News 3/15/17

Top News

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

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

Reader Comments

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

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

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

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

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

HIStalk Announcements and Requests

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

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

Webinars

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

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

Acquisitions, Funding, Business, and Stock

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

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

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

Announcements and Implementations

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

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

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

Government and Politics

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

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

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

Technology

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

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

Privacy and Security

From DataBreaches. net:

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

Other

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

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

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

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

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

Sponsor Updates

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

Blog Posts

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

Contacts

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

Monday Morning Update 3/13/17

Top News

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

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

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

Reader Comments

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

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

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

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

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

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

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

HIStalk Announcements and Requests

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

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

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

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

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

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

This Week in Health IT History

One year ago:

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

Five years ago:

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

Weekly Anonymous Reader Question

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

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

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

Last Week’s Most Interesting News

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

Webinars

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

Acquisitions, Funding, Business, and Stock

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

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

Decisions

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

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

People

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

Privacy and Security

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

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

Other

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

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

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

Sponsor Updates

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

Blog Posts

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

Contacts

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

News 3/10/17

Top News

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

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

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

Reader Comments

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

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

HIStalk Announcements and Requests

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

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

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

Webinars

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

Acquisitions, Funding, Business, and Stock

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

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

Telemedicine platform vendor GlobalMed acquires competitor TreatMD.

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

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

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

Sales

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

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

People

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

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

Announcements and Implementations

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

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

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

Government and Politics

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

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

Other

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

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

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

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

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

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

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

Sponsor Updates

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

Blog Posts

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

Contacts

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

News 3/8/17

Top News

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

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

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

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

Reader Comments

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

HIStalk Announcements and Requests

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

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

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

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

Webinars

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

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

Acquisitions, Funding, Business, and Stock

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

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

Announcements and Implementations

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

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

Other

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

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

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

Sponsor Updates

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

Blog Posts

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

Contacts

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

Tech Mahindra Will Acquire The HCI Group for $110 Million

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

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

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

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

Monday Morning Update 3/6/17

Top News

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

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

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

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

HIStalk Announcements and Requests

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

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

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

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

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

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

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

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

This Week in Health IT History

One year ago:

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

Five years ago:

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

Last Week’s Most Interesting News

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

Webinars

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

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

Acquisitions, Funding, Business, and Stock

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

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

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

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

Sales

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

Decisions

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

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

People

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

Announcements and Implementations

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

Technology

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

Other

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

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

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

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

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

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

Sponsor Updates

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

Blog Posts

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

Contacts

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

Reader Survey Results 2017

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

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

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

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

Respondent Characteristics

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

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

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

Elements Appreciated

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

Suggested Changes

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

Improve the search function.

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

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

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

Create articles around questions that readers can answer anonymously.

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

Spotlight consumer digital healthcare.

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

Add non-US coverage.

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

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

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

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

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

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

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

Do more with social media.

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

Don’t quit writing HIStalk.

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

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

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

Offer an honorarium to ongoing contributors.

I’m perfectly willing to do that. 

Get rid of the smoking doctor’s pipe.

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

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

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

Dump Readers Write.

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

Suggestions

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

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

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

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

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

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

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

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

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

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

Facts are appreciated more than opinion.

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

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

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

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

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

Get a DC insider to write.

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

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

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

Comments

I invited respondents to say anything they want.

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

News 3/3/17

Top News

McKesson and Change Healthcare Holdings (the former Emdeon) complete the creation of the new health IT company Change Healthcare, which combines CHC’s software and analytics business with most of McKesson Technology Solutions.

McKesson will own 70 percent of the 15,000-employee Change Healthcare.

The company’s leadership team is listed above.

Reader Comments

From Alhambra: “Re: EClinicalWorks. The only tool available for EP MU attestation is the MAQ dashboard, which contains a disclaimer that all users must accept when they first log in. ONC is aware and investigating since a certified EHR must be able to accurately produce the required attestation reports.” Unverified as to the ONC part, but above are the screen shots provided. I’m not sure requiring acknowledgement of a standard lawyer-verbose warranty either absolves responsibility to ONC or suggests a lack of capability, so I suppose the issue is who is liable if an incorrect attestation is filed because of flawed data and whether the disclaimer is binding either way.

From Studiously Stoic: “Re: Becker’s Healthcare ‘150 Great Places to Work.’ We won and would like it mentioned.” I should stop being surprised when an organization that wins an award fails to note the worthlessness of their “win.” Becker’s employed no reasonable methodology to come with its click-baiting list – it accepts nominations, but then just lets its “editorial team” (mostly of them recent liberal arts graduates) make up the 150 winners based on unstated criteria that doesn’t seem to involve any research beyond Googling. It’s not like they actually surveyed employees or anything. This is not newsworthy.

From Banacek: “Re: ECG Management Consultants. Apparently cleaning house after last year’s acquisition of Kurt Salmon, with over 30 people being terminated. Senior partners are being targeted.” The company provided this response: “ECG recently completed a three-year strategic plan and organizational restructuring. This resulted in some departures and reassignments, primarily for our administrative function, but included a few consulting staff members as well. Overall departures have been minimal (fewer than five consultants from January 1 through February), and we have continued to make strategic hires – for example, in our revenue cycle and academic practices. Our business is strong and we anticipate continuing to grow in 2017.”

HIStalk Announcements and Requests

We provided a greenhouse and gardening kits for Mrs. M’s class of severally mentally and physically disabled students in Ohio. The students are actively participating and will present their work to their families in May and can then take the seedlings home to transplant them into their own gardens.

I’m annoyed at companies whose marketing people declare that their unchanged software has suddenly transformed into “artificial intelligence” just because it sounds cooler. AI is defined as a device that perceives and reacts to its environment in mimicking human reasoning in performing a complex, nuanced task such as solving a problem and then learning from the process to get smarter. Today’s version of AI is primitive, incapable of doing even a fraction of the intellectual processing of a not-very-bright human even when limited to a super-specialized task in a closed context. I suspect that most AI systems have a “man behind the curtain” who carefully programs the system to appear smart when it’s really not, hoping to find a profitable problem to solve without anyone digging too deeply into the methods involved. 

This week on HIStalk Practice: The Vancouver Clinic adds ActX genomic decision support. Drchrono opens its second office. CMS begins $100 million spend on helping small practices make the QPP switch. Jacksonville Children’s & Multispecialty Clinic selects PatientPay billing. The CMS Innovation Center looks for input on new pediatric care delivery models. Austin Regional Clinic adds Wolters Kluwer clinical guidelines to its Epic EHR. Coordinated care tech startup CrossTx raises $735k. Culbert Healthcare Solutions Executive Consultant Randall Shulkin shares value-based reimbursement success factors for medical groups.

Webinars

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

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

Acquisitions, Funding, Business, and Stock

AnalyticsMD changes its name to Qventus.

Consumer medication reminder free app vendor Medisafe, which apparently makes money by charging drug companies to nudge their patients into profitably taking all their ordered doses, raises $14.5 million. 

An employee overtime lawsuit that was filed against Cerner by delivery consultants and system analysts is certified as class action. The lawyer who represents current or former Cerner employees in several related lawsuits says that Cerner’s job titles make it sound as though learning consultants and delivery consultants are highly skilled positions, but claims that in reality, “these are folks that are entry level, straight out of college, with no real minimal requirements other than a college degree and a willingness to relocate to Kansas City.”

Tech-powered insurer Oscar, which offers exchange medical insurance policies in four states, loses $200 million in 2016. The company hopes to survive by raising prices, narrowing networks, and selling small business insurance plans to reduce its reliance on the volatile individual market.

Sales

The DoD chooses BD’s Pyxis ES automated dispensing cabinet for its 115 inpatient facilities and pharmacies in a $100 million contract award.  BD acquired the former Carefusion – which offered Pyxis dispensing technology, Alaris smart IV pumps, MedMined surveillance software, and medical supplies — for $12.2 billion in 2014. 

CVS Health will extend its use of Epic to its specialty pharmacy, which will join CVS’s MinuteClinic as an Epic user.

In England, three Liverpool trusts choose InterSystems TrackCare in a deal worth up to  $86 million.

People

Signet Accel names co-founder Peter Embi, MD, MS as chief medical officer. He remains president and CEO of the Regenstrief Institute.

Government and Politics

A federal grand jury in Texas indicts 16 people for fraudulently billing Medicare $60 million for hospice care. In addition to paying kickbacks disguised as medical director salaries and submitting false claims, the company’s CPA owner and nurses made medical decisions based on what paid the most, including placing patients on high-dose narcotics regardless of their need. The medical directors also gave their EHR log-in credentials to others to create and sign orders for services that were billed but not performed.

CDC publishes the 500 Cities Project, which allows visually comparing and downloading the prevalence of 27 chronic health condition measures between cities and down to the census tract level in a chosen city.

Other

Facebook is testing algorithms that can identify users who are having potentially suicidal thoughts, after which a company team will rapidly review the user’s posts and comments from friends and then send a message offering resources. Facebook is trying to balance its response to such incidents against the privacy issues that would arise if it automatically notified family, friends, or mental health groups without the user’s permission. It already allows users to manually flag suicidal posts, functionality that has now been added to Facebook Live streaming video. Facebook says it was working on the tools before a series of events in which people live streamed their suicides on Facebook Live, often with the encouragement of other Facebook users.

Amazon Web Services explains its four-hour East Coast outage on Tuesday: a script being run by a technician to take down a few problematic servers contained a typo that instead took a bunch of servers offline, including the one that indexes all locations for running database commands. AWS says it has updated the script tool to disallow taking servers offline if any subsystem will fall below its minimum capacity. It will also speed up an existing project to improve recovery time of the indexing subsystem.

NHS auditors find a hospital’s foreign doctor with poor English proficiency looking up medical terms on Google. The hospital says the doctor no longer works there and it will now require language checks.

A study finds that 80 percent of patient advocacy groups accept money from drug and medical device companies that sell products to people with the conditions they support, raising the question of whether the donations influence the frequent silence of those groups about drug prices. Some groups receive more than half of their funds from industry, while 40 percent of them have industry executives as board members. Even the umbrella group for patient advocacy groups took in 62 percent of its $3.5 million budget from industry. The groups claim such donations don’t affect their decisions, but the authors recommend that they be required to provide full disclosure.

A study confirms what we all suspect and fear – people are indeed peeing in public swimming pools and hot tubs, with an analysis of artificial sweetener content in two pools suggesting they contain from 8 to 20 gallons of urine. Hot tubs had much higher urine levels. Movie gags to the contrary, no blue dye exists to call out the pee-pertrators.

Sponsor Updates

• Medicity launches Community Interchange, which creates a single, de-duplicated, and normalized CCD for hospitals.
• CommonWell TV interviews LifeImage CTO Janak Joshi.
• Children’s Mercy Kansas City (KS) goes live on GetWellNetwork.
• MedData will exhibit at HFMA Utah’s Spring Alliance Meeting March 8-10 in St. George.
• National Decision Support Company will integrate its CareSelect decision support system with McKesson and Meditech. The company also announces that its client base has increased to 250 provider systems and 2,000 facilities in all 50 states. 
• NVoq will exhibit at the CHA Rural Health and Hospitals Conference March 8-10 in Denver.
• Recondo Technology releases a revenue cycle API for prior authorization, eligibility, medical necessity, and pre-service patient collection and related RCM processes.
• NTT Data and Oracle expand their existing relationship, adding cloud capabilities to Oracle’s Healthcare Foundation analytics platform.
• Netsmart extends its behavioral population health solutions to post-acute providers.
• Orion Health begins migration of its Amadeus precision medicine platform to Amazon Web Services.
• CloudWave chooses Commvault to power its backup-as-a-service healthcare offering.
• Definitive Healthcare launches a professional services team to help customers use its healthcare data to understand the market and executive plans.
• Obix Perinatal Data System will exhibit at the March of Dimes Perinatal Nursing Conference March 6-7 in Lombard, IL.
• Medicomp Systems announces Quippe Clinical Lens, a web-based, problem-oriented clinician view of relevant clinical information from EHRs and HIEs.
• Experian Health will exhibit at the FL AAHAM meeting March 8-10 in Palm Coast, FL.
• Uniphy Health releases UH4, an enterprise collaboration platform that supports patient-centric communications and provides real-time patient data at the point of care.
• Kyruus integrates ProviderMatch with Salesforce Health CLoud.
• PatientKeeper previews its new e-book, “Healthcare IT 2017-2022: First Comes Change, Then Comes Value.”
• PokitDok joins the AWS Marketplace, becoming an APN advanced technology partner.
• QuadraMed will exhibit at the ANA Annual Conference March 8-9 in Tampa, FL.
• Imprivata integrates its PatientSecure positive patient ID solution with registration kiosks from CTS, Vecna, and PatientWorks.
• The SSI Group will exhibit at the HFMA Region 5 Dixie Institute March 9 in Savannah, GA.
• The Surescripts National Record Locator Service is live at 14 health systems nationwide.

Blog Posts

• How Hospitals are Solving the Patient Experience Problem (Definitive Healthcare)
• I’ll Be Back: Return of AI and Machine-based Learning (Iatric Systems)
• Identity Theft Victimizes Businesses as Well as Consumers (ID Experts)
• Revenue Cycle Post-Implementation Support (Impact Advisors)
• How Saint Joseph Health System is making checking in more secure and accurate with biometric identification (Imprivata)
• Healthcare Consumer Experience Abounds at HIMSS17: Three Key Takeaways (Influence Health)

Contacts

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

Lorre’s HIMSS17 Summary 3/2/17

During the months leading up to HIMSS, I feel like a CPA anticipating April 15. It is a huge push to get an unbelievable amount of work done in not nearly enough time. After all, I’m the one and only HIStalk team member other than the folks whose time is fully committed to writing what you read every day.

As in previous years, I enlisted the help of a couple of my family members to help me get things to the convention center and distribute the HIStalk sponsor signs. Our booth is small and there is little to it, so it takes about 15 minutes to set up.

It usually takes a couple of hours to deliver all of the sponsor signs since we do it before the exhibit hall setup is complete. It’s hard to find the booths with just their numbers because of irregular aisles. This year, we waited until the opening day when all of the booth signs and numbers were up. We got it done in record time.

Midway through HIMSS16 a year ago, I went to my first booth selection appointment. With the help of someone there, I chose our booth location purely because it was at the top of an escalator and not in the back of the exhibit hall near the loading docks or restrooms like we usually get for our tiny 10×10 space. On Sunday afternoon when I arrived to set the booth up, our booth was the first thing I saw.

Even that first look at our pretty decent-looking spot could not prepare me for the opening of the doors to attendees at 10:00 Monday morning. People were lined up as far back as I could see. The location of the booth made up for all of the prior years combined. Our booth was busy from the time the exhibit hall opened until it closed each day.

Here are the Top 10 comments and questions I heard at the booth:

1. I love HIStalk, I read it every day.
2. Please tell Mr. H not to ever stop writing HIStalk.
3. I am new to healthcare IT and I read HIStalk because it makes me look smart. (I heard this a lot)
4. HIStalk is required reading where I work.
5. Does that really look like Mr. H? (asked while pointing at our cardboard standee of the smokin’ doc).
6. Do you know who Mr. H is?
7. Why are so many people visiting your booth? What do you guys do?
8. Would it be OK to take a selfie with Mr. H? (our cardboard standee)
9. Do you have any extra tickets to HIStalkapalooza?
10. I heard a rumor that this was the last year for HIStalkapalooza. Please tell me it isn’t so!

I am always excited to meet the guests who spend time in our booth. This year I had a chance to talk with Nancy Ham, named as one of the most powerful women in health IT. She spoke about the importance of mentoring young women in the workforce. Keep an eye out for an upcoming HIStalk-sponsored webinar where she will cover a similar topic.

It was interesting to talk with Dr. Regina Benjamin, the 18th Surgeon General of the United States. She was at HIMSS with accessURhealth to emphasize the need for tools and resources to positively impact the identification, treatment, and awareness of mental and behavioral health.

I packed up and left the booth early on Monday so I could be a the House of Blues by 4:30 to walk through the logistics of HIStalkapalooza. It was like HIMSS all over again – we were two hours from opening the door to the attendees and there was so much left to be done. None of the sponsor banners were hung and the step-and-repeat red carpet backdrop I had bought online for $250 was delivered to my feet in two big boxes. I showed the people who would hang the banners where they should go.

I know Mr. H mentioned this, but you had to be there to appreciate the ingenuity and determination Jenny and Val from Optimum Healthcare IT demonstrated. I asked the House of Blues if they could provide someone to help us assemble the frame that holds the step-and-repeat. After spending about 30 minutes on it, one of their production crew told me we were probably missing a part and it couldn’t be put together, leaving us without a backdrop and Mr. H with a wasted investment. I sighed with frustration and went on to the next urgent matter. When I returned, Jenny and Val were sitting on the red carpet with the pieces of the frame spread out, trying to figure out how to assemble it. A few minutes later, they had it standing, albeit a little bit propped up.

There were a lot of challenges with the House of Blues this year, but as always, someone trying to do a good job provided a highlight. I ordered a toast for a group of people and the bartender said a manager would need to approve. She arrived after 15 minutes and said they aren’t allowed to provide shots at events like ours. After the manager was out of earshot, the bartender decided that as long as he placed an ice cube in each glass, it’s not technically a shot. The tradition was upheld.

The result was the now-famous Longo Lemonade toast.

This is Jean, a HIMSS shuttle bus driver who also provided amazing service. I had waited 30 minutes for the shuttle to stop near where I was staying and it finally arrived just as it started to rain. As the last passenger stepped off of the bus and I took the first step to enter, Jean received a call from his dispatcher telling him to return to the garage empty since the shuttle schedule was changing from every 15 minutes to every 30 minutes. After a bit of coercion, Jean agreed to take our group of passengers to the convention center before returning to the garage as instructed. I got there on time and still dry.

We gave out our usual HIMSS survival kits, thanks to Arcadia Healthcare Solutions. Meditech gave us a supply of “Mobile Pockets” and cool green pens to give away. I managed to grab a pocket for the back of my cell phone cover, but the pens were gone before I got one.

I don’t see a lot of cool things at our booth because most companies are demonstrating in their own booths. The one exception was Blausen. It is like a collaboration of WebMD and Pixar, They claim it is the world’s largest library of medical and scientific illustrations and 3D animations, but that was an understatement. Each one has a short video that describes the condition, symptoms, and treatment clearly with visuals that are hard to stop watching.

The team from Spok stopped by for a picture and I admired their company-branded shoes. The Spok logo was subtle and the color matched the logo on their shirts perfectly.

HIMSS17 was manageable for me because of the help I received from Brianne, shown here backstage at the House of Blues with some of the Party on the Moon dancers. She spent the weeks leading up to HIMSS making sure all of the HIStalkapalooza invitations were sent and all of the (never-ending) changes were kept straight. She answered questions from sponsors and kept them on track. During HIMSS, she spent time in the booth and gave people information. She spent almost all of her time at HIStalkapalooza at the door enforcing the rules for admission. Thank you, Brianne.

My favorite part of HIMSS every year is connecting with the readers and sponsors. I interact with people on the phone and through email all year, so it is really a treat to meet people I have only spoken to and get a hug from those I have known for years.

I thought HIStalkapalooza was fantastic again this year. Thanks to the many sponsors that made it possible.

Despite the fact that Mr. H swore he wouldn’t do it again because of the work involved and the financial risk he takes in hoping he can cover the cost with sponsorships, I am already hearing him softening up a  bit. My plan is to find sponsors willing to sign up early to avoid our last-minute panic and reduce his risk. It makes sense to limit the number of sponsors to those who can commit early and thus make it extra special for them. Stay tuned!

Contact Lorre.

News 3/1/17

Top News

Mayo Clinic’s annual report says it will spend more than $1 billion for its five-year Epic implementation.

Reader Comments

From Craptastic: “Re: McKesson’s EIS division. The likely buyer is India-based Tata Consultancy Services. They are conducting web-based video sessions between Charlotte and Mumbai. The EIS division contains dead or dying products like Star, Series, and HealthQuest, so the main target is Paragon, which was hot in small hospitals years ago, chilled down by trying to replace Horizon, then cold as hell once the divestiture rumors started.” Unverified. Publicly traded Tata Consultancy Services, part of the Tata Group conglomerate that manufactures everything from Tetley tea to Jaguars, is perhaps best known in health IT circles for being hit with a $940 million judgment in a trade secrets lawsuit brought against it by Epic.

From Quirky Queen: “Re: HIMSS17. This website lists what people thought were the dominant themes.” The website asked a bunch of people, most of them vendors, which topics dominated the conference. Not surprisingly, vendors donned their tunnel vision glasses to declare that whatever they sell (cloud computing, cybersecurity, or population health management tools, for example) is the Next Big Thing that attracted massive HIMSS17 interest. Beyond the obviously self-serving answers, even the question itself encourages bias – what if there was no big thing, or what if that person missed it? I’ll go to with the former and I’m happy that nobody waved yet another shiny object that does little to improve outcomes or cost. Cybersecurity got more attention mostly because HIMSS pushed that topic as a business opportunity, but nobody I saw had a lot of big developments or compelling case studies for population health management technology, precision medicine, and analytics. The mode seems to be more optimization than acquisition. I consider that positive – hopefully we’ve outgrown the days of providers creating their IT strategies around vendor brochures.

From UMMC IT: “Re: University of Mississippi Medical Center. Looks like staff reductions will happen and IT may get hit hardest with the largest budget on campus and staff.” The hospital says that an unexpected $35 million Medicaid funding cut will require layoffs and elimination of programs. 

From Salty Dog: “Re: marketing conference. I remember seeing that you had a discount registration code for John Lynn’s marketing conference. Do you still have that available? Also, thanks for HIStalkapalooza – I got my annual fix of dancing and enjoyable conversations with both acquaintances and strangers.” Registration for the Healthcare IT Marketing & PR Conference is open through March 6, for which using promo code “histalk” saves you $300 on the $1,395 general registration. Nearly all attendees of last year’s conference gave it at least an 8 on a 10-point scale. I’m glad you enjoyed HIStalkapalooza, where dancing is always a highlight thanks to the incredible Party on the Moon.

From WK Fan: “Re: HIStalkapalooza. I appreciate the broad coverage of HIStalk and thank you for hosting the event. Invitations and HOB being a pain to work with stinks, but the party and vibrations were positive. Band was upbeat, food not so much, but wait staff and bar was inviting. The negatives will sting and linger, but don’t forget to pat yourself and your party planners on the back since it delivered a great time.” Thanks. We did the best we could, anyway. I’m sorry the food didn’t live up to its price tag. I only had chicken, salad, and spinach-artichoke dip and it was pretty good for what it was.

From Darren Dworkin: “Re: HIMSS17. Many of us come back from HIMSS with all sorts of reflections on the industry, the show, the crowds, and of course our share of suggested improvements. But I thought I would take a minute to give a well-deserved shout-out to out going president of HIMSS, Steve Lieber. As you shared in HIStalk a while back, after almost 20 years and navigating some amazing growth, Steve is leaving an organization he did not create but that he certainly helped propel to be a foundational piece of our industry. A friend shared with me recently that building and running an organization can often look glamorous from the outside, but inside it is more akin to the work of picking up tin cans one at a time. Building and running big things is hard  since everyone has an idea how to do it better. Steve, thank you for doing the hard things for our industry and growing HIMSS to what it is today.” I agree. I struggle with the unbridled, sometimes seemingly patient-indifferent ambition of HIMSS that is fueled by a business model of selling vendors access to providers, sometimes veering into purely commercial territory (HIMSS Media, HIMSS Analytics) and orchestrating self-serving advocacy efforts, but Steve skillfully moved the organization to where he thought it needed to go and sometimes dragged the industry along with it.

From Bonny Roberts: “Re: HIStalkapalooza red carpet. Your #1 fan was a retired woman who came to Orlando only to attend the event – she didn’t even register for the HIMSS conference.” That’s pretty cool. Hopefully she found it worth whatever degree of travel was required. Bonny, in the red dress above, was our red carpet host. I don’t know the identity of the person to whom she’s referring.

HIStalk Announcements and Requests

We readers funded Ms. A’s DonorsChoose grant request in buying 30 calculators for her sixth grade math class in South Carolina. She moved me with her report about the impact of the $5 calculators: “My classroom is a much better place because of your willingness to help them in a time of need. These calculators have enhanced our classroom and my students so much … The calculators prior to these new ones were very old, and honestly, they came from the local Dollar Tree store. In the school district that I am teaching at, our salaries are below average and we extend our finances to help our students as much as possible. The need for calculators was extreme, so I purchased my own class set. While they lasted for a short amount of time, they were great for my students … They deserve the best, and they definitely got that from your donation. Again, thank you so much for these beautiful calculators! They do not seem like much, but they will impact my students and classroom so much!”

Our post-HIMSS17 cupboard is a bit bare since everybody wrapped up most things before the conference, so potential new sponsors and webinar promoters can contact me for the specials I always trot out right about now.

I’ve heard from several folks that, like me, they are a bit under the weather post-HIMSS from some combination of stress; sore throats and runny noses (maybe from rebreathed air or exhibit hall glad-handing); and possibly some element of food poisoning.

As a healthcare guy, the first things I thought of upon reading about the Oscars “wrong envelope” fiasco were the following:

• Surely just like in healthcare there was a Swiss cheese effect of multiple exceptions that lined up to allow the usually reliable system to fail. As it turns out, the PwC envelope guy above was screwing around on Twitter in a celebrity-fawning haze instead of paying attention to the job he was being paid to do. Then, a justifiably puzzled 79-year-old Warren Beatty showed Faye Dunaway the card he had been handed to see what she made of it, but then she misunderstood his intention and blurted out the name she saw. That’s pretty Swiss cheesy.
• A human factors expert would have paid close attention to the envelope’s color and labeling, which is no different than redesigning an IV label or patient wristband to prevent mistakes.
• Technology might have helped, such as discreetly barcode checking the envelope before handing it over. In fact, the entire process of relying on duplicate stacks of paper (one on each side of the stage) seems dramatic but ripe for technology improvements, such as having the complete narrative to be read – including the winner’s name – from a teleprompter whose contents are secured until the big reveal.
• Bonnie and Clyde should have taken a time-out before forging ahead with a situation that was obviously puzzling to them.
• The Oscar producers seemed afraid to speak up before the non-winners began their acceptance speeches. It was apparently a stagehand who figured out the problem and stepped in a couple of minutes later, no different than when a cranky surgeon forges ahead into blunder-dom because everybody is reluctant to challenge them.
• The brand damage to PwC (which wags are calling “Probably Wrong Card”) is incalculable.
• Unlike an actual healthcare snafu, nobody was harmed, social media were entertained, everybody was a good sport, and all who were involved lived to tell about it.
• Notwithstanding proclamations of a non-punitive culture, the two on-stage consultants will be thrown under the bus and either demoted or fired and PwC will lose its most visible client.

I strung together a sampling of HIStalkapalooza photos into a YouTube video. This is the last party-related deliverable on my list, except I think the videographer has a final video cut on its way. Here’s a fun fashion footnote: three women told me they ordered fancy dresses from the once-fabulous Rent the Runway, but all three received garments that were obviously ripped. Two spent time trying to patch them up, while the other just gave up and went back to conference wear. Perhaps the company is a victim of its own success and is wearing out its means of production. 

Webinars

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

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

Sales

A cross-border radiotherapy project in Republic of Ireland and Northern Ireland chooses Agfa HealthCare’s health management platform, including its universal viewer.

People

Consumer health website Sharecare — founded by WebMD founder Jeff Arnold and TV huckster Dr. Oz — hires John Solomon (Apple) as strategic advisor and Dale Rayman (Zipongo) as SVP of actuarial consulting and business development.

CompuGroup Medical promotes Benedikt Brueckle to CEO of its US division. He replaces Werner Rodorff, who will return to his previous role as CTO.

Announcements and Implementations

For-profit, five-hospital Cancer Treatment Centers of America Global will integrate NantHealth’s oncology clinical decision support with Allscripts Sunrise.

MModal launches Scribing Services, which provides medical scribes who review audio from encounters – either in real time or afterward – and document directly into the EHR.

Government and Politics

VA Secretary David Shulkin, in his first public address, outlines his priorities, which include improving access to non-VA providers when a veteran can’t get a timely VA appointment, making it easier to fire bad employees, creating new suicide prevention programs, improving coordination with the DoD, and enhancing the VA’s IT.

Meanwhile, the VA says it will increase employee drug testing and drug inspections following government reports of sloppy drug tracking, large numbers of drug diversion investigations of which few resulted in disciplinary action, and lack of consistent drug testing of new hires.

An HHS GAO report recommends that HHS encourage improved information exchange as patients leave hospitals for post-acute care settings.

A Black Book survey of 35,000 consumers who are covered by exchange-sold health plans finds a strong drop in satisfaction in the past year, with the biggest gripes being poor customer service, premium hikes, narrowing networks, reduced benefits, and too-few participating insurers to choose from. Time to resolve member complaints jumped from 12.5 days to 31 days in 2016. Overall satisfaction dropped from 77 percent to 22 percent, wile 58 percent of those surveyed said plan services declined significantly. More than two-thirds of US counties had only one or two insurers to choose from. 

HIMSS declares health IT to be “a bright spot for the US economy,” somehow missing the economic point that a swollen healthcare industry and its supporting services are mostly a drain on the economy and international competitiveness rather than something to brag about.

Privacy and Security

A patient sues New York Presbyterian / Columbia University Medical Center for charging her $1.50 per page plus an administrative fee to provide copies of her medical records, presenting her with a bill for $3,000. State law limits costs to 75 cents per page. Also named in the suit is IOD Inc., to which the hospital outsourced its release-of-information management.

The Equal Employment Opportunity Commission subpoenas TriHealth (OH), demanding that it turn over the medical records of the employees of an unnamed company that is being investigated for making unjustified disability-related medical inquiries. The company says TriHealth doesn’t give it access to the records, while TriHealth says it doesn’t own the records of the approximately 2,000 patients involved and thus can’t turn them over to EEOC.

Other

Amazon Web Services went down in the eastern US Tuesday afternoon, causing problems for websites, apps, and services that rely on its cloud computing services. Explaining to a hospital CEO that their outage was caused by someone else’s data center problems must be tough. I’m not sure which cloud-based vendors went down, but Practice Fusion was one of them.

Tech-powered home caregiver matching company HomeHero, the #1 home care provider in California, finally shuts down after an October 2015 Department of Labor ruling that home care workers must be hired as W-2 employees rather than 1099 contractors, a change advocated by labor unions and California $15 per hour minimum wage advocates. That ruling also required paying overtime rates that doubled the cost of live-in care that made it more expensive than sending a patient to a skilled nursing facility. The now-defunct company pivoted to an enterprise model to work with hospitals, signed up with the Cedars-Sinai digital health accelerator, and developed a CareKit-integrated health app, but then found that large health systems would launch pilot projects strictly for case studies with no intention of buying anything because they had no financial incentive to pay for home care (“being dragged out in the middle of an ocean and abandoned”).

In Australia, merged medical device manufacturers Medtronic and Covidien implement new supply chain systems, with conversion hiccups interrupting the flow of orders for surgical instruments, respiratory products, and sutures for six weeks, causing hospital surgery backlogs and apparently some incidents of patient harm from the use of replacement products.

Laid-off IT workers at UCSF were planning to demonstrate on campus Tuesday to protest the university’s decision to outsource their jobs to India.

A reader sent over an interesting 2015 Health Affairs article about healthcare costs that I had missed. It opines that conservatives blame patients for making bad health choices and paying too little of their healthcare costs to have adequate skin in the game; liberals blame doctors and hospitals for gaming the system to protect their incomes; while both sides ignore the comparative US under-investment in public health and social spending. It concludes, “Improving health requires changing the society itself, not merely changing individual behaviors.” 

A study finds that even though EDs are the source of a lot of inappropriate antibiotic prescribing, most pediatric EDs say they aren’t invited to the table when antimicrobial stewardship programs are being created or managed.

Former CMS Acting Administrator Andy Slavitt notes that only 2.1 percent of HIMSS17 attendees were identified as non-management clinicians and 60 percent came from non-provider settings. That’s based on job title and employer, though, and sometimes clinicians still see patients while working in IT or at a C-level job. The other slice and dice I’d like to see is how many CIOs, IT directors, CMIOs, and VPs came from provider organizations since those are the decision-makers that vendors swear are in short supply in the exhibit hall.

Sponsor Updates

• Medhost’s inpatient, ED, BI, and YourCareUniverse portal earn Meaningful Use Stage 3 certification.
• AdvancedMD will introduce a new dermatology practice model, Practice 2.0, at the ADAM/AAD meetings in Orlando this week and next.
• Sutherland Healthcare Solutions publishes a case study of its ICD-10 transition work with Palomar Health.
• CommonWell TV interviews Aprima COO Neil Simon at HIMSS17.
• The Breaking Health Podcast interviews Arcadia Healthcare Solutions CEO Sean Carroll.
• CRISP publishes a case study about PROMPT, a care coordination platform developed by Audacious Inquiry.
• Palmetto Health Quality Collaborative goes live on Caradigm’s population health management solutions.
• Casenet integrates its TruCare population health and care management solutions with MCG Health’s evidence-based guidelines to improve the prior authorization process.
• CoverMyMeds expands its RxChangeRequest Service at no cost and commits to interoperate with willing trade organizations.
• Cumberland Consulting Group CEO Brian Cahill contributes to Consulting Magazine’s cover story on “The Trump Effect.”
• Elsevier CMO Peter Edelstein shares precision medicine insights from the HIMSS17 show floor.
• EClinicalWorks successfully deploys CommonWell services.
• FormFast will provide forms automation and electronic signature technologies for the Meditech implementations of health IT service provider Engage.
• Healthcare Growth Partners publishes “Health IT Valuation Trends by HIT Subsector.”
• Two studies presented at ATTD 2017 showcase the dramatic improvements in diabetic control and patient outcomes enabled by Glytec’s personalized therapy management and clinical decision support.

Blog Posts

• Five Considerations for Implementing a Successful Disaster Recovery and Business Continuity Strategy (Optimum Healthcare IT)
• Leidos Health Ranked in 2017 Best in KLAS Awards: Professional Services (Leidos)
• Introducing the 2017 Data Gallery (Arcadia Healthcare Solutions)
• Reflections on HIMSS17: Same Same, but Different (Datica)
• Healthcare Innovation Creates Investment Opportunities (CareSync)
• Healthcare Cybersecurity Professionals in High Demand (Direct Consulting Associates)
• Is Your Online Corporate Image Attracting the Best Talent? (Dynamic Computing Services)
• 3 Takeaways from HIMSS17 (Dimensional Insights)
• Doubling Down on Value-based Care: The Ambulatory Strategy (ECG Management Consultants)
• 3 Ways Social Media can Improve Healthcare Marketing Efforts (Evariant)
• The Top 10 Reasons Transformation is the New Normal for Healthcare – Reason 7 (GE Healthcare)
• Optimizing Your EMR Project: Utilize Your Lessons Learned (Hayes Management Consulting)
• How America’s Best Hospitals Engage Patients in Their Care (Healthgrades)

Contacts

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

Monday Morning Update 2/27/17

Top News

Six-hospital Memorial Healthcare System (FL) pays $5.5 million to settle HIPAA charges after notifying HHS that two of its employees — as well as 12 employees of affiliated physician practices — inappropriately accessed patient information that was either sold or used to file fraudulent tax returns.

An investigation found that the health system failed to review audit logs and did not properly maintain access authorization despite having noted those deficiencies in its own risk analyses for several years before the incident occurred.

The information of 115,000 patients was exposed, most of it to someone using the login credentials of a former employee of an affiliated physician practice over a one-year period. 

Reader Comments

From Pittsburgh HIT Minion: “Re: HIStalkapalooza. I just wanted to reach out and thank you for hosting a wonderful HIStalkapalooza at HIMSS. I’ve been honored to receive an invite for the past couple years, and it is without a doubt the highlight of my time at the conference. So many of us are faced daily with the challenges of delivering high-quality care to patients who are scared, confused, and just want our help navigating a difficult and expensive health system. The upbeat crowd, the humor of the awards, and the always incredible Party on the Moon are a welcome respite from the cares that our chosen career path brings. Again, thank you.” You are welcome. It’s a pain dealing with no-shows and an endless parade of self-entitled folks that drain our time and energy right when need it most (boy, could I tell you stories), but it’s nice that attendees enjoy the evening even if I don’t. The only way I would do it again is if I could figure out venue in which I’m not at financial risk (due to high buy-out costs) and if I could just open the doors to anyone with a HIMSS badge without dealing with the whole invitation process that brings out the worst in people. I will also say that I would never do another one at House of Blues Orlando – their only strong competency seems to be nickel-and-diming and saying “no” to even modest requests, which is especially galling given that I was about to write them a check for $99,000 and I couldn’t even get someone to bring me a plate of food backstage.

From Cathy’s Clown: “Re: HIMSS selling booths by volume instead of area. If that’s the case, can one company buy the space above its competitor and advertise against it?” HIMSS should sell the air rights competitively, encouraging companies to lock in the space above them to avoid being trumped by a competitor whose sign there contains a downward-pointing arrow with a legend of “I’m with stupid.” I don’t see a height surcharge listed on the price sheet, but it doesn’t contain a great deal of detail. Based on the information above, however, the largest booths such as those of Epic and Cerner cost in the $400,000 to $500,000 range for floor space alone.

From Dickie Doo: “Re: your HIMSS booth. What was the total cost for your tiny space?” Ouch, that “tiny” part stung a little, as the truth often does. I gulped hard in paying $5,300 for our booth, but I magnanimously sprang $130 for two chairs so Lorre and the 18th US Surgeon General Regina Benjamin wouldn’t have to stand all week. Then it was another $18 for a cardboard trash can, $182 for a standard conference table, and $167 for the cheapest available carpet (and if you noticed the hideous color, you’ll understand the low price, especially since I refused to pay Freeman to run the sweeper over it). We don’t ever even buy a power strip ($150 per day or something like that) or Internet access, so we’re as barebones as it gets. Our location for HIMS18 is horrible, down in the Siberian basement, so I’ll really question the value then. I should instead hit up a big-boothed vendor to donate a free corner of their space in return for a fairly regular inflow of the interesting characters we apparently draw (it’s hearsay to me since I’m not actually there to see it). 

HIStalk Announcements and Requests

Three-fourths of poll respondents think the VA will replace VistA with a commercial solution, with Cerner edging Epic as the most likely product.

New poll to your right or here: For HIMSS attendees: did you discover a product or service that you will follow up on?

Ms. W checked in from her high-poverty South Carolina school to describe how funding her DonorsChoose grant request worked out: “Thank you so much for the STEM materials. When the package arrived, my students were so excited. They felt like it was Christmas all over again. My students love building and creating with the objects, not only for projects, but also during free time. My students will sometimes choose to read or work with a STEM bin once their station is completed. They love getting to use these new materials to help them stretch their minds and build with these materials. Their creativity is really growing. I love watching them love learning!”

Fun stuff from the back of the tee shirt that Eclipse gave me at their booth.

Thanks to Jenny and Valerie from Optimum Healthcare IT for spending at least an hour assembling our step-and-repeat background for the red carpet entrance. That’s another saga in itself. House of Blues wanted $1,250 plus labor to put up a step-and-repeat, so we bought one online for $250, hauled it over to HOB, and then had to figure out how to assemble it right before the doors opened. HOB did stick us for the red carpet itself since we didn’t have an alternative – that chunk of ratty red rug cost me $1,200 to use for the evening even though they surely didn’t pay more than $500 for it and it looked like it had been used at least 1,000 times since.

I’m running my annual post-HIMSS webinar special to rebuild the freshly eliminated backlog. Contact Lorre for a deal.

Webinars

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

Acquisitions, Funding, Business, and Stock

ConsejoSano, which offers digital health tools to help Spanish speakers navigate the US health system, raises $4.9 million in a Series A funding round.

Decisions

• Watauga Medical Center (NC) and Soin Medical Center (OH) will switch from BD Pyxis MedStation to an Omnicell automated dispensing cabinet (ADC) system.
• University of Maryland Rehabilitation and Orthopaedic Institute (MD) will replace its Omnicell ADC with BD Pyxis MedStation.

People

Lucia Savage, JD (ONC) joins Amada Health as chief privacy and regulatory officer. 

Announcements and Implementations

CMS adds Audacious Inquiry to its SPARC contract.

Other

Drug seekers are arriving — sometimes by the carload — in Missouri, the only US state that hasn’t implemented a prescription drug monitoring (doctor-shopper) database that would otherwise thwart their drug-seeking ambitions. Physician and Republican Senator Rob Schaaf, who has led opposition to the database and who says he will filibuster in trying to stop any new bills that would support its creation, explains, “I have always been opposed to having our private medical data on a government database.”

In Canada, Nanaimo Regional General Hospital temporarily shuts down CPOE and goes back to paper ordering as the latest in a series of problems in its IHealth rollout of Cerner.

Healthgrades names its best hospitals for 2017, with 22 states and DC having none of them.

A small observational study finds that ICU doctors and nurses spend an average of 49 percent of their time working on the computer, with some of them hitting 90 percent of their working hours at a keyboard. The authors warn that team communication and interaction with patients and family may suffer, adding, “The job really isn’t fixing bodies and interacting with them. It’s just managing streams of data.”

The Raleigh, NC newspaper profiles Woodrow Batten, MD, a hospital doctor who has retired just months after earning Epic certification. The 95-year-old doctor co-founded the hospital 60 years ago.

Sponsor Updates

• PokitDok Launches on AWS Marketplace, Becomes APN Advanced Technology Partner (PokitDok)

Blog Posts

• #HIMSS17 CIOs discuss extending their EHR [CHIME Focus Group] (Nordic)
• 5 Necessary Steps to Protect Your Patient Data (Spok)
• Revenue Cycle Post-Implementation Support (Impact Advisors)

Contacts

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

Jenn’s HIMSS Report – Wednesday

My last full day at the conference started off cloudy and cool, which made for a comfortable, early-morning walk to the convention center. I have really enjoyed not having to rely on the shuttle this time around. I think I’ll look into booking my room for HIMSS18 within the next month. I must add, though, that I am not looking forward to heading back to Las Vegas. It’s one of the few cities I’ve visited around the world that just doesn’t agree with me (or perhaps it’s the other way around).

After catching up on email and other tasks in the press room, I sat down with Quest Diagnostics SVP and CIO Lidia Fonseca to get a feel for what the company has been up to. I’ve been keeping an eye on their patient-initiated testing pilots (check out my latest coverage at HIStalk Practice), and was eager to learn if the high-profile rise and fall of Theranos had offered any lessons learned. She was quick to tell me they don’t comment on the strategies of competitors, but did add that Theranos had “certainly created a heightened awareness of diagnostics.” It seems reasonable to assume that consumers might trust a company like Quest over a startup like Theranos, given that Quest has been very intentional about playing by the regulatory rules, and seems to be rolling out consumer-directed testing methodically.

After hanging out at our booth for a bit, I trekked over to the Nuance to meet with Ehab Hanna, MD, CMIO at  hospital management company United Health Services of Delaware. He took me through his organization’s roll out of several Nuance transcription technologies, the most recent of which includes PowerMic Mobile, and Cerner’s Document Quality Review, which includes Nuance’s CDI tech. He pointed out that the majority of his physicians (there are still a few holdouts who employ scribes at their own expense) are beginning to see the impact transcription can have on quality scores now that everyone is preparing for MACRA. Hanna added that he would spend some time in the exhibit hall looking at analytics and data warehousing for population health management initiatives, and mobility tools for providers and patients.

Walking to interviews certainly works up an appetite, and so Lorre was kind enough to hand me a HIMSS Bistro ticket left over from the HIStalk CMIO lunch. I set off on quite the adventure to find the place, which ended up being on the lower level of Hall A, tucked away in an inconspicuous wing. It was a nice excuse to get away from the multitudes and enjoy a meal that was a few steps above press room fare. I have a huge sweet tooth and was quick to take advantage of the dessert bar. I’ve tried to eat well while I’ve been here. Any slip ups have been justified by the reality that the miles I’ll walk afterward will surely burn everything off.

I found a much quicker way back to our booth, where I spent some time chatting with readers, many of whom stopped by to ask, “Was that really the last HIStalkapalooza?” Most everyone had an idea of how to save it. I found the notion of charging for tickets interesting, though I’m not sure that would actually cut down on the hassle Lorre suffers through every year. A Swiss provider on the prowl for new ideas said HIStalk could donate anything above and beyond breaking even to Donors Choose, which sounds good in theory. I was happy that everyone was so excited about the event, but I’m not sure that enthusiasm will be there seven months from now when we’d typically start canvassing for sponsors.

My last chat of the day was with CommonWell Health Alliance Executive Director Jitin Asnaani. Their booth, much smaller than in years past, was crawling with reps from their member companies. The organization now has 5,100 sites live, an exponentially huge jump from the 700 sites it was touting at HIMSS in 2015. Asnaani has been pleased by the expansion of membership beyond traditional EHR vendors. Representatives from the long-term and post-acute care worlds – long overlooked by programs like Meaningful Use – have expressed interest in connecting to the CommonWell network. Even ONC has approached the alliance about the ways in which those sectors of healthcare can tap into the care coordination benefits offered by the interoperability it affords.

When I asked what had stood out to him at HIMSS thus far, Asnaani was quick to say the lack of buzz around interoperability, which everyone seemed to be touting the last time around. He’s hopeful that providers are starting to think of interoperability as par for the course. He also noted that attendees and exhibitors seemed to be a bit subdued given the uncertainty surrounding the new administration’s ACA plans. “ONC’s sessions have never been so popular,” he joked.

Exhibit hall closing time was looming, so I took a quick walk through the exhibit hall to see if there was anything left worth seeing.

Quite a crowd had gathered to watch GE Healthcare’s "Who Wants to be a Millionaire" game.

The Nordic team was fun to chat with. They were in full unload mode, and are sending me home with quite a treasure trove of goodies.

The Bottomline Technologies team was happy to pose for a picture. I was pleased to see they had prominently displayed their HIStalk sign.

Conduent Health’s booth was booming.

I noticed quite a few exhibitors with arcade-like grabbing games. I’m not sure I’d stand in a line to try and win a T-shirt. The men at ExtraHop’s booth had no such qualms.

The Access booth seemed busy. I had a nice chat with one of their writers earlier that morning. It’s always nice to compare tips, tricks, and quirks with fellow scribes.

I had to stop by LogicStream Health’s booth to express my regret at not being able to attend their party Tuesday night, which I heard was a blast. They’ve kindly invited me several years in a row, and every year I RSVP with the best of intentions. But then #HIMSSanity overwhelms me …

The closing bell finally rang, at which point all of the remaining exhibitors cheered and clapped loudly. That didn’t stop attendees from continuing to wander the hall as sales teams boxed everything up. I finally got a chance to wander towards the Interoperability Showcase, where I passed this eye-catching setup.

The Showcase still seemed to be hopping; a presentation was even about to get underway, which surprised me. This marked the first time I’ve ever stayed until the bitter end of exhibit hall hours, and I was surprised to see so many folks still around. I did later hear that the conference center taxi queue and airport check-in lines were insane, making me love my decision to depart Thursday even more.

I began the packing process back at my hotel rather than tackling my inbox, which I don’t think I can bear to attempt until I’m back home. Two of my favorite giveaways include a full bag of coffee beans from Nordic and this messenger bag from Chilmark Research, both in the same color scheme of my favorite college football team. I would have included Arcadia’s Survival Kits, but I either used everything in mine or gave it away to friends suffering from blisters or impending colds. Note to just about everyone: Band-Aids and Emergen-C are must haves at HIMSS.

I’m going to take a few days to decompress and then get back into the swing of things over at HIStalk Practice on Monday. Thanks to everyone who took the time to chat with me, invite me to parties, and stop by our booth to tell me how much they enjoy reading. HIMSS may be crazy, but it’s definitely one of the professional highlights of my year. See you in Las Vegas!

Dr. Jayne’s HIMSS Report – Wednesday

I have to say, after two days of walking the halls at HIMSS and attending social functions in the evening, my feet were tired this morning. Nevertheless, I took my cocktail of four ibuprofen, two Tylenol, and a Pepcid and headed back to do it all again.

I spotted this sweet ride in the parking lot behind the Hyatt.

Today’s schedule included a couple of meetings with vendors who attend HIMSS but don’t have booths. It’s always a challenge to find quiet meeting space. We used the meeting area outside the HIMSS Bistro, which was nearly empty at 11 a.m. Speaking of HIMSS Bistro, I can’t wait to hear Lorre’s recap of the CMIO luncheon yesterday. She always takes good notes on the discussion so we can share what CMIOs and clinical informatics folks are thinking as they attend HIMSS.

I noticed lots of vendors sporting their HIStalk sponsor signs today. Thanks to all of you, especially HBI Solutions, Harris Healthcare, Wellsoft, Nordic Consulting, Kyruus, Datica, and Medicity. DrFirst also had their sign out and I stopped in to see their secure texting solution, which is configured as a patient-centered chat.

My booth crawl BFF this afternoon said she thought this giveaway pen looked like me until I pointed out that the physician doesn’t appear to be wearing a shirt.

I took a deeper look at several vendors, including Jellyfish Health, which has solutions to make anywhere the waiting room. My urgent care practice has an online registration and queuing system, but it’s not entirely reliable. I was impressed by what I saw at Jellyfish Health, but we’ll have to see what the COO thinks.

LogicStream Health was showing demos and data from their solutions, which really caught my interest since driving clinician behavior is going to be a big part of organizational success under healthcare reform.

One of my booth crawling pals today is attending her first HIMSS, and was dedicated to seeking out the wildest swag to take home to her granddaughters. She scored at CompliancePoint, who was giving out flashing LED eyeglasses.

We were more impressed by the shirt that Bonny Roberts picked up at Banyan. I wish I had seen it before the hall closed so I could snag one myself.

I also spent a bit of time cruising the hall with @techguy John Lynn. I’m sorry I missed out on the salsa dancing at the New Media Meetup last night, but I learned he knows a thing or two about country western dancing, so I’m hoping a country-themed meetup is in the works. I’ll break out my boots for sure.

He was able to talk me off the ledge when I saw this rounding cart from Omnimed, which caused some bad flashbacks to medical school. I haven’t seen paper charts in a hospital in years, but the rep told us people are still buying them, although with a better top surface to hold a laptop. They also have an IV pole that holds an iPad.

We stopped to talk to Travis Good, MD at Datica, particularly about the company’s rebranding from Catalyze. It takes quite a bit of effort to research potential names, investigate securing web domains, and starting the process for trademark protection. Travis mentioned he thought warm cookies would be a great addition to the booth, and then the discussion turned to pizza. Vendors, take note for next year — you can’t underestimate the power of pizza.

As far as other booth draws, Mimecast had Nerf guns where you could take aim at ransomware, but the line to take a turn was long, which is an interesting commentary. SecureIdeas had a great tagline about being “professionally evil” to protect systems from real evil. Quite a few vendor people were heads-down on their phones and others were just throwing their giveaways at passersby so they didn’t have to ship it home. The rep at Retarus global messaging told us to take what we wanted because “everything must go” and didn’t even ask us what we do or what we’re looking for at the show.

I traded booth crawl partners and spotted some more people in white coats at Marco Inc. and Carepoynt. Why, oh why, does that continue? On the positive fashion side, booth staff at Cerner were wearing the most beautiful orchid-colored sweaters.

The interesting giveaway of the day was at MAD Security, whose offering was a bottle of Macallan 12 scotch. Several vendors were giving out insect repellent this year, including Healthcare Informatics (lemon/rosemary oil) and Battelle with what they were calling their “Zika Pen.” They engaged us by saying, “We’re the biggest company you’ve never heard of,” and after checking out their website, I have to say they’re quite the interesting vendor.

We spotted more funny name badge ribbons at AbbaDox and I snagged a couple for next year.

As the show wound down, many vendors began tearing down their booths while people were still walking through. I headed out for a quick drink with some old friends and we ran into Nick van Terheyden @drnic1, who asked if we were headed to the Harry Potter event. Although it was pouring rain at the time, he said he really wanted to go so he could get a wand – because that’s the only thing that will fix healthcare.

On that note, I closed out HIMSS17. Back to the hotel for packing, blogging, catching up on 200+ emails, and getting a little rest before Disney’s Magical Express whisks me back to the airport.

From HIMSS 2/22/17

From Spitfire: “Re: being anonymous. Why would you want to be anonymous and miss the exposure and benefits?” Being anonymous means I can do exactly what I want. No boss, no ability to be threatened or bribed, and no having people bug me because they know who I am. I can roam the HIMSS floor just like anyone else since I always make up a non-descript employer and title. I don’t want attention and I’m more effective by far without it. More power to those folks who try to milk their tepid fame by taking speaking engagements, accepting vendor-written puff pieces for cash, or  wangling invitations to parties or events, but that’s just not me. I’d rather work alone and without a master.

The final HIStalkapalooza count, at least what House of Blues billed me for, was 693. That’s pretty much perfect since it was right at the minimum headcount I had to pay for without going over. I broke even financially thanks to the participation of some last-minute sponsors, so I’m happy about that since it looked like I was going to lose dozens of thousands of dollars. We invited 1,576 people and got RSVPs back from 974. Even after letting in anyone with a HIMSS badge in later in the evening — once we realized that the usual no-shows would preclude us from hitting our HOB minimum, so we might as well at least get something for the money that was going to be spent no matter what — we only got to 693 attendees. You can see why trying to budget for an event this size is full of risk and uncertainty – the no-show rate is frustratingly massive. Everybody lusts to attend, but at least 70 percent of those we invited didn’t actually show up. Which is a good thing, because if they had, since we built in a big (but not big enough) no-show factor, I would be bankrupt right about now.

I’ll declare the most interesting product I saw at HIMSS as Salesforce. Here’s why I think so:

• Existing EHRs and other healthcare software products are way behind the times in meeting new requirements for health systems to treat patients and doctors as customers and to build relationships with them, including patient engagement.
• It lets health systems that are willing to change their relationships with patients and doctors to do so effectively, with strong analytics and communications.
• It’s cloud-based and is purchased on a relatively inexpensive per-user, per-month price with no capital outlay.
• It’s built on the standard Salesforce CRM that has been battle-tested for years, with just those customizations needed to make it work for healthcare.
• It integrates with the EHR and other patient and provider data sources.
• The Salesforce open ecosystem allows using third-party apps when needed.
• It Includes tools that allow users to build their own rules and apps.
• Salesforce is a juggernaut that can force EHR vendors to open up their systems to obtain the data it needs.
• Salesforce isn’t Oracle or Microsoft – they didn’t create a healthcare-specific product from scratch or acquire a questionable one, so they have no incentive to rebalance their product portfolio and walk away from healthcare and leave users hanging as big healthcare toe-dippers tend to do.

Bistro HIMSS looks like this. It’s down on the 100 level on the end of the concourse. Anyone can wander in and buy a $25 lunch that includes one trip through the buffet (which includes a decent salad bar), fruit, desserts, and coffee and tea. You can buy a table for the price of 10 tickets and use it for the whole day, which is what we did for the CMIO lunch.

People on phones — at least those who are courteous enough to not stumble slowly through the main aisles and risk getting rear-ended while yapping publicly — love spots like this where they are shielded from passers-by. It’s like police officers trained to park their cars a couple of feet to the left of one they’ve stopped to give themselves a protected channel for walking to the driver’s-side window of the stopped car without getting mowed down by a careless driver.

Something was going on here, but I’m not sure what. Does anyone really listen to recorded audio like HIMSS radio and podcasts? I never have.

The concession stand’s Mexican food is apparently so authentic that the employees arriving for work placed their commuting sombreros right on the counter. I also saw attendees eating food from the “Asian” restaurant with chopsticks, which seems odd when the exotic cuisine of the Far East that required authentic tableware is Americanized crap that that no actual Asian would recognize, like orange chicken (Happy Meal-style fried chicken nuggets smothered in marmalade to deliver a megadose of fat, sugar, and salt).

I hope this ill yet resolutely attractive woman recovers to the point that she can be transferred from the HIMSS exhibit hall to Orlando Regional Medical Center. Perhaps someone should start an IV.

The non-profit WGU (Western Governors University) was boldly touting its low-priced yet accredited degrees vs. those of for-profit competitors like Capella, Kaplan, and University of Phoenix. They offer degrees like an RN-to-BSN, MSN, MBA in healthcare management, and  MSN in nursing informatics.

I continue to seek examples where the word “currently” adds value.

Someone had an operation game going. Maybe these white-coated folks are actual surgeons to compete against.

This is one of the more elegant spreads offered. I’m not sure if the sparkling drink was real or fake champagne. I think the vendor was Mozaic Medical.

Random booth observations:

• The magnificent magician / psychic / comedian Bob Garner made someone cry at every one of the several performances I watched at the NTT Data booth today. For example, he asked an attendee to write down the name of a deceased loved one, and with nothing more than that to go on than that, described her father in precise detail right down to his description, name, military service, cause of death, and the exact layout of the military group photo of him that she keeps. I can’t do it justice with any description that I can conjure, but it’s the most amazing thing I’ve ever seen no matter how skeptical I might be of the whole concept. He sought Lorre and me out as the show closed to say hello and to describe his message and purpose as one of hope. I’m jaded, cynical, and a scientifically driven debunker and yet I found myself feeling like I was watching something unknown and yet comforting. Bob has retired, but NTT Data convinced him to return to HIMSS17 and he seemed begrudgingly willing to consider returning to HIMSS18. He’s a nice guy besides. 
• First Databank offered a five-question patient safety quiz kiosk and donated $10 for each correct answer to the National Patient Safety Foundation.
• I said hello to Teresa from Eclipse because she was fully alert and engaging passers-by from the company’s tiny and bare booth. They offer project management tools, and to me at least, a free tee shirt.
• The trend I saw this year was tilted, large touch-screen monitors for doing demos without a mouse or keyboard, also playing video as needed. They are effective.
• I remarked to one vendor that it seemed like there were fewer multi-level booths this year. He said HIMSS started charging by volume rather than just area, so taller booths now require paying more.
• I proposed to one vendor that HIMSS fund a free B2B mixer Wednesday as the show closes to allow exhibitors to strike up conversations that could lead to partnerships or even acquisitions, but then when I saw the huge, snaking line of sales reps towing wheeled bags to the free HIMSS airport shuttle bus within minutes of the exhibit hall’s 4:00 closing, rethought whether anyone would bother sticking around.

Predictive analytics vendor Inovalon reports Q4 results: revenue down 20 percent, adjusted EPS $0.05 vs. $0.13, beating expectations for both.

EMDs hires Eric Weidmann, MD (South Austin Medical Clinic) as chief medical officer.

Arnot Health (NY) selects Harris Healthcare’s ED PulseCheck  ED information system.

That’s all for me from HIMSS17. I’m spending a few more days in Florida, but will keep working from the beach.

Jenn’s HIMSS Report – Tuesday

I think it goes without saying that after Monday night’s dancing I was fairly wiped out Tuesday morning. I really enjoyed looking at everyone’s pictures from the event via Twitter. The above is one of my favorites. Power health IT couple Ross and Kym Martin make it look so easy, don’t they?

But, as HIMSS-goers know, you find a way to power through, buoyed by the knowledge that throughout the day you’ll run into friends you haven’t seen since the last conference, have promising conversations with potential business partners and prospects, and, hopefully, learn a little something about an industry that paradoxically strives for moonshots but implements them at a glacial pace.

And speaking of glaciers, Tuesday was unbearably cold. I was glad I packed a shawl, because I stayed wrapped up in it the entire day.

My morning officially kicked off with a HIMSS-hosted roundtable focused on women in health IT. It was an amazing table to sit at. I was surrounded by judges and winners of this year’s inaugural Most Influential Women in Health IT Award, who talked about what receiving the award meant to them, advice they might offer to younger women looking to move further up the corporate ladder, and how to make the awards program more actionable throughout the year. I was pleased to hear that HIMSS is looking into building out a mentoring program, and pulling its state chapters more into the overall effort.

Nuggets of wisdom included:

• Nursing informatics pioneer and IBM’s Senior Advisor of Healthcare Informatics Marion Ball: "Help promote your fellow female colleagues." As the admittedly most senior woman in the room, Ball emphasized that this wasn’t a common occurrence in her day, and thus is more important than ever.
• Former National Coordinator Karen DeSalvo, MD: "Enjoy the journey. Be open to new opportunities. Focus on what you want to do, not necessarily what you want to be."
• DoD Acting Assistant Secretary of Defense for Health Affairs Karen Guice, MD: "Step out of your comfort zone. Don’t be afraid to fail. Even your failures can be some of your life’s greatest moments."
• CHIME VP of Education Adrienne Edens: "It’s important to realize just how influential women are. We can make such a huge difference if we are intent about spreading that influence."
• Verizon ED of Enterprise Solutions Helen Donnelly: "Never stop learning. Be the person you needed when you were younger."

It was so gratifying to be in a room full of accomplished women, each of whom mentioned her desire to ultimately make the world a better place by giving back.

After that, I spent some time with the ladies above talking about mental health tech. It’s definitely a growing space. Consumers are already paying attention and providers are catching on as the industry attempts to better integrate primary and behavioral healthcare.

I had the opportunity to chat with Christine Moberg, head of psychology at startup Pacifica Labs, which has developed a consumer-facing app to help patients cope with anxiety and depression. The company announced an early-stage funding round alongside a measurements-based, provider-facing version earlier this week, as well as an impending teletherapy feature.

My walk around the exhibit hall included a stop at the Georgia Pavilion, where I chatted with the folks at RightPatient about the current state of biometric patient identification technology.

Dimensional Insight had a nice set up.

Coding services company PJ&A had a prime booth location. The friendly rep and I chatted about our similar experiences of having a small booth in a high-traffic location. I wonder if they spent as little as we did?

I snapped this pic of @innonurse trying out McKesson’s virtual reality surgery demo. You can see what she’s seeing on the screen behind her. It was pretty cool, though I didn’t stay to try it out because the idea of putting on a device that’s been worn by dozens of others grossed me out a bit.

PokitDok’s booth looked busy. I wonder if they’re getting a lot of questions about their blockchain technology? It’s a buzzword/hot topic that seems to be coming up quite a bit this year, along with security, AI, and telemedicine. I’m bummed I won’t make the concurrent blockchain conference going on Wednesday.

Greenway seems to have a much smaller booth in year’s past. The company has been very quiet over the last 12 months in terms of news, though they did announce new care coordination services from Orlando. I’d love to tell you more about them, but my WiFi connection is so atrociously slow that I can’t access the release in a timely manner.

Stoltenburg Consulting had a cool space theme. I’ve been in their dome before. I seem to remember it having a jungle theme several years ago. I always like to see how marketing folks repurpose their spaces year after year.

I may have found MedData’s rival in baked goods. Black Box had tasty, fresh-baked M&M-filled cookies at its booth. I was happy to taste test.

Hunger pains now at bay, I headed over to the Athenahealth booth (one of two) to chat with New Jersey-based Summit Medical Group CIO Paul Shenenberger. Part of Summit Health Management’s MSO, the 700 hundred-plus-physician medical group has seen explosive growth over the last several years thanks to integration (he wouldn’t use the word "acquisition") and organic growth. "We’re the anti-hospital," he said, "perfect for physicians who don’t to move over to the dark side of hospital employment."

Aside from communing with the Athenahealth team, Shenenberger hoped to hit the show floor looking for security solutions and telemedicine offerings, though he was quick to add that Summit is currently looking at telemed startups that are already part of Athenahealth’s More Disruption Please program, including Hale Health, Chiron Health, and SnapMD. "We’re not looking at big telemedicine vendors," he explained, no doubt referring to American Well, Teladoc, and the like. "They want to use me to eliminate me," he added, explaining that, "the primary care physician is a commodity and the price is going down."

My next stop was a pleasant chat at Meditech’s booth with Beaufort Memorial Hospital (SC) CMIO Stacey Johnston, MD, a Meditech super user since her residency days. Johnston regaled me with the trials and tribulations of a rolling go live ("They never seem to end.") and the benefits of a big-bang strategy, which she led her team through last year when the hospital went to Meditech 6.1. Her non-Meditech-related HIMSS priorities include conversations with MModal and Nuance, both of which are interested in helping the hospital bring down its transcription costs. Though the organization is in the middle of an IT buying freeze, Johnston is already looking to free up funds for an integrated patient portal and better sepsis surveillance technology.

My last stop of the day was back at the HIStalk booth to spend time with WebPT CEO Nancy Ham, who kindly doled out career advice to several folks that stopped by. The conversation at one point veered into the challenges women in the investment world have historically faced in light of many veering onto the "mommy track," the differences between mentoring men and women, and the need for salary negotiation training — a topic that has come up in every women-centric event I have attended at HIMSS thus far.

After a quick shoe change at the hotel, I walked across the street to Pointe Orlando and detoured into the shopping area. I had to snap a pic of this pedicab storefront, given that I have never seen anything like it. They seemed to be a popular form of transportation for those leaving the area to head to condo rentals a mile or so away. Every time I see a pedicab, I think of this Portlandia skit.

The area was hopping with parties. Meditech obviously invested in a nice ice sculpture.

The New Media Meetup had a nice crowd. There seemed to be far more social media enthusiasts than influencers, which made me wonder what type of ROI sponsor Stericycle Communications hoped to get from the event.

First Databank looked prepped to show customers a good time. I had hoped to make it to Imprivata’s party, but decided to head for the hotel when I found out it was not within walking distance. It was nice to turn in somewhat early and get a solid seven hours of sleep. I know it’s not the norm at HIMSS.

Here’s hoping tomorrow’s a little warmer …

Dr. Jayne’s HIMSS Report – Tuesday

Today brought a less-stressful commute to HIMSS and easier parking. I started the day at Medicomp Systems (Booth 2303) playing their Quippe Virtual Experience game. Players use Quippe Clinical Solutions to solve a variety of problems. Responses are timed and high scorers receive prizes. They’re giving away Apple watches, so worth checking it out.

From there, it was over to CoverMyMeds (Booth 1214), whose business must be booming based on the size of their booth. They had mailed a scratch-off game card to my house and I left with a lovely parting gift – a beach ball, which was thankfully deflated. Normally I’m not into swag, but I’m thinking about bouncing it around the crowd at the next hospital medical staff meeting.

After that, I headed to the Interoperability Showcase, stopping by the MedData booth for a scone. Today’s flavors: lemon and blueberry. I spoke with a sales rep who was very engaging and it turns out he grew up just a few miles from where I live. We had a nice chat and I realized I’ve done some work for a couple of their clients, so it was nice to make a connection.

The Interoperability Showcase was buzzing with lots of demos. I spoke with Apex Data Solutions about some work they’re doing with the VA regarding data reconciliation. The reps were engaging and knowledgeable. The Showcase had some areas with clinical vignettes demonstrated by various vendor partners, so I checked out this one illustrating asthma care from telemedicine through hospitalization to discharge and outpatient management of complications. The reps did a great job, but I was a bit annoyed by the guy live-casting the entire thing, including the attendees. It’s one thing to catch people in the background of a photo, but it’s another thing to pan your phone around on a selfie stick getting close-ups of unwitting people who happen to be standing next to you and broadcasting them to the universe.

Jenn already scooped me with a picture of the giant Connect Four game at the PEPID booth, but I did stop by for a match. I liked this artwork at the Q-nomy booth.

I’m not sure what happened to the picture I took on the show floor, but I fell in love with the Ballo chair at Humanscale (Booth 1513). I’ve tried the exercise ball chairs and found them to be uncomfortable, but this one was very different. I’m seriously thinking about tracking one down when I get home. They also have wheeled workstations that adjust to a user’s height electronically, which makes users more likely to adjust them, therefore preventing ergonomic problems.

Vendors use a variety of gimmicks to get people into their booths – pens, stress balls, hot/cold packs, hand sanitizer, lip balm, candy, and more. DSS Document Storage Systems was screen-printing tee shirts in their booth, where eSolutions was holding a drawing for a Coach bag. NextGen has a giant Plinko game in their booth, while IBM Watson has live moss and some kind of fuzzy ground cover plants growing on displays in their booth. I haven’t seen too many people in costumes like we used to see on the show floor. Although it’s more professional now, I miss it.

I overheard two women speaking about the Disruptive Women luncheon, which they felt was well worth attending. I also overheard someone talking about vendor reps being rude on the shuttle bus, and naming them specifically. Apparently on yesterday’s morning shuttle, two of them refused to hold their laptop bags on their laps, placing them in seats next to them, which meant people who were trying to board the bus had to be turned away. If you’re wearing a vendor shirt and a name tag, don’t forget that makes you “on stage” in Disney terms. People notice when you’re doing things that aren’t courteous and kind and it might just cost your company business.

Liaison had some sweet badge ribbons at booth 5570. I’ll let you guess which one I chose.

Bottomline Technologies had their sponsor sign on display.

From the exhibit hall, I headed straight to Nordic’s HIMSS reception at Del Frisco’s Steak House. We had a lovely outdoor balcony and I made some new friends, including marketing guru John Pollard and data analytics expert Tim Grilley. They were great to talk with and Tim certainly impressed with the best bowtie and shoes of the day (although his wife apparently thinks the shoes would be more appropriate on a sixth grade girl with pigtails). His suit brought the accessories together nicely.

From there it was off to the New Media Meetup where I spied Jenn and some other social media glitterati. I always feel like the odd man out at events like that since I’m anonymous. I brought a friend with me who didn’t really understand the depth of what is going on with social media and healthcare IT, and by the end of the night, I think she was ready to start her own blog about dysfunctional vendors she works with.

After the Meetup, we headed to meet some friends for one last drink before crashing for the night. I’m averaging more than 10 miles of walking a day, so it’s definitely time for a break.

From HIMSS 2/21/17

From Hooligan: “Re: hot Epic news. They just quietly brought their App Orchard live. It was announced years ago, but it really only applied to customers that wanted to build their own app. This is Epic’s latest thinking on allowing third parties.”

From Skippy Snodgrass: “Re: Epic. They’ve upped their claims about clients making more money and seem to have found a way to involve either Allscripts or Cerner in almost every piece of booth décor. It’s one thing to have some fun in your booth, but I was surprised to see that messaging show up in the Interoperability Showcase… After a great presentation on the VA’s joint viewer project, I visited a demo that featured Epic, Cerner, and Siemens Healthineers. The Epic presenter’s monitor was set to a slide show that replayed the same competitive messaging from their booth on a loop. Maybe I’m naive, but it seemed to be in poor taste given the showcase is built for vendors to demonstrate their collaboration and commitment to bettering our industry. For their end of it, the Cerner and Siemens reps were unarmed – no fancy screensavers – you only saw a HIE diagram and a patient portal UI.”

From Flinty White: “Re: HIMSS. Spotted today at 2:30 pm near the I Drive entrance. Sometimes those feet need a little rest and a post-lunch nap is in order!” I agree. It’s nice to get out in the sun and take a break from the noise, glad-handing, and merchandising.

From HIT Girl: “Re: Mt. Auburn Hospital satellite clinic. Makes EHR training look like a bumpin’ party.” To which I would also reply, in my best J. Walter Weatherman (“Arrested Development”) voice, “And THAT’s why you use punctuation, like hyphens.”

It was a beautiful sunrise over Orlando this morning, although I didn’t fully appreciate it after the two hours of sleep I got.

Edifecs had a “What I Run” campaign that supports women, including offering a female-only event going on tonight.

It is comforting to know that should one of us attendees or exhibitors be stricken, there’s a clinician-staffed hospital right there on the show floor. Either that or we could get a makeover while awaiting the arrival of actual clinicians.

Intelligent Medical Objects has this cool coding timeline thing going on, where visitors were invited to record a notable health IT event on a sticky note and place it in its proper time location. People were really getting into it.

Then there’s this, wherein I reward slightly off-color behavior by unavoidably providing a link to those exhibiting it (pun intended).

The HipLink people were fun, as evidenced by the one on the right who used a stack of flashing pens to create a runway-like arrow leading into their booth. Her self-satisfaction is evident.

The trouble with spell-check is that any version of a word’s correct spelling gets the green light, even when (as in this case) it is spelled very, very wrong for the context in which it was used. This is a big mistake (literally, since it is looming large over the exhibit hall floor).

This is a smart giveaway from PerfectServe.

I asked the personable Zebu rep if I could take a photo of his cool, color-coordinated shoes. He obliged by slipping one off to give me a better angle.

Industry long-timer and WebPT CEO Nancy Ham held court in our booth, offering advice to women interested in career development or mentoring.

Strata Decision Technology is giving away this book, which looks very good. I’ll read it after the conference,

I bought some extra tickets to Bistro HIMSS, so I had lunch there today. It was pretty good and it was nice to escape the chaos, choose fresh food from a decent buffet, and enjoy a semi-quiet moment at a table and chair without being stink-eyed by would-be diners who can’t find anywhere to sit and silently implore you to get up and eat your dessert on the way out the door so they can slide in. Today it was cowboy steak, yellow rice, fresh vegetables, tortellini, rolls, and a few dessert items. Even the iced tea was pretty good.

I should mention that my frequent gripes about HIMSS that usually involve their juggernaut-like domination, cozy vendor financial relationships, and vendor-shilling and questionably knowledgeable media group, they really know how to make a conference run like a Swiss watch.

Random booth observations:

• I saw a quick, over-the-shoulder demo of Meditech’s Web EHR. Apparently they re-built the LSS ambulatory product into an entirely new Web Ambulatory, while other 6.1 modules got a high-tech facelift to give a consistent presentation. I had to circle their booth three times each during three separate visits to finally get someone to make eye contact, but the guy who finally greeted me was friendly even though my enthusiasm had diminished considerably by then.
• I had a fun talk with someone at the InstaMed booth about patient payments in the era of high-deductible plans that push more of the payment burden on them (and more of the collection burden on providers).
• Arcadia Healthcare Solutions gave me an overview of their data aggregation, transformation, and analytics.
• I saw a demo of Spok Care Connect, which greatly broadens the old Amcom Smart Web paging console product into a complete solution for secure communications, alarm notifications, critical lab value alerts, etc.
• I saw a short overview of the Qvera visual interface engine, which is free to use on a limited scale.
• I talked to a rep who predicted that Wednesday morning will be quieter and more deliberate as decision-makers emerge from the shadows to take a deeper look into products that they or their underlings have seen. The rep also said that Wednesday afternoon will be crazy since that’s like a vendor version of “Supermarket Sweep” as they all run around chucking cards at each other in hoping to explore partnerships or other B2B opportunities.

Vince Ciotti chose an interesting HIMSS badge.

Epic will enhance its MASS patient scheduling system, being tested by the VA in a $624 million contract, to allow disabled veterans to schedule appointments using Nuance-powered speech instructions.

Salesforce will integrate patient-generated data into its CRM and Health Cloud using Validic-powered integration.

Jvion, which offers a predictive engine, acquires the healthcare practice of competitor Predixion.

HIStalkapalooza

I heard the event was pretty fun, although I didn’t see most of it other than the band (which was as amazing as I expected). I had a little plate of food and that was fine, especially since the HOB’s house salad is one of my favorite things ever. I enjoyed spending private time backstage with Judy Faulkner and Andy Slavitt.

The House of Blues people said they were getting calls all week from people hoping to score a ticket to the event, which is funny since HOB had nothing to do with ticketing. We also had a few folks (tourists, I assume) who heard Party on the Moon rocking it out and tried unsuccessfully to sweet talk their way in. HOB said it had to be the hottest ticket in Orlando this week based on the constant inquiries they were receiving.

I hope to have photos and videos from our photographers soon. Meanwhile, here are a few shots sent over by attendees.

Nordic quickly put together a great teaser video of the event, to be followed shortly by a longer and more fully edited one. This one is really good, and it’s fun to hear Party on the Moon playing live from last night. Note in the video the Nordic-emblazoned ties they had made for the House of Blues Servers. I talked to two of the females who were wearing jauntily them around their heads “Karate Kid” style as their own form of flair, while I overheard one of the guys telling his co-worker (not sarcastically) that he loves his tie and wishes he could wear it to work at HOB every day.

Here’s how the finale looked from the stage, as captured by the band at 11 p.m. I expect there were some aching heads and feet in the convention center today. A lot of the behind-the-scenes HIStalkapalooza work is frustrating, annoying, and demanding, but I absolutely love watching people dancing joyfully and interacting with the band. My view of HIStalk is sitting alone in an empty room filling up an empty screen every day, so seeing people come together is the best part of the year. I’m most overjoyed when I see someone who is tentatively lingering just off the dance floor for the first few songs trying to overcome their fears, then tentatively yielding to POTM’s exhortations to get out there with the group and move in whatever way feels good to them. I see that moment of child-like rapture and human connection from a normally restrained healthcare IT person and it is magical. It’s hokey, but I feel like I helped them, in some small way, regain the freedom and lack of self-consciousness that they might have otherwise forgotten they ever had. I was proud of every dancer out there.

These photos just started arriving from our photographer:

Thanks to our hosts Barry Wightman, Julie Yoo, and Bonny Roberts. A couple of folks from Optimum Health IT spent forever getting the red carpet background assembled, then joined their co-workers in managing the check-in process. Brianne, Aly, Heidi, and Camille were all over the venue putting out fires. Lorre arranged the entire event and managed a maddening onslaught of issues that didn’t stop until about the time Party on the Moon started playing – I could see her glazing over from mental and physical exhaustion as well as hypoglycemia after a super-long day in which she had eaten only one early-morning banana due to lack of time.

Thanks to our special guests Judy Faulkner, Andy Slavitt, and John Halamka.

And of course, thanks to the sponsors who made this tenth and final HIStalkapalooza possible. Some of them are pledging their support and encouraging me to do it again at HIMSS18, but I’m not enthusiastic about it. It’s a lot of work, involves huge financial risk, and carries high opportunity cost without any real benefit except to attendees. Maybe I will re-engineer it into a different format that I can manage more easily.

Here are the HISsies winners as shown on stage Monday evening. I was sorry that Neal Patterson of Cerner declined to attend, but he’s not big on lifetime achievement awards, he said, since his work is a long way from complete.