Health Value podcast features Diameter Health CEO Eric Rosow.
• EClinicalWorks releases a new podcast, “Tips from a Superuser – How to Improve Functionality.”
• Evariant releases a new case study, “Lehigh Valley Health Network: Engaging Consumers and Physicians in Tandem to Drive Revenue.”
• InterSystems features a Q&A with HBI Solutions CEO Eric Widen.
• InBusiness magazine includes Healthfinch VP Leah Roe in its 2017 class of “40 under 40.”

Blog Posts

• Is HIMSS Really Over? (Access)
• Transform how your front office engages with your patients (AdvanceMD)
• Succeed With MIPS: Improve Your Payment Adjustment In 90 Days (Optimum Healthcare IT)
• Population Health: An old-school approach to handling requests of your IT team [podcast] (Nordic)
• Get Moving in the Right Direction (Agfa Healthcare)
• Visions of the Future of Digital Health at HIMSS 2017 (Datica)
• Go For It! Everyone has Their Own Key to Success (CTG)
• Patient Access Throughput: The Strategy to Success (Culbert Healthcare Solutions)
• HIMSS 2017 Recap (Direct Consulting Associates)
• How Do You Succeed in a Value-Based World? Find a Strategic Partner. (ECG Management Consultants)
• The ACA Replacement: How the Views of Trump, Ryan, and Price Tell Us What to Expect (Hayes Management Consulting)
• Three Ways to Observe Heart Health Month Beyond February (Healthgrades)
• Four Focus Areas in Health IT for Care Coordination Workflow Success (Healthwise)

Contacts

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

Tech Mahindra Will Acquire The HCI Group for $110 Million

Mumbai, India-based IT services firm Tech Mahindra will acquire consulting firm The HCI Group for $110 million.

Tech Mahindra said in a statement, “Healthcare is one of the few sectors globally that is driving adoption of digital technologies. The acquisition will not only position Tech Mahindra as a significant player in the healthcare provider space, but will also provide an opportunity to go deeper in this space via EMR implementation and surrounding services route.”

Jacksonville, FL-based The HCI Group reports annual revenue of $114 million and has 500 employees.

Tech Mahindra has annual revenue of $4.2 billion and has 117,000 employees in 90 countries. It is part of the Mahindra Group conglomerate.

Monday Morning Update 3/6/17

Top News

Advisory Board Company settles its differences with an activist investor, with SEC filings suggesting that hedge fund operator Elliott Management may be interest in acquiring some or all of the company after pressuring Advisory Board to hire an investment bank to explore strategic options.

Elliott had applied similar pressure to Cognizant Technology Solutions, of which it holds 4 percent of the outstanding shares, but reached an agreement with that company last month after Cognizant restructured its board. 

Elliott, which is ABCO’s largest shareholder with an 8.3 percent stake, declared the stock undervalued in January. (update: I incorrectly stated that new purchases reported to the SEC on Friday had raised Elliott’s ownership to 16 percent, but it remains at 8.3 percent).

Above is the one-year price chart of ABCO (blue, up 50 percent) vs. the Nasdaq (green, up 25 percent). The company’s market cap is $1.8 billion.

HIStalk Announcements and Requests

A slight majority of poll respondents who attended HIMSS17 say they discovered a product or service that has earned their further attention. Jef commented, “The lack of innovation is unnerving. This despite that 60 percent of exhibitors this year were first-time exhibitors! Makes one wonder where everyone has gone and why all the churn. Or maybe we know.”

New poll to your right or here: how will the health IT business change over the next year?

A reader recommended that I pose a weekly question to readers who can answer anonymously, with a follow-up post recapping the responses. He or she suggested this first question: describe one unethical decision your employer made in the past year.

HIStalk readers funded the DonorsChoose grant request of Ms. O in Missouri, who requested math materials for her second grade class. She says they have enabled her to differentiate the instruction and practice work she assigns, adding, “I love how I can make problems and the kids can manipulate the materials to show their thinking. I also love how even for my highest of kids I have something that they can work on because I can easily change the materials to fit what they need.”

Listening: new from Portugal.The Man (that’s not a typo – there’s a period in their name), an Alaska-formed indie pop band whose music defies simple genre categorization beyond being personal, melodic, and featuring rich, expressive vocals and an everyman stage presence that lets the band’s talent speak for itself. Their acoustic album, 2009’s “The Majestic Majesty” is unbelievably good. Their spring tour starts this week, with the band swinging through Nevada, California, Arizona, New Mexico and then moving east through the end of July (with stops in HIT-heavy Madison, Atlanta, and Philadelphia). My gosh, they are amazing.

I’ve posted the results of my recent HIStalk reader annual survey. If you participated, thanks. I always learn from the responses. Readers suggest I pay an honorarium for regular contributions from people with these backgrounds, so let me know if you’re a candidate (note: it’s perfectly fine to write anonymously, as Dr. Jayne does, to avoid employer interference):

• Experts in nursing, laboratory, and pharmacy IT who would provide Dr. Jayne-like updates in their respective subject areas at least quarterly
• Someone to write a digital health summary every so often
• An expert in non-US healthcare IT to write a regular summary of what’s going on outside the US
• A leader, provider, or technologist in their 20s or 30s who can represent that point of view

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

This Week in Health IT History

One year ago:

• President Obama launched the Precision Medicine Initiative
• HIMSS VPs John Hoyt and Norris Orms announced their retirement
• EClinicalWorks announced plans to develop an inpatient EHR
• Google’s DeepMind Technologies formed DeepMind Health

Five years ago:

• Nuance bought Transcend Technologies
• Epocrates killed its EMR project
• The VA halted work on its $103 million enterprise service bus that would have connected external products to the EHR it was developing with the DoD
• Kaiser Permanente CEO George Halvorson announced that its new smartphone app got one million hits in its first month, also mentioning that 36 of the 66 EMRAM Stage 7 hospitals were KP’s

Last Week’s Most Interesting News

• McKesson and Change Healthcare Holdings complete the creation of Change Healthcare, which combines CHC’s software and analytics business with most of McKesson Technology Solutions in launching one of the largest health IT vendors with 15,000 employees.
• Mayo Clinic’s year-end financial report says it will spend more than $1 billion to implement Epic.
• An Amazon Web Services outage left some cloud-based EHR users, including those of Practice Fusion, without a system for a few hours.
• Memorial Healthcare System (FL) pays $5.5 million to settle HIPAA charges that two employees plus another 12 of its affiliated physician practices stole patient information to file fraudulent tax returns.

Webinars

March 9 (Thursday) 1:00 ET. “PAMA: The 2017 MPFS Final Rule.” Sponsored by National Decision Support Company. Presenter: Erin Lane, senior analyst, The Advisory Board Company. The Protecting Access to Medicare Act of 2014 instructed CMS to require physicians to consult with a qualified clinical decision support (CDS) mechanism that relies on established appropriate use criteria (AUC) when ordering certain imaging exams. Providers must report AUC interactions beginning January 1, 2018 to receive payment for Medicare Advanced Imaging studies, with the CDS recording a unique number. Outliers will be measured against a set of Priority Clinical Areas and interaction with the AUC. This webinar will review the requirements for Medicare Advanced Imaging compliance and will review how to ensure that CDS tools submit the information needed for reimbursement. 

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

Acquisitions, Funding, Business, and Stock

Just-formed Change Healthcare is looking for a new headquarters location, reportedly considering a move to Atlanta from its leased offices in Nashville.

OhMD, which offers a texting app for patients and doctors, raises $1.2 million in a seed funding round.

“Shark Tank” billionaire Mark Cuban invests $250,000 in Denver-based Matrix Analytics, which offers big data-powered clinical decision support. Founder and chief medical officer Aki Al-Zubaidi, DO is an assistant professor and pulmonologist at National Jewish Health.

Claims management and payments vendor Zelis acquires dental PPO provider Mavarest Dental Network.

Sales

In England, Salford Royal NHS Foundation Trust chooses Validic to integrate patient-generated health data with its EHR, beginning with sleep and fitness information.

Decisions

• NYU Lutheran Medical Center (NY) went live with Epic in summer 2016.
• Fort Hamilton Hospital (OH) will go live with an Omnicell automated dispensing cabinet (ADC) in 2017.
• St. Joseph Healthcare (ME) will go live with BD Pyxis MedStation ADC in 2017.

These provider-reported updates are provided by Definitive Healthcare, which offers powerful intelligence on hospitals, physicians, and healthcare providers.

People

Cheryl McKay, PhD, RN (Orion Health) joins Voalte as chief nursing officer.

Announcements and Implementations

Data science and point-of-decision platform vendor Clearsense will use big data technology components from Hortonworks.

Technology

Walmart enhances its app to allow pharmacy customers to order refills from their phones, pay for them electronically, then breeze through an express lane where they use their phone’s camera to scan a QR code at the register, after which their prescription is handed over and they’re done. Walmart, can you please buy up some hospitals and physician practices?

Other

CoverMyMeds publishes its electronic prior authorization scorecard, which finds that EHRs representing 70 percent of the market committing to implement it.

In Canada, inpatients complain about the cost of in-room TV, phone and Internet provided as a package by a private company, mostly because they can’t predict their stay and thus can’t sign up for longer-term, cheaper packages. The company says its biggest expense is revenue sharing with hospitals, but the hospital in question says it gets nothing for making the service available.

Swedish Medical Center (CO) — which is being sued by dozens of surgery patients who learned that an HIV-positive surgical tech tampered with their IVs to steal narcotics — had outsourced its employee background checks to a private company that failed to uncover the tech’s history of addiction, drug theft, Navy court martial for drug theft, and termination from four hospitals for stealing fentanyl. The class action lawsuit now includes Texas-based PreCheck. The tech, meanwhile, had an additional year tacked on to his 6 1/2 year sentence when he decided to take a family vacation on his way to prison.

Athenahealth’s Jonathan Bush weighs in on the state of health IT:

We’re in the Stone Age. Pretty much everybody thinks of an EHR as a piece of software. There’s no connectivity. Athena is trying to create the second generation. Doctors spend more money administering their office after investing in technology than they did before … That’s never happened in any other industry in history … If you look at companies like Allscripts and NextGen, they were in the toilet. They were about to go out of business, and all of a sudden, $35 billion in federal dollars are earmarked only for EHRs. It was like Cash for Clunkers …  in healthcare, the line is, nobody ever got fired for buying Epic. I think that a lot of people are going to get fired for buying Epic in the next few years. And by the way, this isn’t a fault of Epic. To make it to the last dinosaur, you have to be a phenomenal dinosaur. And Epic and Cerner are phenomenal companies. They’re just not network medicine companies.”

Bizarre: Arkansas will execute eight prisoners over 10 days in April even though capital punishment has been suspended there since 2005. The state wants to finish its work – punishment for murders committed before 1999 and thus prior to the execution ban — because its supply of execution drugs goes out of date on April 30 and manufacturers no longer provide it for executions. The state hopes the inmates expire before its midazolam.

Sponsor Updates

• TransUnion publishes a new report, “Money talks: Rethinking what it means to put patients first.”
• Verscend will exhibit at the RISE Summit March 6-8 in Nashville.
• Solutionreach publishes an ebook titled “Medical Marketing Today: Strategies for Marketing Your Medical Practice in a Digital World.”
• Vital Images produces a new video, “Revitalize Existing Healthcare IT Investments.”
• ZeOmega successfully completes the Direct Trusted Agent Accreditation Program from EHNAC and DirectTrust.

Blog Posts

• Two Big Reasons You Should Be Texting Patients (Solutionreach)
• #HIMSS17 fun, takeaways, giving [recap] (Nordic)
• Considering DRaaS? A Guide to Help Identify Your Best Path to the Cloud (TierPoint)
• Find Your Paperless Workflow and Ditch Your QuickTime Viewer (Ultralinq)
• Digital Discovery: Health Research in Virtual Labs (Validic)
• From the HEDIS trenches: Optimizing your chases (Verscend)
• What Organizations Need to Survive in a Value-Based World (Dimensional Insight)
• Using RTLS Data to Increase Capacity in Ambulatory Care (Versus Technology)
• Real Software NOW Available | Visage 7.1.10 (Visage Imaging)
• Where do we go from No. 1? (Voalte)
• The Hottest Topics at HIMSS17 (Spok)
• Getting the most out of your EHR implementation and adoption (Conduent Health)
• You could still be picked for a Phase 2 HIPAA Audit. Here’s how to be prepared. (Advisory Board)

Contacts

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

Reader Survey Results 2017

I do a reader survey once each year, usually right before the HIMSS conference. I then review the results along with other feedback I receive to plan the upcoming year. I always make at least a few changes that readers suggest. Thanks to everyone who completed the survey, including the person who won the random drawing for a $50 Amazon gift card.

I have a diverse and opinionated readership. Some people are interested in only a subset of industry topics. Others want a basic bullet list of headlines and nothing more. Still other readers either like or don’t like rumors, humor, or certain parts of HIStalk like CIO Unplugged or Readers Write. While I truly appreciate and will consider all suggestions, I don’t want to fall into the trap of “designing by committee,” where the quest to displease no one ends up in pleasing no one, either. So, don’t think I’m not listening just because I didn’t immediately act.

I’ve been able to stick to writing HIStalk for 14 years now only because I do it in a way that makes me happy and satisfied. I’m lucky to have found a self-selected audience that keeps coming back. I’m therefore in agreement with the most common “what should I change” suggestion, which is to not change anything significantly unless it’s a clear improvement that’s within my grasp. I have zero interest in getting bigger or slicker if it’s not fun.

I’ve also learned a big lesson over the years – everybody likes to read, but few like to write. Suggestions often involve getting new non-vendor contributors or participants, which would be fantastic, but that has failed every time I’ve tried. Writing is hard for most people and their jobs often limit their availability, so even the most eager writers often fade away after writing a handful of times. Read on below for the kinds of contributors I can use and would be willing to pay for (another lesson learned – consistent contribution requires some level of payment).

Respondent Characteristics

I received 201 survey responses this year. Some respondent highlights:

• 80 percent have worked in the industry for at least 10 years
• 28 percent work for a provider organization
• 8 percent are CIOs
• 33 percent work for providers and have buying authority greater than $10,000
• 88 percent have a higher appreciation of companies that they read about in HIStalk
• 45 percent have a higher appreciation of companies that sponsor HIStalk
• 92 percent say reading HIStalk helps them do their job better

That last stat is what keeps me coming back every day. Readers, too, probably.

Elements Appreciated

I asked which HIStalk features the respondent appreciates most. I should note that I haven’t run an Advisory Panel for a long time since I was getting fewer and fewer responses, so many respondents probably don’t recall what it is.

Suggested Changes

Here are the most frequently suggested changes, along with my responses.

Improve the search function.

I’ve added somewhat effective “search by date” capability in the sidebar. It’s not perfect, but it works well enough that even I used it when trying to find something I’ve written in a given date range.

Move the Readers Write bios to the top of the article and include that in the email notification.

Good idea. I will do that. I initially had a reason for putting the bio last, but I’ve forgotten what it was.

Create articles around questions that readers can answer anonymously.

I like that idea a lot and I’ll start that this weekend. It will fizzle out quickly if I don’t get responses, but it’s worth a shot.

Spotlight consumer digital healthcare.

I’m a hospital guy, so while I cover the topic when something interests me, it’s not a big emphasis. I would be happy to add a weekly digital health summary if someone wants to write it or help me figure out the kinds of topics it should include.

Add non-US coverage.

My non-domestic audience is about 5 percent, with the top five non-US countries being Canada, India, the UK, Netherlands, and Australia. I would be willing to add a weekly summary of non-US healthcare IT news if I can hire someone knowledgeable to write it in adding more value than I could.

Add the ability to see all of a particular type of article, like Dr. Jayne or CIO Unplugged.

That’s available now. Hover over the Archives link at the top of the page, then click Dr. Jayne or Ed Marx to see all of their posts. You can also hover over Articles and then choose Index to see a newest-to-oldest list (rather than the full articles) by category, then click on any article to jump to it.

Add Dr. Jayne-like commentary from nursing, lab, pharmacy, etc. even if only quarterly.

I’ve appealed for such writers before with no takers, but I’ll throw it out there again and offer compensation for someone who is skilled and reliable. I always ask the person for examples of similar writing they’ve done or for them to write a sample article. That’s usually where the previously enthusiastic conversation ends. As I mentioned before, I can run the articles anonymously since I know first-hand from nearly being fired for writing HIStalk that employers aren’t always supportive.

Create an iPhone app since I like to do my reading in the morning.

Bringing up the site on a mobile device should display the site in an easily navigated mobile format. If not, scroll down and you’ll see the “desktop/mobile” chooser. I’ve looked at full-fledged mobile apps, but they don’t seem to offer a lot more than the mobile-optimized theme I already have.

Do more with social media.

My personal experience is that social media is overrated for a site like mine. I’ve looked at the stats and there’s no uptick in actual site readership from a blitzkrieg of tweets, Facebook posts, and LinkedIn items. I’ll think about revisiting, but social media campaigns work best for consumer sites rather than business-related ones. I’m happy to take advice from experts who believe otherwise.

Don’t quit writing HIStalk.

This came up a bunch of times. I have no plans to quit. Writing HIStalk is a hobby rather than a job to me, so I have no motivation to stop doing it any more than someone else would to quit playing golf, going to movies, or having dinner parties.

I know a lot of fellow readers of the site who are in their 20s (thanks to Epic staff for encouraging employees to read the site regularly) who would love to see some representation outside of predominantly older, white male execs. That’s a totally valid and relevant piece of the industry, but there are also a lot of badass young leaders, providers, and technologists (not just start-up founders shilling product) who I’d love to see on this platform, too.

That would be great if I could fine someone, even if they have to contribute anonymously for work reasons.

Offer an honorarium to ongoing contributors.

I’m perfectly willing to do that. 

Get rid of the smoking doctor’s pipe.

I’ve made so much fun of newbies who think they possess rare insight in noticing that the logo of a healthcare IT site is a smoking doctor that I have to assume this was (like the logo) intentionally ironic. If not, I’ll counterbalance it with another reader’s suggestion – give the doctor an additional accessory of a martini.

Add a thumbs up/down capability to articles and comments.

I admit I cheated a bit in reading this comment several weeks ago and then buying the thumbs up/down plug-in that’s on the site now. It has been used nearly 3,000 times since I installed it over the holidays, including by me.

Dump Readers Write.

I admit I’ve considered this several times. I turn down a lot of articles that are boring, unoriginal, vendor-slanted, or not all that related to health IT, but most of what remains still has some of those characteristics because vendors pay their PR people crank out dull, inexpert prose in which a vendor pitch is not too cleverly concealed. I keep thinking that providers will step up to the minor challenge of stating their opinion (even anonymously), but that rarely happens.

Suggestions

Convert webinars into podcasts so I can listen to them on my commute.

I think that’s probably doable. I also wondered whether people would appreciate having the transcribed webinar narration available to read as a PDF so they could distribute it, mark it up, etc. But let’s hear what you think – complete my little poll of which (if either) of those options you would use.

A Facebook-like look back of the news of that day five years back.

Great idea. I’ll add that to my calendar to add to each Monday Morning Update.

Use hashtags or tags of some sort so people can follow specific topics that interest them and get a weekly digest of headlines or posts relating to this topic.

Several people suggested that HIStalk posts could be repackaged into a curated summary of some type. I would have to understand the topics, but certainly one would be all items for specific vendors, which might then create a separate post (maybe on a separate site just to keep the clutter down) or as a weekly email with its own subscriber list. Tell me what you need.

Please stay focused on what you do. Additional news or too many communications can become overwhelming.

I agree, which is why I write one consolidated news article three times per week instead of blasting out every story individually. Anything I add would most likely have its own email subscriber list.

I love the idea of an email bulletin, beyond the headlines.

I agree. Email newsletters are hot again, especially if they are pithy and sassy. About three-fourths of a small number of respondents to a recent poll I ran said they would read a daily email, although I didn’t ask about a weekly one.

Facts are appreciated more than opinion.

Not to everyone. I know it seems obvious when you’re reading a site to think that every reader perceives it the same way, but I can say with certainty that it’s not that simple. More people say they read HIStalk for opinion, rumors, humor, and even music recommendations than say they wish I would stick to the same facts (usually from press releases) that every other site runs. I try not to be heavy-handed or to pedantically pontificate, but I also don’t hesitate to interject my opinion and welcome readers to agree or disagree in the comments.

Improve the home page layout. Having three columns is distracting and makes the page feel pinched when you get further down. And I never use the sponsor quick links – they just take up a lot of space on the screen, making it look busy.

I’m considering making some changes to skinny down the items in the right columns. Most are important, but they don’t necessarily need to display with each page view – a flyover menu of some sort would make them readily available without taking up space. Stay tuned.

Add one random and/or humor related item to the summary email you send for posts.

I try to do that, although I admit that I’m usually physically and emotionally drained by the time I send the email because I’ve been heads-down in deep thought for hours.

Get a DC insider to write.

I assume that means DoD and VA, although maybe I’m interpreting too narrowly and you’re actually interested in more political topics (in which case I’ll pass). As a reader, what would you like to see?

You could seriously sell your content curation and insights, especially if they were well-indexed for research purposes.  I would buy a personal subscription.

I’m not interested in selling anything, but tell me what you would find useful.

Comments

I invited respondents to say anything they want.

• How long until you quit? I want to make sure I’m done before then; I can’t imagine doing my job without you providing the necessary information I need for my job.
• It’s still my favorite work-related read of the day.
• I love HIStalk. It’s my favorite guilty pleasure.
• I like the balance of news and fun. Also appreciate your candor when people send you unsubstantiated information.
• Love it — and you’re great, but I’ve got to say that I get downright excited to read Dr. Jayne.
• This is a wonderful service to the community.
• I think you do a phenomenal job of bringing the news and sharing your personal insight as a long-time industry observer. I’ve been reading HIStalk since I started working in the industry 12 years ago. I think the site could be even better if it stopped running unsubstantiated rumors as if HIStalk was the National Enquirer or Fox News.
• Love it — specifically feel indebted to you for your summation of various complicated government rulings and policies. Also greatly admire what you have done with your reach when it comes to DonorsChoose.
• Dr. Jayne is my favorite. I also love how Mr. H is not cow-towed by disgruntled readers. Got the balance right!
• I continue to find HIStalk a very valued resource. You also made a recent comment about death and who cares once you are dead. I hope you are thinking about who would take over HIStalk when you lose the interest in keeping up with it. I do not think this is a prepare to die exercise — rather a realization that HIStalk is a valuable resource and honest broker of information in the HIT world and very worthy of continuing. Based on your humor, your often highlighted other interests, I assume that someday you will want to spend your time on other things beyond the care you put into HIStalk.
• Conduct regional social events where readers can get together, or do it at Health 2.0 meeting.
• I was once a complainer about the pro-Epic vibes and I have to say that I don’t feel the vibe anymore so if you were trying (or maybe I was over-analyzing and grew another year older?). Thanks!
• It’s an amazing site and any criticism I have is honestly quibbling — I would hate it if you hung it up.
• I work with the DoD and VA on their interoperability and have noticed that your periodic comments about that subject are quite dated. The two departments over the past 2-3 years are far more cooperative, interactive and mutually supporting in interoperability/data sharing needs than ever before.
• Appreciate all of your hard work.  Yours is the first news site I look at every day since I get both news and humor.
• It is an invaluable part of any HIS professional’s tool box.
• Thank you for this invaluable service. I truly appreciate that you offer thoughtful commentary, and not the generic re-spewing of outdated not-news that so many other healthcare IT sites espouse. My favorite articles are often Dr. Jayne’s blogs. I love hearing about actual in-the-trenches experiences. Of course, Weird News Andy is good for a chuckle or a smh. And I appreciate the donation updates.
• I check you daily and often share articles with others in my group. I’ve attended a few webinars and found them generally useful. On a regular basis I read something I find immediately useful for what I do, or something that spurs me to look deeper into some topic. In short, you’re great!
• I have been reading since the beginning and I’m a big promoter. I have mandated that my executives subscribe to the blog everywhere I’ve worked. So many people don’t bother to look outside their own little empires to understand the broader industry. You force readers to do that, and I am really grateful.
• So appreciate this resource. Single best blog I read and have read for 10 years now.
• I’m just a lowly independent Epic consultant (10+ years) but you really have helped me do my job better. I can chit-chat with a CIO waiting in line for lunch; and when I mention something I just read in HIStalk, he/she perks up and takes notice of me and we can carry on with a well-informed conversation. I have noticed that folks can tell if one has read HIStalk. I mention your site at least three times on every gig, so word-of-mouth DOES work. I can steer clear of (or be attracted to) Epic implementations that are in trouble, depending on the mood of my checkbook and my BS tolerance at any given time. I love Dr. Jayne’s commentaries and will go back to find one if I’ve missed a week. Her perspectives from "the trenches" are very beneficial from a physician’s perspective and I enjoy her writing style very much.  Your donor matching program for kids makes my heart sing — that’s all I can say, except you are contributing to a generation of life-long learners. Ed is Ed, and I like him. Weird News Andy is a hoot — wish he’d do more, but he’s probably busy doing real work most of the time. And you, Mr. H, should be commended for maintaining a non-biased and well-written site for all of us to benefit from. You are a voice of reason (or at least, devoid of BS) in this whirlwind of healthcare drama. Your dry wit doesn’t hurt, either — I get at least one chuckle a day guaranteed, if not a belly laugh. Please keep doing what you’re doing. Peace Out and Happy 2017!!
• Thank you for all that you do, Mr. H., and I hope you benefit from HIStalk as much as your readers do. I feel that the site is at its best when it provokes disagreement between readers, as this is a good indication of a particularly sticky problem yet to be solved.