News 6/28/17

Top News

A cyberattack of an unspecified nature against Nuance takes all of its cloud services – including dictation and transcription – offline. UPDATE: Nuance has since listed those applications that were not affected and the company is providing service updates.

One HIStalk reader reports that the culprit was ransomware. The company’s announcement says the attack originated in Europe.

I reached out to Nuance but my email couldn’t get through because of a Nuance mailserver error that was likely caused by powered-down servers.

Other newly reported ransomware attacks include drug maker Merck and Heritage Valley Health System (PA), which had to take all computers offline. A reader forwarded an email stating that a West Virginia hospital is also under attack.

Early reports suggest that Ukraine-based hackers used a tool developed by the National Security Agency to create the malware, which is also how the WannaCry ransomware was developed. A Ukrainian financial software firm that was infected then apparently inadvertently spread the malware widely via its software update.

Security firms believe the malware is a variant of Petya, which encrypts entire hard drives rather than just the files they contain. Like WannaCry before it, the malware can’t penetrate properly updated Windows computers. Microsoft released a patch MS17-010 in March that closed the exploit used by both WannaCry and Petya.

Preliminary hacker reports suggest that the a “kill switch” has been found that involves creating a file called C:\Windows\perfc. It has also been observed that the hacker message is displayed immediately as the hard drive encryption starts and CHKDSK is invoked, meaning the infected computer can be powered down immediately and left down and intact until the malware can be removed after booting from a Windows OS copy on disk or USB.

Reader Comments

From Meghan Roh: “Re: Epic App Orchard reader comment correction. We offer 50 percent off the first year’s fee, and if any member is dissatisfied in the first six months, we’ll refund the program fee. We have not reduced program benefits. For developers who don’t know what we offer, we provide a list of more than 300 APIs during the enrollment process to help them make their decision.” Meghan is director of public affairs for Epic.

From Established Relationship: “Re: health systems implementing Epic. Epic does not require hospitals to follow its hiring practices (tests, interviews, etc.) They recommend testing applicants, but it’s up to hospitals to say yes or no. If a hospital opts to set aside their usual hiring practice and follow one recommended by a software vendor, they have to accept responsibility for losing experienced resources and implementing a system with a high percentage of inexperienced resources.” I think most health systems follow Epic’s model of maddeningly SAT-like tests and competitive interviews for newly their newly created positions that follow Epic’s recommended job descriptions and titles. I’m mixed on the practice, as follows:

• It seems to work in ensuring successful project outcomes, even though it was developed by Epic for hiring new college graduates into their first jobs.
• It’s not really too much different from other IT migrations in which those who maintained the legacy system are seen as one-trick ponies who are put out to pasture once their single skill is no longer needed, marginalizing the value of their non-system skills, experience, and relationships.
• It would be tough as a health system project executive to announce that you’ve decided to ignore Epic’s advice, whether it involves hiring, project reporting, or anything else. You don’t want to be the person identified as having gone rogue when the project stumbles.
• The biggest unsettling fact is that Epic’s model places minimal (actually negative) value on experience with other IT systems, yet its rigid certification and project management requirements nearly always deliver the expected results. That’s threatening to those who equate broad, long experience with better project outcomes.

From Smuggler: “Re: health insurance. Why should the government be allowed to require consumers to buy insurance, or anything else for that matter?” I agree, as long as those invincibles who decide to roll the actuarial dice sign a legally binding waiver acknowledging that they won’t get a penny in benefits from Medicare, Medicaid, or hospitals when something unexpected happens. It’s like homeowner’s insurance, flood insurance, or car insurance – if you opt out of the system, you’re on your own. Whatever’s left of the ACA made insurance available and relatively affordable, so it’s hard to drum up a lot of sympathy for those who could have afforded coverage but chose not pay the taxpayer-subsidized price. All of this would be moot if US healthcare costs weren’t so ridiculously high compared to the rest of the world, the elephant in the room that politicians seem unwilling to address, leaving the only balloon-squeezing choices of covering fewer or healthier people, restricting access to care via ever-narrowing networks or uncovered services, or raising premiums and deductibles.

From KLAS: “Re: reader’s comment about market share. The correct information from the 2016 and 2017 KLAS market share reports is as follows.”

• Acute wins for 2015-2016 for Cerner — 249 (includes one Soarian add-on in 2015).
• Total Millennium losses for 2015 and 2016 – 53.
• Cerner’s net growth — 196 acute hospitals for 2015 and 2016.

HIStalk Announcements and Requests

We provided an iPad Mini for Ms. N’s elementary school class in New York, which is using the tablet for self-assessing their art projects. She reports, “Students are able to take photos of their work give it a title and describe their art, including what materials they used and how they feel their worked turned out. The Mini allows students a sense of independence. Students are better able to share their work with family by using an art app that gives family an opportunity to comment on the artwork.”

Every year I offer a “Summer Doldrums” deal on newly signed sponsorships and webinars, because otherwise it’s pretty quiet and I get nervous that my industry irrelevancy has escalated. Contact Lorre.

Listening: new from San Antonio-based Nothing More, which plays a slick blend of prog rock, Muse-like soaring orchestration, and hook-laden alternative rock.

Webinars

June 29 (Thursday) 2:00 ET. “Be the First to See New Data on Why Patients Switch Healthcare Providers.” Sponsored by Solutionreach. As patients pay more for their care and have access to more data about cost and quality, their expectations for healthcare are changing. And as their expectations change, they are more likely to switch providers to get them met. In this free webinar, we’ll look at this new data on why patients switch and what makes them stay. Be one of the first to see the latest data on why patients leave and what you can do about it.

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

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

Sales

Women’s Care Florida chooses the Healow patient engagement mobile app from EClinicalWorks to help women manage their pregnancies, integrated with the OB/GYN group’s ECW EHR.

People

Kyruus hires Soojin Chung (Caradigm) as general counsel and chief administrative officer.

Jennifer Rouse (IBM) joins ClearData as VP of marketing.

Announcements and Implementations

A new TransUnion Healthcare survey finds that two-thirds of patients with hospital bills of under $500 don’t pay off the full balance, a big jump from 2014 as deductibles increased. The company projects that 95 percent of patients won’t pay their bills in full by 2020, noting also that the percentage of patients who pay nothing at all toward their balances is increasing.

An HFMA/Navigant survey of 125 health system CFOs and revenue cycle management executives finds that 74 percent are increasing their revenue cycle technology budgets, but are struggling to keep up with EHR upgrades and optimization. Consumer-facing tools such online payment portals and cost-estimation tools are common, but few health systems run propensity-to-pay models for individual patients.

Long-term care software vendor Cantata Health chooses Ability Network as its preferred revenue cycle management software vendor.

Baxter International integrates its DoseEdge Pharmacy Workflow Manager with Epic’s Willow pharmacy system to meet CMS requirements for documenting IV preparation accuracy. 

Craneware announces GA of Trisus Claims Informatics, which automates claims review for completeness, accuracy, and conformance to normal charging behavior.

St. Joseph Hospital (NH) goes live on the EarlySense continuous monitoring inpatient system that uses an under-mattress sensor to monitor heart rate, respiratory rate, and motion.

In Canada, Waypoint Centre for Mental Health Care goes live on Meditech 6.1.

The State of Connecticut and the Connecticut State Medical Society will launch competing HIEs the next few months, with both organizations hoping users will be willing to pay for their services.

An Advisory Board analysis finds that the average 350-bed hospital fails to capture $22 million in revenue.

Government and Politics

The chairs of the Senate Veterans Affairs and Armed Services committees urge the VA to ask the DoD about lessons learned in its EHR procurement and implementation, expressing concern about potential VA cost overruns, implementation delays, lack of standardized processes, and excessive customization. 

A GAO report says the VA’s clinical productivity metrics provide incomplete and possibly misleading information, noting that those metrics fail to capture information from contract physicians and advanced practice providers; don’t adequately incorporate clinical workload intensity; and are hampered by providers who don’t log their time and activities consistently. The lack of good data prevents the VA from identifying and promoting best practices, GAO concludes.

Other

A hospital scrub nurse in Australia develops Scrubit, which improves OR setup by automating preference cards, setups, and lists of required equipment.

British military doctors blame the Ministry of Defence’s IT system for their mis-prescribing of antimalarial drugs for soldiers being shipped out to Afghanistan. They say the system is slow and can’t always bring up patient histories, meaning soldiers may be inappropriately prescribed mefloquine, which can cause depression and suicidal thoughts. The decade-old DMICP system is a customized version of EMIS PCS, provided by Canada-based vendor CGI, which has been the key player in quite a few IT screw-ups including Healthcare.gov.

MIT Technology Review says IBM is overhyping Watson, but the product still has the best chance among AI competitors of delivering healthcare value assuming that IBM can gain access to the data the system requires. The article says IBM has a leg up on startups because conservative large health systems trust it more than any other company. It notes that both IBM and MD Anderson raised expectations unreasonably before the organizations recently shuttered their joint $39 million project (budgeted for only $2.4 million). A snip:

To train Watson to go through giant pools of data and pull out the few pieces of information important to a single patient, someone has to do it by hand first, for thousands and thousands of cases. To recognize genes linked to disease, Watson needs thousands of records of patients who have specific diseases and whose DNA has been analyzed. But those gene-and-patient-record combinations can be hard to come by. In many cases, the data simply doesn’t exist in the right format—or in any form at all. Or the data may be scattered throughout dozens of different systems, and difficult to work with … To really help doctors get better outcomes for patients, however, Watson will need to find correlations between what it reads in health records and what Tang calls “all the social determinants of health.” Those factors include whether patients are drug-free, avoiding the wrong foods, breathing clean air, and on and on. But Tang concedes that today almost no hospitals or medical practices get that data reliably for a significant percentage of patients. Part of the problem is that hospitals have been slow to take up modern, data-driven practices. “Health care has been an embarrassingly late adopter of technology,” says Manish Kohli, a physician and health-care informatics expert with the Cleveland Clinic.

Researchers find that less than 1 percent of pathology specimens provide incorrect results due to mishandling (either switching samples between patients or “floater” cross-contamination), but DNA fingerprinting can eliminate those problems, albeit at a cost of $300 per test. Private insurance generally pays the cost to avoid higher bills for unnecessary or delayed treatment, but Medicare doesn’t. One urology practice starting using the error prevention system after being threatened by a lawsuit after it removed a man’s cancer-free prostate based on another patient’s specimen.

A study finds that a combination of wireless smart pill bottles, lottery-based incentives, and social support did not improve medication adherence or readmissions for post-MI patients. 

A drug company whose opiate addiction treatment drug was getting little market traction hires lobbyists and makes political contributions to influence drug court judges, who then order offenders to be treated with the product that is injected monthly. The resulting sales have increased the company’s market cap to $9 billion. On the positive side, the drug seems to work well in blocking the pleasurable effect of opiates, it’s not addicting, and it’s long lasting. The negatives are lack of proof of long-term efficacy and its $1,000 per month cost.

Sponsor Updates

• The local paper recognizes AssessURhealth Director of Operations and veteran Kyle Mynatt for his community contributions.
• Besler Consulting releases a new podcast previewing HFMA ANI 2017.
• Glassdoor.com recognizes CoverMyMeds CEO Matt Scantland as a highest-rated CEO.
• The General Services Administration (GSA) awards Audacious Inquiry (Ai) the 8(a) STARS II Governmentwide Acquisition Contract (GWAC).

Blog Posts

• Let’s make decisions, not dilemmas (Infor Healthcare)
• All CMS-Qualified Registries are Not Created Equal (Forward Health Group)
• Clean Your Garage, Desk and Car, Then We’ll Talk (Access)
• 5 Ways for Healthcare Providers to Get Ready for New Medicare Cards (AdvancedMD)
• With Device Diversity and Flexibility for All (Spok)
• Agfa Healthcare Celebrates Innovation (Agfa Healthcare)
• Shining the Spotlight on Datica Customers (Datica)
• Make the Most of the CCM Opportunity (CareSync)
• Genomics Information Primer (Clinical Architecture)
• 8 Common Project Management Mistakes – and How to Avoid Them (CTG)
• CMS Quality Payment Program – APM Path (Culbert Healthcare Solutions)
• Hiring the Right Leaders with Direct Retention Search (Direct Consulting Associates)
• Portfolio Management Development Techniques in Today’s M&A Environment (Divurgent)
• Valuing Your Patient Relationships (Docent Health)

Contacts

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

Monday Morning Update 6/26/17

Top News

Google adds medical records to the handful of categories that users can ask the company to remove from searches. Someone whose medical records have been exposed inadvertently or otherwise can ask Google to hide their information from its search results.

Medical records thus join the Google categories of federal ID numbers, bank account numbers, credit card numbers, scans of signatures, copyrighted materials, and revenge porn that are already covered by Google’s removal policies.

The material is still visible on whatever site posted it, but is less likely to be discovered when it’s filtered from Google searches.

Reader Comments

From Vendor Locking, Data Blocking: “Re: Cerner and the DoD/VA. You covered this a year ago and it’s even more outrageous in light of the VA’s decision. Cerner forced the DoD to host MHS Genesis because, by Cerner’s rules, only Cerner can, even though the DoD finds that it’s technically doable by others. Cerner ‘is not willing to negotiate at this time for the procurement of the data rights that would enable the government to utilize the Cerner solution in a competitive environment.’ Why? Because it ‘could adversely impact Cerner’s … competitive market advantage.’  Is this is the good faith Shulkin should expect heading into negotiations without a competitive bid?” I don’t know much about government procurement (and don’t want to), but publicly naming Cerner and presumably Leidos as the VA’s no-bid vendor for a contract whose value could exceed $10 billion seems absurd regardless of the Congressional pressure the VA is facing. The DoD messed up in failing to force Cerner (pre-contract, of course) to open up the DoD’s hosting options even though Cerner came up with a hollow-ringing excuse about population health management requirements, forcing us taxpayers to ante up a few more dozen million dollars that unfortunately constitute little more than a rounding error in the massive project.

From Supine Position: “Re: losing an IT job when systems are replaced. It’s SOP for health systems implementing Epic.” Indeed it is. Epic forces its own employment model onto its customers, requiring experienced hospital IT employees to interview competitively for newly created Epic positions and to take Epic’s bizarre but apparently effective logical reasoning and IQ-type tests that are scored secretly by Epic, resulting in only a gladiator-like thumbs up or down passed along from Epic to the hospital’s project executives who defer to Epic’s wisdom for fear of rocking the boat of their employer’s gazillion-dollar project. It’s almost like Epic is invalidating the hospital’s own methods of choosing and keeping employees. The rank and file who get passed over for the Epic team are thanklessly turfed off keep the legacy system lights on, huddling depressed like death row inmates as they watch former teammates head off to new physical locations, Epic training, and a secure employment future. I’m surprised that hospitals are readily willing to part ways with employees who have decades of experience, but on the other hand, the Epic model of creating new jobs and then eliminating the old ones is a convenient way to clean house without feeling guilty. Make no mistake – when your health system employer chooses Epic but not you, your IT life, your social standing among peers, and perhaps your city of residence will change.

From Interested: “Re: Quantros. The CEO is leaving, according to this announcement that identifies her new position.” A May 26 trading update from Informa PLC says that Quantros CEO Annie Callanan will join the business intelligence and publishing company this summer. She joined Quantros in July 2014.

HIStalk Announcements and Requests

The majority of HIStalk readers don’t believe Apple will live up to the hype in making the iPhone a significant interoperability component. John Smith says Apple doesn’t understand interoperability but instead is mostly interested in selling hardware to customers of its walled garden. Nick predicts Apple will be Fitness Trackers Round Two in giving already healthy people yet another gadget to play with. JC says the company’s deep pockets and strong consumer focus could allow it to make a difference, while Mobile Man says people need ways to store and share the medical information of themselves and family members that could be accessed by providers and anything Apple can do to support that would be great.

New poll to your right or here: Have you ever lost a job due to a health IT implementation?

Jenn did a great job covering for me while I was on vacation for several days. I like that she makes me at least temporarily redundant so I can get away without worrying about HIStalk, although I’m always anxious to get back in the saddle.

My candidate to become the next MySpace – LinkedIn, which under Microsoft’s ownership has become maddeningly slow, is being bloated with questionably useful and unintuitive features, and is becoming a nagware showcase of trying to get users to buy premium services. I actually dread looking someone up on LinkedIn now, nearly as much as I hate getting unsolicited pitches from it (like never-ending recruiter spam and generic partner pitches from India-based companies).

Webinars

June 29 (Thursday) 2:00 ET. “Be the First to See New Data on Why Patients Switch Healthcare Providers.” Sponsored by Solutionreach. As patients pay more for their care and have access to more data about cost and quality, their expectations for healthcare are changing. And as their expectations change, they are more likely to switch providers to get them met. In this free webinar, we’ll look at this new data on why patients switch and what makes them stay. Be one of the first to see the latest data on why patients leave and what you can do about it.

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

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

This Week in Health IT History

One year ago:

• Massachusetts General Hospital (MA) notifies 4,300 patients that their information was exposed in a February 2016 breach of dental practice systems vendor Patterson Dental Supply.
• McKesson announces that it will divest its Technology Solutions business into a new joint venture company that it will co-own with Change Healthcare (the former Emdeon).
• The VA signs up for IBM Watson to bring precision medicine to cancer treatment.
• Teladoc announces its planned acquisition of consumer engagement platform vendor HealthiestYou for $155 million.

Five years ago:

• ONC’s Director of Meaningful Use, Joshua Seidman, PhD resigns to take a job as managing director of quality and performance improvement with Evolent.
• The Supreme Court rules to uphold the ACA, including the individual mandate.
• A GAO report finds that the VA and DoD have made progress in their pilot project to integrate care at the James A. Lovell Federal Health Care Center (IL), but delays in implementing the IT component have created additional costs.
• Practice Fusion gets $34 million in Series C funding from by Artis Venture.
• Five senators introduce a bill that would create a national standard for notifying affected individuals about information security breaches.

Ten years ago:

• Michael W. Carelton joins HHS as CIO.
• The Healthcare Solutions business of JPMorgan Chase and RelayHealth offer an integrated set of claim and payment processing solutions.
• Mediware delists itself from the NYSE Arca stock exchange.
• Two DoD medical agencies attempt to stifle use of the Joint Patient Tracking Application so they can spend millions to build their own.
• Cerner gets 510(k) clearance for its new transfusion and specimen collection system that will be marketed under the Cerner Bridge Medical name.

Weekly Anonymous Reader Question

Last week’s survey: what is the best practice you’ve seen for a company to encourage gender equity?

• Pay equality.
• Promote the qualified women into management, upper management, and into the C-suite.
• I have not seen this implemented anywhere, but names should be removed from resumes. Resumes should stand alone on the quality of the content, not the name of the applicant. This would also level the playing field for people who get bypassed (and there are a LOT who do) for their “ethnic” sounding name.
• Can we please stop referring to our MAs, RNs, and receptionists as “girls,” as in “I’ll have one of my girls get that for you” or “My girls didn’t come in today, so we unable to see patients.”
• Actually promote women to senior line roles. Most senior teams are a horde of white guys and a few token women in legal, HR, and marketing.
• Data, data, data. Benchmark all positions against market rates and target hiring/paying everyone at the 50th percentile. Stop asking new hires what they make (now the law in Massachusetts); decide what the position is worth and pay that to all applicants.
• Having a respected female leader.
• Hire more men? Not always true at upper management, but at middle and down, my teams have been dominated by women for as far back as I can remember. Nurses (female-predominant career) switching to IT plays a huge role in this.
• None that I’ve seen, but the term gender equity is a good example of an oxymoron.
• Truly following an employee engagement strategy like those from Gallup, Press Ganey, etc.
• It’s not really a best practice per se, but I started my career at Epic, and as a female, I did not see any limits to my career based on gender. The CEO and many senior leaders are female. I think having that as a first example helped shape what I will accept and what I have sought out culturally at future employers.
• Several years ago while I was on active duty, the Air Force opened fields that were previously closed to women. Of all the careers positions that I have held since then, I have come to appreciate that no organization does a better job at “assimilation” than the military.
• Promoting a feminist to CEO.

This week’s survey: If you were offered a new job, what would be your limit on expected weekly work hours and travel requirements? I’ve never had a travel-intensive job so I don’t really know how that works, other than I’ve heard people gripe about spending their evening hotel hours catching up on work after a full day in front of clients and prospects. Maybe my next survey should address travel tips from road warriors who have learned to live out of a suitcase with little time back at the office.

Last Week’s Most Interesting News

• Senate Republicans publish the Better Care Reconciliation Act of 2017, the GOP’s renewed effort to repeal and replace ACA.
• Theranos reaches a tentative settlement with Walgreens that would result in the retail pharmacy getting only $30 million and losing more than $100 million of its original investment.
• Teladoc acquires Best Doctors, a telehealth vendor focused on offering remote second opinions to support complex medical cases.
• CMS publishes the 2018 Quality Payment Program proposed rule.
• FDA Commissioner Scott Gottlieb, MD outlines his digital health plans for the agency, which include the development and launch of a third-party certification program for low-risk digital health products.

Announcements and Implementations

The ACOs and IPA of Orange Care Group will implement Epic’s Healthy Planet population health management system and will also offer its EHR via Memorial Healthcare System (FL) and Epic Connect.

Government and Politics

Some of the scariest words I’ve heard out of Washington, DC involve the idea that people shouldn’t be forced to buy health insurance they “don’t want or need.” Who might that be, other than psychics who can predict with certainty that they won’t have an auto accident, experience a stroke or heart attack, get hit by an exploding genetic time bomb, or find that they have cancer? Choosing not to buy insurance is a gamble in which those who bet wrong on the likelihood of circumstances beyond their control stick hospitals with their bills (and thus everybody else who was responsible enough to insure themselves), receive inadequate care, or lead their families into medical bankruptcy. There’s a reason that even good drivers are forced to buy auto insurance even though they might rather spend the money elsewhere. Healthcare is so expensive that even the relatively rich couldn’t afford the uninsured cost of a major, short-term illness or any long-term one. Personal responsibility in healthcare comes from both lifestyle decisions as well as backstopping the inevitable eventual costs with insurance.

Meanwhile, here’s the most insightful comment I’ve seen on the US healthcare system given that everybody focuses on the cost of insurance that inevitably reflects the cost of healthcare services.

Sales

Australia’s Northern Territory selects InterSystems for its $196 million clinical systems replacement project. Telstra Health, Epic, and Allscripts failed to make the cut from the shortlist, while Cerner, Meditech, and Orion Health didn’t advance to the final four.

Decisions

• Ocean Beach Hospital (WA) will replace Healthland (CPSI) with Epic in October 2017.
• University of California Irvine Medical Center (CA) will go live on Epic in November 2017.
• Winneshiek Medical Center (IA) will replace Meditech with Epic in September 2017.
• Mayo Clinic Hospital – Rochester (MN) will go live on Epic in 2018.

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

Privacy and Security

Anthem will pay $115 million to settle a class action lawsuit over the 2015 cyberattack that exposed the information of 78 million people.

Other

A hospital in India denies well-placed rumors that its patient oxygen supply went offline for 15 minutes and thus killed 11 patients, even though reporters seeking information found that the records of the victims had vanished along with the oxygen supply logbook. Administrators of the 1,400-bed hospital say there’s no need for alarm since 10-20 patients die there each day. The same hospital killed two children last year after giving them nitrogen instead of oxygen.

A professor in South Korea says hospitals interested in artificial intelligence should focus their efforts on EHRs instead of IBM Watson. He adds, “I have to question whether we can use Watsons with absolute trust. It seems that hospitals have introduced the technology mainly for publicity reasons. They are promoting Watson to win the competition, especially now that its cost is falling.”

A depressing New York Times article covers the opioid addiction problems of Delray Beach, FL, whose paramedics responded to 748 overdose calls in 2016, 65 of them involving fatalities. Most of the victims were from elsewhere since the town has several addiction treatment centers that draw in addicts from all over the country who stick around afterward, who are then pursued by minimally supervised, often fraudulent, and insurance-paid treatment centers, labs, and group homes that profit from their relapses. Delray’s mayor notes that you can’t cut hair in Florida without a license, but you can run a substance abuse center. Also noted is that the Affordable Care Act gave young addicts insurance that made them a target for unscrupulous operators found in abundance in South Florida, to the point that they try to steal business from each other by offering addicts manicures, gym memberships, and sometimes even drugs, also rooting for their relapses that restart the insurance benefits clock. Residents complain that the rapidly proliferating sober homes create endless noise, property crime, and homelessness once a resident’s insurance runs out.

Georgia Tech researchers are developing a touchscreen that will allow dogs to call 911 if their owners experience distress or ask them to summon help. Those in technology-powered homes who plan in advance might name their dogs Alexa or Siri to double their chances of obtaining assistance.

Weird News Andy notes the potential rollout of “self-driving doctors,” in which a Seattle design firm proposes a rather ridiculous system of in-home monitoring and a self-driving health pods that people step into to have their health-related measurements taken at their own location. The pods would also offer telemedicine sessions and dispense medications via artificial intelligence, whatever what means. The company says it’s just a concept, but adds that “there’s a very big need for much better care experiences.” I wish the many people who propose Jetsons-like ideas for improving health would take the time to understand it first, particularly from a public health perspective, but unfortunately all the techno-gimmickry focuses on that small population of self-paying people who can theoretically fuel a company’s bottom line.

Sponsor Updates

• QuadraMed, a Harris Healthcare company, Sagacious Consultants, The SSI Group, T-System, ZirMed will exhibit at the HFMA ANI Conference June 25-28 in Orlando.
• Surescripts will exhibit at the AHIMA Long-Term Post-Acute Care & HIT Summit June 25-28 in Baltimore.
• Verscend Technologies releases a new podcast, “why value-based care requires ‘strength from all sides.’”
• ZappRx names Julia Austin (Digital Ocean) to its board.

Blog Posts

• A New Plan to Help B2B Marketers Reach Their Goals (Salesforce)
• Improving Hospital Point-of-Service Collections (The SSI Group)
• 5 Ways to Text Your Practice’s Way to Success (Solutionreach)
• 2016 National Progress Report Points to New Tools to Combat Opioid Abuse (Surescripts)
• UltraLinq’s Summer Release is June 29th (UltraLinq)
• Can you? Visage can: Image Display (Visage Imaging)
• No-fuss user experience. (Voalte)
• Behind the Scenes at West’s Emergency Call Relay Center (West Corp.)
• Predictive Modeling Keeps What You Don’t Know from Hurting Your Revenue (ZirMed)
• Meeting the Challenges of the Revenue Cycle (Leidos Health)

Contacts

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

News 6/23/17

Top News

Senate Republicans release a draft of the Better Care Reconciliation Act of 2017. Main points of discussion thus far seem to be the bill’s curtailment of Medicaid expansion, elimination of most of the taxes created to pay for coverage expansion, elimination of subsidies for out-of-pocket costs beginning in 2020, restrictions on tax subsidies, and giving payers the right to charge older consumers more than younger ones. It does away with individual and employer mandates, and keeps policies related to pre-existing conditions and dependent coverage. A vote on the final bill is expected next week.

HIStalk Announcements and Requests

This week on HIStalk Practice: Industry insiders react to the 2018 Quality Payment Program Proposed Rule. The Dark Overlord strikes again. Persivia adds quality measurement reporting and submission capabilities to its PHM tech. Drchrono COO Daniel Kivatinos describes the ways in which blockchain just might survive healthcare. Eagle Physicians implements Carequality framework via ECW EHR. Tandigm Health selects Tabula Rasa’s medication risk mitigation technology. Formativ Health moves forward with $1.6 million expansion. Aledade announces Medicare Advantage ACO plans in Arizona.

Webinars

June 29 (Thursday) 2:00 ET. “Be the First to See New Data on Why Patients Switch Healthcare Providers.” Sponsored by Solutionreach. As patients pay more for their care and have access to more data about cost and quality, their expectations for healthcare are changing. And as their expectations change, they are more likely to switch providers to get them met. In this free webinar, we’ll look at this new data on why patients switch and what makes them stay. Be one of the first to see the latest data on why patients leave and what you can do about it.

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

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

People

Navicure hires Robert Hendricks (McKesson) as chief product officer and Andrea Maizes (Tradestation Group) as chief human resources offer.

Stanford Medicine (CA) hires physician burnout expert Tait Shanafelt, MD (Mayo Clinic) as its first chief physician wellness officer. Shanafelt will direct the WellMD Center and serve as the School of Medicine’s associate dean.

Acquisitions, Funding, Business, and Stock

Theranos reaches a tentative settlement with Walgreens that would result in the retail pharmacy getting only $30 million and losing more than $100 million of its original investment. Theranos recently told investors that it only has $54 million left, while its monthly expenditures are said to be around $10 million.

Bucking the current market-exit trend, Oscar Health will expand its ACA health plan offerings in Ohio, Texas, New Jersey, Tennessee, California, and New York. “For all of the political noise, there are simply too many lives at stake for representatives in Washington, DC not to do what’s right for the people,” says CEO Mario Schlosser, who co-founded the company in 2013 with Josh Kushner, the brother of President Trump’s son-in-law Jared.

Chronic disease management startup Omada Health lays off 20 employees just over a week after announcing a $50 million investment round led by Cigna.

Forward Health Group is awarded a patent for its “system and method for the visualization of medical data,” which the population health analytics vendor will use to enhance its PopulationManager and PopulationCompass products.

Announcements and Implementations

Epic will offer end users the ability to license Mediware’s blood bank management system in combination with its Beaker LIS.

University of Pennsylvania Health System goes live on NLP technology from Linguamatics.

Technology

GetWellNetwork will add medical animations from Nucleus Medical Media to its Interactive Patient Care software starting next month.

Iatric Systems will help US and Canadian providers integrate Think Research’s cloud-based medication reconciliation tool with their respective EHRs.

The SSI Group releases Analytics 2.0 to give providers deeper RCM insight.

ICare will add evidence-based content from Zynx Health via FHIR to its EHR for acute and post-acute markets.

Sales

WellStar Health System (GA) will roll out PatientPing’s real-time care notification technology at 25 locations.

Ohio Valley Surgical Hospital (OH) will implement Meditech’s Web Acute EHR next year.

The City of Corpus Christi Fire Department in Texas selects RCM software and ambulance supplemental payment program consulting services from Intermedix.

In England, Taunton and Somerset NHS Foundation Trust will implement DeepMind Health’s Streams patient safety alerts app over the next five years. DeepMind Health is a London-based Google company that encountered media scrutiny in the UK last year after patients cried foul at having their data involved in a Streams pilot without their consent.

Carolinas HealthCare System (NC) will deploy Cerner’s HealtheIntent population health management technology across the organization, including its Carolinas Physician Alliance. The health system – a Cerner Millenium shop – will also extend its remote hosting agreement with the company.

Privacy and Security

From DataBreaches.net:

• The Halifax Supreme Court in Canada rules that Roseway Hospital must pay $1 million to members of a class-action lawsuit filed over a 2012 privacy breach. It seems to be the first successful suit of its kind in Canada.
• Michigan-based Purity Cylinder/Airway Oxygen notifies 500,000 customers of a ransomware attack that did not ultimately compromise PHI.
• Four-physician Cleveland Medical Associates experiences an unsuccessful ransomware attack that prompts it to switch medical records systems.

Innovation and Research

An Accenture report projects a annual growth rate of 40 percent through 2021 for AI focused startups working in healthcare, with robot-assisted surgery, virtual nursing assistants, and administrative workflow assistance topping the list of top AI applications in healthcare.

A CHIME survey on medication reconciliation practices conducted on behalf of DrFirst shows that 75 percent of hospital executives are most concerned about inaccurate or incomplete medication data, followed by inconsistencies across departments and shifts, and discharged patients being given incorrect medication lists.

Government and Politics

AHRQ reports that between 2005 and 2014 opioid-related ER visits doubled and opioid-related inpatient visits increased by 64 percent.

In India, the state of Andhra Pradesh’s Department of Health, Medical, and Family Welfare signs a three-year agreement with Cerner for HIE services, data analysis, and policy expertise. The organizations will set up a Knowledge Command Centre from which to direct operations. Chief Minister N. Naidu has expressed a desire to eventually give every citizen access to their health data electronically.

Other

A man who jumped from an ambulance in a drunken state sues the City of Staten Island, its fire department, and the EMS workers who attempted to care for him. He claims they should have prevented him from taking the leap, and ultimately caused the injuries he sustained as a result. The patient’s lawyer contends that, though the facts of the case are unusual, he was in such an inebriated state that he was in no condition to make decisions about his own safety.

Sponsor Updates

• LogicWorks announces managed services support for Microsoft Azure.
• Experian Health, MedData, and Navicure will exhibit at the HFMA ANI conference June 25-28 in Orlando.
• Netsmart will exhibit at the Long Term Post Acute Care and HIT Summit June 26 in Baltimore.
• Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the AWHONN 2017 National Convention June 25-27 in New Orleans.
• Reaction Data publishes “Hottest Trends in Revenue Cycle Management.”
• Walter Groszewski joins The Direct Companies (Direct Consulting Associates and Direct Recruiters) as director of client partnerships, HIT & Life Sciences.
• DrFirst exhibits at the Annual Physician-Computer Connection Symposium through June 23 in Ojai, CA.

Blog Posts

• Lab on Demand Geo-Location: Launching From the Closest Datacenter (Learn on Demand Systems)
• Patient Engagement in Healthcare: The Impact of the Patient Centric Model of Care (Liaison Technologies)
• The Senate’s health care bill just dropped. Here’s what you need to know. (The Advisory Board)
• Best practices in clinical communications: The Rocket, The Reuben, and the Rubberband (Meditech)
• Cause of Death: Alphabet Soup Overdose (Medicomp Systems)
• Lessons from summer vacation packing – What’s on your revenue cycle team’s list? (Navicure)
• International MUSE Conference Recap (Parallon Technology Solutions)
• Opinions-as-a-service and other service-oriented musings (CloudWave)
• Healthcare Pros Prescribe Mobile Technology Use for Enhanced Care (PatientPing)
• The 3 Keys to Unifying Clinical Communications and Workflow (PatientSafe Solutions)
• The Telehealth Revolution: 5 Obstacles Standing In The Way (PokitDok)
• How to Reduce Length of Stay through Communication Performance Metrics (Uniphy Health)
• Four Principles of Productivity (Access)
• When is the Best Time for an EHR Go-Live? (The HCI Group)
• Go phish: How to build a human firewall to protect against phishing (The Advisory Board)
• Better Together: Spok + Cisco Elevate Healthcare Communications (Spok)
• 4 Questions with Robert Tarola, CFO of Southcoast Health Systems (Optimum Healthcare IT)

Contacts

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

News 6/21/17

Top News

Teladoc will acquire Best Doctors, a global company that provides virtual medical consult services to employers and payers, for $375 million in cash and $65 million in common stock.

Reader Comments

From Ex-Epic: “Re: Epic billing services. Not sure if this has already been announced publicly. It looks like Epic is starting a Billing Services team: ‘Epic is seeking bright, motivated individuals to join our new Billing Services team as we enter the world of medical billing. Our goal is to simplify the payment process by helping Epic organizations with the complexities of submitting claims and posting payments. Attention to detail is vital as you’ll be posting payments and denials; reconciling payment files, claims, and statements; resolving posting errors; and calling payors to follow up on outstanding or unpaid claims.’”

From Ex-McK: “Re: McKesson’s ranking. The Fortune 500 issue was not too kind to the Pharma division of McK and it’s difficult to fathom how John Hammergren can bring in an average of $60M+ per year over the last 10 years. As one of those who was ‘released’ from my employment I find it galling, but that’s probably just me.” Fortune’s annual list puts McKesson at number five, just ahead of UnitedHealth and CVS Health. I didn’t care to dig any deeper into the list given its obnoxious interface and floating auto-play ads that took too long to recognize my many attempts to stop them.

Webinars

June 22 (Thursday) 1:00 ET. “Social Determinants of Health.” Sponsored by Philips Wellcentive. Presenter: David Nash, MD, MBA, dean, Jefferson College of Population Health. One of the nation’s foremost experts on social determinants of health will explain the importance of these factors and how to make the best use of them.

June 29 (Thursday) 2:00 ET. “Be the First to See New Data on Why Patients Switch Healthcare Providers.” Sponsored by Solutionreach. As patients pay more for their care and have access to more data about cost and quality, their expectations for healthcare are changing. And as their expectations change, they are more likely to switch providers to get them met. In this free webinar, we’ll look at this new data on why patients switch and what makes them stay. Be one of the first to see the latest data on why patients leave and what you can do about it.

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

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

Acquisitions, Funding, Business, and Stock

LTC EHR vendor MatrixCare acquires competitor SigmaCare for an undisclosed amount.

The SSI Group expands its reseller agreement with Cerner, offering its RCM services to Cerner Millenium end users.

People

Robin Hackney (Greenway Health) joins Ingenious Med as CMO.

After just one year on the job, Memorial Hermann Health System (TX) CEO Benjamin Chu, MD resigns without providing a reason beyond his desire to pursue his “passion in health and public policy.” Charles Stokes, EVP and COO, has been named interim CEO.

Ability Network hires Jamison Rice (BCBSMN) as EVP and CFO.

Announcements and Implementations

Woman’s Hospital (LA) deploys electronic patient signature and eForms technology from Access.

HIE operator Vermont Information Technology Leaders implements Wolters Kluwer’s Health Language Enterprise Terminology Management solution.

University of Toledo Medical Center’s multispecialty physician group (OH) rolls out PatientKeeper’s Charge Capture technology to streamline billing at UTMC and affiliated SNFs.

Technology

Health Catalyst develops new technology to help providers better understand costs of care as they relate to patient outcomes.

Apple is reportedly working with digital health startup Health Gorilla in its efforts to turn the iPhone into a personal health data storage device. CNBC reports they are working to add integration points that will allow iOS to import results from hospitals and lab-testing companies like Quest Diagnostic and LabCorp.

Payment technology vendor Patientco announces enhanced integration with Epic.

Modernizing Medicine adds electronic prior authorization capabilities from CoverMyMeds to its EMA specialty-focused EHR.

SCI Solutions adds new scheduling and worklist management features for multi-location providers to its Schedule Maximizer software.

Recondo Technology adds payment collection capabilities from HealthPay24 to its RCM offering.

Sales

Auburn Community Hospital (NY) selects analytics and 340B drug discount program solutions from Sentry Data Systems.

Hartford HealthCare (CT) will implement Stanson Health’s analytics and clinical decision support software.

Privacy and Security

Citing last year’s ransomware attack on MedStar (MD), the Wall Street Journal reports that some hospital executives avoid reporting ransomware breaches because HHS rules say hospitals only need to report attacks that result in exposure of medical or financial information, while ransomware attacks encrypt the information, but don’t necessarily expose it.

From DataBreaches.net:

• Torrance Memorial Medical Center (CA) notifies patients of an April email breach that may have exposed personal information. Hospital officials have hired a third-party forensics firm to assess the scope and impact of the phishing attack.
• Daniel Devereux, a homeless computer hacker in the UK known as His Royal Gingerness, is jailed for his 2015 attacks on the Norfolk and Norwich University Hospital and Norwich International Airport.
• Thanks to a proactive encryption strategy, Waverly Health Center (IA) experiences little to no disturbance from a June ransomware attack.

Government and Politics

Michigan Lt. State Governor Brian Calley with Henry Ford Health System and Appriss Health representatives to announce $2.1 million in funding to connect the Michigan Automated Prescription System with provider EHRs across the state. Calley hopes the integration, which will be aided by Appriss technology, will increase physician use of the PDMP from 28 to 80 percent.

The Office of the Chief Actuary of CMS forecasts a 13 million reduction in insured patients by 2026 if AHCA is passed, 10 million less than the CBO’s prediction. Reuters reports Senate Republicans will unveil their version of the bill on Thursday.

CMS releases the 2018 Quality Payment Program Proposed Rule. Health IT-related highlights of the 26-page summary include continuing to allow providers to use 2014 certified EHRs, and offering bonus points for using 2015 technology exclusively.

Innovation and Research

A West survey on patient experience finds that shorter wait times, upfront pricing, more communication options, and not feeling rushed during appointments are key to their satisfaction with providers. Nearly 80 percent claim they won’t hesitate to fire doctors that don’t meet their expectations.

Other

Australia makes genome sequencing available to patients for $6,000 through Genome One and the Garvan Institute in Sydney. Should demand increase, the Australian Genomic Healthcare Alliance may look for a way to fund testing through the country’s Medicare program.

Babies in China, on the other hand, can have their genome sequenced for the bargain price of $1,500. Earlier this month, Boston-based DNA sequencing company Veritas Genetics – a spinoff of Harvard’s Personal Genome Project – launched full genome sequencing via MyBabyGenome. Its sequencing report addresses 950 inherited diseases, 200 genes connected to drug reactions, and 100 physical traits the child is likely to have.

Sponsor Updates

• Besler Consulting releases a new podcast, “Working with the first CJR reconciliation report.”
• CoverMyMeds will sponsor Startup Weekend Columbus – Maker Edition June 23-25 in Ohio.
• The Cleveland Plain Dealer and WorkplaceDynamics include Direct Consulting Associates in its list of Top Workplaces for 2017.
• Diameter Health supports the Juvenile Diabetes Research Foundation Promise Ball Gala.
• ECG Management Consultants will exhibit at the National Bundled Payment Summit June 26-28 in Arlington, VA.
• EClinicalWorks, Hayes Management Consultants, Imprivata, and Kyruus will exhibit at the HFMA ANI conference June 25-28 in Orlando.
• The Healthgrades award-winning internship program cultivates new talent to achieve excellence.
• InterSystems will exhibit at the International Healthcare Summit June 26-27 in Kelowna, BC.
• Solutionreach publishes a new white paper, “The Patient-Provider Relationship Study: The Ripple Effect Starts with Boomers.”
• Mez Pharma Group selects the Liaison Technologies Alloy Platform for Healthcare.

Blog Posts

• Are you Prepared for EMRAM Stage 7? (The HCI Group)
• Customer Care or Couldn’t Care Less? (Access)
• Let’s hack together! #AgfaHack17 (Agfa Healthcare)
• Integrity and Commitment (Aprima)
• Onramp to the Healthcare Cloud (Datica)
• Just in Time: A Heart of CareSync Story (CareSync)
• Creation of Institute of Medicine Care Plans with an Eye on Up-front Care – Oncology Care Model (Carevive Systems)
• Practicing Humankindness (Docent Health)
• Key Takeaways from DIUC17 (Dimensional Insight)
• 5 Inescapable Issues for Medical Groups (ECG Management Consultants)
• Chronic Care Management and Aging (EClinicalWorks)
• Arming the Marketer: Getting Started with Nurturing in Healthcare (Evariant)
• Know the Score: Understanding the MACRA Advancing Care Information Category (Hayes Management Consultants)
• Stop Duplicating Patient Data in Multiple Systems (Iatric Systems)
• 5 Steps to Getting Your Healthcare Technology Investment Approved (Influence Health)
• 5 Ways to Keep Healthcare Payments Secure All Summer Long (InstaMed)
• A Roundtable, An Epiphany, Six Takeaways (InterSystems)
• Three Ways Poor Provider Data Hurts Core Business Processes (Kyruus)

Contacts

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

Monday Morning Update 6/19/17

Top News

FDA Commissioner Scott Gottlieb, MD outlines his digital health plans for the agency, which include the development and launch of a third-party certification program for low-risk digital health products that it deems “software as a medical device.” He adds that using “a unique pre-certification program for SaMD could reduce the time and cost of market entry for digital health technologies.”

Reader Comments

From Peg Leg Pete: “Re: Problems at Baptist Health. As a group concerned with how EHR implementations are affecting hospitals and their financial situations, we are currently seeing some problems in Florida. Baptist Health in Pensacola is having delays and cost overruns on their Allscripts implementation. The hospital may face layoffs. As it’s a private hospital, this news isn’t reported publicly.” The 492-bed Baptist Health selected Allscripts in 2015, deciding to implement Sunrise plus a number of other financial and population health management technologies. The provider’s bond ratings agency noted in April of last year that it had taken on a $22 million loan from Allscripts to fund the roll out.

From Potato, Tomato: “Re: VA Cerner vs. DoD Cerner. There seems to be some debate at the VA and in Congress as to whether Cerner will use an ‘identical’ system to the DoD or a ‘similar’ but separate system. (I’ll bet 10 out of 10 HIStalk readers know the answer.) No doubt Cerner’s PowerPoint experts are frantically focus-grouping which line style looks the most ‘seamless’ when you draw it between a VA box and a DoD box.”

From Gordon Gecko: “Re: Cerner financials. I read somewhere (was it HIStalk?) that Cerner’s stock price didn’t pop on the VA announcement because it was already expected/baked in. More likely, the street is aware that … if you take out the DoD and one deal that bundled 30 micro-hospitals … Cerner has actually lost more hospitals as customers (96) than it has added new (92) in the last two years. Not confidence-inspiring, especially when coupled with a late and scope-reduced DoD pilot.”

From Eagle Eye: “Re: Middle Eastern HIT. Ministry of Health Saudi Arabia is about to sign a $1.5 billion dollar deal with GE. GE will be developing an HIS that consists of its specialty modules (maternity, cardiology, etc.), and combine it with two very basic health information systems – one locally-developed billing solution and a Turkish HIS. The MOH is in for a major mess as the solution has not been even built. It is not clear whether GE is planning to re-enter the HIS market after exiting it a long time ago, or if it’s a one-off thing taken on for the money.”

HIStalk Announcements and Requests

The “Noes” have it when it comes to considering research studies before purchasing health IT or signing up to participate in private or public clinical programs. Pragmatist puts the role of such studies during decision-making in perspective: “Research results are very important from many standpoints, but generally provide minimal insight into commercial systems that are not readily subjected to research comparisons due to intellectual property considerations.”

New poll to your right or here: Given the latest round of industry speculation around Apple’s healthcare efforts, do you think it is truly capable of moving the patient-centered interoperability needle? I know it’s a loaded question, and so I’m hoping you’ll expound on your “yes” or “no” by leaving a comment.

Welcome to new HIStalk Platinum Sponsor PatientPing. The Boston-based, Silicon Valley-backed company is building a network of providers who are notified via real time "pings" when their patients receive care elsewhere, allowing them to share care instructions for better care coordination. The network includes physicians, nurses, case managers, and care coordinators in hospitals, EDs, ACOs, physician practices, SNFs, home health agencies, and payers, all of whom rely on PatientPing’s network to support their delivery of high-quality, cost-effective care with improved patient outcomes and experience. I interviewed CEO Jay Desai earlier this year and he did a great job explaining the company’s lightweight technology, the resulting workflow, and its business model. Thanks to PatientPing for supporting HIStalk.

This Week in Health IT History

One year ago:

• Reuters reports that McKesson is discussing a merger of its Technology Solutions IT business with Change Healthcare (the former Emdeon).
• An independent investigation recognizes Healthcare.gov as the second-most secure consumer website, while Twitter took top honors.
• Doctors at the University of Pennsylvania are seeking approval to use CRISPR gene editing technology on humans for the first time.
• Federal agents have arrested 300 suspects in the largest ever crackdown on Medicare fraud, with suspected losses totaling $900 million.
• VA Undersecretary of Health David Shulkin, MD says during testimony before the Senate Committee on Veterans Affairs that its EHR modernization plans are “not dependent on any particular EHR.”

Five years ago:

• CMS reports that more than 110,000 EPs and over 2,400 hospitals have been paid a combined $5.7 billion in EHR incentives from Medicare and Medicaid.
• The VA establishes a goal of conducting more than 200,000 clinic-based telemental health consultations in fiscal year 2012.
• An FDA report finds that software problems cause 24 percent of medical device recalls.
• The US Supreme Court refuses to consider an appeal by former McKesson Chairman Charles McCall to overturn his 10-year prison sentence for scheming to inflate company revenue.

Ten years ago:

• Richard Granger, head of NHS Connecting for Health in the United Kingdom, has announced that he will leave the program at the end of the year.
• Pro basketballer Dikembe Mutombo buys a smartcard-driven EHR for a hospital in the Congo.
• Athenahealth announces IPO plans.

Weekly Anonymous Reader Question

Last week’s survey: What characteristics made the worst doctor you’ve ever had so bad?

This week’s survey: What is the best practice you’ve seen for a company to encourage gender equity?

Last Week’s Most Interesting News

• Rumors circulate that Apple wants to store health information on the IPhone, and work with EHR developers to allow users to export information to providers as needed.
• The House Appropriations Committee approves a $65 million down payment toward the VA’s Cerner procurement, with the stipulation that it will integrate with both DoD and private EHR systems.
• Omada Health raises $50 million in a round led by Cigna, which will offer the company’s digital chronic disease management technology to its members.
• Kieran Murphy is named president and CEO of GE Healthcare, succeeding John Flannery who has been promoted to CEO and chairman elect of GE.
• An OIG report concludes that CMS inappropriately paid eligible providers $729.4 million in EHR incentive payments.

Webinars

June 22 (Thursday) 1:00 ET. “Social Determinants of Health.” Sponsored by Philips Wellcentive. Presenter: David Nash, MD, MBA, dean, Jefferson College of Population Health. One of the nation’s foremost experts on social determinants of health will explain the importance of these factors and how to make the best use of them.

June 29 (Thursday) 2:00 ET. “Be the First to See New Data on Why Patients Switch Healthcare Providers.” Sponsored by Solutionreach. As patients pay more for their care and have access to more data about cost and quality, their expectations for healthcare are changing. And as their expectations change, they are more likely to switch providers to get them met. In this free webinar, we’ll look at this new data on why patients switch and what makes them stay. Be one of the first to see the latest data on why patients leave and what you can do about it.

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

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

Acquisitions, Funding, Business, and Stock

ChartSpan Medical Technologies raises $16 million in a venture round led by Cypress Growth Capital, bringing its total funding to $22.15 million since launching five years ago. The Greenville, SC-based chronic care management-focused technology vendor plans to create 300 jobs over the next 18 months and expand beyond its Appalachian borders.

Inspira Health Network (NJ) announces plans to open the Inspira Innovation Center to develop and commercialize patient-focused health IT.

Government and Politics

TIAG will customize its Warrior Performance Platform to meet the needs of US Navy sailors. Originally developed for training programs for Special Operations forces, the WP2 will evolve into the Human Performance Self-Service Kiosk, enabling sailors to log fitness, training, and nutritional goals, plus sync them with data from select wearables. No word on whether the data will eventually link with the DoD’s MHS Genesis EHR from Cerner.

Decisions

• Wadley Regional Medical Center At Hope (AR) will go live with Cerner in December.
• Sartori Memorial Hospital (IA) will switch from McKesson to a Cerner inpatient EHR in October. (Its clinic will remain with an Epic ambulatory EHR.)
• Hereford Regional Medical Center (TX) will switch from Healthland (a CPSI company) to Cerner next month.
• Select Specialty Hospital – Danville and Gainesville (PA) plans to switch to Epic.
• Regency Hospital Of Central Georgia will go live with Epic in 2019.

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

Privacy and Security

In New York, prescription eligibility check vendor CoPilot Provider Support Services agrees to pay $130,000 to settle a case with the state attorney general after waiting more than a year before notifying affected patients that a hacker had accessed its system and stolen 220,000 patient records.

A Global Cyber Alliance survey finds that US hospitals have, for the most part, not yet invested in cybersecurity tools at an enterprise level – a statistic that bodes well for hackers looking to take advantage of organizations that have made themselves sitting ducks either through lackadaisical attitudes on the part of upper management or lack of funds. Just six of the 50 largest public hospitals have adopted an email authentication, policy, and reporting protocol known as DMARC. Presumably bigger budgets have enabled 22 of 48 for-profit hospitals to implement DMARC; only one of those has implemented it to the level that it prevents suspicious emails from hitting inboxes.

Innovation and Research

Researchers from the University of Miami Miller School of Medicine and the California Pacific Medical Center will use a $300,000 grant from the Muscular Dystrophy Association to develop and integrate an ALS Toolkit with Epic. The kit will consist of a set of smart forms within the EHR that will help MDA ALS Care Center providers collect and access standardized health data for clinical and research purposes.

Sponsor Updates

• Summit Healthcare helps raise money for The Gatehouse, this year’s MUSE conference’s selected charity.
• QuadraMed, a division of Harris Healthcare, will exhibit at the Wisconsin Rural Health Conference June 21-23 in Wisconsin Dells.
• Salesforce will accept applications for its incubator program through July 15.
• The SSI Group renews its HFMA Peer Review designation for the sixth consecutive year.
• SK&A publishes a “US Elder Care Market Summary.”
• Versus Technology offers its RTLS for wayfinding initiatives using Bluetooth Low Energy networks.
• Zirmed will exhibit at the CAPG Annual Conference June 22-28 in San Diego.
• LogicStream Health will exhibit at the 2017 AMDIS Physician Connection Computer Symposium June 20-22 in Ojai, CA.

Blog Posts

• Are Alternative Payment Models Working to Reduce US Healthcare Spending? (The SSI Group)
• VUE17 registration is now open. (Voalte)
• Simple Tricks to Leverage Social Media to the Fullest (Solutionreach)
• Tackling the Adherence Epidemic with Innovative Technology (Surescripts)
• When Waste Becomes Fraud: Where Do You Draw the Line? (Verscend Technologies)
• VUE17: Sun, Surf and Intracoastal Connections (Versus Technology)
• Full Year MIPS Reporting – It Can Be Done. Even Now (Forward Health Group)

Contacts

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

News 6/16/17

Top News

Rumors related to Apple’s healthcare takeover abound, with CNBC reporting that the company is working behind the scenes to develop an Iphone-based repository of health data that users can share from at will. Lab results and allergy lists seem to be first on Apple’s pick list of data points to tackle. Tied in with that is the recommendation of a Citigroup analyst that Apple buy up Athenahealth in a move that would give it access to the EHR vendor’s 83 million patient records and its Epocrates physician end users and technology. Apple is certainly a force to be reckoned with when it comes the ubiquity of its mobile devices (though some have lately challenged that notion), but it seems the issue of interoperability with other competing platforms – as seen so often with healthcare – would raise its ugly head sooner rather than later. It would be fun to see how Apple fanboys would take to Jonathan Bush’s cult of personality.

Reader Comments

From First Fruits: “Re: App Orchard. Prices have gone up by $5,000 for the top two tiers effective May 25th from what I can tell. And they have taken away benefits, i.e. the number of included support hours, free app listings, and registrations to events. You don’t get any indication of available APIs until after you pay your annual fee. Does anyone consider this a pay-to-play interoperability?”

From Chip Hart: “Re: Larry Weed, MD. Larry passed away at the age of 93 earlier this month. Arguably the great-grandfather of EHRs, and certainly of the organized medical record. (He invented the SOAPM and POMR concepts.) His lectures are famous. I believe you’ve linked to them in the past. The stuff from the 70s is still relevant today. Here’s one.”

HIStalk Announcements and Requests

This week on HIStalk Practice: The FBI looks into Zoom’s falsified risk-adjustment payments. Community Health and Wellness Center of Greater Torrington leans on Stone Health Innovations for CCM expertise. Several cancer care practices select Flatiron Health software and support. Digital Noema Telehealth adds EazyScripts e-prescribing to virtual consult software. The Medical Society of the State of New York expands partnership with DrFirst. Spry Health raises $5.5 million. Dermatologist Stacia Poole, MD discusses the role health IT plays at a practice with older patients. Thanks for reading.

Webinars

June 22 (Thursday) 1:00 ET. “Social Determinants of Health.” Sponsored by Philips Wellcentive. Presenter: David Nash, MD, MBA, dean, Jefferson College of Population Health. One of the nation’s foremost experts on social determinants of health will explain the importance of these factors and how to make the best use of them.

June 29 (Thursday) 2:00 ET. “Be the First to See New Data on Why Patients Switch Healthcare Providers.” Sponsored by Solutionreach. As patients pay more for their care and have access to more data about cost and quality, their expectations for healthcare are changing. And as their expectations change, they are more likely to switch providers to get them met. In this free webinar, we’ll look at this new data on why patients switch and what makes them stay. Be one of the first to see the latest data on why patients leave and what you can do about it.

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

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

Acquisitions, Funding, Business, and Stock

Omada Health raises $50 million in a round led by Cigna, which will offer the company’s digital chronic disease management technology to its members.

Cleveland Clinic and Oscar Health will offer co-branded insurance plans to people in northeastern Ohio. The move is a first for both organizations, marking Oscar’s entry into the state and the health system’s first time offering an insurance product bearing its name.

Weirton Medical Center (WV) sues Cerner and its Siemens subsidiary for their failure to provide adequate support and service related to a $30 million contract extension for Soarian in 2013. A trial by jury has been requested. WMC’s end goal appears to be termination of its contract with Cerner, and Cerner’s free-of-charge assistance in switching the hospital to a new vendor.

PokitDok acquires the software and pharmacy assets of Oration, a prescription management and savings app developer. PokitDok plans to make Oration’s commercial pharmacy benefit data available through its DokChain network.

Announcements and Implementations

JD McCarty Center for Children with Developmental Disabilities (OK) implements Evident’s Thrive EHR. The center enlisted the consulting services of TruBridge to assist with the roll out. Evident and TruBridge are both subsidiaries of CPSI.

Technology

Physician’s Computer Company adds FDB’s MedsTracker e-prescribing tool to its EHR for pediatricians.

MModal’s CAPD tools now support Epic’s NoteReader CDI module.

Salesforce adds new communications features to its Health Cloud CRM, enabling caregivers outside of the doctor’s office to communicate via mobile device, and to share care plans across different organizations.

Sales

Community Medical Centers (CA) will implement LogicStream Health’s Clinical Process Improvement solutions.

Neighbors Emergency Center selects Presidiohealth’s FSEC Foundation software, which combines T-System’s EDIS with Presidio’s PM technology.

People

Clinical Computer Systems, developer of the Obix Perinatal Data System, promotes Cindy Bell to VP of customer services.

Cambia Grove founder and executive director Nicole Bell will join Amazon Web Services as principal business development manager, serving as a healthcare industry liaison.

Erin Jospe, MD (PatientKeeper) joins Kyruus as CMO.

Citing closer proximity to family, Vancouver Island Health Authority President Brendan Carr, MD plans to step down to take over as president and CEO of the William Osler Health System in Ontario. His five-year tenure at Island Health has included oversight of the rocky rollout of the IHealth EHR, which still has physicians up in arms over its risk to patient safety. “I’ve learned immensely from that experience,” he explains, “sometimes painfully so. It’s been a challenging thing, and I think it’s something that will absolutely allow this organization to do great things in the future.”

Privacy and Security

Microsoft releases a bevy of security updates to protect users from WannaCry-like attacks. In addition to automatic updates, the company is making the updates available for manual download and installation for unsupported software versions including Windows XP and Windows Server 2003.

Sensato Cybersecurity Solutions will focus on the attacker’s perspective during its Hacking Healthcare Workshop, set to take place September 13-14 in Asbury Park, NJ.

Government and Politics

A GAO report finds that pharmacists at the VA have trouble accessing patient data via its pharmacy system, and often run into trouble when transferring or refilling prescriptions from non-VA facilities. Recommendations include updating the system and taking a deeper look at barriers to interoperability.

Innovation and Research

Colorado’s UCHealth launches the virtual Applied Decision Science Lab through its CARE Innovation Center to collaborate with entrepreneurs on healthcare technology. Researchers are particularly interested in using AI and machine learning to enhance EHR workflows and clinical decision support.

Other

Bloomberg reports that nearly half of the $2 billion raised on popular crowdfunding platforms like GoFundMe are being used to pay medical expenses. Facebook has gotten in on the action, adding a health category to a new feature that lets users set up fundraisers for personal causes.

A US District judge sentences Wilbert Veasey, Jr. to pay over $23 million to CMS and serve 17 years in prison for his part in what authorities call the biggest home health fraud in the history of Medicare and Medicaid. Veasey, along with four conspirators, convinced already vulnerable Medicare patients to sign up for unnecessary home health services, after which they then filed for reimbursements for via a number of shell companies. The racket ultimately ran up $374 million in fraudulent claims.

The Michigan Attorney General charges HHS Director Nick Lyon and Chief Medical Executive Eden Wells in the latest round of criminal charges related to the Flint water crisis in 2014 and 2015 that resulted in 12 deaths and dozens more sickened by contaminated drinking water. Lyon’s actions were particularly reprehensible. According to court documents, he “willfully disregarded the deadly nature of the Legionnaires’ disease outbreak, later saying he ‘can’t save everyone,’ and ‘everyone has to die of something.’”

Sponsor Updates

• Meditech releases a new podcast, “Home Care & Population Health.”
• Liaison Technologies will host an IT Leaders Forum on data strategy June 21 in London.
• Meditech will host the 2017 Revenue Cycle Summit June 20-21 in Foxborough, MA.
• Navicure will exhibit at the Florida MGMA 2017 Annual Conference June 21-22 in Orlando.
• Experian Health publishes a new case study featuring Yale New Haven Health.
• Health Catalyst adds Duncan Gallagher (Allina Health) to its Board of Directors.
• The Medical Society of the State of New York will offer its members complimentary access to DrFirst’s e-prescribing and medication management app.
• InterSystems customers Northwell Health and Mount Sinai Health System connect their private HIEs to the New York-based Healthix public HIE.
• ROI Healthcare Solutions will present at Inforum 2017 July 10-12 in New York City.

Blog Posts

• Is “Cloud Slice” the Next “VM” for Hands-on Learning? (Learn on Demand Systems)
• Planning for Collaboration: CMS Emergency Preparedness (LiveProcess)
• Easy as Pie: Most Effective Training Techniques for Learning New Technology (Navicure)
• Interoperability: It’s Time to Get in the Game (Netsmart)
• You Can Book Flights Online – Why Not Medical Appointments (Experian Health)
• Patient Payments and Patient Experience: A Chicken & Egg Scenario (Patientco)
• Brexit Follow-up (Reaction Data)
• Managing the surprisingly troublesome impact of real-time healthcare on decision-making (PerfectServe)
• Testing, it’s not just for IT anymore (Optimum Healthcare IT)
• Healthcare IT’s Relatively Brief and Exciting History (Spok)
• 6 essential tips for adding on Epic’s home care applications (Nordic)
• Interoperability Bubble (ClinicalArchitecture)

Contacts

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

News 6/14/17

Top News

An audit reveals that CMS may have paid out nearly $729 million in improper Meaningful Use incentives between 2011 and 2014. OIG auditors based their estimate on the review of 100 payments – 14 of which were made for incorrect reporting periods, or were based on incomplete verification documentation, and totaled just over $290,000. Auditors also found that CMS should not have paid out $2.3 million to providers who switched between Medicare and Medicaid incentive programs during that timeframe. OIG recommends that CMS recoup the money and undertake a more thorough review of all payments made.

Reader Comments

From OITNB: “Re: Athenahealth/Medhost deal. I think you may have it wrong or that Medhost may have multiple suitors. Allscripts CEO Paul Black was at the Medhost office on the executive floor a few weeks back.”

Webinars

June 22 (Thursday) 1:00 ET. “Social Determinants of Health.” Sponsored by Philips Wellcentive. Presenter: David Nash, MD, MBA, dean, Jefferson College of Population Health. One of the nation’s foremost experts on social determinants of health will explain the importance of these factors and how to make the best use of them.

June 29 (Thursday) 2:00 ET. “Be the First to See New Data on Why Patients Switch Healthcare Providers.” Sponsored by Solutionreach. As patients pay more for their care and have access to more data about cost and quality, their expectations for healthcare are changing. And as their expectations change, they are more likely to switch providers to get them met. In this free webinar, we’ll look at this new data on why patients switch and what makes them stay. Be one of the first to see the latest data on why patients leave and what you can do about it.

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

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

Announcements and Implementations

Torrance Memorial Medical Center (CA) rolls out Mobile Heartbeat’s smartphone-based clinical communications system to its 2,700 team members.

Acquisitions, Funding, Business, and Stock

Genetic testing company Invitae acquires Ommdom, developer of the CancerGene Connect risk assessment and family history analysis tool.

Cognizant plans to acquire TMG Health, a subsidiary of insurer Health Care Service Corp., later this year. TMG, which caters to government-sponsored health plans, will continue to provide IT and business process services to HCSC business units. Cognizant’s largest publicized acquisition was TriZetto in 2014 for $2.3 billion in cash.

People

Erin Trimble (Athenahealth) joins Redox as VP of business development.

GE promotes healthcare lead John Flannery to CEO and chairman elect. GE Healthcare Life Sciences CEO Kieran Murphy will take over Flannery’s role. Murphy will likely devote much of his time to strengthening GE Healthcare’s technology with the relocation of hundreds of tech workers to its office in Boston, as well as with a planned $500 million software spend over the next several years.

Patientco hires Alan Nalle (Accenture Strategy) as chief strategy officer.

The American Medical Association names New Mexico Oncology Hematology Consultants CEO Barbara McAneny, MD president-elect at its annual meeting. She will succeed newly sworn-in Mercy Clinic VP David Barbe, MD.

Tycene Fritcher (Solutionreach) joins health system-focused telemedicine company Avizia as CMO.

Sales

Greater Baltimore Medical Center (MD) selects Phynd’s Enterprise Provider Data Management solution tool to help it manage the data of 15,000 credentialed and referring providers.

Meditech signs up 16 hospitals in the first quarter of 2017.

Technology

Caradigm releases a trio of population health tools to help Medicare ACOs understand clinical and financial risk and utilization patterns, and to identify high-risk patients who may need clinical intervention.

Glytec integrates AgaMatrix’s wireless blood glucose monitoring app with its EGlycemic Management System, giving providers the ability to offer patients more mobile and tailored insulin dosing management between appointments.

Government and Politics

Vice President Pence stresses the president’s focus on repealing the Affordable Care Act during remarks to HHS employees. His main points focused on rising premiums, reduced coverage options due to payers leaving the exchanges, and the number of people dropping out of ACA insurance plans – figures that some have called into question. He emphasized that the Republican-crafted American Health Care Act quietly working its way through the Senate will “transition our healthcare economy away from the regulations and mandates and taxes of Obamacare to a patient-centered healthcare system built on personal responsibility, free-market competition, and state-based reform.”

Innovation and Research

A survey of just over 1,000 consumers finds that only 17 percent believe health-related industries are the most innovative compared to sectors like consumer electronics, telecommunications, and media. Respondents have high hopes for healthcare innovation, though; 70 percent believe health IT will eventually make the biggest impact on their personal health management. They cite wearables, robotics, 3D printing, smart home devices, and AI as technologies likely to make the most waves.

Vanderbilt University Medical Center (TN) researchers create an algorithm based on hospital admissions data that is “80-90 percent accurate when predicting whether someone will attempt suicide within the next two years, and 92-percent accurate in predicting whether someone will attempt suicide within the next week.”

Drones carrying defibrillators to the scenes of heart attacks arrive five minutes after launch – 12 minutes faster than local ambulance services, according to a study featured in JAMA. Drones were launched from a fire station within six miles of where previous cardiac arrests had occurred.

Other

The New York Times looks at the growing role the Dark Web plays in helping opioid-pushing drug dealers sell and ship their products. Thanks to increased potency and decreased size, “enough fentanyl to get nearly 50,000 people high can fit in a standard first-class envelope.”

Sponsor Updates

• The Millenium Alliance advisory firm interviews Arcadia Healthcare Solutions VP Michael Meucci.
• Besler Consulting releases a new podcast, “Completing your Medicare Occupational Mix Survey.”
• CareSync publishes an infographic on annual wellness visits.
• Docent Health will participate in Boston TechJam June 15.
• EClinicalWorks will exhibit at The Private Healthcare Summit 2017 June 20 in London.
• FormFast joins the Salesforce AppExchange.
• HCS will exhibit at the Texas Hospital Association Behavioral Health Conference June 15-16 in Austin.
• The HCI Group customer St. Luke’s University Health Network achieves HIMSS Analytics EMRAM Stage 7 status.
• InterSystems will exhibit at the HIMSS NY Chapter Annual Conference June 20 in the Bronx.
• Meditech South Africa celebrates 35 years.
• InstaMed releases its Trends in Healthcare Payments Annual Report.

Blog Posts

• How 3 P’s Can Transform Your Hospital (Access)
• NCPDP: Engineering Manager, Mark Harris, Presents on Open APIs (CoverMyMeds)
• Enabling the “Data-Driven Organization” – Making the Most of Your Data: The Importance of Metadata Management and Business Intelligence (CTG)
• Catching Up at C-Live (Culbert Healthcare Solutions)
• 7 Hottest Jobs in HIT (Direct Consulting Associates)
• Integrating Statistics into Diver with R (Dimensional Insight)
• Interoperability – Medical data at the point of care (EClinicalWorks)
• What’s the Secret to Effective Physician Alignment? (Evariant)
• 9 Questions to Ask When Winding Down Your Accounts Receivable During an IT Transition (Hayes Management Consulting)
• Valuations Round 2: Health IT SaaS vs. Health IT Non-SaaS (Healthcare Growth Partners)
• The Report on Improving Cybersecurity in the Health Care Industry – where and how to start updating your cybersecurity strategy (Imprivata)
• Healthcare Marketers can Maximize CRM for a Better Consumer Experience (Influence Health)
• What are Omnichannel Payments and Why Do They Matter to Healthcare? (InstaMed)
• Is Health IT Really Ready for a FHIR Takeover? (InterSystems)
• Integration Doesn’t Have To Be Difficult (Access)
• How to Make MyChart as Indispensable as Amazon (Nordic)

Contacts

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

Monday Morning Update 6/12/17

Top News

Cork University Maternal Hospital and University Hospital Kerry in Ireland report significant added expense as a result of their implementations of the nation’s first Maternal and Newborn Clinical Management System. The initial $39.2 million price tag has increased by $785,000 in Deloitte consultancy fees, with millions more expected as 17 additional hospitals prepare to go live on the Cerner-powered system over the next several years. Ireland’s Health Service attributes the over-budget, delayed implementations to a lack of expertise on the part of its clinical and business staff.

Ireland experiences similar woes with its eHealth project, which is “not in a good place,” according to Chief Scientific Adviser Mark Ferguson, adding that the project is moving forward with several initial pilots to help alleviate patient concerns about  the digital storage of PHI. The project will ultimately include the launch of a nationwide EHR, unique identifiers for patients, and capacity for genome-sequencing.

Providers at University Hospital Limerick are particularly depressed with projections that eHealth implementation at their facility could take up to 10 years. The hospital uses a number of different data-sharing systems, and is still plagued by an inefficient paper record-keeping system. “We have many, many computer systems in the health service,” says the hospital’s founding president, Ed Walsh, “but they don’t talk to each other. [The health service is] consumed by inefficient bureaucracy, which is based on a Victorian paper system. And until we move that, we won’t be able to move the resources necessary to provide the healthcare that the patient requires.”

Reader Comments

From Kiwi: “Re: Orion Health’s financials. It seems to be letting an error by HCIT go uncorrected. Their Healthcare Informatics 100 listing cites $193 million in revenue in 2016, but reported financials show a different story (and the company is publicly traded). If my math is correct, the New Zealand dollar has moved between being worth about $.68 to $.74, making their earnings anywhere from $140M to $152M in 2016 and even less this for FY 2017.”

HIStalk Announcements and Requests

The anonymous vendor who donated $500 to my project to fund DonorsChoose teacher grant requests in return for mentioning a survey they’re interested in tells me they’ve almost hit the 100-response mark, which will trigger a second donation even bigger than the first. Providers, please click here and spend just a few minutes to help a classroom in need. Thank you.

Over 75 percent of survey takers would consider switching systems if their vendor became involved in a situation akin to that of EClinicalWorks. It’s All Good contends, however, that “the basis of the allegations/settlement is not a reason to switch. There were defects. They’ve been fixed. But …  a switch could be considered because such a settlement could force the company into insolvency. Or at least support and innovation will suffer as the company tightens its’ proverbial belt so it can pay the fine.” Ross Martin wonders if this will be the tip of the health IT iceberg – one that’s similar to finding out VW wasn’t the only carmaker to game the emissions compliance system. He suspects that, “in the context of the Great Meaningful Use Land Grab of 2009 and the spend-stimulus-fast development of certification criteria, we will find a good amount of fudging among the vendors. Even vendors who complied with the letter of the reg are nowhere near enabling the plug-and-play level of interoperability we need.”

New poll to your right or here: Do you take research studies into consideration when making health IT purchasing or clinical programming decisions? Given the Washington Post’s piece last week on the tendency of journalists to make headlines out of studies they don’t truly understand and/or that are poorly designed in the first place, I’ve been wondering if hospital executives look at them with the same skeptical eye that I do. Your comments, as always, are appreciated.

I decided early on to have only two HIStalk Founding Sponsors, spots held by Medicity and Nuance since around 2007 or so. Nuance’s new marketing crew has decided that sponsoring HIStalk doesn’t interest them, meaning that their Founding spot is therefore available to the first company who commits to taking it over. Contact me at mrhistalk@gmail.com to grab Nuance’s premiere ad position on the page along with the usual Platinum sponsor benefits. Thanks to Nuance for supporting HIStalk for 10 years.

Welcome to new HIStalk Gold Sponsor ZappRx. The Boston-based company solves the inefficient workflow and time drain involved with prescribing specialty drugs. Its platform modernizes the multi-step, manual prescribing process – often involving multiple platforms – to automatically populate prior authorization information, obtain digital patient consent, track prescriptions, and communicate bi-directionally with the specialty pharmacy, reducing administrative burden and improving team collaboration without resorting to phone calls. Patients get their critical therapy faster and more accurately with complete transparency. Practices can estimate their time savings using the company’s online calculator – the average prescription order requires just three minutes of provider time with ZappRX. Thanks to ZappRx for supporting HIStalk.

This Week in Health IT History

One year ago:

• Connecture, a technology company that builds online health insurance marketplaces, acquires ConnectedHealth, a benefits technology platform that helps employers choose health plans.
• Cerner launches a one-year pilot study that will help determine whether patient’s genetic data can play a motivating role in promoting behavior change.
• The VA fires three more administrators within the Phoenix VA Health Care System for “negligent performance of duties and failure to provide effective oversight.”
• In light of voided test results and potential CMS sanctions, Walgreens ends its relationship with Theranos, closing all 40 of its Theranos Wellness Centers in Arizona.
• South Australia looks for a spokesperson to reassure the public that its over budget, behind schedule 80-hospital Allscripts EHR implementation is still a worthwhile investment.

Five years ago:

• Private equity firm TPG Growth acquires critical care systems vendor iMDsoft.
• NIH and the National Cancer Institute announce grants to fund development of tools that empower consumers, patients, and/or their providers.
• A CareFusion site from which medical equipment firmware updates are distributed is found to be loaded with malware, triggering a Department of Homeland Security investigation.
• Steve Larsen, the federal government’s most powerful health insurance regulator responsible for consumer protection and insurance exchanges, quits to become EVP of Optum.

Ten years ago:

• IBA is considering suing CSC and Connecting for Health after CSC blocked its bid to acquire ISoft.
• The Northeastern Pennsylvania RHIO shuts down.
• DoD’s AHLTA EMR system (formerly CHCS II) is running in 138 military treatment facilities.
• Henry Schein tries to expand its medical software line with an offer for Australia’s Software of Excellence International.
• The South Australian Department of Health launches big upgrades of its patient and nursing systems.

Weekly Anonymous Reader Question

Last week’s results: Would you recommend to someone that they switch careers to health IT?

This week’s survey: What characteristics made the worst doctor you’ve ever had so bad?

Last Week’s Most Interesting News

• The VA announces it will shut down its VistA EHR and join the DoD in implementing Cerner Millennium.
• HHS appoints Bruce Greenstein CTO.
• Athenahealth acquires Praxify Technologies for $63 million.
• The Health Care Industry Cybersecurity Task Force releases its report to Congress.
• HHS alerts providers that the WannaCry ransomware attack is still causing problems for several US hospitals.

Webinars

June 22 (Thursday) 1:00 ET. “Social Determinants of Health.” Sponsored by Philips Wellcentive. Presenter: David Nash, MD, MBA, dean, Jefferson College of Population Health. One of the nation’s foremost experts on social determinants of health will explain the importance of these factors and how to make the best use of them.

June 29 (Thursday) 2:00 ET. “Be the First to See New Data on Why Patients Switch Healthcare Providers.” Sponsored by Solutionreach. As patients pay more for their care and have access to more data about cost and quality, their expectations for healthcare are changing. And as their expectations change, they are more likely to switch providers to get them met. In this free webinar, we’ll look at this new data on why patients switch and what makes them stay. Be one of the first to see the latest data on why patients leave and what you can do about it.

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

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

People

Michael Hyder, MD (Southcoast Health) joins Clearsense as president. He will also take on the role of EVP of healthcare delivery at sister company Optimum Healthcare IT.

Apple hires Sumbul Desai, MD (Stanford Center for Digital Health) to join its healthcare team in an unidentified role.

Arik Anderson (Terumo Cardiovascular Systems) joins smart inhaler company Adherium as CEO.

Government and Politics

In a first for the FDA, it asks Endo Pharmaceuticals to stop selling Opana ER – an opioid that has become a favorite among drug users who have taken to crushing it and injecting it or snorting it. If Endo fails to withdraw the drug voluntarily, the FDA will force its removal by revoking its market approval. “We will continue to take regulatory steps when we see situations where an opioid product’s risks outweigh its benefits,” says FDA Commissioner Scott Gottlieb, MD “not only for its intended patient population but also in regard to its potential for misuse and abuse.”

The Secretary of the Navy recognizes Naval Hospital Bremerton (WA) sailors for the parts they played in an ongoing process-improvement program that has so far reduced the Patient Administration Medical Records Division workload by 40 percent, and saved $156,400 and 7,300 man hours a year. In their downtime and with little prior coding know-how, the sailors developed a Medical Records Data Automation Program that now automates the daily operations of the hospital’s medical records department. MRDAP will soon serve as a transition program between the hospital’s Composite Health Care System and the forthcoming Cerner-powered MHS Genesis system. Cmdr. Robert McMahon, Director for Administration, refreshingly adds:

“What is most impressive is these young sailors had no fear of failure and despite no personal or monetary gain they continued to capture the ideas of their coworkers to improve workflows in their department that benefited everyone. Promoting innovation is like growing grass. Sometimes you already have the soil, water and sun. All that is needed is a safe and supportive environment to grow.”

Technology

Healthcare app development company Medable creates Synapse, a cloud-based tool that enables providers to launch CareKit apps for their care teams.

Privacy and Security

After Bronx-Lebanon Hospital Center (NY) and its contractor IHealth sent threatening cease-and-desist letters to the author of DataBreaches.net (who let them know that their PHI was exposed due to an improperly configured server), the hospital tucks tail and asks her to go through the 500 mb of data she used in her original investigation to let them know which patients were affected. The audacity of the request, which did not come with an apology and with which she refuses to comply, prompts her to offer this advice:

• Don’t rush to send legal threat letters. What your mother taught you about catching more flies with honey than vinegar appears true here, too.
• If you wouldn’t send a legal threat to the New York Times over their reporting, don’t send one to me. This site may be small, under-funded, under-staffed, and under-appreciated, but with the support of great law firms like Covington & Burling, this site will always fight back against attempts to erode press freedom or chill speech.

Decisions

• St. Mary Corwin Medical Center (CO) switched From Meditech to Epic in April 2017.
• Perry Memorial Hospital (OK) will switch from Evident to Athenahealth in August 2017.
• Jefferson Regional Medical Center (PA) is switching from Omnicell to BD Automated Dispensing Cabinets. The conversion process started last month.

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

Innovation and Research

A survey of executives from 104 healthcare organizations points to AI as the next big thing when it comes to transforming the way the industry interacts with patients: 84 percent believe AI will “revolutionize” their encounters with healthcare consumers, while 72 percent report already using virtual assistants. Their interest in AI will likely fuel their near-term efforts to better understand what consumers want even before they articulate it. Eighty-one percent feel organizations should shape digital health tools based on patient preference rather than their own. A similar percentage believe those that understand the motivations behind consumer behavior will ultimately win the day.

Other

McKesson CEO John Hammergren drops the price of his $22 million compound in San Francisco by $6 million after watching it sit on the market for a year. The solar-powered estate consists of a main house with six bedrooms and 10 bathrooms; a sports complex with tennis, bocce, racquetball, and squash courts, plus a gym, rock climbing wall, steam room, sauna, yoga center, and spa; and a carriage house with a five-car garage, car wash station, and banquet hall. The accompanying pool and spa have their own pool house.

Sponsor Updates

• QuadraMed, a division of Harris Healthcare, will exhibit at the MaHIMA Annual Conference June 11-13 in Boston.
• Salesforce publishes its “2017 Connected Patient Report.”
• Kyruus wins the “Best Healthcare Big Data Platform” Award from MedTech Breakthrough.
• CRN names Impact Advisors to its 2017 Solution Provider 500 list.
• Senator Cory Booker (D-NJ) helps to christen Conduent’s new global headquarters in New Jersey.
• Gartner names AdvancedMD a leader in its FrontRunners for Mental Health Quadrant.
• Encore publishes a new white paper discussing the role of data governance in the shift to value-based care.

Blog Posts

• Why you shouldn’t delay your EHR upgrade (Nordic)
• 2017 Healthcare Revenue Cycle Management Challenges Met by Technology (The SSI Group)
• Why Group Messages are Better Than Mass Messages (Solutionreach)
• Why providers burn out on EHR documentation – and how to fix it (Nordic)
• How surveillance tools help nurses to focus on their patients (Meditech)
• Better Actionable Intelligence Means Better Healthcare for All (Surescripts)
• Better healthcare in Boise. (Voalte)

Contacts

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

News 6/9/17

Top News

Athenahealth acquires EHR optimization vendor Praxify Technologies for $63 million. The six year-old company employs 80 at its office in Palo Alto, CA and maintains a development presence in India. Athenahealth CTO Prakash Khot is enthusiastic about the benefits Praxify’s machine learning and natural language-processing capabilities will bring to the company’s cloud-based products. Praxify is perhaps best known for its Mira voice-enabled charting technology.

Reader Comments

From AirStrip Technologies CEO Alan Portela: “Re: Rumored NantHealth acquisition. AirStrip has not been acquired and continues to gain momentum in the industry. AirStrip has formed a strategic alliance and commercial agreement with NantHealth that leverages synergies between the AirStrip One mobile interoperability platform and the Nant platform, particularly in the areas of data aggregation, normalization, real-time data streaming and visualization. Our alliance will focus initially on supporting clinical workflows in acute-care settings, with a gradual move toward post-acute and community-based care settings.”

From GraySky: “Re: Athenahealth/Medhost deal. Athenahealth is in due diligence conversations to acquire all or part of the Medhost products. It’s looking to get access to the small community and rural hospital market that Medhost has access to with its inpatient and ED solutions. Cerner officially passed up Medhost late last year after doing due diligence. Valuation was too high in the area of $200M-$400M. Shrinking customer base that includes only a few large customers that are evaluating conversion to Cerner or Epic. Aging product suite.” Athenahealth declined to confirm or deny.

HIStalk Announcements and Requests

This week on HIStalk Practice: Siemens Healthineers finalizes its acquisition of Medicalis. Merritt Hawkins releases its annual physician recruitment/salary report. Mindcotine hopes to use virtual reality to help smokers kick the habit. Brad Boyd outlines ways to leverage MACRA to support long-term strategic goals in the Consultant’s Corner. Plaintiff dismisses lawsuit against MDLive. Hematology-Oncology Associates of Central New York nearly suffers a $250k loss due to clerical error. Salus Telehealth finds an untapped telemedicine market in summer music tours. EClinicalWorks adds telemedicine capabilities to its app. Thanks for reading.

Webinars

June 22 (Thursday) 1:00 ET. “Social Determinants of Health.” Sponsored by Philips Wellcentive. Presenter: David Nash, MD, MBA, dean, Jefferson College of Population Health. One of the nation’s foremost experts on social determinants of health will explain the importance of these factors and how to make the best use of them.

June 29 (Thursday) 2:00 ET. “Be the First to See New Data on Why Patients Switch Healthcare Providers.” Sponsored by Solutionreach. As patients pay more for their care and have access to more data about cost and quality, their expectations for healthcare are changing. And as their expectations change, they are more likely to switch providers to get them met. In this free webinar, we’ll look at this new data on why patients switch and what makes them stay. Be one of the first to see the latest data on why patients leave and what you can do about it.

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

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

People

Former CMS Chief Data Officer Niall Brennan joins the Health Care Cost Institute as president and executive director.

Digital diagnostics services company Analyte Health appoints Kevin Weinstein (Valence Health) CEO. Former CEO Frank Cockerill, MD will take on the position of CMO.

Announcements and Implementations

Einstein Healthcare Network (PA) selects Teladoc to help it jumpstart a telemedicine program that will initially focus on the health system’s 8,500 employees.

Rush University Medical Center (IL) starts a three-month pilot of Proteus Digital Health’s Discover smart pill sensor, one that is added directly into traditional pills. The sensor detects when the pill has been ingested via a patch worn on the patient’s stomach, and then sends a signal updating an app with medication adherence data.

Humber River Hospital in Toronto works with GE Healthcare to build a 4,500 square-foot digital command center that will aggregate and analyze real-time data from systems across the hospital to help improve staff workflows and patient care.

Technology

Meditech adds MModal’s Fluency Direct speech-recognition dictation capabilities to its Web EHR.

Apple updates the ResearchKit app to include new tests related to range of motion, and selective and visual attention.

Cerner will integrate CareVive’s care planning software with its PowerChart Oncology EHR.

Nuance adds PowerScribe Workflow Orchestration and PowerScribe Lung Cancer Screening to its line of screening program tools for radiologists.

Nuance seems to have quietly acquired San Mateo, CA-based radiology solutions company Primordial, its partner in developing the aforementioned technologies.

Privacy and Security

From DataBreaches.net:

• Southwest Community Health Center (CT) notifies patients of a potential data breach resulting from two separate break-ins during which burglars took several computers. No mention is made of whether or not the devices were encrypted. The center is offering affected individuals free identity monitoring and restoration services.
• Mississippi’s Medicaid Division alerts 5,220 people of potential PHI exposure stemming from six online forms managed by a third party that were sent to staff via unencrypted emails for nearly three years.
• Public school guidance counselor and West Carolina Counseling Services owner Joseph Korzelius admits to using information from his sessions with elementary students to file $450,000 worth of false Medicaid claims. He faces up to 10 years in jail and a $250,000 fine.

Innovation and Research

A team of researchers from MIT and Harvard develop a proof-of-concept tattoo ink that changes color based on metabolism changes in the body, allowing the tattoo to act as a low glucose or dehydration indicator.

Healthcare researchers call out the tendency of journalists to create headlines out of health studies that are “deeply flawed,” citing several articles related to the tenuous (and later debunked) claim that EHRs do in fact lead to improved outcomes. “Health care already consumes almost a fifth of America’s GDP — two or three times every other nations’ costs despite our often inferior outcomes,” they write in their conclusion. “It is vital that all stakeholders — journalists, scientists, policymakers, editors and the public — have a better understanding of basic research design and data interpretation. During this unusual moment in history, when politicians seek out whichever facts suit their ideology, the role of good science — and good reporting — could not be more vital.”

A Black Book survey finds that an overwhelming majority of hospital executives and managers will ultimately look to population health management-focused IT as patient accounting systems as they continue to shift their organizations to value-based care. Allscripts, Cerner, and Epic seem to have the most mindshare of those surveyed.

Government and Politics

President Trump decides to keep Francis Collins, MD on as head of NIH, a position he has held since 2009.

A VA spokesman confirms that Cerner will replace only the agency’s EHR, and that Epic’s $624 million contract to implement an appointment scheduling program for the VA is not in jeopardy.

HHS appoints Bruce Greenstein CTO. Greenstein was most recently president of behavioral health tech company Quartet Health, and served under Louisiana Governor Bobby Jindal as secretary of the Dept. of Health and Hospitals.

Other

The Government of Nova Scotia narrows the field of contenders for a “One Person, One Record Clinical Information System” to Allscripts and Cerner. Based on the procurement listing sent over by HITGeek, it looks like they beat out Evident, Harris Healthcare, and Meditech in preceding rounds that began last December.

In other northern health IT news, the provincial auditor of Saskatchewan recommends the Ministry of Health replace its 50 year-old IT system with one that can better screen the billing activity of physicians that are still paid on a fee-for-service basis. The auditor also recommends the development of standard criteria to more efficiently identify physicians whose billing practices should be investigated.

E-prescribing of controlled substances increased year over year by 256 percent, according to the latest progress report out from Surescripts. Nearly 75 percent of prescriptions in 2016 were electronic, totaling 1.6 billion.

Sponsor Updates

• Meditech customers lead lists of five-star and double five-star hospitals.
• Liaison Technologies will exhibit at the Cerner North Atlantic Regional User Group June 12-14 in Springfield, MA.
• MedData will exhibit at the Ohio Hospital Association Annual Meeting June 12-14 in Columbus.
• Medecision, NTT Data, RelayHealth, Surescripts, and ZeOmega will exhibit at AHIP Institute & Expo June 7-9 in Austin, TX.
• Meditech releases the latest installment of its video series, “EHealth Partnership Unites Ontario Hospitals on Meditech.”
• Frost & Sullivan recognizes Medicomp Systems with the 2017 Enabling Technology Leadership Award.
• National Decision Support Co. adds Society of Nuclear Medicine and Molecular Imaging Appropriate Use Criteria to its CareSelect Imaging system.
• Navicure will exhibit at the NJ MGMA conference June 14-16 in Atlantic City.
• Experian Health will present at the HIMSS Brand IT Marketing Conference June 15 in Las Vegas.
• YourStory.com profiles GE Healthcare’s efforts to bring healthcare accessibility and skills to rural areas in India.

Blog Posts

• Rockin’ the Suburbs and ESignatures (Access)
• Are You Ready for a Chief Data Officer? (Liaison Technologies)
• Aligning Technology, Leadership and Organizational Culture in Healthcare Providers (NetSmart)
• Defining a Legacy EMR/PM Strategy (Mica Health)
• Meditech 6.x Implementation Phases part 8: Post-Live (Parallon Technology Solutions)
• DocRank: Computer Science Capstone Project with the College of Charleston (PokitDok)
• The 7 health IT presentations you won’t want to miss in 2017 (Advisory Board)
• Are you Investing Time in an Exceptional Training Program? (Optimum Healthcare IT)

Contacts

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

News 6/7/17

Top News

VA Secretary David Shulkin, MD announces the VA will shut down its VistA EHR and join the DoD in implementing Cerner Millennium, explaining, “The VA’s adoption of the same EHR system as DoD will ultimately result in all patient data residing in one common system and enable seamless care between the Departments without the manual and electronic exchange and reconciliation of data between two separate systems.”

HIStalk readers (who predicted the Cerner decision in a reader survey earlier this year) didn’t waste time weighing in once the news crossed the wire yesterday – nearly a month before Shulkin’s self-imposed decision deadline. VA Worker says, “Here we go again. VA wants to replace VistA with Cerner but will never be able to afford it.” USA First? points out that, for all the Trump Administration’s efforts to keep American jobs on American soil, they’ve chosen a vendor that has sent 3,000 software jobs overseas.

Epic also shared its reaction via a presumably non-marketing rep: “As the largest electronic health record vendor in the United States, covering two-thirds of the nation’s patients, we are proud to serve our veterans both through the VA scheduling project and through our customers that care for millions of veterans across America. These customers are the top health systems in America and we stand with them, committed and eager to ensure veterans get the very best medical care regardless of where they receive it.” 

My thoughts are these: Cerner was the only reasonable choice since the DoD had already selected it, but it’s still surprising they went without bidding and named Cerner before negotiation with them began (that’s more of how Epic customers buy software). The company will presumably have more control over naming its price than it did with DoD, where it was a subcontractor under Leidos, and it may be that Cerner gets to keep all the money this time. It’s also to the company’s strong negotiating advantage that both Congress and the President have publicly cheered the VA’s choice of Cerner, making it unlikely that the VA wants to rule out Cerner over price negotiations. The VA has previously suggested that its price tag will be multiples of the DoD’s, perhaps well over $10 billion to $12 billion.

The systems will be theoretically interoperable, but there’s still a lot of work to be done to standardize terminology and functionality to make even the same system talk to another user whose workflows and use cases are different. There’s probably still a lot of consulting work required. It will be interesting to see which firms attempt to feed at the trough of this contract, as well as whether or not the VA and DoD will truly work as a single customer. Will Cerner and the inevitable consultants get stuck trying to broker agreements on major decisions so they don’t end up creating dissimilar systems?

It’s also worth noting that project timelines will need to be synched to avoid temporary interfaces to the legacy systems. Ironically, having the same system may require more VA-DoD cooperation than running separate ones. On the flip side, it’s also important to recognize that the VA and DoD have vastly different needs, and that in the case of the VA (unlike the DoD), its VistA system contains a lot of VA-specific non-clinical functionality, such as management modules for departments that aren’t involved in patient care. VistA is not just an EHR.

Reader Comments

From Mighty Med: “Re: Walnut Hill Medical Center closure. The self-touted hospital of the future abruptly shuts its doors after being open for less than three years. It’s just another example of healthcare disruption gone awry.” The $100 million, 100-bed Dallas hospital did indeed cease operations as of June 1, citing only it’s decision to no longer participate in the Medicare program. A former employee wrote a Facebook farewell message (later taken down) praising his colleagues for working without the “unlimited resources” of traditional hospitals, implying that it was struggling in some way. Officials touted the facility as being designed “completely from the patient’s perspective to create a stress-free atmosphere for healthy recovery.“

From Just Wondering: “Re: John Fleming’s desire for a single unified EHR. Is he as stupid as he sounds?” Hardly. The former Louisiana representative, businessman, and MD has done stints at the Navy Regional Medical Center (CA) and in private practice. He implemented his first EHR in 1997 and went fully paperless two years later. Fleming’s belief that “every American should have a single, unified electronic health record system that resides in the cloud and is under full control of the patient, of the individual, of the American” is the same pipe dream that dozens, if not hundreds, of health IT companies and venture capital firms have been throwing millions of dollars at for years. As the new deputy secretary of health technology reform, he’s becoming privy to the many public- and private-sector interests that will keep that pie-in-the-sky patient record from being developed anytime soon.

HIStalk Announcements and Requests

An anonymous vendor has graciously donated $500 to my project to fund DonorsChoose teacher grant requests in return for mentioning a survey they’re interested in. They’ll also donate a bunch more money if the survey gets at least 100 responses. Providers, please click here and spend a handful of minutes and together we’ll to help a classroom in need. Thanks.

Webinars

June 22 (Thursday) 1:00 ET. “Social Determinants of Health.” Sponsored by Philips Wellcentive. Presenter: David Nash, MD, MBA, dean, Jefferson College of Population Health. One of the nation’s foremost experts on social determinants of health will explain the importance of these factors and how to make the best use of them.

June 29 (Thursday) 2:00 ET. “Be the First to See New Data on Why Patients Switch Healthcare Providers.” Sponsored by Solutionreach. As patients pay more for their care and have access to more data about cost and quality, their expectations for healthcare are changing. And as their expectations change, they are more likely to switch providers to get them met. In this free webinar, we’ll look at this new data on why patients switch and what makes them stay. Be one of the first to see the latest data on why patients leave and what you can do about it.

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

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

Acquisitions, Funding, Business, and Stock

Learning management systems vendor Relias Learning acquires WhiteCloud Analytics for an undisclosed sum. Reliance has been on a bit of a spending spree since March of last year, acquiring six other companies including analytics firm Care Management Technologies.

Aegis Health merges with digital marketing firm Clariture to form Trilliant Health. The companies will retain their brands as separate business units.

Announcements and Implementations

Mayo Clinic (MN) will use 2bPrecise’s clinical genomics solution to add genomic information into its Epic EHR. The organizations will also work together to research and develop genomics-based care protocols, particularly for patients with cardiovascular genetic disease.

Aprima announces record growth for the fiscal year, including revenue, customer retention rate, and the relocation and expansion of its headquarters.

Technology

Apple announces new devices and features at its developers conference – none of which are all that earth-shattering and only some of which are relevant to healthcare. The company will attempt to keep up with the virtual assistant Joneses with the introduction of a Siri-powered HomePod. It has added AI capabilities to its Watch, giving it the ability to serve up motivational fitness messages when steps are down. Users will also be able to link their devices to Dexcom’s glucose sensor via a new API. Perhaps the most potentially life-saving enhancement is the Iphone’s forthcoming “do not disturb while driving” feature, which shuts off all distracting notifications when the phone is connected to your car.

Casenet develops a prior authorization submission and tracking tool.

PointClickCare adds Ability Network’s claims management capabilities to its EHR for long-term and post-acute care providers.

Safety Net Connect releases an enterprise version of its Converge referral and care coordination technology that brings together behavioral and physical health, and social services.

ICare adds order sets and care plans from Zynx Health to its EHR for acute care providers and SNFs.

Government and Politics

ONC announces the winners of its Privacy Policy Snapshot Challenge, the aim of which escapes me as the number of these contests seems to increase in direct correlation to the market-worthy usefulness of their winning ideas.

Sales

Tufts Medical Center (MA) chooses ZappRx to automate the ordering of specialty drugs, expecting to reduce the average prescribing time from 20 minutes to three minutes.

Children’s Hospital of Wisconsin selects CRM software from Healthgrades.

Privacy and Security

HHS alerts providers to the “significant” challenges two unnamed multi-state hospital systems are still experiencing as a result of WannaCry malware, noting that the virus can live on a machine that has been patched, and that its repeated attempts to scan can disrupt Windows operating systems.

Innovation and Research

Early performance data on IBM Watson for Oncology shows that Watson-generated treatment plans for 362 cancer cases were found to be in line with oncologist recommendations in 96 percent of lung, 81 percent of colon, and 93 percent of rectal cancer cases.

People

Michael Caponetto (West Health) joins government healthcare program services company SynerMed as CFO.

Other

The New York Times addresses the “virtual velvet rope” creeping into healthcare – one that is moving beyond celebrities and sheikhs taking over hospital wings and turning the more mundane world of direct primary care into one of ultra high-end concierge practices. Private Medical, for instance, charges between $40,000 and $80,000 per year per family for round-the-clock physician access and near-immediate access to specialists and hospitals across the country. Launched by HealthLoop founder Jordan Shlain, MD in 2002, the company has almost no Web presence, gaining new patients almost exclusively through word of mouth.

Sponsor Updates

• Direct Consulting Associates donates fabric and stuffed animal kits to help middle-school students make stuffed animals, blankets, and pillows for local charities.
• ClinicalArchitecture partners with OpenAirWare to more easily integrate patient data from standard clinical information exchange formats with its Advanced Clinical Awareness Suite.
• Software Advice names AdvancedMD a 2017 Mental Health FrontRunners Quadrant Leader.
• Agfa HealthCare successfully completes the recertification audit cycle for its information security management system.
• Aprima Medical Software will exhibit at the NJ MGMA meeting June 14-16 in Atlantic City.
• Bernoulli Health will exhibit at AAMI Conference and Expo June 9-12 in Austin, TX.
• Besler Consulting releases a new podcast, “Looking at price data on local healthcare markets across the United States.”
• Kyruus will host its ATLAS Conference on patient access September 19-20 in Boston.
• Casenet, Cumberland Consulting Group, EClinicalWorks, InstaMed, and InterSystems will exhibit at AHIP Institute & Expo June 7-9 in Austin, TX.
• Dimensional Insight remains a top performer in the Wisdom of Crowds 2017 Business Intelligence Market Study.
• Casenet clients and employees donate gift bags to children at CHA Cambridge Hospital (MA).
• ECG Management Consultants will present at the 2017 Science of Team Science Annual Conference June 13 in Clearwater, FL.
• Glytec will exhibit at the American Diabetes Association Scientific Sessions June 9-13 in San Diego.
• Healthwise will exhibit at the Cerner North Atlantic Regional User Group June 12-14 in Springfield, MA.
• Iatric Systems will exhibit at the NCHICA AMC Security & Privacy Conference June 12-14 in Chapel Hill, NC.
• The Atlanta Business Chronicle names Ingenious Med a “Pacesetter” for the fifth consecutive year.
• Kyruus will exhibit at the Annual Conference of Healthcare Call Centers June 7-9 in Salt Lake City.
• Inc. Magazine includes PMD on its list of best places to work.
• Definitive Healthcare CEO Jason Krantz is named a finalist for E&Y’s Entrepreneur Of The Year 2017 New England Award.
• Imprivata releases a new report, “High-value, complex clinical workflows require enhanced communications capabilities.”

Blog Posts

• Medication Adherence in the Safety Net: Where Simple Innovations Make Big Impact (FDB)
• 5 areas to focus your 2017 MIPS strategy (Nordic)
• CMS Quality Payment Program – MIPS Path (Culbert Healthcare Solutions)
• Take Action Now to Protect Your Online Information (Dynamic Computing Services)
• Key Takeaways from the 2017 Wisdom of Crowds BI Market Study (Dimensional Insight)
• Healthcare Informatics: One-On-One with CEO Jason Mabry (Optimum Healthcare IT)
• Putting ClinicalKey in doctors’ hands through Research4Life’s developing country access (Elsevier Clinical Solutions)
• Can interoperability defeat the asymmetry beast? (EClinicalWorks)
• The Art & Science of Understanding Physician Activity and Referral Patterns (Evariant)
• 5 Cool Things in Healthcare (Hayes Management Consulting)
• Three considerations when implementing two-factor authentication (Imprivata)
• A Healthcare CIO’s Consumer Experience Wish List (Influence Health)
• A quick and painless intro to rolling out your EHR (Nordic)
• 10-Step Guide to Securing Data at Your Hospital (Spok)

Contacts

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

Monday Morning Update 6/5/17

Top News

The Health Care Industry Cybersecurity Task Force releases its slightly overdue report to Congress, detailing six high-level directives over the course of 88 pages:

• Define and streamline leadership, governance, and expectations.
• Increase the security and resilience of medical devices and health IT.
• Develop the workforce capacity necessary to prioritize and ensure cybersecurity awareness and technical capabilities.
• Increase industry readiness through improved cybersecurity awareness and education.
• Identify mechanisms to protect R&D efforts and intellectual property from attacks or exposure.
• Improve information sharing of industry threats, risks, and mitigations.

CHIME has published a far less intimidating 11-page summary of the report’s 100-plus recommendations. HHS officials have thus far been mum on the forthcoming HHS cybersecurity center’s role in fleshing out the recommendations.

Reader Comments

From Jet Blue: “Re: AirStrip Technologies. I met with a prominent venture capital firm today, and we discussed the many high-flying digital health companies that have been funded over the last few years. I learned that AirStrip Technologies has been acquired by Patrick Soon-Shiong, MD. He intends to combine AirStrip with his other companies such as ISirona and Harris CareFx. Apparently the deal is being kept under wraps.” Unverified. ISirona and Harris are among the eight companies NantHealth has acquired over the last six years. AirStrip has flown fairly under the radar this year, and issued just a handful of press releases in 2016. I interviewed President Matt Patterson, MD last March.

From HIT Apostle: “Re: Integration. We are exploring different options for how to best integrate EHR data into our analytics product suite. This would include becoming HIPAA compliant, hiring an ETL team, and adding data processes to our operating model. Have you ever asked your readers what a ballpark figure cost is for this? Are there more cost efficient options, like working with an integration vendor, such as Redox?” I don’t believe I have, so I’ll invite readers to comment with advice and experiences.

HIStalk Announcements and Requests

A HIStalk sponsor and Donors Choose supporter asked me to share this survey on EHR services. They plan to double their already sizable donation once they reach 100 responses.

It’s almost an even split when it comes to the benefits readers believe CommonWell brings to patients, a stat that MC calls into question: “Something very funny happened with this poll. When there were about 80 to 100 responses it was OVERWHELMINGLY leaning towards LESS THAN EXPECTED. Now it is 244 to 252?” April isn’t crazy about how the poll was worded: “Voting ‘less than expected’ (regardless of whether your expectations were very high) leaves the poll results looking like CW isn’t doing anything to benefit patients. ‘More than expected’ indicates you didn’t expect it to do much to begin with. I like the fact that CW is showing steady progress in addressing some of the hardest issues in interoperability. I also like the fact that they opened up the ability for patients to initiate their own record search earlier this year.”

New poll to your right or here: Would you consider switching EHRs if your vendor was involved in a legal situation similar to that of EClinicalWorks? Feel free to add write-in commentary regarding what vendor(s) you would put at the top of your shopping list and how much weight certification would carry.

This Week in Health IT History

One year ago:

• Rumors surface – again – that McKesson is considering selling or merging its McKesson Technology Solutions business unit in the face of drug pricing pressures.
• Intermountain Healthcare, Stanford Cancer Institute, and Providence Health & Services launch a genomic data-sharing network.
• Vice President Biden forms the Genomic Data Commons, an open-access cancer database that will help researchers collaborate and share information, as part of his Cancer Moonshot.
• Practice Fusion settles with the FTC over charges that it misled consumers by asking for reviews of their physicians without adequately disclosing that those reviews would be posted publicly online.
• The House passes the Helping Hospitals Improve Patient Care Act, exempting ambulatory surgical centers from MU and MIPS penalties.

Five years ago:

• Microsoft and GE Healthcare complete the formation of their 50-50 join venture Caradigm.
• Allscripts nominates a three-member board slate to settle a lawsuit and proxy fight brought by key shareholder HealthCor Partners.
• Kaiser’s Oakland hospital gets hit with a $75K Department of Health fine for a 2010 incident in which nurses ignored a telemetry patient’s tachycardia alarms.
• Data analytics vendor MedAssurant changes its name to Inovalon.
• In the UK, Brighton and Sussex University Hospitals NHS Trust is fined $500,000 when hard drives containing the medical information of patients were sold on eBay.

Ten years ago:

• Healthcare management company MED3OOO becomes a major stakeholder in Scottsdale-based InteGreat Concepts.
• Allscripts and NaviMedix announce an agreement to provide Allscript’s eRx NOW ePrescribing solution to NaviMedix’s network of more than 190,000 physician customers.
• David Brailer launches a $700 million private equity fund, Health Evolution Partners.
• Walgreens licenses kiosk and EMR software from Ethidium Health Systems for use in its Take Care Health Systems retail clinics.
• Duke Clinical Research Institute concludes that extra pay does not improve hospital performance.

Weekly Anonymous Reader Question

Last week’s results were slim, indicating that either I asked for too much or that readers don’t have much experience with mentor/mentee relationships (which I doubt given the interest in our webinar on that very topic several weeks ago). Here are the responses I received:

• I work in a company full of people who are almost all fantastic at their jobs. I try to identify the strongest skills in the people I work with most often, and then I emulate them when in relevant situations. As my assignments change, the people and skills I’m exposed to change, so I continue to develop further.
• They listen when I have a complaint – about life or work, they listen. Occasionally some wisdom comes back, but they mostly know just to listen and let me be heard.

This week’s survey: Would you recommend to a relative or colleague that they switch careers to health IT? Why or why not?

Last Week’s Most Interesting News

• EClinicalWorks will pay $155 million to settle DOJ False Claims Act allegations.
• Tablet-based patient education and pharmaceutical advertising vendor Outcome Health raises $500 million.
• Ascension-owned Seton Healthcare (TX) goes back to paper after detecting suspicious activity on its network.
• 21st Century Oncology (FL) files chapter 11 bankruptcy.
• The VA’s IT budget is reduced as it grapples with the decision to either modernize VistA or implement a commercial EHR.

Webinars

June 22 (Thursday) 1:00 ET. “Social Determinants of Health.” Sponsored by Philips Wellcentive. Presenter: David Nash, MD, MBA, dean, Jefferson College of Population Health. One of the nation’s foremost experts on social determinants of health will explain the importance of these factors and how to make the best use of them.

June 29 (Thursday) 2:00 ET. “Be the First to See New Data on Why Patients Switch Healthcare Providers.” Sponsored by Solutionreach. As patients pay more for their care and have access to more data about cost and quality, their expectations for healthcare are changing. And as their expectations change, they are more likely to switch providers to get them met. In this free webinar, we’ll look at this new data on why patients switch and what makes them stay. Be one of the first to see the latest data on why patients leave and what you can do about it.

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

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

People

Aviacode hires David Fong (Gebbs Healthcare Solutions) as VP of marketing and communications, and Jordan Stannard (IMedx) and Byron Triplett (Gebbs Healthcare Solutions) as regional sales executives.

Acquisitions, Funding, Business, and Stock

Health insurance startup Bright Health raises $160 million in a Series B round led by Greenspring Associates. Co-founded by former UnitedHealthcare CEO Bob Sheehy, the Minneapolis-based company works with health systems looking to package insurance plans with their clinical services.

Decisions

• The University Of South Alabama Health System (AL) plans To switch from Siemens Soarian to a new Cerner EHR.
• Buchanan County Health Center (IA) switched from Meditech to Epic in March.
• Girard Medical Center (KS) outpatient clinics will go live with the Prognosis Ambulatory EHR in Q3 2017.
• Platte Valley Medical Center (CO) will switch from Siemens Soarian to Epic on May 30.

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

Announcements and Implementations

Reaction Data publishes a new report on the UK imaging market. Carestream, Sectra, and Agfa Healthcare have the best foothold on enterprise business across the pond.

Hackensack Meridian Health (NJ) will add Cota Healthcare’s precision medicine technology to its five-month pilot of IBM Watson as a clinical decision support tool for oncologists. The trial will involve 10 physicians and up to 500 patients.

Sales

Memorial Hospital (IL) will convert from Meditech to Cerner early next year.

Lewis County General Hospital (NY) considers upgrading to Meditech 6.1. Director of Information Systems Robert Uttendorfsky anticipates that transition will cost at least $1.5 million and take 18 months.

St. Luke’s Health System (ID) will deploy Voalte’s communications technology across its eight hospitals.

The Queen’s Health Systems (HI) will integrate Recondo Technology’s ClaimStatusPlus with Epic. The organization got its start in 1859, when Queen Emma and King Kamehameha IV went on a door-knocking tour to raise funds for what would become The Queen’s Medical Center. It is the first (and perhaps only) health system in the US to be founded by royalty.

Government and Politics

HHS Inspector General Daniel Levinson releases OIG’s semi-annual report to Congress, highlighting challenges related to protecting the privacy and security of the data it collects and maintains, as well as “effectively using data to detect and prevent improper payments and to ensure safety and quality of care for program beneficiaries.”

Privacy and Security

From DataBreaches.net:

• Appthority dubs a new backend data exposure risk HospitalGown, outlining in the cheekily titled report above the havoc it could wreak in enterprise environments.
• Identity management system company OneLogin experiences a data breach, putting the information of the Stanford School of Medicine (one of its biggest customers) at risk.
• An unspecified IT issue at The Cosmetic Institute in Australia causes a private index of patient data – including pre- and post-surgery photos, Medicare numbers, and other intimate patient details –  to become publicly accessible via the surgery’s website.

Innovation and Research

MIT Technology Review reports on 23andMe’s decision earlier this month to ask its customers for help in conducting research on pain tolerance. The consumer-friendly genetics company aims to enroll 20,000 people to take surveys on pain tolerance and pain history; 10,000 of those will conduct at-home cold pressor tests, where subjects stick their hand in ice for up to three minutes. The data will likely be used to inform studies on personalized pain medication.

Other

Doctors of BC President Alan Ruddiman, MD cites a “broken culture” at Island Health and its Nanaimo Regional General Hospital as one of the main reasons for continued physician dissatisfaction with the Vancouver health authority’s $135 million Cerner implementation. According to Ruddiman, such discontent has led to physician burnout and resignations – a state of affairs that will not only affect patient care, but the community, too. “If the medical personnel are hurting and they are uncoupling from this hospital then it’s only a matter of time where this gets known as a community that’s not an attractive place to live and work and that hurts everybody …” he added.

The local paper casts Judy Faulkner-like aspirations onto VitusVet founder Mark Olcott, an entrepreneurial veterinarian working to make pet health records interoperable, and appointments and prescriptions easier to fill. Focusing on practices with four or more vets, the company hopes to pass the $1 million revenue mark this year after grossing a quarter of that in 2016.

Sponsor Updates

• LogicWorks develops a new set of DevOps tools for running applications on the AWS cloud.
• Inc. Magazine includes Nordic in its list of “Best Workplaces 2017.”
• NTT Data Services wins the “Deal of the Year” award for its acquisition of Dell Services.
• Clinical Computer Systems, developer of the Obix Perinatal Data System, PatientKeeper, and Wellsoft will exhibit at EHealth Canada June 4-7 in Toronto.
• Experian Health will host its Connect Health Conference June 6 in Chicago.
• The SSI Group will host a regional user group meeting June 6-7 in New York City.
• Surescripts and ZeOmega will exhibit at the AHIP Institute & Expo June 7-9 in Austin, TX.
• TransUnion publishes “No More Surprises: Increase POS Collections with Pre-Care Cost Estimates.”
• Versus Technology will host an open house at its new Bayside Education & Visitor Center June 7 in Traverse City, MI.
• Huron releases a video, Transforming Healthcare, featuring Harvard Business professor and author Clayton Christensen.
• ZirMed publishes a new e-book, “Leveraging Predictive Analytics to Ensure Professional Revenue Integrity.”
• Diameter Health publishes a new video featuring Chief Strategy Officer John D’Amore and Kansas Health Information Network Executive Director Laura McCrary.
• Encore, a Quintiles company, outlines what providers need to become Advanced APMs under MACRA in this white paper.

Blog Posts

• Emergency Preparedness Training and Testing: CMS Rule (LiveProcess)
• Empowering patients with digital innovation and design thinking (Meditech)
• Willow Health Care in Drivers Seat Cruising Down Road to Success (Netsmart)
• The New CISO Leader (Orchestrate Healthcare)
• The Evolution of Clinical Mobility: Unifying Communication and Workflow (PatientSafe Solutions)
• Notes from the Field: Consensus 2017 (PokitDok)
• The important role nurses play in care transition and reducing readmissions (PerfectServe)
• ROI Celebrates Annual Red Nose Day (ROI Healthcare Solutions)
• The Importance of Simulations in EHR Training (Sagacious Consultants)
• How to Know When to Quit (Salesforce)
• Consumer Impacts Patient Satisfaction: What Healthcare Providers Can Do (The SSI Group)
• Improved Patient Communication Can Help Save Lives (Solutionreach)
• Supporting Project C.U.R.E. at 2017 ASE (UltraLinq)
• From the HEDIS 2017 Trenches: The Final Countdown (Verscend Technologies)
• Picking up the pace. (Voalte)
• The Missing Ingredient to Building Healthy Communities (Conduent Health)
• Promoting Patient Engagement with Care Plans (Zynx Health)
• Human Error, Not Hacking, Most Common Cause of Data Breaches at VA Hospitals (Definitive Healthcare)

Contacts

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

News 6/2/17

Top News

Doctor office advertising and patient education technology company Outcome Health raises $500 million in funding, valuing the Chicago-based company at $5 billion.

Forbes estimates that the 31-year-old co-founder Rishi Shah owns 80 percent of the company’s shares, giving him a paper net worth of $3.6 billion.

Forbes also estimates that the company’s annual revenue is $200 million and it’s growing 100 percent per year, with most of the money coming from drug companies anxious to get their message in front of patients at an opportune time.

Vivek Kundra, the first US CIO, is a company EVP.

HIStalk Announcements and Requests

Tuesday’s HIStalk page views exceeded 10,000, which isn’t a record or even all that much higher than the usual daily traffic, but it’s the highest count during a non-HIMSS week other than June 28, 2016 (when McKesson announced that it would divest its Technology Solutions business) and July 30, 2015 (when the DoD awarded Leidos/Cerner its EHR contract).

I thought it would be interesting to look at the percentage of females serving on the executive teams of the top five healthcare IT companies by revenue as listed on the new Healthcare Informatics 100, which might bring to mind the old Doors song “Five to One”:

• Optum – 25 percent
• Cerner – 18 percent
• Cognizant – 16 percent
• McKesson – 25 percent
• Philips – 17 percent

This week on HIStalk Practice: Allergy Partners opts for Medfusion technology. Rhode Island practices unite as Brown Physicians Inc. Outcome Health raises $500 million in a quest to assist 70 percent of practices. Practice Fusion’s Matthew Douglass argues that America’s doctors need net neutrality. HealthTap expands to New Zealand, while Heal heads to Washington, DC. EVisit raises $2 million. US HealthWorks taps AmericanWell to power its new telemedicine service for employers.

Thoughts on the $155 Million DOJ Settlement of EClinicalWorks

I had these reactions when writing about the company’s settlement.

• I was curious about how many EPs have attested to Meaningful Use using EClinicalWorks. ONC’s Health IT Dashboard shows around 25,000, making it the #3 EHR vendor (behind Epic and Allscripts).
• The settlement amount represents 35 percent of the company’s annual revenue of $440 million.
• The settlement could be only the beginning of ECW’s problems, as it now has to deal with potential customer defections, the inevitable drop-off in sales, and potential class action provider lawsuits. It could possibly be sued by its certifying body, Drummond Group, plus it is required by the settlement terms to implement internal and external review programs.
• I assume the value of the settlement was based on the MU payments that were made to ECW-using EPs, which I’ll also assume means that HHS won’t go after the EPs individually. The complaint says the federal government is entitled to recover triple the value of fraudulent claims (presumably the MU incentives paid) plus a percentage of the company’s profits that represented “undue enrichment.” Still, as reader Debtor points out, ECW-using EPs could have been paid around $2 billion in Meaningful Use incentives, so as he or she says, “that the DOJ settling for pennies on the dollar and no criminal prosecution is unbelievable.”
• Does Drummond Group, which certified ECW’s EHR, bear any responsibility (legal or otherwise) for failing to detect that ECW was – according to the complaint – rigging its test results? On the other hand, it could argued that since the certification testing scenarios are public and static, the certification body has no easy way to detect fraud in observing only the desired scenario outputs. Certification testing is not dynamic nor comprehensive – it’s following a script to see if the expected outputs are produced.
• The $30 million whistleblower payment will surely encourage others to report any similar problems with other vendors.
• Clearly DOJ was not happy that ECW apparently charged customers for software updates, made it hard and/or expensive for them to migrate from ECW to other EHRs, and did not make it easy for its customers to exchange information with other practices.
• The kickback portion of the complaint arose from ECW giving users a $500 maintenance credit to refer a prospect who eventually signed on as a customer (those payments totaled $144,000), paying users to host site visits ($249,000), compensating customers to provide good product references, and providing consulting fees, honoraria, and gifts to influential users who pitched its product, with one unnamed doctor earning “tens of thousands of dollars in ‘consulting’ fees.” The complaint makes it clear that manufacturers can’t pay any kind of remuneration to encourage use of their products for which the federal government pays via Medicare and Medicaid. 
• It’s not clear how the settlement affects ECW-using EPs who could continue attesting under the Medicaid part of Meaningful Use for several more years. Apparently not at all since the product’s certification remains intact.
• Two ECW technical employees will pay relatively small settlement amounts over the product’s inability to process RxNorm terminology for e-prescribing. One of those employees was the developer in charge of the RxNorm software functionality and the other submitted ECW’s final certification application. The complaint says the certification body certified the product in 2013, heard afterward from ECW employees that the software didn’t really process RxNorm codes, and then re-tested the product with the same protocol in 2015, which ECW passed only because it hard-coded the expected 16 RxNorm codes.
• The complaint says ECW’s EHR did not use LOINC or SNOMED CT terminology.
• The complaint says ECW released software without adequate testing, relied on customers to report problems, allowed critical problems to remain unresolved for months or years, and reintroduced previously fixed bugs because its software version control was not reliable.
• The company’s October 6-9 user group meeting should be interesting.

The whistleblower in the case was Brendan Delaney, who was a New York City employee implementing ECW at Rikers Island for prisoner healthcare when he noticed software problems. He has also worked on ECW projects for Arcadia Solutions, HSM Consulting, and as a self-employed contractor. His LinkedIn says he’s revenue cycle manager at NYU Langone Medical Center, or at least was before he learned he’ll be pocketing $30 million (but unfortunately for him, whistleblower windfalls are taxed as ordinary income).

Interesting points from the five-year Corporate Integrity Agreement the company signed with HHS OIG:

• ECW is required to implement a quality assurance program to oversee software defects, usability problems, and any other issues that affect patient safety or product certification and to post known software problems on its portal.
• The company is required to create usability and patient safety advisory teams, consisting of at least a doctor, pharmacist, and nurse.
• ECW is prohibited from using contract language that prohibits customers from disclosing patient safety concerns and agrees that it won’t enforce that requirement in existing contracts.
• The company must help customers who want to migrate to other EHRs and can’t charge them any fees, penalties, or service charges.
• ECW is required to contact every customer with an email subject line of “Important information about your EHR software and services. You have new options free of charge to you.” The communication must start with a statement indicating that ECW has settled with HHS OIG to offer them free upgrades to the latest production version.
• The company must track any payments made to existing customers for marketing purposes and must list all of payments it makes to providers on its website.

What other vendors should do based on the settlement:

• Review the certification process to make sure nothing is being faked, talking to the technical people rather than managers anxious to avoid becoming the shot messenger.
• Don’t provide any kind of incentives for customers or their employees to help make new sales.
• Make sure customers are notified quickly of software problems that endanger patients or that can cause billing mistakes or certification shortcomings.

Meanwhile, the law firm that represented the whistleblower in the lawsuit adds a few points:

• The firm filed Brandon Delaney’s lawsuit against ECW in 2015.
• The firm’s website includes archived copies of advisories ECW sent to its customers that warned of software problems.
• Brandon Delaney provided this statement: “I was profoundly saddened and disappointed by the indifference of senior health department officials and investigators for New York City when I provided detailed information about serious flaws in the EHR software that could endanger patients. I am grateful that Phillips & Cohen and federal government attorneys recognized the seriousness of my charges and dug into the matter quickly and thoroughly.”

The Letter EClinicalWorks Sent to its Customers Thursday

Dear Customer:

Yesterday we announced a settlement with the government. As part of the settlement, eClinicalWorks paid $155 million and agreed to bolster its compliance program. The inquiry leading to the settlement primarily centered on technical aspects of the Meaningful Use program and allegations that eClinicalWorks software had technical non-conformities related to some of the criteria, all of which have since been addressed.

eClinicalWorks cooperated fully with the government. We have not admitted any fault or wrongdoing, and our goal as a company is to always make sure we are doing the right thing. We have decided to put this matter behind us and concentrate all of our efforts on our customers and continued innovations to enhance patient care delivery. Importantly, our software remains fully certified under the Meaningful Use program.

One of the technical non-conformities alleged by the government involved the use of RxNorm codes in electronic prescriptions. From 2014 to August 2016, electronic prescriptions sent by eClinicalWorks users included NDC codes rather than RxNorm codes.  During this time period, more than 500 million prescriptions were successfully transmitted and filled, and most major pharmacies did not support RxNorm codes. The failure to include RxNorm codes in electronic prescriptions was completely inadvertent on the part of eClinicalWorks, as our software used RxNorm codes in other parts of the system, such as in C-CDAs. We gained nothing by not including the codes, which are available for free from the National Library of Medicine. We resolved this issue as soon as we learned of it.

Another technical non-conformity identified by the government involved data portability. The 2014 Edition certification criteria require EHR software to “batch export” patient records. There was confusion about the meaning of this requirement, however, prompting ONC in 2015 to issue a clarifying FAQ. When eClinicalWorks was tested for certification in 2013, its authorized certification body (ACB) at the time, CCHIT, determined that our software satisfied this requirement. In 2015, our new ACB, Drummond Group, disagreed and identified this as a non-conformity. eClinicalWorks resolved the non-conformity in 2015, and our software meets all MU Stage 2 data portability requirements.

Historically, technical non-conformities with the MU Program were addressed through an administrative rather than a legal process (visit the ONC’s Certified Health IT Product List (CHPL) website for a list of EHR vendors with non-conformities: https://chpl.healthit.gov/#/search). eClinicalWorks chose to settle this matter to avoid the uncertainty of a prolonged legal dispute which could have been disruptive to our customers, our employees and our company.     

The government also alleged that eClinicalWorks’ customer referral program violated the federal Anti-Kickback statute. Under this program, called “Refer a Friend.”eClinicalWorks granted a credit, typically in the amount of $500, against existing users’ support and maintenance fees. Between 2011 and 2016, eClinicalWorks paid $392,000 to users under this and related programs. While referral programs like this are common in the industry, and while HHS-OIG has provided no guidance regarding them, the government took the position that the payments were improper. We disagreed but have nevertheless discontinued the program.     

There is a silver lining to this settlement. Today, eClinicalWorks has a more robust compliance program, and we continue to invest our resources and energy into making sure the products and services we deliver serve our customers well in the long run. We paid the settlement amount using cash on hand and have the resources to continue to grow and innovate.

It is our privilege to serve you. I am committed to enhancing our products and services. We will be releasing V11 later this year as planned and seeking certification for Meaningful Use Stage 3.   

We founded this company 17 years ago with the mission of improving healthcare together. The settlement does not change that.

Sincerely,

Girish Navani, CEO

Webinars

June 22 (Thursday) 1:00 ET. “Social Determinants of Health.” Sponsored by Philips Wellcentive. Presenter: David Nash, MD, MBA, dean, Jefferson College of Population Health. One of the nation’s foremost experts on social determinants of health will explain the importance of these factors and how to make the best use of them.

June 29 (Thursday) 2:00 ET. “Be the First to See New Data on Why Patients Switch Healthcare Providers.” Sponsored by Solutionreach. As patients pay more for their care and have access to more data about cost and quality, their expectations for healthcare are changing. And as their expectations change, they are more likely to switch providers to get them met. In this free webinar, we’ll look at this new data on why patients switch and what makes them stay. Be one of the first to see the latest data on why patients leave and what you can do about it.

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

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

Acquisitions, Funding, Business, and Stock

Medical image viewing system vendor TeraRecon acquires machine learning vendor McCoy Medical Technologies and creates a new company that will distribute trained machine learning algorithms for clinical decision support, also offering researchers and hospitals an easy way to distribute their algorithms for research or commercialization.

Accenture will acquire 250-employee laboratory informatics consulting firm LabAnswer, which it will fold into the newly created Accenture Scientific Informatics Services. 

Sales

Carilion Clinic (VA) chooses Influence Health’s directory listings management system to monitor its online presence, provide accurate online location listings, and call out unofficial social media pages.

Memorial Sloan Kettering Cancer Center (NY) and Intermountain Healthcare (UT) will use the genomics platform of Philips for cancer research and treatment.

People

Children’s of Alabama (AL) hires Bob Sarnecki (ClearData) as interim CIO.

In England, Beverly Bryant (NHS Digital) will join System C as COO.

SurveyVitals, which offers digital patient experience surveys, hires Robert Harrington, Jr., MD (Reliant Post-Acute Care Solutions) as chief medical officer.

Rob Bart, MD (LA County Department of Health Services) joins UPMC as CMIO.

Announcements and Implementations

An Ellis and Adams research report reviewing the impact of hospital acquisitions on quality finds that the average quality score of an acquired hospital slipped 5 percentage points in the first year.

DrFirst launches new solutions for Meditech users – SmartSig to manage free text prescription instructions and integration with prescription drug monitoring program databases.

Privacy and Security

The medical records (including photos) of 15,000 patients of a Los Angeles plastic surgery clinic – some of them celebrities – have been stolen by a fired employee.

In India, the Mumbai health department’s online birth and death registry is taken offline following complaints that its lack of security was allowing anyone to look up random names and print their birth or death certificates. A government official complains that only the medical health officer is now allowed to use the system and “he cannot keep printing certificates for everyone” in keeping up with the city’s daily workload of 400 births and 200 deaths.

Australia’s health department decides that the records of people who opt out of its My Health Record system won’t be deleted, but rather hidden from providers, allowing those who opt out to change their minds later.

Other

Australia’s Digital Health Agency issues a request for tender for developing a plan to connect all health-related systems over 5-10 years.

A five-sentence letter published in NEJM in 1980 concluding – without much evidence – that opiates aren’t addicting when prescribed for chronic pain has been cited more than 600 times since, with references to the article spiking after OxyContin was brought to market in 1995. The authors note that most of the citations misinterpreted the information or mischaracterized the letter’s conclusions in encouraging doctors to use long-term opiate therapy that contributed heavily to today’s national addiction, leading to their recommendation that authors cite previous studies carefully.

Facebook is hosting an invitation-only meeting next week to court drug companies as advertisers.

Sponsor Updates

• ECG Management Consultants publishes its “2017 Thought Leadership Compendium.”
• EClinicalWorks will exhibit at the California Primary Care Association Region IX Clinical Excellence Conference June 4-6 in Lahaina, HI.
• FormFast and Imprivata will exhibit at EHealth Canada June 4-7 in Toronto.
• Aprima wins Frost & Sullivan’s product leadership award for its RCM platform.
• HBI Solutions publishes a new white paper, “Turn Data Science into Value: The Four Key Requirements.”
• The Atlanta Business Chronicle profiles CFO of the Year finalist and Ingenious Med Chief Compliance Officer and CFO David Lamm.
• InterSystems’ TrakCare tops global EHR deployments, according to a new KLAS report.

Blog Posts

• Arkansas: Concerns and opportunities (EClinicalWorks)
• Go Beyond the Acquisition: Wake Forest Baptist Health Leverages Journey Mapping for Improved Patient Engagement (Evariant)
• Empowering patients with digital innovation and design thinking (Meditech)
• How to Land Top Information Security Talent (Fortified Health Security)
• 5 Common Pitfalls of Technology Strategy Development (Hayes Management Consulting)
• 3 Roadblocks to Digital Transformation (The HCI Group)
• The CIO as a Change Agent (Optimum Healthcare IT)
• The Right Alert, The Right Time, The Right Person (Impact Advisors)
• A Healthcare Marketer’s Guide to Ranking Number One (Influence Health)
• 3 Quick Tips for Refunds in Healthcare (Plus, How to Avoid Them in the First Place) (InstaMed)
• Garbage In, Gospel Out? (InterSystems)

HIStalk sponsors were listed in the Healthcare Informatics 100 highest-revenue healthcare IT companies, representing 38 of the vendors named:

• Ability Network (#75)
• Advisory Board (#19)
• Agfa HealthCare (#72)
• CSI Healthcare IT (#70)
• Cumberland Consulting Group (#95)
• EClinicalWorks (#34)
• Elsevier (#64)
• Evolent Health (#48)
• Experian Health (#45)
• GE Healthcare (#12)
• Harris Healthcare (#58)
• HCI Group (#82)
• Impact Advisors (#99)
• Imprivata (#71)
• Infor (#38)
• InterSystems (#32)
• Leidos (#9)
• Lexmark Healthcare (#61)
• Medecision (#94)
• Medhost (#67)
• Meditech (#33)
• MModal (#43)
• NantHealth (#90)
• Navicure (#87)
• Netsmart (#46)
• NextGen Healthcare (#31)
• Nordic (#59)
• Nuance (#16)
• Optimum Healthcare IT (#73)
• Philips (#5)
• Roper Technologies (#26)
• Solutionreach (#91)
• Spok (#57)
• Sutherland Healthcare (#68)
• T-System (#97)
• Verscend (#42)
• West Corporation (#41)
• Xerox (#8)

Contacts

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

EClinicalWorks Will Pay $155 Million to Settle DOJ False Claims Act Allegations

EClinicalWorks will pay $155 million to settle a federal False Claims lawsuit alleging that ECW misrepresented its EHR product and paid customers kickbacks for promoting it, the Department of Justice announced today.

The government claims that ECW fraudulently obtained certification for its EHR by hard coding some of the testing elements as provided to its certifying entity. It also says ECW’s software did not accurately maintain a user audit log, did not reliably record diagnostic imaging orders, failed to perform drug interaction checks, and failed to meet interoperability requirements, thus causing false claims for HITECH incentive payments to be paid by HHS.

According to ONC’s Certified Health IT Product List, ECW’s Authorized Certification Body is Drummond Group.

The company and three of its founders will pay the $155 million settlement.

ECW also entered into a five-year HHS OIG Corporate Integrity Agreement that requires the company to have its software quality control systems externally audited and reported to HHS OIG. The company also agreed to provide prompt notice to customers of any EHR-related safety issues, to make software updates available at no cost, and to assist customers in migrating to other EHRs without charging them. ECW is also required to hire an Independent Review Organization to certify that the company’s agreements with providers comply with anti-kickback laws.

The whistleblower lawsuit was filed by Brendan Delaney, a software technician with New York City Division of Health Care Access and Improvement, who will receive $30 million of the settlement.

I’ve run several reader-provided rumors about the Department of Justice investigation, going all the way back to late 2015.

News 5/31/17

Top News

An internal UCSF study finds that 82 percent of the text in a typical Epic progress note comes from copying/pasting or importing from other sources. Clinicians physically enter only 18 percent of the note.

Several hundred of the 24,000 notes reviewed contained no human-entered text at all.

The study is especially interesting because it used a new text analysis tool – apparently provided by Epic – to determine the source of every character of text in the note.

Reader Comments

From Jack Fruit: “Re: CommonWell. Who were the original members?” CommonWell Health Alliance was founded in March 2013 by Cerner, McKesson, Athenahealth, Greenway, and RelayHealth (which is also owned by McKesson) as the Epic fears of the publicly traded competitors intensified to the point that they cooperated (and pony up a rumored $2 million each) to have something to announce at HIMSS13. Since then, McKesson has mostly pulled out of healthcare IT by spinning off Change Healthcare and looking for a buyer for its enterprise business and Greenway Medical Technologies was taken private by Vista Equity Partners a few months after the CommonWell announcement. Athenahealth shares are up 38 percent since the announcement, those of Allscripts are down 10 percent, and Cerner shares have risen 41 percent as all the founding companies have tried to diversify themselves out of a HITECH-free EHR market. CommonWell later added CPSI (now Evident) and Sunquest as founding members in mid-2013, but Sunquest is no longer listed as such on its site even though Sunquest’s site still says it’s a member.

From Kathy: “Re: CommonWell survey. It would be most accurate for me to vote that it performed exactly as I expected – which was very little. CommonWell was never going to work. It was a political and business tactic.” Above are the early poll results.

From Tammy: “Re: CommonWell. I work for RelayHealth supporting the CommonWell network. CommonWell is not one EHR, it’s a network. It brings together multiple health IT systems and helps to solve the challenge of connecting disparate software run by different companies, using different technology. People’s definitions of numbers are different depending on what and how they count. What really is important is that we are all working towards helping providers and people get access to important health data that they previously couldn’t. CommonWell is definitely moving the meter in the right direction on this. What is different about what CommonWell is doing is that providers don’t have to search for records and guess where they might be located. They also don’t have to download and store every document for their patients – we’re about making it more efficient to get the data that is most valuable to the provider when they need it. Providers can query and view what documents are available, similar to a search engine, and only download those they need. I have seen 2x the volume of query and retrieval growth in the past year.”

From David McCallie (Cerner): “Re: CommonWell. It seems like a case of apples to oranges – it would be bad math to compare numbers that aren’t measuring the same thing. For Cerner, CommonWell queries are a small (but important) fraction of Cerner’s overall document exchange interoperability. We don’t know exactly what counts as a ‘record’ or gets included in Epic’s CareEverywhere statistics, but for Cerner, document exchange includes not only CommonWell, but also many existing point-to-point query interfaces (via Cerner Resonance, including many connections to Epic clients) as well as local HIE-based document queries, and data routed to providers through the ‘Cerner Hub’ services.  Cerner also supports a growing Direct-based document exchange.  To the clinician, these are all equally available sources for external documents and data. In general, the user interface does not distinguish the means of transport. CommonWell in many ways represents a national-scale ‘back stop’ for data that can’t be found via local queries. Now that CommonWell and Carequality have committed to mutual interchange, we expect that the number of CommonWell-mediated transactions will grow, since CommonWell will provide a common gateway to both its own network as well as any requested Carequality sites. CommonWell automatically bundles an MPI and a national Record Locator Service, so the clinician does not need to spend time deciding where to look for documents that aren’t local. Don’t count CW out … the network is growing, and any numbers they report represent a very high quality of interoperability use case.”

From Spiker: “Re: health IT writing. Biggest problem is advertiser-friendly puffery. And mistakes like this one.” I disagree. The biggest problem is writer naiveté even in the absence of advertiser bias (unintentional or otherwise). Gushy, “world peace” kinds of health IT articles are always written by folks who have never actually worked in a health IT or clinical leadership role and thus have not learned from hard-won experience to distrust vendors, politicians, and health system executives until they provide a reason to believe otherwise. They’re also scared of being called out for lack of knowledge, so their writings tend to be harmless little bubbles floating aimlessly above the fierce, patient-impacting HIT battles being fought. The bar I set for everything I read regularly (especially if it expresses editorial opinion) is:

• Does the writer enough knowledge and experience to be trusted?
• Does the article tell me something I didn’t already know?
• Can I really use the information?
• Does the writer present the information clearly, concisely, and at my level, without time-wasting padding or distractingly unskilled writing?
• Am I entertained, amused, or emotionally motivated in a positive way that makes me want to read more by the same writer?
• And for the specific user-provided example above, make sure the author knows the difference between “pared down” and “parsed down” and doesn’t misstate “rev cycle” as “rest cycle.”

From FlyOnTheWall: “Re: Mary Piepenbrink, RN. Joined a startup called Pieces Technologies as SVP of sales. What do you know about them?” I’ve heard of the Dallas predictive analytics company, but only barely. They’re a Parkland Health spinoff as I recall. Founder and CEO Ruben Amarashingham, MD, MBA has good credentials in informatics. The company raised $21.6 million in a single Series A round just over a year ago and apparently has earned a couple of customers.

HIStalk Announcements and Requests

The web hosting company is migrating the site to a bigger server, so let me know if you see anything weird, other than the fact that I’m posting this later than usual to accommodate the switch.

You’ll see some inarguably huge news related to a Meaningful Use-related EHR vendor settlement coming out, possibly as early as later today. The financial terms are mind-boggling. More to come once the Justice Department’s announcement is released.

Listening: The Stanfields, Nova Scotia-based hard-working rockers who wrap thoughtful, lyrically rich biographical stories with searing guitar (and mandolin) riffs. like AC/DC covering an Irish pub’s house band. It’s sonically spectacular poetry. You’re a poser rather a musician if you can’t play and sing acoustically in a bare room, to which I submit the amazing “Vermilion River.”

Webinars

June 22 (Thursday) 1:00 ET. “Social Determinants of Health.” Sponsored by Philips Wellcentive. Presenter: David Nash, MD, MBA, dean, Jefferson College of Population Health. One of the nation’s foremost experts on social determinants of health will explain the importance of these factors and how to make the best use of them.

June 29 (Thursday) 2:00 ET. “Be the First to See New Data on Why Patients Switch Healthcare Providers.” Sponsored by Solutionreach. As patients pay more for their care and have access to more data about cost and quality, their expectations for healthcare are changing. And as their expectations change, they are more likely to switch providers to get them met. In this free webinar, we’ll look at this new data on why patients switch and what makes them stay. Be one of the first to see the latest data on why patients leave and what you can do about it.

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

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

Acquisitions, Funding, Business, and Stock

Health management software vendor Mediware Information Systems acquires Kinnser Software, which offers home health and hospice systems.

Two former Theranos board members – former US Navy Admiral Gary Roughead and former US Secretary of State George Shultz – say they didn’t ask founder Elizabeth Holmes about media reports stating that the company wasn’t running many tests on its proprietary Nanotainer finger stick technology but instead was using commercially available analyzers. Legal experts question whether the company’s board failed to meet their responsibilities in providing checks and balances to Holmes, who controls 98.3 percent of voting shares. To paraphrase “Animal House” in work-friendly terms, “You messed up … you trusted us.”

Consumer health information site Sharecare, founded in 2010 by Dr. Oz and WebMD founder Jeff Arnold, receives an unspecified investment from Summit Partners, increasing its total to more than $300 million.

Announcements and Implementations

Google launches the free Data Gif Maker, a data illustration tool aimed primarily at journalists who need to tell data-driven stories but potentially useful to a wider social media audience. 

Medisolv chooses CloudWave’s OpSus Healthcare Cloud for making its quality management system available to customers as a SaaS offering.

Nordic announces that it has grown to 700 consultants serving 200 clients.

Reaction Data publishes a new report on patient referrals and self-scheduling.

Government and Politics

The CEO of Blue Cross Blue Shield North Carolina says that the ACA marketplace is stabilizing in price, utilization, and risk to the point that an 8.8 percent premium hike would have sufficed for 2018, but instead the company has filed for a 22.9 percent increase because the White House keeps saying that it may not continue paying the premium subsidies that have been challenged legally. “The information we’ve seen coming from the administration actually creates more uncertainty,” the CEO says.

Privacy and Security

Other

A study finds that hospital EDs charge an average of 3.4 times the Medicare-paid rate for services they provide, providing as an example EKG interpretation, for which Medicare pays a median of $16 but for which hospital EDs charge other patients anywhere from $18 to $317, averaging $95. The highest-charging hospitals are for-profit, mostly in the South and Midwest, and serve more uninsured and minority patients.

USA-based Syria medical aid group UOSSM launches Syria Solar, a project to install solar power systems in the country’s hospitals, which run generators that use erratically available diesel fuel. Much of Syria’s electrical grid has been destroyed by bombing, leaving already struggling hospitals to deal with power outages for incubators, dialysis machines, and other vital equipment. 

Rapidly rising drug prices are hitting seniors hard with higher co-pays even as Medicare’s share of the Part D cost has become its fastest-growing expense.  Novartis AG has raised the price of cancer drug Gleevec 77 percent in the past five years, increasing Medicare’s annual cost from $500 million to $1.23 billion and leaving the average Medicare patient paying $4,400 per year out of pocket.

I’ve read that Europe has become even more overrun with summer tourists in the past few years because huge-population countries like China and India are moving up the economic food chain and their now-wealthier citizens are joining the lines in Rome, Paris, and London. A New York Times article says that’s also true in healthcare, as frustrated, affluent citizens of China are bypassing the country’s overloaded hospital system and paying cash for care in the US and other countries despite the inevitable problems with transoceanic care coordination.

A Wall Street Journal article questions whether towns should continue operating tax-supported nursing homes, seven percent of which are government-owned. Their financial losses are increasing due to a glut of Baby Boomer residents, a high proportion of Medicaid residents as those with more assets seek out tonier facilities, and the White House’s proposal to cut Medicaid by nearly a trillion dollars. Cities are selling their nursing homes to private operators with mixed experience. The article profiles the city-owned, 45-bed nursing home in Cape Cod’s Nantucket, MA, which is losing $3 million per year, needs major repairs as the city grapples with other huge infrastructure upgrades, and attracts only the financially struggling year-round residents who would have to move out if the city’s only nursing home shuts down or raises rates.

Sponsor Updates

• AdvancedMD publishes a MIPS Improvement Activities fact sheet.
• Aprima will exhibit at the Associated Professional Sleep Societies Annual Meeting June 5-7 in Boston.
• Audacious Inquiry publishes a series of white papers on what HIOs need to know about the 21st Century Cures Act.
• Bernoulli publishes a new case study, “Achieving medical device connectivity across a multiple-hospital enterprise.”
• Datica will present at the Wisconsin Entrepreneurs’ Conference June 6-7 in Madison.
• Carevive Systems will exhibit at the ASCO Annual Meeting June 2-6 in Chicago.
• Casenet will exhibit at AHIP Institute & Expo June 7-9 in Austin, TX.
• Docent Health is featured in Redox’s “Digital Health Done Right” series.
• The Jacksonville Business Journal includes CSI Healthcare IT in its list of “Best Places to Work 2017.”
• Dimensional Insight will host its annual User Conference June 5-8 in Boston.

Blog Posts

• On-Call Scheduling 101: Your Guide to Supporting Care Providers and Patients (Spok)
• The New CISO Leader (Orchestrate Healthcare)
• Can Risk Adjustment Help Address Physician Burnout? (Arcadia Healthcare Solutions)
• Government Ramps up HIPAA Enforcement (Besler Consulting)
• MIPS and the Business of Healthcare (Caradigm)
• CPC+ At Its Best (CareSync)
• Value in Healthcare – Part 3: Alternative Payment Models and Enabling Technologies (ClinicalArchitecture)
• MACRA Overview – Is Your Organization Prepared? (Culbert Healthcare Solutions)
• Robots Take Jobs but Also Create Them (Direct Consulting Associates)

Contacts

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

Monday Morning Update 5/29/17

Top News

In Canada, a report by Alberta’s auditor general says the government’s $1.2 billion proposed project to replace the clinical and administrative systems of Alberta Health Services with a single system is not likely to generate the expected $900 million in cost savings because it doesn’t include primary care practices.

The project, announced a year ago, would replace 1,300 individual AHS systems.

The report notes that Albertans pay the highest healthcare costs of all provinces in Canada, yet the quality and integration recommendations of previous reports have been mostly ignored. It observes that despite claims of how good healthcare is in Canada, it’s almost as bad as in the US, which finishes dead last among 11 developed countries despite spending far more than any of them.

The Auditor General also notes that fee-for-service payments have hampered accountability and integration. It also says that health leader turnover is high due to political cycles, with the average AHS hospital CEO lasting just 1.2 years.

Province physicians use at least 12 incompatible EHRs. Canada-wide, 94 percent of hospitals use IT only for administrative tasks.

The report observes that if banks used IT like Alberta Health Services:

• Each branch bank would have its own systems that can’t communicate with other branches.
• Systems at some branches would be so prone to failure that paper files would be kept ready.
• Tellers, mortgage officers, and investment specialists wouldn’t be able to access each other’s information.
• The only access to banking information would be via faxing.
• Customers would be required each time they visit a branch to fill out the same form asking for name, address, employment information, and financial history.
• Traveling customers could not withdraw money without opening an account first because the branch would not know who they are.
• Applying for a mortgage would require visiting each prospective lender individually and completing their proprietary application package.
• Online banking would not exist.
• Obtaining an account balance would require making a written request and waiting two weeks for the mailed information to arrive.
• Bank managers would not have enough information to understand the performance of individual branches.
• The banks would spend $600 million per year to maintain IT systems but without a plan to standardize them and keep them up to date.

Reader Comments

From More Math: “Re: CommonWell’s 60,000 documents downloaded. Looking at the latest from Epic’s website, it appears that Care Everywhere hits CommonWell’s lifetime exchange number every 15 minutes. Sounds like Epic is willing and able. Bigger question is whether the CommonWell is drying up.” CommonWell’s March 2017 fact sheet says that 5,100 provider sites have gone live and have generated 85 million queries, although I don’t know how “queries” translates into “documents.” The quoted figure of 60,000 documents retrieved doesn’t indicate the time frame involved, but if that’s all of them since CommonWell’s beginning in 2013, that’s a pretty anemic number. Cerner said in a HIMSS16 presentation that it had 4,000 providers live on CommonWell, which suggests that almost all live CommonWell members are Cerner users; that those providers enrolled only an average of 50 patients each; and that only eight documents per provider were actually retrieved. EHR vendors pay a per-transaction cost to CommonWell and providers don’t really like sharing their patient information with competitors, so there’s not a lot of economic incentive for anyone other than the patient to use CommonWell’s services.

From Laura Palmer: “Re: Cure Forward. Has shut down, according to its site.” The Boston startup offered a platform that matched patients with clinical trials, although previous announcements suggest that its system may never have graduated from beta testing status. The company raised $19 million in a June 2015 investment and nothing since. Sole investor Apple Tree Partners has expunged Cure Forward from its website, omitting the company from its “legacy investments” section and removing previous Cure Forward press releases (thereby practicing the investing world’s legendary 20-20 hindsight). Cure Forward founder Martin Naley, who launched the company as a entrepreneur in residence at Apple Tree Partners, says on his LinkedIn profile that the company “ceased operations at the end of May 2017 due to financing difficulty.”

HIStalk Announcements and Requests

Readers funded the DonorsChoose grant request of Mrs. M in Ohio, who requested math fluency games and fitness-related “brain breaks.” 

Two-thirds of the 247 poll respondents who say they have certification or fellowship credentials don’t list them on their business cards or in their email signatures. KG says credentials should be listed only on CVs other than for practicing clinicians, while Sue says her earned credentials are important to her work and her clients use them as well. John opines that healthcare people deploy “a fruit salad of acronyms” such that the more of them someone lists, the less he believes what they say.

New poll to your right or here: to what extent has CommonWell benefited patients since its 2013 founding? I appreciate your vote and, even more so, your comments explaining it.

Gregg Allman died Saturday at 69, leaving zero of the two brothers who founded the Allman Brothers Band in 1969 still alive (also making Cher the ex-wife of two deceased celebrities). I’m not a fan at all of the retired band’s music since I really dislike Southern boogie and country music even when it’s bluesy (other than Lynyrd Skynyrd, anyway), but it’s apparent that hard living took its toll on the founding members — Duane Allman died at 24 in 1971 in a motorcycle accident, bass player Berry Oakley died a year later in the same manner and location, and drummer Butch Trucks killed himself earlier this year. That leaves guitarist Dickey Betts (73) and drummer Jaimoe Johanson (72).

I’ve had problems for years where I leave the laptop running and Firefox is open to pages that refresh (like Twitter or news sites) – Firefox gets sluggish and Windows Task Manager shows it eating up a huge amount of memory and CPU, requiring me to hard-cancel it. The solution – I finally switched to Chrome for everything browser related, which makes even more sense now that I’m using a Chromebook and an Android phone. My only non-Google technology is an iPad Mini and the Windows laptop, both of which will move to a Google platform when it’s time to replace them.

In Flanders Fields
By John McCrae, MD (1872-1918)

In Flanders fields the poppies blow
Between the crosses row on row
That mark our place; and in the sky
The larks, still bravely singing, fly
Scarce heard amid the guns below.

We are the Dead. Short days ago
We lived, felt dawn, saw sunset glow,
Loved and were loved, and now we lie
In Flanders fields.

Take up our quarrel with the foe:
To you from failing hands we throw
The torch; be yours to hold it high.
If ye break faith with us who die
We shall not sleep, though poppies grow
In Flanders fields.

This Week in Health IT History

One year ago:

• Forbes revises its estimate of the net worth of Theranos founder Elizabeth Holmes from $4.5 billion to zero.
• An ONC study finds that 84 percent of US hospitals are using at least a Basic EHR, a nine-fold increase since HITECH’s adoption in 2009.
• DrFirst acquires Meditech-focused consulting firm The IN Group.
• CHIME awards $30,000 each to the two finalists in the concept round of its national patient ID challenge, with those contestants moving to the final $1 million round.

Five years ago:

• Allscripts caves in to a proxy fight and adds three new board members advocated by key shareholder HealthCor Partners, which had publicly called for Allscripts to fire CEO Glen Tullman.
• Three-fourths of respondents to my poll disagree with Neal Patterson’s assertion that Cerner and Epic will end up being the only hospital EHR survivors.
• Fired HCA doctors say the hospital chain hired huge numbers of physicians to prepare for an ACO environment, then terminated those whose practices weren’t profitable.

Ten years ago:

• A research article finds that few hospitals are using bedside barcode-checking of medications and that nurses bypass those systems frequently.
• An article describing problems with Kaiser Permanente’s shuttered kidney transplant program blames information management problems and its paper-based systems.
• A rumor suggests that Misys is trying to sell its hospital systems.
• Former National Coordinator David Brailer launches the $700 million private equity fund Health Evolution Partners.
• MED3OOO takes a majority ownership position in InteGreat.

Weekly Anonymous Reader Question

Last week’s results: job promotion factors.

This week’s survey: what is the role of the person you most value as a mentor and/or professional peer, how did you connect with them, and how do you maintain the relationship?

Last Week’s Most Interesting News

• The Wall Street Journal notes that uncertainty surrounding the Affordable Care Act has forced some health IT startups to change their strategies.
• Five hospitals in Australia experience an IT incident cause by applying security patches to protect against WannaCry ransomware.
• Apple acquires sleep monitoring sensor and app vendor Beddit.
• The Congressional Budget Office estimates that the Affordable Health Care Act would increase the number of uninsured Americans by 23 million by 2026 in reducing the deficit by $119 billion.
• The Bipartisan Policy Center calls for private-public efforts to improve health IT safety, but does not mention ONC’s proposed EHR safety center.
• The director of Denmark’s equivalent of the FDA warns that big US tech companies like Google and Apple are rolling out health apps without demonstrating their efficacy and safety and that those companies are gaining permanent access to patient data.
• The local paper says that Erie County Medical Center’s ransomware infection is still affecting the hospital six weeks after the hospital decided not to pay the demanded $44,000 ransom, also running a screenshot provided by a hospital employee that suggests that the culprit was Samas, the same malware that took down MedStar Health in 2016. 

Webinars

June 22 (Thursday) 1:00 ET. “Social Determinants of Health.” Sponsored by Philips Wellcentive. Presenter: David Nash, MD, MBA, dean, Jefferson College of Population Health. One of the nation’s foremost experts on social determinants of health will explain the importance of these factors and how to make the best use of them.

June 29 (Thursday) 2:00 ET. “Be the First to See New Data on Why Patients Switch Healthcare Providers.” Sponsored by Solutionreach. As patients pay more for their care and have access to more data about cost and quality, their expectations for healthcare are changing. And as their expectations change, they are more likely to switch providers to get them met. In this free webinar, we’ll look at this new data on why patients switch and what makes them stay. Be one of the first to see the latest data on why patients leave and what you can do about it.

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

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

Acquisitions, Funding, Business, and Stock

Debt-ridden Florida-based clinic operator 21st Century Oncology – which was breached by hackers in 2016 in exposing the records of 2.2 million patients and resulting in at least 13 federal class action lawsuits – files Chapter 11 bankruptcy. As companies tend to do, 21st Century calls the bankruptcy a “positive development,” brags that it is “fundamentally strong and profitable,” and claims that “very little, if anything, should change during the Chapter 11 process,” calling into question either the credibility of the company or of the US bankruptcy process that is often used as a shrewd corporate strategy to legally screw employees and creditors for the benefit of executives.

Decisions

• Fitzgibbon Hospital (MO) will replace Meditech and GE Healthcare with Cerner in November 2017.
• Pinnacle Hospital  (IN) will go live with Prognosis Innovation Healthcare in June 2017.
• Illinois Valley Community Hospital (IL) will implement Athenahealth’s EHR in November 2017, replacing McKesson.
• Pioneers Medical Center (CO) will go live with Athenahealth in 2017.
• Riverside Tappahannock Hospital (VA) will replace Siemens with Epic in June 2017.

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

Announcements and Implementations

Vanderbilt LifeFlight develops an Uber-like app to allow first responders to request a helicopter, sending the service an the GPS coordinates and and requestor information while giving the emergency responder a real-time flight map and estimated arrival time.

Other

A co-founder of startup Iodine — which published patient-submitted experience with medications — says his company, as well as other digital health startups, were naive in thinking that their technology could create a healthcare revolution. Iodine quietly sold itself off to drug discount coupon publisher GoodRx a few months ago. Thomas Goetz says not only did disruption not happen, it probably never will, because:

• Healthcare regulation hinders rapid transformation.
• Entrenched players are huge and have their hands in multiple aspects of healthcare.
• Nobody cares about better-faster-cheaper in healthcare.
• There’s no ability to shop prices.
• The government is the biggest customer.
• Incentives are misaligned.

The Columbus, OH paper profiles prescription prior authorization system vendor CoverMyMeds, the first local startup to sell itself for at least $1 billion (to McKesson in January of this year for $1.1 billion, this case). CEO Matt Scantland says the company’s formula for success was, “Start with a big problem and solve it not by disrupting anything, but by finding a way that everyone wins,” adding that it wasn’t the first company to tackle the problem, but rather the first to develop a scalable solution. The article notes that CoverMyMeds has over 500 Columbus-based employees who get a free gourmet lunch each day and have a virtual reality room to play video games with peers in its Cleveland office. I interviewed Matt in September 2014 when the company had just 73 employees and $19 million in revenue, but he was predicting bigger things:

Prior authorization seems like a very niche thing. It kind of is, but at the same time, it’s also right at the intersection where a doctor is making a decision about the tradeoffs between the cost of a treatment and its efficacy. We think that that’s a fundamental problem in healthcare. We have built both the network and the connectivity and then also the relationships with pharma, payers, pharmacies, and providers. We think we can help doctors make more intelligent consumption decisions. We think is a very large opportunity, starting with drug, but helping to get to more personalized medicine in terms of prescribing, and then also other procedures as well. Because of the growth of the size now, we have a lot of interest from the financial and strategic partners. We’re always willing to listen. We think this is a very big standalone company on its own.

He went down, under. In Australia, a member of Parliament laughs so hard while watching the US TV show “Veep” that he chokes on his sushi, passes out, and stumbles through his house before falling face-down unconscious into his granite kitchen island, leaving him with a black eye, three stiches, and a get-well tweet from star Julia Louis-Dreyfus.

Sponsor Updates

• Encore, A Quintiles Company publishes a white paper titled “Care Management Framework – The Critical Path to Implementing a Care Management Strategy.”
• QuadraMed, a Harris Healthcare company, will exhibit at the NYHIMA Annual Conference June 4-7 in Rochester.
• Salesforce announces strategic agreement with Dell Technologies.
• Solutionreach expands leadership team with new promotions.
• Summit Healthcare and Access will exhibit at the 2017 International MUSE Conference May 30-June 2 in Dallas.

Blog Posts

• How IT Leaders will Guide Digital Transformation (Salesforce)
• Is Hospital Pricing Transparency Possible? (The SSI Group)
• Three Ways to Take Appointment Reminders to the Next Level (Solutionreach)
• How Secure are Your Backups? (Summit Healthcare)

Contacts

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

Reader Survey Results: Job Promotion Factors

I asked what factors affected a job promotion.

Being humble, but speaking up in meetings (especially with solution ideas for important problems).

Many factors worked together to promote me through three levels in five years. An ability and willingness to drive change and tackle challenges in areas traditionally labeled as “impossible” because they required revamping entrenched negative habits. An unflinching determination to get tasks done on time (with no short cuts) and work out compromises even with the most difficult stakeholders. The ability to get to the root cause of an issue and focus on how to avoid future snafus with education and documentation without dwelling on placing blame. Consistently keeping EVERYONE very well aware of a projects progress and problems – so everyone felt in the know. Taking copious and diligent notes so as to instill trust and confidence when making statements at meetings, allowing decision makers to move forward more quickly. It also didn’t hurt getting another master’s degree specializing in a key niche area! Never let your skills become stale or your attitude become obstinate.

Proving myself works in getting more responsibilities. Moving to a new company was required to get a promotion.

Paying attention. I don’t believe in random luck, I believe that if you keep your mind open, you will be able to see the opportunities that are all around you. Luck is the ability to see the doors that are already open, waiting for you to step through. Also, be kind and generous.

I do not seek a promotion as something to have, a title to add to my business card or resume. I do not seek a promotion as a reward for time served or deeds already done. I seek a promotion for the opportunity to connect with new people to share ideas, the ability to move forward with new kinds of projects, the ability to tap into new resources. If you can articulate your desire for promotion in the context of moving forward instead of looking backward (a reward) or appearance (new business cards), then your organization will see you as a part of their future as well.

Always doing what I think is the right thing,and the best things for my customers. Always be honest and when I see a problem or an opportunity for improvement, regardless if I am responsible for it or not, I try to identify a solution.

Not looking for the promotion and focusing on making my boss(es) look good. Supporting their ideas and approaches.

I’ve had three offers to get a significant bump in salary and/or role. Every time was when I threatened to quit.

Receiving offers from other companies willing to pay me more.

Job changes, willingness to take on new projects, show value and communicate it.

Building relationships and consistently delivering results.

Who you know and certifications. Also geographical location seems to be a factor — if the person who is doing the hiring is from the same area of the country as you, then that helps with a connection.

Being better at the job than all the other people around me.

I’m a white male. I am also smart, talented, and hard working. But judging from my colleagues, being a white male is often all that is needed to climb the ladder. Competency does not seem to be a requirement.

A good boss. There are ideas, and there is doing. Do. Prompt responses to your boss and your boss’s boss.

#1: Asking for them. Having competing offers (that helped with salary level). Having (at the time) a relatively unique background with IT and medical experience. Having the right networks of people who give your request credibility

Company laid off one-third of people. We all applied elsewhere, they begged us to stay. To stay, I requested improved salary, vacation, and title. They obliged.

Leaving.

Most of my promotions have occurred when I’m working for someone who gets things done and cares about my career. Lesson: Think about who you are aligned with professionally.

Self-sufficiency and a willingness to figure things out on my own.

The ability to lead others, even if not in an appointed leadership role. Last promotion to Lead Analyst role earned by demonstrating ability to assist new and current co-worker analysts to achieve positive results. Sometimes though one is born with an innate nature to lead and enjoy doing so (without be overbearing – i.e., “bossy”). One can always possess a technical ability to perform job duties, but needs guidance and mentoring to achieve success.

My ability to smile while professionally dealing with the jackasses that infest our fine HIT industry.

Being a woman. Just kidding!

My top 3: specific measureable business results from work. The ability to communicate effectively with both non-IT and IT people. Reasoned risk-taking.

Integrity, dedication to performing at the best of my ability, and respect for everyone’s role and contribution to delivering quality services.

Being in the right place at the right time. Having a track record of delivering results. Being helpful and useful. Thinking critically and anticipating my next action. Dressing nice, being well groomed and presentable, speaking clearly and confidently, having a sense of humor, and being able to relate to everyone, not just my peers.

News 5/26/17

Top News

The uncertain future of the Affordable Care Act is forcing some health IT startups – especially those that sell mostly to hospitals – to change their strategies, according to a Wall Street Journal report.

The political turmoil has also raised the funding bar as investors seek out companies with solid revenue and market validation, thereby putting their money into fewer but larger deals.

These companies are reported to have made changes due to ACA uncertainty:

• Smart pill bottle maker Pillsy is refocusing its sales efforts on consumers rather than providers.
• Diabetes management technology vendor Omada Health is increasing its sales emphasis on clinical evidence and return on investment.
• Pregnancy tracker app vendor Babyscripts is concentrating on large health systems instead of physician practices.
• Take Command Health, which helps people who can’t get employer-provided health insurance find coverage, is revamping its platform to target small businesses that reimburse employee healthcare costs.
• Amino, whose tools target specialty care, raised $25 million after changing its platform to analyzing the cost of preventive services that may no longer be free with ACA changes.

Reader Comments

From Ex Epic: “Re: CommonWell. In the Madison consultant community, it’s pretty much understood that CommonWell is/was a Cerner marketing campaign to win the DoD. They tweeted these numbers at their collaboration forum last week, with quick math showing they have roughly one document retrieved per customer facility.”

HIStalk Announcements and Requests

This week on HIStalk Practice: Solutionreach’s Jim Higgins highlights the importance of patient relationship management in attracting and keeping millennial patients. Qliance Medical Management abruptly shuts down clinics amidst financial and legal difficulties. Lemonaid Health raises $11 million. Harbin Clinic adds PrecisionBI analytics to its Athenahealth tools. School nurses up in arms over incentivized telemedicine consent. Femwell Group Health will offer HealthGrid patient engagement tech. ClearHealth Quality Institute looks for telemedicine committee candidates.

Webinars

June 22 (Thursday) 1:00 ET. “Social Determinants of Health.” Sponsored by Philips Wellcentive. Presenter: David Nash, MD, MBA, dean, Jefferson College of Population Health. One of the nation’s foremost experts on social determinants of health will explain the importance of these factors and how to make the best use of them.

June 29 (Thursday) 2:00 ET. “Be the First to See New Data on Why Patients Switch Healthcare Providers.” Sponsored by Solutionreach. As patients pay more for their care and have access to more data about cost and quality, their expectations for healthcare are changing. And as their expectations change, they are more likely to switch providers to get them met. In this free webinar, we’ll look at this new data on why patients switch and what makes them stay. Be one of the first to see the latest data on why patients leave and what you can do about it.

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

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

Acquisitions, Funding, Business, and Stock

Clinical trials software vendor Medrio receives a $30 million equity investment from Questa Capital Management.

Apple acquires Finland-based Beddit, which offers a sleep tracking app that uses mattress-attached flexible sensors.

People

Jessica Campbell (Leidos Health) joins Nordic as VP of client partnerships.

Announcements and Implementations

Elsevier will add its ClinicalKey clinical search engine to the World Health Organization’s Research4Life journal access program for developing countries. 

The DiamondView HIE of South Country Health Alliance (MN) goes live with Medicity Notify, which provides electronic notification services for population health management that will be rolled out across its 11 counties.

Government and Politics

ProPublica reports that some Republican lawmakers who are being called out on social media for their support of the American Health Care Act (and their sometimes incorrect statements about it as copied and pasted from White House talking points) are blocking their vocal constituents on social media after deleting their comments. An example is Congressman Peter King (R-NY), who not only appears to be censoring critical comments, but is also declining to conduct in-person town hall meetings because attendees scream at him.

Privacy and Security

In Australia, Queensland Health experiences a major EHR failure after applying WannaCry security patches from Microsoft, Cerner, and Citrix that slowed down systems and affected the ability of users to log on.  

A survey finds that only 9 percent of medical device manufacturers test the security of their products at least once a year, with nearly half saying they don’t perform security testing at all. One-third of both manufacturers and health systems say no single person is in charge of device security and half say they don’t follow the FDA’s guidance to reduce security-related risk.

A security researcher finds that medical claims processed by insurer Molina Healthcare were freely accessible over the Internet simply by changing the number at the end of any claim’s URL to bring up a different claim, with no authentication required. The company fixed the problem after being notified and has shut down its portal pending a security review.

Other

NantHealth CEO Patrick Soon-Shiong announces plans to open a cancer center, saying that the city has a great basketball team and newspaper (he owns a chunk of both), but not a great cancer center.

Slides from Cerner’s investor conference presentation show that Cerner and Epic (which Cerner references by name, which doesn’t happen often) each hold 24 percent of the acute EHR market. Cerner won decisions involving 109 hospitals in 2016 vs. Epic’s 91, although it was 69 vs. 66 when excluding existing customer add-ons. It also notes that 2,400 hospitals are using legacy systems that offer a replacement opportunity, with more than one-fourth of them running Meditech Magic or C/S.

A group from Kaiser Permanente writes a Harvard Business Review article about KP’s efforts to get surgery patients out of the hospital quicker by using standardized processes and team coordination. The authors honor Jess Jacobs, who at the time of her death in 2014 at 29 had measured that in her 20 ED visits, 54 inpatient days, and 56 outpatient visits, only 0.08 percent of her time was spent actually treating her medical problems.

The State of New Jersey temporarily suspends the medical license of a psychiatrist who had prescribed thousands of doses of oxycodone for a single patient, with the attorney general announcing, “Our message to these doctors is clear: if you are not checking the Prescription Monitoring Program database as required by the new law, we will take swift and punitive action against you.”

The Wall Street Journal profiles CVS Health EVP/CIO Stephen J. Gold, who says that 30 percent of the company’s pharmacy customers use its text messaging system for prescription refills. He mentions CVS’s Fast Mobile Prescription Pickup, which allows customers to pick up their refills at the counter or drive-through by scanning the barcode sent to their phones. The company is also using a proprietary health engagement engine to look for intervention opportunities, such as sending a message to patients who aren’t taking medications as prescribed or reminding diabetics to test their blood glucose. Another CVS digital tool allows patients to synchronize the refills of all of their prescriptions to save a trip and to improve adherence.

The State of Minnesota, admitting that it can’t keep up with complaints about nursing homes that mistreat their residents, warns nursing homes that they cannot harass families who install “granny cams” in the rooms of residents to document the care their loved one receives. The ruling came after a woman who had placed a $199 video camera in her mother’s room complained that nursing home employees frequently covered it with a towel, unplugged it, pressured her mother to remove it by refusing to speak to her when entering her room, and eventually seized it.

The US finishes in its customary back-of-the-pack spot in a new global health measure that looks at: (a) how well countries prevent deaths by applying known medical interventions; and (b) how health measures improve with increasing national wealth. The author says it’s “an embarrassment” that the US spends $9,000 per citizen annually on healthcare while failing to improve its lagging world health position.

Sponsor Updates

• The Chartis Group publishes a white paper titled “Performance Transformation: An Undeniable Requirement in Uncertain Times.”
• GE Healthcare previews its upcoming film, “Heroines of Health.”
• Meditech announces that it sold systems to five customers representing 16 hospitals in Q1.
• EClinicalWorks will exhibit at the 2017 MPHCA Annual Conference May 30-June 2 in Biloxi, MS.
• FormFast, HealthCast, Iatric Systems, Imprivata, and Intelligent Medical Objects will exhibit at the 2017 International MUSE Conference May 30-June 2 in Dallas.
• As of May 18, people have counted on Healthwise information 2 billion times.
• DrFirst is sponsoring next week’s MUSE conference, where its executives will present seven medication management sessions.
• InterSystems will exhibit at the DoD/VA and Gov Health IT Summit May 31-June 1 in Alexandria, VA.

Blog Posts

• Prevention is Better Than a Cure: An In-Depth Look at Proactive Health (Evariant)
• From working with the pediatric population to diving into technology (Infor)
• 3 reasons why the CBO score should be a wake-up call for hospitals (Advisory Board)
• Four Considerations for CJR Payment Reconciliation: Is Your Organization Prepared? (ECG Management Consultants)
• Recap of expanded Community Giveback Week (Nordic)
• Why Healthcare Technology Innovation Must Consider the Patient Story (Hayes Management Consulting)
• Responding to the WannaCry Cyber Attack (The HCI Group)
• 4 Questions with Joan McFaul, Former CIO of Southcoast Health System (Optimum Healthcare IT)
• Houston. Healthcare. Fossils. Profits. (Healthcare Growth Partners)
• Smart Pumps at MUSE 2017 & how this topic relates to all of us (Iatric Systems)
• Patches aren’t the silver bullet; hospitals can keep systems running when hit by ransomware attacks (Imprivata)
• Why Horizontal Martech Won’t Work for Healthcare (Influence Health)
• 3 Key Security Threat Trends Healthcare Organizations Can’t Ignore (InstaMed)
• Overcoming Entropy: Cultivating Care Coordination at eHealth Week (InterSystems)
• Five Must-Track Digital Marketing Metrics for Health Systems (Kyruus)

Contacts

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