News 12/16/16

Top News

SocialWellth — whose parent company DHX on Monday revived the Xcertia mobile health app guidelines program with HIMSS, the AMA, and the American Heart Assocation – brings back the Happtique app certification program.

Happtique closed its doors in late 2013 after researchers found obvious security holes in apps that had passed Happtique’s certification criteria that included security. SocialWellth acquired the dregs of the company in December 2014.

Apparently SocialWellth stripped app certification out of the new Xcertia and is separately offering “to showcase their proprietary apps, offer promotions, and provide discounts and services” at an unstated cost. 

Reader Comments

From In Poor Taste: “Re: Epic VP Eric Helsher. He took to Twitter to throw shade at CommonWell once the CEQ/CW announcement was released. He then deleted the tweet. Wonder who got to him? It was mentioned in Politico’s daily email and that probably brought unintended attention. Don’t think for a minute that Epic doesn’t take an aggressive or competitive stance on the interop topic. Shame that at least he (if not all of Epic) are keeping score on such an important topic.” The deleted tweet apparently said, “Welcome @CommonWell to the interoperability party,” which seems innocent enough. His colleague, Epic VP Peter DeVault, left this comment on my Tuesday night post that explains the company’s position:

As for Epic’s ‘notorious’ non-participation in CommonWell, I’ve been saying for years that it’s likely there will always be multiple health information exchange networks such as Care Everywhere, CommonWell, various state-run HIEs, etc., and new ones not yet born. What Carequality neatly does is provide the governance and technical framework for any of those networks to communicate with each other. What that means is that not everyone needs to belong to everyone else’s networks in order to exchange information. That was never going to happen (just as it’s never happened, to my knowledge, in any other industry). What it means most importantly is that patients who receive care at facilities that belong to different networks that have implemented the Carequality framework are much more likely to have their complete record available at the point of care.

In addition to the networks themselves implementing the Carequality framework, individual organizations that are part of those networks have to agree to the Carequality rules of the road. Almost all Epic clients have already done so, as have clients of several other vendors. Assuming many CommonWell members’ customers also agree to those rules of the road, this will be seen as having been a great day for patients.

This has never been about us versus them, although that makes better copy for the press. It’s about deploying the right technology and agreeing on the right governance to make interoperability widespread, easy, and realistic – regardless of the endpoints, so that patients get the best care. 2016 has been a good year for that.

From Jack Polarity: “Re: rags rewriting press releases. The plagiarism checker I tried showed the so-called news item to be mostly just repurposed vendor verbiage.” And you were surprised?

HIStalk Announcements and Requests

Our long-time HIStalkapalooza red carpet sponsor Elsevier has declined to participate this year, so I’m looking for a replacement who will get a ton of invitations and exposure. I’ll even allow the red carpet sponsor CEO to greet attendees personally, hang around backstage or in my inner sanctum, and welcome guests from the stage – because otherwise I’m writing a scarily large (and probably NSF) personal check to cover a significant chunk of the event’s cost, which will then render this 10th annual HIStalkapalooza the last one since I’m not going into debt to throw a free party. Contact Lorre. Meanwhile, thanks to the several companies that are helping to underwrite the event — I’ll recognize them soon.

I need your advice: Should a health system’s vendor contract extension or product upgrade be listed in my "Sales" section? I set up a poll so you can tell me. I’m slightly leaning toward “no” since I think readers are mostly interested only in sales involving new products, but I’m torn because of new contracts like Soarian to Millennium or Meditech Magic to Web EHR, which require the customer to sign a new contract and implement a new system.

Mrs. G from Minnesota says her first graders are already using the new science books we recently provided in funding her DonorsChoose grant request, where she allows them to choose a book to read for 20 minutes each day and then take home to read with their families.

This week on HIStalk Practice: The Los Angeles County Dept. of Health Services selects the Ez-Cap managed care tool from Allscripts. GAO reports on a plethora of data-sharing practice challenges. Physician Retraining and Re-entry Program finds slow going in impacting physician shortage. McKesson Specialty Health expands. Seven health IT CEOs make the "Best Value" list. First Choice Healthcare Solutions CEO Chris Romandetti recounts the importance of disaster recovery preparedness in the wake of Hurricane Matthew. Marathon Health goes with Quippe documentation tech. Humana consolidates its quality metrics by 80 percent. Kansas City Care Clinic VP of Behavioral Health and Community Programs Dennis Dunmyer details the IT challenges involved with integrating primary care, behavioral health, and oral care.

Everybody has poetic songs that make them a bit sniffly. One that’s been one of my favorites for a very long time: “The Drinking Song” by the long-defunct, fantastic Moxy Fruvous. The band wouldn’t say if it’s about the obvious (alcoholism), the subtle (the AIDS epidemic), or perhaps even death-caused loss in general. On the other hand, when I want to raise some goose bumps, it’s usually the live version of  Rush’s “Working Man,” which I was fortunate to have seen played live with stunning virtuosity on their Time Machine tour.

Webinars

None scheduled soon. Contact Lorre for webinar services.

Here’s the recording of this week’s webinar, “Three Practices to Avoid Drift Between Audits.”

Acquisitions, Funding, Business, and Stock

Athenahealth raises 2017 earnings guidance, sending shares up 23 percent Thursday. They’re still down 26 percent in the past year.

Publicly traded physician practice EHR/PM/RCM vendor Medical Transcription Billing will sell $10 million in Series A Preferred shares to help pay for its October 2016 MediGain acquisition and to acquire more companies. Shares of the money-losing MTBC face Nasdaq delisting since they trade for $0.82, having dropped 33 percent in the past year, and are down 84 percent since the company’s July 2014 IPO. The company’s market value is $8.5 million.

CareSync will hire 350 people as it moves its headquarters to Tampa, FL. I interviewed CEO Travis Bond a few weeks ago.

Scanadu, the one-time disruption poster child for its Tricorder-like diagnostic device, ends support for its Scout product, explaining that it was an investigational device and the FDA required the study to be closed (the accuracy of last statement is questionable). It’s not much of a loss except to those who paid $150 and more to participate in the $1.6 million online fundraising project of Scanadu (or “Scamadu,” as upset users are calling it). Scout never lived up to the Tricorder hype anyway, having been stripped down to record just a few rather boring vital signs like temperature and heart rate for all the dozens of millions of dollars it spent on research. The company is now pitching Scanadu Vitals, which measures blood pressure, temperature, heart rate, and pulse oximetry (which it manages to spell wrong on its site). It’s not as shady as Theranos or as predictably flawed as Google Glass, but it the similarities are increasing. The product also didn’t give users access to their own data.

Sales

Workplace health center operator Marathon Health chooses Medicomp’s Quippe and its MEDCIN Knowledge Engine to transform unstructured data into meaningful information and to streamline encounter documentation with templates and workflow tools.

People

Rachel Neill (Nordic) joins Carex Consulting Group as president.

Privacy and Security

From DataBreaches.net:

• A single-doctor medical practice in New Jersey notifies 4,277 patients that it was hit with a ransomware attack on October 6. 
• Yahoo says 1 billion of its accounts have been breached in an incident going back to 2013, just three months after the company reported that the information of 500 million accounts was stolen in an unrelated breach. My bet is that this second huge breach will kill Verizon’s plan acquire Yahoo for $4.8 billion.

Kent Murphy, MD of Summit ENT Associates (TN) left a comment on a recent HIStalk post stating that his practice was hit by a ransomware attack on Wednesday. He paid the demanded $1,600 ransom but his EHR isn’t back up yet.

In India, hackers breach the systems of Apollo Hospitals, the country’s biggest private hospital chain, and gain access to the medical record from the recent 75-day stay of now-deceased Jayalalithaa Jayaram, chief minister of Tamil Nadu. The hackers also breached the accounts of several journalists and found emails suggesting that Jayalalithaa was given the wrong diabetes medication. Another article notes that  her stay will cost the government at least $2 million, as the entire floor of 30 rooms surrounding hers were vacated, 39 doctors were involved, and experts were brought in from the UK and Singapore.

Innovation and Research

Amazon announces completion of the first autonomous, GPS-directed drone delivery in its Prime Air service, which dropped the customer’s package in his yard 13 minutes after he placed his order.

Other

University of Louisville pays go-away money to two former executives who are targeted in a federal investigation. The university paid former VP of Health Affairs David Dunn, MD, PhD $1.15 million to leave the school, while former CIO Priscilla Hancock received $250,000 before she retired. Also under investigation is Russell Bessette, MD, former AVP of health affairs and health informatics. The FBI is reviewing the possible misuse of federal grant money. Dunn’s attorney says he was attempting to make U of L “a leader in healthcare informatics” as authorized by the university president. Dunn and Bessette previously ran the now-defunct Health DataStream, which sued SUNY Buffalo for stealing its health status-scoring algorithms.

MD Anderson Cancer System considers layoffs and research cutbacks as its losses hit $102 million during the first two months of its fiscal year. Officials name its Epic implementation as one of the four issues affecting its financials, but its president concludes, “The situation requires serious attention, but it is not out of control, our long term balance sheet is strong.”

As just about anyone could have predicted, Pokemon GO turned out to be a quickly-abandoned fad offering minimal long-term health benefits, with BMJ-published research concluding that while users moderately increased their daily step count right after installing it, they had returned to their old levels of inactivity within six weeks (at least those who weren’t run over by cars or shot for trespassing in wandering around in a zombie-like trance at a rate only slightly higher than among regular phone users). 

A newspaper’s field test of presenting prescriptions for two dangerously interacting drugs at 255 Chicago pharmacies finds that half them dispensed the medications with no warnings or intervention. Independent pharmacies failed 72 percent of the time vs. 49 percent for drugstore chains. The newspaper concludes that pharmacists cut corners to keep up with crushing workload demands and computer system alert fatigue may contribute, while one pharmacist said the pharmacy tech receives the warning and may or may not alert the pharmacist. “The patient will get mad if you call the doctor and take time, “ said a pharmacist who caught the potential error. “Sometimes they think it is fast food.” The report notes that while most Kmart pharmacists dispensed the risky drug combination without question, they were good about pestering the patient into signing up for the company’s loyalty program.

A fascinating New York Times article frames the US economy (and its world-leading inequality) around the much-ballyhooed 2013 revival of the Twinkie. Private equity firms bought the brands and bakeries of bankrupt and PE-owned Hostess for $186 million, then flipped the company four years later for $2.3 billion after closing plants, slashing the workforce from 8,000 to 1,200, eliminating union contracts and pension payments, and saddling the company with a $1.3 billion loan that was used to pay the PE owners and investors in advance. The article notes that the highest-earning CEOs in the country run private equity firms, with their one-year compensation listed above (note that the group is about as diverse as Hostess’s Wonder Bread). Those CEOs defend their activities by saying their firms provided much-needed capital and expertise to turn the companies around, which nearly always involves employee takeaways. You would think news like that would encourage people to start businesses rather than serve as wage slaves for others, but I’m not sure our educational and social system is geared to produce people willing and able to become something other than faceless widgets in the means of production.

The Pope — visiting a Vatican children’s hospital whose former president is charged with using $440,000 of its money for apartment renovations — urges its employees to resist the urge “to transform a good thing like a children’s hospital into a business, where doctors become businessmen and nurses become businessmen.” He apparently hasn’t seen the salaries that US children’s hospitals pay their executives.

The feel-good, viral story about a terminally ill five-year-old hospital patient who died in the arms of a man portraying Santa Claus turned out to be another example of sloppy journalism intended to draw eyeballs without editorial control. The Knoxville newspaper says it can’t stand behind its original story since it can’t verify anything written by its columnist, who took the fake Santa’s description of the event at face value even though he refused to provide identities, dates, or even the name of the hospital that was supposedly involved. The worst part is that the average Facebook user wants to be entertained, not informed, and probably will neither notice nor care that the story as written was crap. I bet both the editor and the columnist (not to mention the snotty big-name papers that ran the story without question) are secretly high-fiving each other for drawing clicks at the expense of accuracy and objectivity. Just because analytically challenged readers react emotionally to a story doesn’t mean it’s true.

Sponsor Updates

• The Orange County Register includes MedData in its list of Top Workplaces for 2016.
• Infor will offer its customers McKesson Strategic Supply Sourcing and McKesson EIS, in turn, will offer Infor CloudSuite Healthcare to its user base.
• Two hundred Meditech customers receive an ‘A’ hospital safety rating from The Leapfrog Group.
• GetWellNetwork will participate in the VA’s “Telehealth Education Delivered” mobile showcase that will visit 200 VA medical centers.
• Buyers Laboratory awards Lexmark its BLI PaceSetter 2017 award for Healthcare: Group Practices.
• PeriGen hosts a team-building bike challenge for Big Brothers Big Sisters.
• Surescripts recaps its video chat on the “abysmal” prior authorization process.

Blog Posts

• Productivity vs. Information Security: Balancing Offense and Defense (ID Experts)
• Physician Engagement for EHR Implementation (Impact Advisors)
• Influencer Perspective: Influence Healthcare with Your Leadership (Influence Health)
• What InstaMed Customers Need to Know About MasterCard’s New BIN Range (InstaMed)
• The EHR Implementation is Complete, Now it’s Time for Optimization (Optimum Healthcare IT)
• Why Columnar Databases are the Future of Business Intelligence (Dimensional Insight)
• Do you know how primary care providers make decisions about specialty referrals? (Kyruus)
• The Heart of Health: The Voice of the Patient (Spok)
• Data Sharing: Why Does It Remain Such a Struggle? (Aprima)
• Gartner releases top 25 Healthcare Supply Chains of 2016 (Infor)
• 3 Ways Data Blocking Threatens Patient Registries’ Impact on Healthcare (Liaison Healthcare)
• Epic Community Connect: 3 Executives Who Stand to Benefit From An Outreach Program (HCI Group)
• Progress: The Anna West Act Passes (Netsmart)
• Cocoa is for Coders (SayIt 11/2 is here!) (Nvoq)
• 5 Steps to Take Before Selecting Your Next Integration Engine (Orion Health)
• ICD-10 Changes are on the way. Are you ready? (Intelligent Medical Objects)
• Healthcare Trend #2: Demand Drives Adoption of Healthcare E-Commerce (PokitDok)
• 3 Key Delivery Channels of Effective Secure Communication Platforms (Uniphy Health)
• Phynd Expands Customer Base (Phynd Technologies)
• Five Things You Might Not Know About Medicare’s New Merit-Based Incentive Program (PMD)
• The 21st Century Cures Act and Health IT: A Birds’ Eye View (Point-of-Care Partners)
• Interoperability: Removing the Obstacles and Inefficiencies to Actually Improve Patient Care (Summit Healthcare)

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 12/14/16

Top News

CommonWell Health Alliance and Carequality will connect their respective systems, allowing their members to share information.

Most notable (but unstated) in the announcement is that Epic uses Carequality’s Interoperability Framework but is a notorious non-participant in CommonWell, with the agreement potentially allowing Epic to connect to other systems outside of its own proprietary connectivity suite. Likewise, Cerner is a CommonWell founding member but doesn’t participate in Carequality.

I’m not sure if the announcement can be accurately characterized as health IT’s version of the transcontinental railroad’s golden spike, but it has potential to become a significant joining of the patient data tracks, assuming of course that competing health systems are actually willing rather than conveniently unable to exchange patient information.

Reader Comments

From Much Too Much: “Re: HIMSS17 registration list. Vendors received it Friday. For the first time, this list does not include a postal address. Vendors wishing to send direct mail will have to have the campaign approved by HIMSS and then use HIMSS preferred mailing vendor. The cynic says this is just expanded vendor extortion, while the optimist says that maybe we’ll get less junk in the mail before the conference.” I surmise that the motivation was income rather than junk mail curtailment. However, from a purely economics standpoint, HIMSS should keep raising the exorbitant prices it charges vendors for the annual conference until they push back by not participating. The frenzy to rack up HIMSS points to allow spending even more money on prime exhibit hall square footage suggests that the supply-demand curves do not yet intersect.

HIStalk Announcements and Requests

HIStalk reader Mike sent a DonorsChoose donation that, with some pretty amazing matching money, will give Ms. A’s fourth grade class in Stone Mountain, GA an iPad Air, Amazon Echo, and Amazon Fire and also economics books and games for Mrs. M’s gifted classes in Springdale, AR. Mrs. M responded, “It is so exciting to have others help in providing amazing resources to my students. Your generosity is appreciated more than you can imagine! I can not wait to receive these resources to share with my students! Your help allows my students to experience hands-on real world economics.”

Mrs. G in Wisconsin says the best part of the day for her elementary school students is using the makerspace materials we provided in funding her DonorsChoose grant request, as their confidence is growing from making decisions together as teams. 

Listening: the latest album from Australia-based Wolfmother, which is down to just one of its three original members but still rocks it out well in the fashion of Black Sabbath or perhaps Led Zeppelin. If rock ever makes a comeback, these guys should be part of it.

Webinars

December 14 (Wednesday) noon ET. “Three Practices to Minimize Drift Between Audits.” Sponsored by Armor. Presenter: Kurt Hagerman, CISO, Armor. Security and compliance readiness fall to the bottom of the priority lists of many organizations, where they are often treated as periodic events rather than ongoing processes. How can they improve their processes to ensure they remain secure and compliant between audits? This webinar will cover the healthcare threat landscape and provide three practices that healthcare organizations can implement to better defend their environments continuously.

Here’s the recording of the recent webinar titled “Charting a Course to Digital Transformation – Start Your Journey with a Map and Compass.” 

Acquisitions, Funding, Business, and Stock

Analytics vendor Inovalon lowers full-year revenue and earnings guidance after a collaboration agreement with an unnamed partner fell through last week unrelated to the company’s offerings. Inovalon expects annual revenue of $426 million instead of $470 million and net income of $25 million vs. the previous guidance of $43 million. Shares were predictably hammered on the news, shedding 36 percent of their value by the market’s close on Tuesday. INOV shares are down 64 percent in the past year vs. the Nasdaq’s 12.5 percent increase.

EHR vendor IMedicor warns that three of its financial statements from 2014 and 2015 should not be relied on because they misstated liabilities that were later discovered in a year-end audit. The amount involved was only $471,000, however, caused by double-recording the same set of warrants in two accounts. The greater question might be how a money-losing company with a market cap of barely $1 million can afford to remain publicly traded with a current share price of $0.0009, which suddenly makes that $471K seem more significant.

Canada-based VSS Medical Technologies acquires a majority interest in Legato Healthcare Marketing. VSS also owns Sigmund Software, MedicFusion, VersaForm, DeviceTrak, and Health:PCP.

Sales

In Canada, Mackenzie Health chooses Orion Health’s Rhapsody integration engine.

AtlantiCare Health System (NJ) selects Santa Rosa Consulting to strengthen its analytics program.

Frances Mahon Deaconess Hospital (MT) will upgrade to Meditech’s Web EHR.

People

Tom Clark (Direct Recruiters) joins Direct Consulting Associates as VP of operations. He is a former US Army captain and Airborne Ranger.

Announcements and Implementations

The American Heart Association, AMA, DHX Group, and HIMSS launch the non-profit Xcertia, which will establish best practices for mobile health apps. It’s the second time around for Xcertia, having been originally announced a year ago under the direction of Columbia University and vendor Social Wellth, which bought the assets of defunct health app certification vendor Happtique in December 2014 and created its own app guidelines. SocialWellth CEO David Vinson created the non-profit DHX along with the AHIP insurance company trade group with the intention of offering app certification, which apparently isn’t a priority for Xcertia 2.0.

Black Book’s 2016 RCM survey finds that hospital outsourcing of complex claims has jumped from 20 percent to 40 percent in the past three years, with hospitals that previously wrote off those claims because of the effort and expertise required to pursue them realizing they were leaving significant money on the table.

Another Black Book survey finds that competing priorities have killed off hospital ERP implementations, with just a 29 percent penetration and 2 percent growth in 2015. Shockingly, more than one-third of those hospitals that have bought ERP systems aren’t keeping up with available upgrades, rendering those systems basically obsolete. More than half of hospital C-suite executives admit that they didn’t really understand their supply chain (which represents nearly a third of hospital budgets) until the move to value-based care forced them to dive deeper.

Consulting firm RTI International and Validic partner to optimize the use of wearable consumer sensors in health research.

Centralized tele-ICU programs can increase case volume by 44 percent and contribution margins by 665 percent, according to a journal-accepted study by UMass Memorial Medical Center (MA), which uses Philips eICU. 

Connected home software vendor Orbita releases a development tool for creating Amazon Echo-powered home health voice assistant apps.

Government and Politics

President Obama signs the 21st Century Cures Act into law.

CMS’s chief data officer Niall Brennan is among the federal political appointees leaving their jobs (voluntarily or otherwise) with the administration change. He will be replaced in interim by Office of Enterprise Data and Analytics Deputy Director Christine Cox.

The VA creates a website for its Digital Health Platform, which describes its approach and includes use case videos. Previously issued documents indicate that the VA plans to acquire five system components:

• An EHR
• An operation management platform (resource allocation, financial, supply chain, and HR system) integrated with the EHR
• A CRM system
• An analytics system
• An API framework

The FTC settles consumer deception charges it had brought against Aura Labs, which sold $600,000 worth of its $4, smartphone camera-based Instant Blood Pressure app that it falsely claimed to be as accurate as a blood pressure cuff.

Privacy and Security

Quest Diagnostics notifies 34,000 people that a hacker has breached its systems via a vulnerability in its MyQuest mobile app, exposing their demographic information and lab results. The app also allows users to record their provider contact information, prescription information, allergies, and health statistics.

Financial consulting firm PwC threatens legal action against a security advisory firm that had warned it of a vulnerability in a PwC-developed security tool, insisting that the company not go public with details. PwC says it has fixed the problem and says the security firm wasn’t licensed to work with its software. The security firm ignored the warning and published its security advisory anyway.

Grammar matters: Russian hackers were able to penetrate the Democratic National Committee’s email system even though a Clinton campaign aide intercepted a phishing email sent to Campaign Chairman John Podesta. In his haste to alert Podesta, the aide mistyped “illegitimate email” as “legitimate email” in his urgent warning, after which Podesta obligingly clicked the phony password update link that compromised his account.

Innovation and Research

Inova Health System (VA) launches a venture capital arm and its Personalized Health Accelerator.

Technology

A surgeon in England uses Snapchat’s Spectacles – $130, camera-equipped sunglasses — to record 10-second video clips of a surgery he performed, allowing medical students follow his progress live and afterward.

Other

Cost estimates for the California prison system’s implementation of Cerner have doubled to $400 million in the past three years as the state realized it signed a contract that omitted the cost of maintenance, hardware replacement, mobile devices, additional required software, and dental recordkeeping capability. The federally appointed receiver in charge of the system mostly blames Cerner, which is being paid $177 million over 11 years, but also says his own office bears considerable responsibility for the overrun in missing several required items. He also says employees are struggling to learn the system, doctors don’t like doing their own data entry and are seeing one-third fewer patients due to the extra work required, and the pharmacy system was “damn near unusable” due to design and implementation problems. The state turned control of the prison healthcare system to the federal government in 2006 to settle lawsuits claiming that poor inmate care constituted cruel and unusual punishment. The receiver’s budget has since doubled to $1.9 billion per year.

The imaging system used by hospitals in South Australia goes down for six hours due to unspecified technical issues. 

A report from Imprivata and the Ponemon Institute finds that misidentification of hospital patients is a regular occurrence and the average hospital loses $17 million per year due to rejected claims due to missing or incorrect patient information, with respondents favoring the implementation of biometric ID at registration to improve both situations.

In England, an woman dies after a hospital admits her for a broken arm but then fails to send anyone to treat her for several days. The hospital had changed the way it lets doctors know they have new patients, moving from an old-school whiteboard to an email-based program. The patient shared a first name with another patient and the unit secretary mistakenly removed the woman’s name thinking it was a duplicate entry.

AHRQ reports that hospital-acquired conditions are down 21 percent since 2010, with potential savings of 37,000 lives and $28 billion in costs. I guess the good news is that hospitals still harm and kill people every day with their screw-ups, but at least less often than they used to.

A city in Japan offers free barcoded, personalized fingernail stickers for people with dementia who are prone to wandering, allowing police to scan the QR code to find their families. Stickers were already being attached to shoes or items of clothing, but those weren’t always being worn when needed.

A study finds that veterans with dementia who use the VA healthcare system and who also receive Medicare benefits have twice the odds of medication problems due to lack of connectivity between VA and non-VA doctors.

The bond ratings agency of PeaceHealth (WA) notes that its $293 million Epic implementation costs have temporarily hurt its margins. The same agency reviews Seattle Cancer Care Alliance (WA), which it says is considering replacing its EHR  (it doesn’t say which one, but I think they’re running Cerner and they have listed Epic jobs).

Here’s a frontlines report from the war on drugs. The owner of a chain of “clean and sober” residential drug recovery centers called “I.C. Clean People” in Washington State is arrested for drug trafficking, with a raid on his office turning up crystal meth, heroin, marijuana, oxycodone, methadone, and a loaded pistol.

Strange: a mother sues the hospital where she gave birth in a 2012 incident in which employees mistakenly gave her newborn baby to another mom to be breastfed. Abbott Northwestern Hospital (MN) says it has since switched to electronic bracelet baby-mother matching.

Sponsor Updates

• EClinicalWorks employees help out families through Project New Hope, Project Just Because, and the United Way.
• Medecision launches population health management consulting services.
• CloudMine and Validic will partner to advance integration of patient-generated health data into clinical workflows.
• Healthgrades SVP Chris Baxley joins the Nashville Health Care Council Fellows.
• Santa Rosa Consulting publishes a white paper titled “Critical Aspects of a Successful BI and Analytics Program.”
• The Indo-UK Institute of Health names GE Healthcare a preferred technology partner in its IUIH Medicities program in India.
• Agfa HealthCare will implement enterprise imaging for radiology in the first Acibadem International Medical Center in the Netherlands.
• KLAS includes Bernoulli as a top vendor option for clinical alarm management and alarm reduction.
• Besler Consulting releases a new podcast, Epic Conversion – Revenue Cycle Lessons Learned.
• Elsevier Clinical Solutions offers predictions for the next 100 years of medicine.
• Evariant releases a series of best practice guides on a variety of topics.
• Built In Colorado features Healthgrades Director of Talent Acquisition Jenny Truax.

Blog Posts

• A 180-Degree Turn From Illness to Wellness (Arcadia Healthcare Solutions)
• What a Trump Presidency Could Mean for Population Health (Caradigm)
• Physician Engagement for EHR Implementation (Impact Advisors)
• Top 10 Reasons CareSync is Number 1 (CareSync)
• Post-Election Healthcare and the Future of the ACA (Optimum Healthcare IT)
• EHR Replacement – Can You Afford to Wait? (ECG Management Consultants)
• New Technology Connecting Patients & Providers (FormFast)
• Our Top 10 Blogs of 2016 (Galen Healthcare Solutions)
• A Veteran and Cancer Survivor Sits Down with VP Biden to Stand Up to Cancer (GE Healthcare)
• The MACRA Final Rule: Easing the Pain of Implementation (Hayes Management Consulting)
• Healthcare Innovation: Why You Need an Innovation Team (HCI Group)

Contacts

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

Monday Morning Update 12/12/16

Top News

The Wireless-Life Sciences Alliance trade group and the HIMSS-owned Personal Connected Health Alliance merge.

PCHA — formed in 2014 by Continua Health Alliance, mHealth Summit, and HIMSS – merged with the Partners Connected Health Symposium in October 2016. 

PCHA’s Connected Health Conference, the former mHealth Summit, kicks off today (Monday), but its speaker star power seems to have dropped off considerably since I saw Bill Gates there in 2010. Here’s what I had to say about the mHealth Summit when I attended in 2013, which anyone attending this week’s show is welcome to compare and contrast:

I felt as though I had intruded on a geeky academic conference in 2010 … Presentations back then were often about public health projects in Africa, government informatics research, and government policy … I felt somewhere between virtuous and bored being there. HIMSS, as it usually does, put all of that unsexy and unprofitable subject matter almost out of sight. Now the conference is a freewheeling ode to capitalism showcasing companies willing and able to pay big bucks for space in the exhibit hall and in the endless number of HIMSS-owned publications. The exhibit hall is like a downsized version of that at the HIMSS conference and most of the educational sessions are either about companies or feature vendor people as presenters or moderators … HIMSS seems to be positioning the mHealth Summit as the minor league of its conference portfolio. Most of the small mHealth exhibitors will be toast in a couple of years, but those who survive will graduate to the big show, the HIMSS conference … The same issues dominated this year as in 2010. Nobody’s really sure what mHealth is, basically punting off by saying anything that runs on a smart phone must be, which means the subject matter is entirely unfocused and confusing. Startup companies keep trying to convince each other that they can hang on long enough to be bought out. Everybody fervently believes that mobile apps and brash startup spirit can transform the US healthcare system into one that’s cheaper, more health-focused, and more consumer driven. It’s always easy for me to be cynical and dismissive, but especially so at the mHealth Summit.

Reader Comments

From FlyOnTheWall: “Re: SPH Analytics. President and CEO Al Vega is out and the VPs, SVPs, and enterprise teams are all gone.” Unverified, but Vega’s bio has been expunged from the executive page and four of the eight execs listed on the August 2016 cache of the page are equally invisible. Vega’s apparent replacement, J.T. Treadwell, is a money guy who sits on the board of half a dozen companies. I didn’t recall having heard of SPH Analytics, having mentioned them just twice in HIStalk, once for hiring someone and another for choosing an underlying technology.

From The PACS Designer: “Re: CDI with ICD-10. With the launch next month of ICD-10 Procedure Codes, the increased specificity of ICD-10-PCS Clinical Document Improvement will give procedures much improved descriptions of what treatments a patient has endured. For example, a patient having a two stent insertion procedure would have the following ICD-10 Procedure Coded recorded: 02710D6 Dilation of Coronary Artery, Two Arteries, Bifurcation, with Intraluminal Device, Open Approach. This more specific ICD-10 code replaces 5 ICD-9-CM codes which are 36.03,00.41,00.44,00.46, and 36.06. As one can see, ICD-10 is a big improvement over ICD-9.”

From Smelly James: “Re: IBM. Putting itself at the feet of Donald Trump with several healthcare mentions. It wasn’t shy about suggesting future business interest with the VA. This letter will fit well in future RFP protests.” IBM CEO Ginni Rometty apparently congratulated Trump right after the election, suggesting six areas in which IBM could support his political agenda, including a cognitive computing system for the VA. She also dropped not-so-subtle hints that IBM would appreciate his proposed changes to a “punitive” tax system in which IBM’s $68 billion offshore cash stash would be taxed at a Trump-proposed 10 percent vs. the current rate of 35 percent in bringing it into the US, saving the company (and costing taxpayers) $13.6 billion.

From Rural HIT: “Re: Smith County Memorial Hospital and Family Practice. Went live on Cerner, the first of 25 critical access hospitals in the Great Plains Health Alliance switching to Cerner CommunityWorks.” The internal announcement suggests that the hospital was using Siemens Soarian and was steered to Millennium by its new owner Cerner.

HIStalk Announcements and Requests

Most poll respondents are interested in the most significant international health IT news stories. Mobile Man says it’s hard to make comparisons since other countries have different payment models, while Susan is interested because we in the US think we have the best healthcare in the world but really we excel only in spending the most. HIT Geek summarizes, “Innovation has no nationality.” New poll to your right or here: how do you expect your healthcare spending (including insurance premiums) to change in 2017 vs. 2016?

Thanks to Jenn for covering my little pre-Christmas break last week. I waded deep into some HIStalk website technology catch-up when I returned, with some tricky upgrades to newer versions of PHP and other stuff that will hopefully make the site more stable and secure.

I was chatting with someone about terrible singers who still have managed to create hugely successful singing careers – the names that came up included Neil Young, Bob Dylan, Willie Nelson, and Rod Stewart. That doesn’t even count those warblers who sound passably good only through audio techno-trickery. One who could carry a tune, though, was Emerson, Lake, and Palmer’s Greg Lake (also of King Crimson), who died last week at 69. We lost two-thirds of ELP in 2016 with the suicide of Keith Emerson, leaving just P and ensuring that their collective demise will be alphabetical.

Listening: a new cover of the telethon chestnut “You’ll Never Walk Alone” from Massachusetts celt-rockers the Dropkick Murphys.

We provided 21 sets of headphones for Ms. S’s elementary school class in Tennessee in funding her DonorsChoose grant request. She teaches math and science to two classes totaling 44 students and says the classroom sounded like an arcade as students used the Chromebooks for assigned exercises, but now it’s quiet and they can concentrate.

Donations from reader Laura and Direct Consulting Associates, plus matching money, fully funded these DonorsChoose teacher grant requests:

• An amplifier and microphone for Ms. L’s high school class in Center Line, MI
• Two Chromebooks for the seventh grade math class of Ms. F in Phoenix, AZ
• Two tablets and headphones for the kindergarten class of Ms. W in Los Angeles, CA
• A library of 26 science books for Mrs. G’s first grade class in Saint Paul, MN
• A greenhouse set for Mrs. M’s high school class of severely mentally and physically handicapped students in Elyria, OH
• Eight tablets for reading and math listening libraries for Ms. B’s kindergarten class in Kansas City, MO
• A 9×12 reading circle carpet for Mrs. V’s first grade class in Seagoville, TX
• A document camera for Ms. B’s second grade math class in Phoenix, AZ
• 15 sets of headphones for Mr. S’s second grade class in Yonkers, NY

Ms. W sent a note saying, “Your kindness and generosity bring tears to my eyes! I love telling my students how amazing and kind people all over the world donated and funded our projects so we can have fun learning and be successful in the future. Then, I remind them when they have accomplished that to remember to pay it forward. For now they will learn how they can help protect our environment with the tablets!”

Last Week’s Most Interesting News

• The Senate passes the 21st Century Cures act, which includes healthcare IT provisions related to interoperability, privacy, and security.
• Entrepreneur Sreedhar Potarazu, MD, founder, chairman, and CEO of the now-defunct business intelligence vendor VitalSpring Technologies, pleads guilty to defrauding shareholders of the company by hiding its tax liabilities, overstating its financial condition to the tune of $30 million, and falsely telling investors that the company was on the threshold of being sold for a profit.
• CompuGroup Medical ends discussions about a possible takeover of Agfa.
• Epic’s quality assurance employees again sue the company claiming they were misclassified in being ineligible for overtime pay.
• China-based Apex Technology completes its acquisition of Lexmark, renaming its enterprise software group (which includes the former Perceptive Software) as Kofax and announcing plans to sell it.

Webinars

December 14 (Wednesday) noon ET. “Three Practices to Minimize Drift Between Audits.” Sponsored by Armor. Presenter: Kurt Hagerman, CISO, Armor. Security and compliance readiness fall to the bottom of the priority lists of many organizations, where they are often treated as periodic events rather than ongoing processes. How can they improve their processes to ensure they remain secure and compliant between audits? This webinar will cover the healthcare threat landscape and provide three practices that healthcare organizations can implement to better defend their environments continuously.

Here’s the recording of last week’s webinar titled “Get Ready for Blockchain’s Disruption.”

Acquisitions, Funding, Business, and Stock

Asset monitoring vendor Emanate Wireless raises $1.5 million in angel funding.

Health coaching app vendor Vida Health raises $18 million in a Series B funding round, increasing its total to $24 million.

Sales

Rusk County Memorial Hospital (WI) chooses Harris Healthcare Affinity ERP.

Los Angeles County Department of Health (CA) selects Allscripts EZCap for benefit management.

Decisions

• Cogdell Memorial Hospital (TX) will go live on Cerner in 2017.

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

People

Ed Park will join Athenahealth’s board following his previously announced resignation as EVP/COO that takes effect December 31.

Steve Holmquist, industry long-timer and SVP of new client development at Allscripts, died on November 29, 2016 in Phoenix, AZ. He was 55.

Announcements and Implementations

New Zealand primary care provider Pegasus Health chooses Canada-based Intrahealth as its patient management system vendor of choice, ruling out Epic due to its cost.

Government and Politics

John Halamka summarizes the health IT impact of the 21st Century Cures act. He seems mostly positive, but is concerned about the effort required of EHR developers. His highlights:

• ONC’s HIT Policy Committee and HIT Standards Committee will be merged into a single HIT Advisory Committee.
• HHS is charged with developing voluntary certification of health IT for medical specialties and sites where the technology isn’t available or is not mature.
• Vendors are prohibited from information blocking, are required to publish APIs, and must provide HHS with performance documentation. HHS is empowered to reward or punish performance as appropriate.
• New interoperability, security, and certification testing criteria will be developed and ONC will get $15 million to support them.
• HHS will develop or support a trusted exchange framework and ONC will publish an annual list of health information networks that are capable of using it.
• Vendors must be able to exchange data with registries and will be treated as patient safety organizations for reporting and conducting care improvement activities.
• The GAO will review ONC’s work on patient matching.
• The GAO will conduct a study of the ability of patients to review their own PHI.

NIH issues a challenge to develop a wearable sensor that can measure blood alcohol levels in real time, offering $200,000 for the first-place prototype and $100,000 for second place. The sensor would help researchers study alcohol use disorder and related conditions without relying on questionably reliable self-reported drinking data.

Privacy and Security

Fortified Health Security releases a review of 2016’s significant cybersecurity issues and its outlook for 2017.

Other

EClinicalWorks issues a curious patient safety announcement about its EHR as part of its “ongoing effort to respond to and minimize such risks,” suggesting that users:

• Pay attention to the company’s patient safety notices and apply available patches and upgrades
• Update their Multum or Medispan drug databases
• Designate a patient safety officer as ECW’s patient safety liaison
• Confirm that orders are accurate and encourage patients and their families to do the same
• DC and re-enter changed medication orders rather than modifying the existing order.
• Limit the use of custom medications
• Report any patient safety concerns or unexpected software behavior to ECW or by filing an ONC complaint.

ONC cited ECW’s announcement as the key item in its email newsletter, echoing the company’s recommendation to iECW’s customers that they apply available upgrades and report problems to the company and via ONC’s complaints website. I asked ONC If the announcement was triggered by a settlement with ECW over some unspecified issue and they said no, but the announcement suggests some kind of problem that raised ONC’s interest.

Partners HealthCare posts its largest operating loss ever at $108 million, most of that coming from its Medicaid insurance division. Partners says it isn’t being paid enough by commercial insurers and government programs to cover its labor and drug costs. Including investment performance that must have been awful, Partners lost $249 million in 2016.

India-based media claim that 280 people have died of grief and shock following the December 5 death of Tamil Nadu Chief Minister Jayalalithaa Jayaram, raising the question (at least for me) of how their cause of death was determined. The political party in power says it will compensate their families and will also pay $750 to a party official who set himself on fire and another who cut his finger off in mourning.  

Sponsor Updates

• Spok publishes a case study of the implementation of its Care Connect Suite at St. Dominic – Jackson Memorial Hospital (MS).
• TelmedIQ earns a 91.4 score in KLAS’s review of secure communications.
• Dimensional Insight earns top scores in 14 KPI categories in BARC’s “The BI Survey 16.”
• The Chartis Group publishes “Election 2016: Implications for Providers.”
• PeriGen’s PeriCalm Checklist is nominated for an Edison Award.
• TeleTracking releases a new podcast, “The Essentials: 2017 Regulatory and Compliance Requirements for Patient Flow.”
• CIOReview names Validic a Most Promising Healthcare Solution Provider of 2016.
• Glassdoor ranks CoverMyMeds and Health Catalyst in the top 50 places to work nationally.
• Verscend Technologies celebrates the 20th anniversary of its DxCG risk adjustment and predictive modeling solution that serves as the foundation of CMS’s hierarchical condition categories.

Blog Posts

• 5 Healthcare IT Trends to Watch in 2017 (PokitDok)
• Meditech’s 6.1 Revenue Cycle Drives Efficiency at Anderson Regional (Meditech)
• New Report Suggests Increased Patient Financial Responsibility Impacts Provider Net Revenue (Patientco)
• The Fourfold Impact of Secure Communication Platforms on Healthcare Delivery (Uniphy Health)
• Health IT’s role in the radiology value equation (Lexmark Healthcare)
• How to avoid peer-to-peer conversations (Qpid Health)
• Considerations When Preparing for a Cardiology Install in 2017 (Sagacious Consultants)
• The Month After … What Does It Mean for Healthcare (Summit Healthcare)
• How Medication History is Creating Value and Improving Care at Health Systems Nationwide (Surescripts)
• 5 Reasons Organizations are Driving Toward Hybrid IT (TierPoint)
• Best Practices to Ensure End-to-End Payment Accuracy in Your Organization (Verscend)
• Simple Communication for Complex Care. (Voalte)
• 3 Lessons for Healthcare Providers on Improving the Patient Experience (West Corp.)
• Preparing for patient financial responsibility and consumer expectations in 2017 (ZirMed)

Contacts

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

News 12/9/16

Top News

The Senate passes the 21st Century Cures Act in a 94 to 5 vote, sending it to the President’s desk for signature. The President praised the $6.3 billion legislation Wednesday and confirmed that he would sign it. Sen. Lamar Alexander (R-TN), chairman of the Senate health committee and one of the most ardent proponents of the bill, was understandably excited given that it has been circulating for two years and is considered to be one of most heavily lobbied pieces of legislation in recent memory. It provides money for cancer research; funds mental health treatment and resources to combat the opioid abuse epidemic; helps the FDA speed up drug approvals; and bolsters healthcare technology goals related to interoperability, privacy, and security.

HIStalk Announcements and Requests

This week on HIStalk Practice: Arianna Huffington includes Doctor on Demand in new wellness venture. Banner Urgent Care goes with RCM services from Zotec Partners. Health apps found sorely lacking in privacy precautions and safety standards. Marathon Health upgrades its EHR for workplace health centers. Montana preps for statewide HIE. PPJ Healthcare Enterprises raises $5 million.

Webinars

December 14 (Wednesday) noon ET. “Three Practices to Minimize Drift Between Audits.” Sponsored by Armor. Presenter: Kurt Hagerman, CISO, Armor. Security and compliance readiness fall to the bottom of the priority lists of many organizations, where they are often treated as periodic events rather than ongoing processes. How can they improve their processes to ensure they remain secure and compliant between audits? This webinar will cover the healthcare threat landscape and provide three practices that healthcare organizations can implement to better defend their environments continuously.

Acquisitions, Funding, Business, and Stock

Google Ventures founder Bill Maris raises a $230 million venture fund dubbed Section 32 (a likely homage to Star Trek’s Section 31 security operation) that will focus on healthcare investments. Maris, who left Google earlier this year, plans to run the fund solo from San Diego rather than Silicon Valley.

Augmedix closes a $23 million round of funding led by new investors McKesson Ventures and OrbiMed. It has raised over $60 million since launching its Google Glass-powered remote scribing service in 2012. Jenn talked with CEO and co-founder Ian Shakil about the company’s plans to move beyond its core services in “Value-based Care Prompts Glass to Grow Up.”

Brentwood, TN-based consulting and staffing firm Vaco merges the newly acquired Pivot Point Consulting and Greythorn – both based in Washington – to form Pivot Point Consulting, a Vaco company. The new subsidiary brings together 50 employees and combines Pivot Point’s EHR implementation and advisory services with Greythorn’s recruitment expertise.

The patent case over CRISPR-cas9 technology, likely the most valuable patent in biotechnology, begins as the University of California argues to have MIT and Harvard’s patent invalidated and transferred to UC. The patent office awarded The Broad Institute of MIT and Harvard its first CRISPR patient in April 2014, during which time it was reviewing UC’s patient, filed in May 2012.

After much speculation, Fitbit buys Pebble’s software assets for an undisclosed sum, though Bloomberg has valued the transaction at less than $40 million. Pebble, which launched via a crowdfunding campaign in 2012, will no longer produce or sell its smartwatches.

Looking to further bolster its diminishing wearables market share, Fitbit also will work with Medtronic to add glucose monitoring to its fitness trackers. Type 2 diabetes patients will be able to combine their Fitbit-generated data with Medtronic’s IPro2 Continuous Glucose Monitoring system, which can send pertinent data to a patient’s provider.

People

Juliana Hart (Verscend Technologies) joins MedCPU as vice president of market development.

Brooke Patterson (FEI Systems) joins health IT and management consulting firm ARDX as SVP of government services.

Cricket Health appoints University of California-San Francisco nephrologists Carmen Peralta, MD chair of its medical advisory board, and Anna Malkina, MD medical director.

Announcements and Implementations

Chicago-based Union Health Service implements RadNet’s RIS, speech recognition, and mammography tracking.

Nemours Children’s Hospital, Seven Rivers Regional Medical Center, and Westchester General Hospital sign up for the Florida HIE’s event notification service, which patient hospital encounter notifications to participating ACOs, physicians, and payers.

Technology

SecureDx.net develops Secure Data Exchange messaging technology featuring two-factor authentication.

Sales

Looking to set up a private HIE, Chicago-based Rush Health chooses HealthShare interoperability technology from InterSystems.

Schleicher County Medical Center and Nursing Home (TX) taps CPSI subsidiary American HealthTech to help it implement technology upgrades to its clinical and business management operations. The company will also provide Medicaid AR management services.

TaraVista Behavioral Health Center (MA) signs on for MedSphere’s OpenVista EHR. The inpatient facility will also utilize the company’s Phoenix Health Systems division for IT support.

Government and Politics

The FBI indicts 21 employees from Forest Park Medical Center (TX), claiming that they paid $40 million in bribes and kickbacks in exchange for referrals to its purely out-of-network health system. Those indicted include owners Alan Beauchamp, Richard Toussaint Jr., Wade Barker, and Wilton Burt; and Jackson Jacob and Andrea Smith, both of whom set up separate shell companies to funnel bribe and kickback payments to surgeons in exchange for the referrals.

The DoD taps Medical Information Network – North Sound to develop and maintain an HIE-like portal that will be accessible in any clinic or hospital within the DoD system. Integration with the department’s new Cerner-built EHR, currently in pilot phase at several bases in Washington, is expected.

The House passes the telemedicine-friendly Expanding Capacity for Health Outcomes (ECHO) Act, which now heads to the president’s desk after receiving unanimous Senate approval last week. Once signed into law, the act will set in motion an HHS study on the feasibility of training providers to expand technology-enabled healthcare delivery in underserved areas.

Research and Innovation

NantHealth makes its Quantum Immuno-oncology Lifelong Trial (QUILT) Programs available via ClinicalTrials.gov. CEO Patrick Soon-Shiong, MD believes making the QUILT trials available through the NIH registry will improve patient access to active and future immunotherapy-based trials for a variety of cancers.

Other

Quite a space oddity: David Bowie treats former astronaut Buzz Aldrin in a New Zealand hospital after Aldrin was rescued from the South Pole after falling ill. The 86 year-old was part of a tourist group that was visiting the Amundsen-Scott South Pole Station through December 12.

Sponsor Updates

• Imprivata will exhibit at the CIO Forum December 8 in Yorba Linda, CA.
• Ingenious Med receives the Emerging Company of the Year Phoenix Award from the Metro Atlanta Chamber.
• Database Trends and Applications Magazine names InterSystems Cache a trend-setting product in data and information management for 2017.
• Kyruus will present at the Carolina Healthcare Public Relations & Marketing Society meeting December 9 in Charleston, SC.
• Liaison Healthcare expands its relationship with London-based reseller partner AK Loman.
• LifeImage releases video insights from RSNA 2016.
• Gartner includes LiveProcess as a representative vendor in its 2016 market guide for clinical communication and collaboration.
• Meditech shares a brief case study featuring Anderson Regional Medical Center (MS).
• Netsmart will exhibit at the Community Behavioral Healthcare Association of Illinois Conference December 12 in Schaumburg.
• Computerworld names NTT Data VP of Digital Experience Lisa Woodley a 2017 Premier 100 Technology Leader.
• Black Book ranks Nuance first in CDI for the third consecutive year, and first for end-to-end coding, CDO, transcription, and speech-recognition technology.
• Health Catalyst receives the 2017 Glassdoor Employee Choice Award.
• Rock Health names Health Catalyst CEO Dan Burton the winner of its annual Most Beloved CEO award for 2017.
• Verscend Technologies publishes a new white paper, “The Evolution of DxCG, the Gold Standard in Risk Adjustment and Predictive Modeling.”

Blog Posts

• Your Breach Response Team May Not Matter … Until it Does (ID Experts)
• Top 5 Success Strategies for Integration Projects (Impact Advisors)
• Prepare Your Hospital’s 2017 Digital Marketing Strategy (Influence Health)
• The Pollsters Were Wrong: What are the Big Data Implications? (Liaison Healthcare)
• Telling Your Front-Office Team, “I’ve Got Your Back!”: Tips for Maximizing Patient Payment Revenue (Navicure)
• Printing Healthcare’s Bright Future, in 3D (Orion Health)
• CHIME 2016 Fall CIO Forum underscores increasing financial pressures in healthcare; need for better analytics (Infor Healthcare)
• Innovations in Encrypted Paging Protect PHI (Spok)

Contacts

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

EPtalk by Dr. Jayne 12/8/16

The FDA is making available its data on adverse events stemming from foods, dietary supplements, and cosmetics. I found it interesting that the coded symptom data contains numerous British English spellings: hospitalisation; dyspnea; diarrhea; and pale faeces to name a few. Pretty unusual for a United States governmental agency. Repeat offenders included the full range of “5-Hour Energy” products; B-complex vitamins; cabbage; and a number of products with the name “cleanse” in their names, which is not surprising to this physician.

I attended a continuing education session this week. Although I learned a lot, it was the first time that I heard so many gambling metaphors in one place. I’m used to hearing sports phrases, but the gambling references were new to many of the attendees. I had the privilege of explaining what “table stakes” were to a newly-minted pediatrician, as well as the meaning of “double down.” I’m grateful to my former partner who once invited me to be part of a ladies’ poker night, which ended up being less about poker and more about wine and catching up. It’s always a good reminder for presenters to consider their audience before including figures of speech. There were also some Yiddish references and some regional slang, which, although entertaining, might have been confusing to some.

The reader mailbag brought quite a bit of correspondence this week. I always enjoy hearing from readers, even if it’s just a “thanks for writing” type comment. Being anonymous and doing most of my work solo while watching “Call the Midwife” can feel pretty lonely, so thanks for the feedback.

From Texas Tornado: “I enjoyed your recent mention on MU reporting. Would text analytics be helpful in this MU attestation scenario? I understand the push to do more discrete documentation, but what if you could report on structured and unstructured data combined? Does it really matter if the data is discrete or not as long as you can report on it?” That type of approach would certainly be appreciated by many clinicians who have been clicking their little hearts out over the last half decade. With most of the EHR-based quality reporting platforms I’ve seen, however, most documentation has to be discrete and in a fairly narrow workflow to “count” for quality measures. Ultimately, as natural language processing evolves, I think we will see more information being transformed to discrete data points; but I’d love to see some other approaches.

From Roaring Waters: “Thanks for your discussion of the need for clinical participation in IT projects. As a vendor selling to the acute care environment, I am always shocked at how often patient care workflow solutions are handed to an IT or non-clinical person to evaluate and determine how it will impact clinical workflow. I know people have been talking about end-users making user workflow decisions for decades, but for some reason these basics of project management are lost. Providers themselves are just as guilty, as I see them constantly passing these decisions off to a non-doc or non-clinical user to make decisions about their workflow and ultimately the patient care they deliver. It’s mind-boggling!” The providers that pass the buck for decision-making are often the first to complain when workflows or solutions don’t meet their needs. Another variation on this that I’ve seen lately is to pass the decision to a clinical representative who doesn’t actually practice or who doesn’t have any real buy-in to the clinical situation at the institution. I’ve been working with a group for nearly a year that has a CMO who constantly criticizes the EHR and demands a move to Epic, yet hasn’t shown up at a single executive briefing or strategy session where the EHR has been discussed. His comments are strictly hit and run via email and one-off conversations with the Board of Directors, which hasn’t learned to say no to his shenanigans. His peers are working hard for solutions and all he does is tear down their work, which is unfortunate.

From Science Guy: “Thank you for your comments about clinical staff having to take ownership of the quality reporting. Having worked in healthcare in both the payer and clinical side … there is a paradigm shift taking place that many clinicians have not come to grips with. That is that the payers are driving more and more of the clinical decisions based on outcome data and not clinical judgment. It is becoming increasingly difficult to practice medicine in a vacuum without using clinical information to justify decision making. Having worked at a University Medical Center, I saw this very plainly as the more experienced physicians struggled with this very topic and resented the IT staff for ‘creating additional hoops for them to jump through.’ I heard the statement more than once that ‘my time is too valuable for this … and my time is better spent healing patients than working on the computer.’ On the other side of the coin, there is a whole new generation of physicians coming out of school that are much more computer literate. They embrace using information from the health record to support their decision making. They realize this information could assist them with their clinical decisions, and all of this data was really just another clinical diagnostic tool to improve care. I guess my point is that like any other change, this current shift will cause a lot of frustration for a lot of staff, but it is certainly not going away. Hopefully many of the more experienced staff will be motivated to change as they see their younger peers embracing this technology and ultimately the patients will benefit from these changes. But hopefully, in the meantime, your information will help with the whole ‘shooting the messenger (the IT staff) mentality.’”

As a young physician working in clinical informatics for the first time, it took me longer than it should have to learn to stop shooting the messenger. Looking back, I realize I was working with a very inexperienced IT staff that had no idea how to work with physicians and didn’t understand how much havoc a poorly-run EHR project could have on a practice. I assumed that since the hospital had contractually agreed to provide me a paperless practice with a functional HER, that they would also provide staff that had the skills to deliver it. Some of the individuals involved in that debacle are now some of my information technology BFFs and we continue to learn a great deal from each other. Whether it was encountering chicken wire in the wall that was interfering with wireless connectivity or having providers install their own black-ops routers under their desks, it was kind of fun working in the early days (read “Wild Wild West”) of health IT.

Have you ever used poultry netting as a drywall patch? Email me.

Email Dr. Jayne.

News 12/7/16

Top News

Ireland goes live on a nationwide maternal and newborn clinical management system at Cork University Maternity Hospital, making newborns like Emily, above (dubbed the country’s “first digital baby”), initial recipients of a digital patient chart. The Cerner-developed MN-CMS will roll out across the country’s 19 maternity units over the next three years, with near-term go lives planned for University Hospital Kerry, Rotunda Hospital, and National Maternity Hospital in Dublin. The new technology is the first of its kind in the world, and marks the Irish healthcare system’s first interoperable EHR.

Webinars

December 7 (Wednesday) 1:00 ET. “Charting a Course to Digital Transformation – Start Your Journey with a Map and Compass.” Sponsored by Sutherland Healthcare Solutions. Presenters: Jack Phillips, CEO, International Institute for Analytics; Graham Hughes, MD, CEO, Sutherland Healthcare Solutions. The digital era is disrupting every industry and healthcare is no exception. Emerging technologies will introduce challenges and opportunities to transform operations and raise the bar of consumer experience. Success in this new era requires a new way of thinking, new skills, and new technologies to help your organization embrace digital health. In this webinar, we’ll demonstrate how to measure your organization’s analytics maturity and design a strategy to digital transformation.

December 14 (Wednesday) noon ET. “Three Practices to Minimize Drift Between Audits.” Sponsored by Armor. Presenter: Kurt Hagerman, CISO, Armor. Security and compliance readiness fall to the bottom of the priority lists of many organizations, where they are often treated as periodic events rather than ongoing processes. How can they improve their processes to ensure they remain secure and compliant between audits? This webinar will cover the healthcare threat landscape and provide three practices that healthcare organizations can implement to better defend their environments continuously.

Acquisitions, Funding, Business, and Stock

Potomac, MD-based ophthalmologist Sreedhar Potarazu pleads guilty to charges related to a $30 million investment fraud scheme tied to VitalSpring Technologies, his now-defunct healthcare business intelligence company. Potarazu admitted to defrauding over 150 shareholders by lying about the company’s finances, failing to pay payroll taxes, hiding tax liabilities, and even going so far as to concoct a charade around a fake prospective buyer. He faces 15 years in jail.

Theranos will dissolve its Board of Counselors, including two former secretaries of state, the former director of the CDC, and a former secretary of defense. James Mattis, a retired Marine general who has gained notoriety as President-elect Donald Trump’s pick for secretary of defense, will remain on the company’s Board of Directors.

Grail, a spinoff of DNA-sequencing company Illumina, looks to raise $1.7 billion to fund large-scale clinical trials in the UK to test early-stage cancer detection tools. The company was initially funded early this year via a $100 million Series A round led by Illumina.

Boston-based PatientPing raises $31.6 million in a Series B financing round led by Leerink Transformation Partners and Andreessen Horowitz. The company plans to double its workforce and expand beyond the six states it currently serves. Vermont announced statewide adoption of the care alert technology in April. The company raised $9.6 million in venture funding last year.

Germany-based CompuGroup Medical walks away from Agfa acquisition talks for undisclosed reasons. It began discussions with the Belgian company in late October.

People

Shafiq Rab (Hackensack University Health Network) will join Rush University Medical Center as CIO and SVP effective January 9.

Joe Driscoll (PC Connection) joins Verscend as CFO.

The American Society of Clinical Oncology hires George Komatsoulis (NIH) as its first chief of bio-informatics.

Announcements and Implementations

ColumbiaDoctors (NY) will roll out mobile patient engagement technology from HealthGrid across its 95 locations.

Dayton Children’s Hospital (OH) begins a two-phase implementation of GetWellNetwork’s bedside Interactive Patient Care software. Phase two will take place next Summer with the opening of a new hospital tower.

Athenahealth adds ADP’s workforce payroll and time and attendance software to its AthenaOne offering for hospitals and health systems.

Rochester RHIO adopts the Connect Image Exchange Transfer-to-PACS workflow from EHealth Technologies.

Sales

Lurie Children’s Hospital of Chicago chooses MerlinOne’s digital asset management system.

The Oklahoma Dept. of Human Services opts for case management technology from Mediware to help it better care for aging and/or disabled residents.

Rusk County Memorial Healthcare (WI) selects Harris Healthcare’s Affinity ERP solution for automation and integration of accounting and financial tasks.

Pharmacy procurement and utilization management company Sentry Data Systems signs on with NTT Data Services for data security and hosting.

Technology

Baxter launches the Sigma Spectrum Safety Management system, including infusion data analysis and reporting and technical support.

Premier develops performance benchmarking technology that sheds light on potential reimbursements and prioritizes areas of improvement.

Meditech releases a fall risk-management tool kit.

Government and Politics

HHS releases the latest round of healthcare spending figures, which show a 5.8-percent growth in 2015 – the fastest rate since 2008. That puts the average annual healthcare spend for one person at close to $10,000. The increase coincided with 9.7 million people gaining insurance coverage under the ACA, and 10.3 million more enrolling in Medicaid.

Research and Innovation

Tenable publishes a cross-industry analysis of cybersecurity preparedness, noting that readiness scores dropped an average of six percent from last year. It gave the healthcare industry a “D” in overall preparedness, a grade lower than its score of the previous year.

Sponsor Updates

• Agfa Healthcare will present several sessions at the European Summit on Digital Innovation for Active & Healthy Ageing this week in Brussels.
• Audacious Inquiry wins The Baltimore Sun’s 2016 Top Workplaces Award.
• Arcadia Healthcare Solutions will exhibit at the CCO Oregon Cost of Care Conference December 13 in Salem.
• Besler Consulting releases a new podcast, “Key takeaways from the 2017 OPPS Final Rule.”
• B2B Marketing features Bottomline Technologies CMO Christine Nurnberger.
• E-MDs offers early bird pricing for its user conference and symposium June 18-20 in Grapevine, TX.
• EClinicalWorks will exhibit at the 2016 Connected Health Continuum December 11-14 in National Harbor, MD.
• HCI Group releases a new podcast, “EHR Training: Developing Your Curriculum, Using Your LMS, and Organizing Your CTs ft. Stephen Tokarz.”
• An Aprima survey of 312 physicians and practice staff finds that 52 percent believe a Trump presidency will improve healthcare, while 48 percent seem confident in a positive financial impact.
• Meditech customer Farrer Park Hospital (Singapore) receives numerous health IT accolades.
• PokitDok publishes, “5 Healthcare IT Trends to Watch in 2017.”
• EClinicalWorks issues reminders about patient safety and the use of its EHR software.

Blog Posts

• Understanding the AIDS Crisis (Arcadia Healthcare Solutions)
• HHS Guidance on HIPAA Compliance in the Cloud: What You Need to Know (Catalyze)
• What are the Key Population Health Management Capabilities? (Caradigm)
• Protected: Emerging Therapies & Clinical Trial Opportunities for ER-Positive, HER2 Negative Metastatic Breast Cancer and HER2-Positive Breast Cancer (CareVive Systems)
• Electronic Prescribing and Electronic Prior Authorization – Key Differences You Need to Understand (CoverMyMeds)
• What is the Most Important Thing to Know About MACRA for 2017 (Culbert Healthcare Solutions)
• Easing into Population Health (ECG Management Consultants)
• Driving Audit Productivity and Efficiency: 5 Key Steps (Hayes Management Consulting)
• EHR Implementation: Choosing and Supporting Your Super Users (HCI Group)
• What’s More Important When Picking a Vendor, Technology or Relationship? (Access)

Contacts

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

Morning Headlines 12/6/16

US Health Spending in 2015 Averaged Nearly $10,000 Per Person

Healthcare spending climbed 5.8 percent in 2015, the fastest rate since 2008, according to a recently published HHS report.

Theranos Dissolves High-Profile Board of Counselors

Theranos announces that its Board of Counselors, including two former secretaries of state, the former director of the CDC, and a former secretary of defense, will retire in 2017.

Global Cybersecurity Assurance Report Card

Tenable publishes a cross-industry analysis of cybersecurity preparedness, noting that readiness scores dropped an average of six percent from last year, and giving the healthcare industry a “D” in overall preparedness.

Illumina spinout Grail is seeking to raise $1.7 billion for large-scale clinical trial: sources

Grail, a spinoff of DNA-sequencing company Illumina, is in the process of raising $1.7 billion to fund large-scale clinical trials in the UK to test early-stage cancer detection tools.

Curbside Consult with Dr. Jayne 12/5/16

Many organizations are starting to get ready for their Meaningful Use attestations early next year. Those that prepared well in advance and monitored their performance as the year rolled along are simply dotting the proverbial “i” and crossing the “t” before the year closes out. Others are in panic mode, realizing that they waited too long to get serious about it, or failed to follow up. I was contacted recently by a couple of clients that fell into the latter category, and was sorry to have to tell them that there isn’t a lot that I can do to help them.

One group started the year strong, using their EHR’s quality measures dashboard to make sure providers were posting solid metrics for their identified measures. They provided retraining for the end users as needed, making sure documentation was done using as much discrete data as possible. They were headed strong into May, and then had some changes in their office dynamics that resulted in the loss of some key staffers. The new office manager was tasked with picking up the Meaningful Use readiness work, and there is some debate about whether she simply didn’t do it or whether she told one of the partners that she was too overwhelmed to take it on.

Practice leadership realized about a month ago that they hadn’t been seeing any reports, and hired a new resource to start managing things. It took her several weeks to get up to speed, and even then it seems that it was too little, too late. Many of the providers have slipped back into documenting their visits using free text and dictation, and based on how the system reports, they aren’t getting credit for their documentation. The managing partner reached out to me asking for my firm to completely take things over for the rest of the year. I was willing to give it a go, until he demanded that I assure him that his providers would meet certain numbers on the metrics. Without a magic wand or a time machine, it would be pretty impossible to correct that much missed documentation, so I elected to take a pass.

Another client had a supposedly savvy IT person who was modifying patient visit data on the backside of the system. He would take the providers’ visits, and if there was free text documentation that kept the visit from qualifying for certain metrics, he would perform database inserts to trigger the discrete data points. That might be a valid approach as long as there is solid documentation on what is being done and clear boundaries around it, but they failed to document the plan or the authorization. Now the physicians are in a battle about having people modify their charge without approval of the individual visits, and it’s probably going to tear the practice apart. They wanted me to come in and audit the database and see how widespread the modifications are, but given the state of the practice, there isn’t enough money on the table for me to get into the middle of something like that.

These examples illustrate, in part, a major issue that we’re still seeing in healthcare IT. Far too many providers and organizations still think that these types of projects are technology projects. I hear a lot of nebulous references to “the IT department” owning such initiatives when really they are clinical/operational initiatives with IT support. There’s also a lot of blame on the EHR vendors. Although I’ve definitely seen my share of flawed workflows, strange workarounds, and oddly calculating measures, clients have to realize that unless they’re willing to switch systems, they have to work with what they have in front of them. Of course, they should also open tickets or support cases or use whatever complaint mechanism their vendor provides, but at some level the customer is responsible for selecting or staying with a particular vendor.

When physicians push back against my assertion that they need to own these projects along with their practice operational leaders, I ask them if they would assume that the company that manufactured the fax machine or the person who dialed it is responsible for the information written in the letter they’re sending to their consulting or referring physician. (Don’t get me started on the fax machine analogy. It’s sad that I have to use it, but so many offices are still faxing letters back and forth that it’s an effective way to make the point.)

It’s now December, and there are somewhere around 17 or 20 work days left in the year for most practices, depending on how you handle your holidays. If you’ve been asleep at the quality measures wheel for most of the year, there is virtually no way to make it up before the attestation window closes, unless you’re willing to engage in database shenanigans or know someone who will on your behalf. You’re not going to be able to retrain providers to fix their workflows for this year, but you can start educating them on what they need to do differently for 2017. And hopefully those organizations who are in a bind at the moment have realized what they too need to do differently for next year, if they want to be successful.

Whether you look at it as succeeding in a world of changing payment structures or avoiding penalties or complying with the requirements of your employer, staying ahead of quality reporting requires a lot of work. Providers have to be constantly monitored for compliance with recommended workflows. End users have to be educated on ways to support the providers so they don’t become data entry clerks. Practice managers and administrators need to be running reports regularly and taking action to mitigate issues as soon as they identify them.

Leadership should be careful on how often they run reports though and what results they expect – I had one client who was running them twice a week, and complaining that they weren’t improving. We had to have a lengthy conversation about interventions and how long they take to bear fruit, since it’s nearly impossible to change provider or end user behavior overnight. That’s also assuming that you actually reached the providers with the intervention, and that half of them weren’t in the operating room or missing it because they were rounding or not reading their email. Even with significant incentives or penalties, it’s still going to take several weeks (if not months) for new workflows to become part of daily routines.

Managing quality metrics is definitely more of a marathon than a sprint. How is your group doing with MU attestation preparation? Email me.

Email Dr. Jayne.

Monday Morning Update 12/5/16

Top News

Allscripts acquires Australia-based Core Medical Solutions for an undisclosed sum. The company’s BOSSnet clinical information system seems to be its best known product, with numerous implementations across the Western part of the country. CMS will operate as an Allscripts subsidiary out of its South Australian headquarters in Adelaide. Allscripts has had a strong foothold in South Australia since 2010, when the government enlisted the company to develop and roll out an Enterprise Patient Administration System across its 80 hospitals to the initial tune of $225 million – a figure that has since escalated to $317 million over 10 years.

Last Week’s Most Interesting News

• The House passes the 21st Century Cures act in a rare, bipartisan 392-26 vote and sends it off for the Senate to review.
• A CDC report finds that the number of people struggling to pay their medical bills has fallen sharply in the last five years. Researchers cite reduced unemployment and the implementation of ACA as the primary reasons.
• The Senate unanimously passes a bill requiring HHS and GAO to analyze the University of New Mexico’s Project ECHO pilot program and report on opportunities to expand the program nationally.
• President-elect Donald Trump selects Rep. Tom Price, MD to replace Sylvia Burwell as the next HHS secretary, and health policy consulting firm CEO Seema Verma to succeed Andy Slavitt as the next CMS administrator.
• Rupert Murdoch will likely lose $200 million in Theranos investments after his own newspaper, the Wall Street Journal, exposed the company for misleading investors.

Webinars

December 6 (Tuesday) 1:00 ET. “Get Ready for Blockchain’s Disruption.” Sponsored by PokitDok. Presenter: Theodore Tanner, Jr., co-founder and CTO, PokitDok. EHR-to-EHR data exchange alone can’t support healthcare’s move to value-based care and its increased consumer focus. Blockchain will disrupt the interoperability status quo with its capability to support a seamless healthcare experience by centralizing, securing, and orchestrating disparate information. Attendees of this webinar will be able to confidently describe how blockchain works technically, how it’s being used, and the healthcare opportunities it creates. They will also get a preview of DokChain, the first-ever running implementation of blockchain in healthcare.

December 7 (Wednesday) 1:00 ET. “Charting a Course to Digital Transformation – Start Your Journey with a Map and Compass.” Sponsored by Sutherland Healthcare Solutions. Presenters: Jack Phillips, CEO, International Institute for Analytics; Graham Hughes, MD, CEO, Sutherland Healthcare Solutions. The digital era is disrupting every industry and healthcare is no exception. Emerging technologies will introduce challenges and opportunities to transform operations and raise the bar of consumer experience. Success in this new era requires a new way of thinking, new skills, and new technologies to help your organization embrace digital health. In this webinar, we’ll demonstrate how to measure your organization’s analytics maturity and design a strategy to digital transformation.

December 14 (Wednesday) noon ET. “Three Practices to Minimize Drift Between Audits.” Sponsored by Armor. Presenter: Kurt Hagerman, CISO, Armor. Security and compliance readiness fall to the bottom of the priority lists of many organizations, where they are often treated as periodic events rather than ongoing processes. How can they improve their processes to ensure they remain secure and compliant between audits? This webinar will cover the healthcare threat landscape and provide three practices that healthcare organizations can implement to better defend their environments continuously.

Acquisitions, Funding, Business, and Stock

Apex Technology and related investors wrap up their acquisition of Lexmark, originally announced in April. Lexmark’s Enterprise Software Group will separate from the investor-led company and rebrand to Kofax. Former Vice President and CFO David Reeder will take over as president and CEO, and appears intent on selling off the software business as quickly as possible to focus on its imaging assets. The sale includes the assets of Perceptive Software, which Lexmark acquired in 2010.

Dallas-based civil and criminal justice technology company Securus Technologies acquires Quebec-based PHD Medical’s telemedicine assets. Securus has been intent on broadening its healthcare offerings for correctional facilities, having acquired EHR vendor Cara Clinicals last year, and healthcare management systems business Archonix in 2013.

Cerner finds itself in the real estate market thanks to legal battles with Ahmed Saeed Mahmoud Al Badia, a property developer with ties to the United Arab Emirates Ministry of Health, which hired Cerner in 2008 via a subcontractor agreement with Al Badia’s company, ICapital, to develop a national EHR system. Cerner contends it hasn’t been paid the full amount due, despite finishing the project. It is suing Al Badia and trying to seize a $30 million mixed-use development and other assets to recoup $63 million it claims to have lost on the project.

Epic faces another class-action lawsuit pertaining to its overtime pay policies. This particular suit contends that quality assurance workers were illegally denied overtime pay despite the fact that they mainly tested Epic’s software products by simulating user experiences and documenting problems – work that required little training or education in computer programming or engineering. (Higher-level employees like analysts, programmers, and software engineers are typically exempt from overtime pay rules.) The company faces two other overtime-related lawsuits filed early last year on behalf of technical writers who believe Epic illegally classified them as exempt from overtime wages and then paid them a fixed salary irrespective of the number of hours worked.

People

James Aita (Idea Couture) joins Medicomp Systems as director of strategy and business development, North America.

Decisions

• Sleepy Eye Municipal Hospital (MN) will switch clinical and physician documentation software from Healthland to Meditech on December 1.
• UConn John Dempsey Hospital (CT) will go live on Epic in June 2018.

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

Announcements and Implementations

The New Hampshire Health Information Organization can now share data with NH providers who care for veterans inside and outside of the VA.

Gillette Children’s Specialty Healthcare expands its telemedicine program to facilities in Central Minnesota. The state passed legislation last year requiring payers to cover virtual consults to the same degree they would in-person appointments.

Privacy and Security

From DataBreaches.net:

• Tampa General Hospital (FL) settles a class-action lawsuit related to a non-hospital employee’s unauthorized access of patient information and the hospital’s failure to adequately protect that information. The hospital maintains it is not responsible for the misdeeds of former employees related to the access.
• Glendale Adventist Medical Center (CA) fires a nurse after the employee accessed the records of 528 patients without permission.

NIST’s National Cybersecurity Center of Excellence seeks help with designing simple and secure mobile login methods for first responders. Organizations interested in supporting the single sign-on effort can submit a letter of interest to NIST, which hopes to begin developing use cases in January.

University of Iowa Hospitals and Clinics recovers from a six-hour Epic downtime caused by an electrical problem in one of its main server rooms. The health system shifted to standard downtime procedures and transferred critical services from its data center to a redundant data center off site.

Innovation and Research

A HealthLoop health literacy study of 2,226 diagnostic imaging patients finds that those offered educational materials via digital means were more likely to correctly identify what ionizing radiation was than those that received paper materials. The digital engagement group was also “significantly” more at ease with undergoing examinations using such radiation compared to their paper-based counterparts.

Sponsor Updates

• Experian Health will present at the VA AAHAM meeting December 9 in Williamsburg, VA.
• PokitDok will present at Health 2.0 Asia-Japan December 6-7 in Tokyo.
• Surescripts and ZeOmega will exhibit at the AHIP Consumer Experience & Digital Health Forum December 6-9 in Chicago.
• TierPoint will host the Nebraska Security Summit December 8 in Omaha.
• Zynx Health will exhibit at the National Forum on Quality Improvement in Healthcare December 4-7 in Orlando.
• Sutherland Healthcare Solutions publishes “Meaningful Use Stage 3 and its Impact on the Healthcare Industry.”

Blog Posts

• The Advent of the True VNA (Lexmark Healthcare)
• Thanks, Docs (PatientKeeper)
• To Drive ROI, Clinical Communications Platforms Need 3 Integrations (Uniphy Health)
• RSNA: Past, Present, and Future (Lexmark Healthcare)
• Phynd Technologies Releases Major Software Upgrade (Phynd Technologies)
• What Do You Like Most About PMD? (PMD)
• A Practical Approach to Implementing a Population Health Management Program (Point-of-Care Partners)
• Threats to Patient Data Security from the Board’s Perspective (Protenus)
• Preparing for MACRA: Technology’s Role in the Quality Payment Program (Surescripts)
• Extraordinary Nurses in Patient Flow (TeleTracking)
• CareOregon: how to achieve measurable quality improvement (Verscend)
• 3 Reasons We Have a Department Named Client Experience (VitalWare)
• Out with the old. In with a platform. (Voalte)
• These two healthcare leaders are forging connections to build a healthy future (Xerox Healthcare)
• End-to-end or means to an end: Choosing the right clearinghouse (ZirMed)
• Focusing on the Sometimes Difficult Device You Can’t Live Without . . . the Infusion Pump (Ivenix)

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 12/2/16

Top News

The House passes the 21st Century Cures act in a rare, bipartisan 392-26 vote and sends it off for the Senate to review next week.

Provisions include a less-thorough FDA drug approval process, $5 billion in NIH research funding, $1 billion to address the opioid epidemic, and mandatory EHR interoperability requirements that prohibit information blocking with potential fines of $1 million. The bill would also combine ONC’s HIT Policy and HIT Standards committees

A controversial measure that would have reduced requirements for drug companies to continue publicly reporting their payments to providers was removed.

The bill would be funded by taking money away from preventive health projects.

Reader Comments

From Luna Immortal: “Re: [vendor 1 name omitted]. I’m hearing that they have an upcoming merger and wonder if it might be [vendor 2 name omitted] since there’s a lot of people who worked at both companies and Vendor 2’s home health software vendor stake would help Vendor 1, whose product isn’t robust.” Unverified. Sorry about all the Vendor 1/Vendor 2 stuff, but I don’t usually list the names of publicly traded companies when I run rumors even when it’s not hard to figure out who’s who.

From Byte Bard: “Re: upcoming webinar. Your speaker’s bio says his prior company went public. That’s not accurate – it was an SEC Regulation D investment.” I see a good bit of accomplishment inflation in this industry, like the executive’s LinkedIn profile I was reviewing this morning that, in the absence of actual graduate education, listed one of those super high-priced, days-long visit to the campus of a big-name school that offers programs for those who are flush with cash but who don’t find it convenient to earn an actual graduate degree like many of their underlings managed to do. I’ll trust your resume forensics in this case. I recall that I got all kinds of nasty and threatening emails years ago when I wrote about unaccredited schools and linked to the bios of healthcare people who were throwing around their fake MBAs and PhDs. If the credential can’t withstand any sort of inspection, then it has no place on a resume or LinkedIn.

DonorsChoose Updates

Donations from (a) the anonymous vendor executive who asked me to do a reader cybersecurity survey; (b) long-time reader Marty; and (c) our own @JennHIStalk funded these DonorsChoose classroom projects:

• A library of books and a storage cart for Mrs. L’s first grade class in Cedar Hill, TX.
• 30 calculators for Mrs. S’s sixth grade math class in Union, SC.
• Math games for Mrs. S’s first grade class in Independence, MO.
• Learning center headphones for Ms. M’s elementary school class in Chicago, IL.
• Programmable robots for the library’s makerspace of Mrs. E’s elementary school in Greenwood, SC.
• Science teaching items for the sixth grade class of Mrs. S in Union, SC.
• Hands-on learning stations for the learning disabled students of Mrs. P’s kindergarten class in Oklahoma City, OK

Mrs. S from SC, who says she was “thrown in” to teaching science after school had already started and therefore had no materials to work with, checked in:

You do not know how much this means to me and to my students. This has been a difficult year trying to teach my students with limited supplies. I can’t wait to tell my students tomorrow morning. I’m sure they will be just as excited as I am. Thank you for your generosity.

Industry long-timer Tom sent a very generous personal donation with a note saying that it’s sad that charity has to provide classrooms with essential learning tools, but he’s still happy to donate for “our future adult citizens.” The matching money really added up in funding these teacher grant requests with Tom’s donation:

• A listening center for Mrs. H’s first grade class in Battle Creek, MI.
• Additional books for the library of Mrs. L’s first grade class (the first donation to her class was above).
• A mobile organizer and spelling games for Mrs. S’s elementary school class in Gaffney, SC.
• Three sets of building blocks for Mrs. K’s elementary school class in Rome, NY.
• An iPad Mini for read-along lessons for Ms. N’s elementary school class in Brooklyn, NY.
• A social emotional library of 33 books for the International Baccalaureate class of Mrs. M in Nashville, TN.
• Non-fiction books and subscriptions for Ms. S’s elementary school class in Chula Vista, CA.
• Robotics and engineering kits for Mrs. G’s elementary school class in Springfield, NY.
• STEM learning project kits for Ms. L’s elementary school class in Independence, MO.
• Music and band supplies for Mrs. R’s elementary school class in Wasco, CA.

My fatigue is growing with lazy health IT reporters who craft “news” stories consisting mostly of loosely woven together tweets or quotes extracted from them. They should be practicing journalism that they promote via Twitter, not using Twitter as a news source. Every time I think that journalists (if you care to call them that) can’t possibly get lazier or less informed, they prove me wrong. The “eyeballs at any cost” movement among sites that don’t charge a subscription fee (and thus trade in titillation rather than education) has made us collectively dumber than we already were and that’s saying a lot. 

I’m also tired of people repeating the well-intentioned but dead wrong trite assertion that “Your ZIP code determines your health more than anything.” If that were true, people would be miraculously cured just by moving. Health status is certainly related to socioeconomic factors that are prevalent in a given ZIP code, but you and I won’t fall apart medically just because we move to East St. Louis. It’s a cute phrase that ironically confuses cause with effect and applies broad group characteristics to every individual in the group. Healthcare people should know better.

This week on HIStalk Practice: AbleTo adds care coordination capabilities to behavioral telehealth service. PCPs found extremely lacking in willingness to fess up to medical errors. Topline MD practices roll out telemedicine capabilities. Orb Health raises $3.2M for CCM-focused care coordination tech. Culbert Healthcare Solutions CMO Nancy Gagliano, MD shares four reasons why telemedicine hasn’t taken off more quickly. Excellus BCBS preps for MDLive roll out. CompuGroup Medical adds rehabilitation module. WebPT CEO Nancy Ham shares her thoughts on the importance of workplace culture in attracting top talent.

Listening: new from Seattle-based lo-fi rockers Dude York, which to my untrained ear can sound like the Pixies one minute and the Thermals the next. Their drummer nails it. I’m also kind of enjoying their former neighbors from their Walla Walla days, the riot grrrlish Chastity Belt, who bristle at being called a “girl band” in saying that all the members “just happen to be female” and that nobody would call Led Zeppelin a “boy band.” We get great recorded performances of both courtesy of the U-Dub affiliated KEXP in Seattle, which offers live streaming of its radio programming (I’m listening to it now). 

Webinars

December 6 (Tuesday) 1:00 ET. “Get Ready for Blockchain’s Disruption.” Sponsored by PokitDok. Presenter: Theodore Tanner, Jr., co-founder and CTO, PokitDok. EHR-to-EHR data exchange alone can’t support healthcare’s move to value-based care and its increased consumer focus. Blockchain will disrupt the interoperability status quo with its capability to support a seamless healthcare experience by centralizing, securing, and orchestrating disparate information. Attendees of this webinar will be able to confidently describe how blockchain works technically, how it’s being used, and the healthcare opportunities it creates. They will also get a preview of DokChain, the first-ever running implementation of blockchain in healthcare.

December 7 (Wednesday) 1:00 ET. “Charting a Course to Digital Transformation – Start Your Journey with a Map and Compass.” Sponsored by Sutherland Healthcare Solutions. Presenters: Jack Phillips, CEO, International Institute for Analytics; Graham Hughes, MD, CEO, Sutherland Healthcare Solutions. The digital era is disrupting every industry and healthcare is no exception. Emerging technologies will introduce challenges and opportunities to transform operations and raise the bar of consumer experience. Success in this new era requires a new way of thinking, new skills, and new technologies to help your organization embrace digital health. In this webinar, we’ll demonstrate how to measure your organization’s analytics maturity and design a strategy to digital transformation.

December 14 (Wednesday) noon ET. “Three Practices to Minimize Drift Between Audits.” Sponsored by Armor. Presenter: Kurt Hagerman, CISO, Armor. Security and compliance readiness fall to the bottom of the priority lists of many organizations, where they are often treated as periodic events rather than ongoing processes. How can they improve their processes to ensure they remain secure and compliant between audits? This webinar will cover the healthcare threat landscape and provide three practices that healthcare organizations can implement to better defend their environments continuously.

Acquisitions, Funding, Business, and Stock

Document Storage Systems will acquire Streamline Health’s patient engagement suite that includes patient scheduling and surgery management. Those are the former systems developed by Unibased Systems Architecture, which Streamline acquired in 2014 and then renamed from ForSite2020 to Looking Glass Patient Engagement. I ran a reader rumor from Twice Bitten on October 5, 2016 saying that Streamline had laid off half of the team involved. DSS offers products and services to government and commercial clients based on the VA’s VistA, so I’m not sure what they’re planning to do with the former USA products.

Omnicell will acquire Raleigh, NC-based Ateb, which offers pharmacy-enabled care and population health management solutions, for $41 million in cash. CEO Frank Sheppard left his IBM developer job in 1992 to form the company.

Lifestyle telehealth software vendor Fruit Street raises $3 million from physician investors in a Series A funding round.

I messed up my New Zealand dollars currency conversion conversion in summarizing Orion Health’s just-announced results. Here’s the corrected version:

Orion Health announces first-half 2017 interim results: revenue up 9 percent, operating loss $12 million vs. $19 million in the first half of 2016. Shares dropped 18 percent to a record low on the news and are down 64 percent since the company’s 2014 IPO. While revenue is up, losses are down, and the company projects profitability in 2018, Orion’s cash position has dropped to $17 million after a net cash outflow of $23 million in the first six months of the fiscal year. The company has also expressed some concern that its predominantly US customer base might defer decisions following the presidential election, but it believes healthcare IT initiatives have bipartisan support.

Sales

Allied Physicians Group (NY) chooses Dimensional Insight’s Diver Platform for analytics.

People

Greg White (Allscripts) joins PerfectServe as COO.

Announcements and Implementations

Spok announces the T52 two-way pager that allows encrypting messages.

Health Catalyst launches Healthcare.ai, an online repository of open source machine learning algorithms.

National Decision Support Company expands its CareSelect clinical guidelines to include the Choosing Wisely campaign,medications, labs, and blood management.

NTT Data Services (the former Dell Services) announces analytics partnerships with Imbio (lung analytics) and AnatomyWorks (brain mapping analytics).

DrFirst will integrate pharmacogenetics-based point-of-care electronic prescribing from Translational Software into its Rcopia medication management system.

Northwell Health and Siemens Healthineers form research partnership to address imaging effectiveness and outcomes.

Government and Politics

A CDC study finds that the number of people whose families are struggling to pay their medical bills has dropped 22 percent in the past five years due to an improving economy and the large number of people who gained insurance through the Affordable Care Act.

Privacy and Security

From DataBreaches.net:

• In Australia, SA Health fires two more employees for inappropriately accessing medical records, raising its total to seven after a February crackdown.
• A research team hacks 10 types of implantable medical devices, claiming that a hacker could kill pacemaker and defibrillator patients within 15 feet.
• In Canada, Carleton University temporarily bans Windows-using students from its network after ransomware takes down its internal systems.

Innovation and Research

A group of cadets in an Israel Defense Force officer training course creates a digital bracelet and associated sensors that can be attached to wounded soldiers to record information about their treatment. The bracelet is powered by near-field communication technology that connects to the smartphones of medics. Medical teams are testing it for potential general army rollout.

Other

California is testing an electronic registry for POLST (Physician Orders for Life-Sustaining Treatment) forms that would allow first responders and clinicians to look up their wishes for emergency treatments. POLST forms, intended for use by people near the end of their lives, contain actual provider orders and thus are more stringent than advance directives. Advocates fear that the barrier to widespread electronic registry use will be that hospitals won’t share their data. 

This is sobering: gunshot detection system vendor Shooter Detection Systems gets its first (unnamed) health system customer.

Sponsor Updates

• Agfa Healthcare, GE Healthcare, and Lexmark Healthcare complete the RSNA Image Share Validation program.
• Xerox develops a printer for ambulatory providers capable of sharing patient information via the cloud.
• EClinicalWorks will exhibit at the Orthopaedic Summit December 7-10 in Las Vegas.
• Deloitte includes Evariant in its list of fastest growing technology companies in North America.
• Iatric Systems will exhibit at the Privacy & Security Forum 2016 December 5-7 in Boston.
• Imprivata will exhibit at IHI’s National Forum on Quality Improvement in Healthcare December 4-7 in Orlando.
• Deloitte includes Ingenious Med on its list of fastest growing technology companies.
• InterSystems will exhibit at the NYeC Digital Health Conference December 6-7 in New York City.
• CompuGroup Medical adds a rehab module to its WebEHR.
• EHR integrations drive nationwide adoption of CareSelect Imaging.
• Navicure will exhibit at the HIMSS Revenue Cycle Solutions Summit December 6-7 in Boston.

Blog Posts

• Clinical Order Sets and Why They Matter (Optimum Healthcare IT)
• Data-Driven Decisions and the Learning Health System (Dimensional Insight)
• Meditech Cuts Costs, Improves Productivity at Phoebe Putney (Meditech)
• The ROI of ROI: Can you link your HCM solution to your ERP system? (Infor)
• Collaboration Opportunities Support Digital Health Strategy (ECG Management Consultants)
• Cyber Security: Insider Threat and the “Unknown Unknown” (HCI Group)
• Our Guide to Thrive (Healthfinch)
• Data Breaches Made Easy (ID Experts)
• The Internet of Things (Impact Advisors)
• Create Content to Engage Healthcare Consumers (Influence Health)
• 6 Topics Trending at NextGen UGM (InstaMed)
• Stand Out from the Herd with a Data-Driven Approach to EMR Adoption (InterSystems)
• ATLAS Conference Takeaways: Actionable Ways to Enhance Patient Access in 2017 (Kyruus)
• Liaison Gives Thanks for Customers – and Receives Gratitude in Return (Liaison Technologies)
• Interoperability the Key to Value-based Imaging (LifeImage)
• Beware of Imposters! (Vyne)
• The Past Makes the Future Possible (Netsmart)
• What the best healthcare IT consultants do at the end of their contracts (Nordic)
• SayIt Wireless Mic for iPhone (NVoq)
• The Migration Challenge: Part 3 (Orion 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.

Morning Headlines 12/1/16

21st Century Cures seeks multiple health IT policy improvements

The 21st Century Cures Act passed a House vote and will now move to the Senate for consideration. The bill includes provisions calling for the reduction of documentation requirements associated with EHRs, a change that would allow scribes to document in lieu of providers, and a simplification of meaningful use requirements.

U.S. Senate passes law to bring Project ECHO model to rural health care

The Senate unanimously passes a bill requiring HHS and GAO to analyze the University of New Mexico’s Project ECHO pilot program and report on opportunities to expand the program nationally. Project ECHO uses telehealth to expand access to specialists to patients in rural areas.

OptumRx and CVS Pharmacy Partner to Expand Consumer Choice, Reduce Costs and Improve Health Outcomes

CVS Pharmacy partners with OptumRx, a free-standing UnitedHealth Group pharmacy care services business. The partnership will bring OptumRx’s patient engagement solutions to CVS patients and will create a single platform where the two businesses will co-develop new solutions.

Value-based Care Prompts Glass to Grow Up

HIStalk looks at the ways in which smart glasses – once thought to be an over-hyped novelty – are turning into a not-to-be ignored market force aimed at helping healthcare transition to value-based care.
By @JennHIStalk

The name “Google Glass” once evoked guffaws aimed at the early consumer adopters (Glass Explorers) who were seen sporting them in everyday settings. “OK Glass” – the command used to jumpstart the wearable’s software – was not, contrary to initial manufacturer expectations, uttered at a rate that demanded further mass consumerization.

Healthcare, however, did express interest, and at least a few headset-wearing folks walked the halls of the HIMSS conference in 2013 and 2014 The Glass hype in healthcare was understandably strong, given the industry’s propensity to create high-tech cures for low-tech problems.

Though privacy and security concerns caused Google to take a step back from the consumer market for Glass, its prospects in the world of business quietly flourished (despite the fact that HIStalk readers voted Glass “the most overrated technology” in the 2014 and 2015 HISsies). Even Apple has taken notice, with rumors resurfacing of its intent to develop an iPhone-compatible pair of smart glasses. Healthcare providers and vendors have also shown increasing interest in the devices, which in turn has helped a number of startups flourish in the face of almost gleeful naysaying.

From Pipe Dream to Readmissions Reducer

San Francisco-based Augmedix has made a name for itself in the smart glasses space, becoming one of the first companies in healthcare to recognize the value this type of technology can bring to physician workflows. Founded in late 2012 by Ian Shakil and Pelu Tran, the company — which offers remote scribing capabilities via smart glasses — has grown from two to over 700 employees.

“In the beginning, people viewed us as a novel hype play,” Shakil admits. “Now that the hype has bled away, people are starting to view us a real, substantive, hard-nosed solver of big problems in healthcare. The problem we’re going after is the sad fact that doctors spend two to three hours a day charting, typing, and clicking. They hate it and the patients hate it. We’ve thrived in the world of volume and paper; doctors are busy and burdened, and so saving them a third of their day with our remote scribing capabilities is very valuable. Those same factors are still true in the emerging world of value-based care. Doctors are scarce, they’re expensive, and their overhead is expensive. Reclaiming those lost hours enables them to focus their energies on spending more time with patients or population health endeavors. Either way, the value translates in both worlds and it’s really starting to be tallied and received by the market, which is feeling a lot of growth.”

Augmedix’s J-shaped growth curve over the last four years is indeed indicative of healthcare market interest, which has helped spawn a number of other competitors. Mountain View, CA-based Drchrono jumped onto the Glass bandwagon in 2014, developing the first EHR-compatible “wearable health record” in partnership with Google and Box.

Founded in 2004, Advanced Medical Applications got into the smart glasses game in 2014 with the first live broadcast of a surgery using Google Glass between two continents. The company, which specializes in mobile technology development for a number of verticals, has managed to find its niche in smart glasses-enabled telemedicine and emergency services.

Austin-based Pristine plays in a similar space. The three year-old startup has focused on creating a telemedicine solution that enables doctors to provide their expertise visually from anywhere at any time.

“The ‘See What I See, Hear What I Hear’ collaboration solution was initially adopted by teaching hospitals, ambulance organizations, healthcare systems that provide care for remote patients, assisted living facilities, and anywhere access to expertise was limited,” explains Pristine CEO Peter Evans. “In the past year, we’ve seen two changes that are accelerating that adoption. First, there has been a shift in approach from Explorers and those kicking the tires on the concept, often funded by grant money, to organizations that have specific pain points and realize that the traditional approaches to providing care are not scalable.”

“Second, we are seeing a rise in adoption by manufacturers of healthcare products,” Evans adds. “Companies that make complex healthcare technologies, produce pharmaceuticals, and provide other third-party solutions are enhancing their support models to healthcare providers through adoption of augmented reality and smart glass solutions. As an example, we are seeing the implementation of the rep-less model, where sales reps who normally provide in-person, in-theater support for a surgeon or doctor can now provide the same or significantly better support and expertise without having to physically be there. This improves efficiencies and reduces operational costs for both the hospital and vendor, while enabling reps to scale and support multiple clients.”

That accelerated adoption has helped Pristine’s provider customers begin to realize significant operational efficiencies. “Studies by our customers are showing that the ability to get the right skilled knowledge in the right place at the right time in an efficient manner is improving patient care and outcomes. Some of our customers using our solution for telemedicine applications have reduced readmissions by over 17 percent and reduced recovery time by almost 30 percent. We believe that we can be one piece of a complex puzzle that enables providers to be rewarded based on quality on value, not just quantity.”

Following in the Smartphone’s Footsteps

Evans believes that the maturity of the market for smart glasses will grow in lockstep with related hardware. “The hardware is trying to catch up to the applications that users envision,” he says. “While many may be familiar with Google Glass, there is very good technology that has been introduced by companies like ODG, Vuzix, Epson, and Intel with its acquisition of the Recon Jet product.

“The state of smart glass hardware reminds me of the evolution of the smartphone,” Evans continues. “Early versions of the iPhone 2, for example, had hardware shortcomings. It didn’t have a camera, long battery life, GPS, or 3G. However, it had value with initial applications – sending texts, surfing the Web, and core apps that had immediate value. Over time, the hardware became more robust. Richer applications were developed and the incremental value grew. We are witnessing the same maturity of smart glasses and augmented reality solutions for business. The hardware has some limitations, but they are being addressed rapidly.”

Shakil also believes there are lessons to be learned from the world of smartphones. “It’s a vibrant space out there, with more smart glass offerings coming by the day,” he says. “Think back to when the first PalmPilots came out, and then compare that with the iPhone 7 – it’s like night and day. I think we’re going to see a similar progression in smart glass technology. They’re going to become more like normal-looking glasses – lighter, with a better battery life, more comfortable, and more resilient.”

Opening Up Use Cases

Today’s hardware limitations don’t seem to be holding providers back when it comes to reaping the benefits of smart glass technology. Shakil says that Augmedix customers anecdotally report more satisfied and engaged patients. “We’re beginning to see that showing up in the data,” he adds, “but it’s still early days. With our solution, the doctor feels more enabled to go deeper and get more investigative. The whole process becomes more hands-on for provider and patient.”

Customers participating in the OpenNotes initiative are also realizing new use cases for smart glass capabilities. “Sutter is one of our most progressive health system partners,” Shakil explains, “and while they’re very engaged with OpenNotes, they’ve struggled to deploy it operationally because it takes a lot of time and effort to write a beautiful note in rich, comprehensible English, get it into Epic, and then make it available to the patient by the time they get home. The Sutter team has found that, by using Augmedix, the note is almost always done in plain English by the time the visit is over, and is immediately available to the patient. They love being able to offer that. It engages the patient in their own care, helps them identify things they may have initially missed, and improves compliance in all the usual things. We’re really excited about the ways in which we can enable OpenNotes and all the downstream benefits that entails.”

Shakil is quick to add that some of the company’s more progressive end users – particularly those on the forefront of technology-enabled patient engagement efforts – have already expressed interest in taking smart glass capabilities even further. “Some of our health systems have an interest in going one step beyond OpenNotes to open up the visit from Glass itself for later retrieval on the patient portal,” he says. “We’re not doing that anywhere yet. We want to make sure that we have all the secure storage capabilities, opt-ins, and opt-outs from the patient side. Personally, as a patient, I think it would be amazing to go home and relive the appointment with my family – how to use the asthma inhaler, when to come in for refills, instructions on follow-up care. I think it will improve care and engagement in a big way.”

With Scale Comes Management Concerns

The need for complementary solutions is also a strong indicator that smart glass technology is here to stay. VMware AirWatch has added smart glasses management to its line of enterprise mobility management technologies and services, a move the company attributes to increasingly larger pilot programs and the resultant need for assistance with device management.

“We are seeing research being carried out in healthcare to identify use cases from training to documentation to data visualization during surgery,” says VMware Vice-President of Product Marketing Blake Brannon. “Pioneering customers are starting to pilot smart glasses and report gains in productivity and reduction in costs. We have started to see pilots move from less than five devices to a few hundred, or in some cases, a few thousand. When the scope of pilots increases to that extent, that’s typically when IT gets involved and needs a game plan to secure, configure, and deploy them at scale.”

The Cybersecurity Question

Though patients seem to have become more comfortable with smart glasses from a privacy point of view, enterprise adoption comes with its own set of adoption challenges. “Privacy and data protection will definitely come up as potential issues,” says Brannon, “resulting from any local storage of information and transmission of data. I’m not sure cybersecurity concerns will be addressed. They’re more likely to be amplified. We saw issues with Google Glass – not knowing if you were being filmed or having pictures taken of you. There will also be the same concerns as with other mobile devices. What if it gets stolen? Does it have patient information on it? Images? Can they be remotely wiped? Is the software or firmware up to date? Questions like these from our customers prompted us to develop an answer.”

The Future

Though smart glasses seem here to stay, albeit in a very niche capacity, Brannon believes the market still has to do its fair share of growing up. “The market is fragmented right now,” he notes. “There are many manufacturers with different devices that run different versions of Android. Some devices are also running proprietary operating systems. In the short term, we could see certain manufacturers create specific enterprise policies to differentiate their hardware, but, long term, we expect to see more consistency as the core hardware vendors emerge and build to a specific standard.”

Evans takes a more long-term view with the expectation that smart glass technology will become part of a person’s daily routine for work and play. “Some pundits are predicting that in 10 years we will see the demise of the smartphone, as it will be replaced by smart glasses. Anything that can be done on a smartphone or tablet can be done on the same Android operating system on smart glass.”

“Once the hardware becomes lighter,” he emphasizes, “then people will engage others by looking up rather than down at a small screen. Voice-recognition technology, which we’re already seeing with Siri and Alexa, will become a key enabler. We can all speak commands faster than we can type them, after all. Individuals will prompt their smart glasses with voice commands and other external beacons like barcodes and object recognition and will be immediately able to call up any information needed, to be displayed while we continue to interact with the world around us. The days of smartphone-induced disengagement will become a thing of the past.”

News 11/30/16

Top News

President-elect Trump nominates former orthopedic surgeon and Affordable Care Act critic Rep. Tom Price (R-GA) as secretary of the 78,000-employee HHS. He would replace Sylvia Burwell.

Price’s Empowering Patients First Act calls for age-adjusted tax credits for those buying health coverage on their own; a one-time credit for starting a health savings account; state-administered high-risk pools for people with pre-existing conditions; tort reform; and allowing insurers to sell policies across state lines. It would also allow individuals to opt out of government plans such as Medicare, Medicaid, and the VA programs and take the tax credit instead to buy their own insurance and would allow small businesses to create their own national insurance buying groups. It would also prohibit HHS from using comparative effectiveness or patient-centered outcomes research to deny federal insurance coverage of specific treatments. However, Price says he’s open to compromise and the only line he draws in the sand is the one opposing the ACA.

Here’s what I quoted Price as saying about the HITECH act back in 2011:

Instead, what does the federal government do and think it’s getting high tech? It is defining every little thing, every box that the physician or nurse has to check every time you see a patient, in order to get an extra 1.5 percent of reimbursement from the government. Or, not getting dinged for an extra 1.5 or 2 percent. These are the Meaningful Use things.  Washington always has these great lines, right, these wonderful Meaningful Use standards. They’re neither meaningful nor useful and they’re so ridiculous that they actually incentivize pathologists to have to ask on every single patient that they care for how old they are, how many allergies they have, what medications they’re on, when was the last time they saw their primary care physician, on and on and on, including of a slide of a patient … the pathologist never actually sees that patient … or a corpse for an autopsy. This is no lie. The federal government wants the pathologist to determine whether or not a corpse has any allergies. How you feeling today, right? This is nonsense.

So what do you do with technology to make it so it actually works for healthcare? I think the proper role of government in the area of technology in healthcare is to say, OK, this is the platform we will use. This is the highway upon which we will ride. Everybody needs to have a system that allows it to speak to another system within these parameters. And not dictate what the docs are doing on a day-to-day basis for a given patient, because it doesn’t make any sense. It’s a waste of time. They can never, ever put in place the right standards for a bureaucrat to determine whether or not the doctor’s doing the right thing.

President-elect Trump also nominates Seema Verma, MPH to serve as CMS administrator, replacing Andy Slavitt. The health policy consulting firm owner is mostly known for her work on Medicaid expansion and her Indiana ties to VP-elect Mike Pence.

Reader Comments

From Dillon Darkbird: “Re: Epic. NYCHHC does business with Epic, which doesn’t even pay its own state taxes.” DD provided a screen shot of New York’s tax warrant system showing that Epic owes the state $626,000, but I repeated the search and turned up nothing, which I assume means that Epic has since paid its tab.

From EHR Nomad: “Re: EHR migration. I’m looking for information moving from one system to another. Conversion is probably not a good option, as indicated by a number of sources that led me to that thought. What other options are there?” This is a hospital-based reader, so I’m thinking this refers to inpatient systems. You’ll probably want at minimum an application retirement system that will allow you to look up previously generated information as needed. It’s probably also both unnecessary and unwise to start with a blank EHR slate, converting at least the basic patient, provider, and clinical information to avoid frustrating users of the new system. However, it’s a good time to start over (at least technically) on order sets and system defaults. Readers with expertise in this area are welcome to respond. EHR Nomad didn’t specify the EHRs involved, but let’s assume they’re moving to Meditech 6.1. UPDATE: EHR Nomad clarifies that the conversion involves a practice the hospital is buying that runs MEDENT and they want to convert them to Allscripts. He’s wondering whether to just take possession of the practice’s server and keep it running or whether there’s a way to extract the information and store it in a logical way in case it’s needed. I think he’s given up on the idea of importing the information into Allscripts.

HIStalk Announcements and Requests

Nordic donated $500 to my DonorsChoose fund, which with the addition of matching money fully funded these teacher grant requests:

• Three sets of non-fiction books for the first grade classroom of Mrs. G in Saint Paul, MN.
• Makerspace supplies for the school library of Mrs. G in Middleton, WI.
• Three Chromebooks for Mrs. J’s first grade class in Lugoff, SC.
• STEM modeling materials for Mrs. M’s elementary school class in De Soto, KS.
• Headphones for students with profound disabilities in Mr. P’s middle school class in Oklahoma City, OK.
• STEM materials for Mrs. W’s first grade class in Easley, SC.

Mrs. J was quick to respond, referring to her class — as teachers often do — as “us,” which gets me every time:

I am absolutely blown away by the generosity of others at this time of year and all year round with DonorsChoose. My students are going to be so surprised when these Chromebooks arrive! My students love technology and your donations and kindness will really make a difference in their learning. Thank you so much for your gift. Words can’t begin to tell you how much your gift means to us.

I don’t intentionally solicit funds for DonorsChoose because I don’t like being strong-armed for donations myself, but readers often send money voluntarily and I’ll always put it to good classroom use. I’ll have another round of funded projects to describe next time thanks to some new donations that came in on Giving Tuesday.

Webinars

December 6 (Tuesday) 1:00 ET. “Get Ready for Blockchain’s Disruption.” Sponsored by PokitDok. Presenter: Theodore Tanner, Jr., co-founder and CTO, PokitDok. EHR-to-EHR data exchange alone can’t support healthcare’s move to value-based care and its increased consumer focus. Blockchain will disrupt the interoperability status quo with its capability to support a seamless healthcare experience by centralizing, securing, and orchestrating disparate information. Attendees of this webinar will be able to confidently describe how blockchain works technically, how it’s being used, and the healthcare opportunities it creates. They will also get a preview of DokChain, the first-ever running implementation of blockchain in healthcare.

December 7 (Wednesday) 1:00 ET. “Charting a Course to Digital Transformation – Start Your Journey with a Map and Compass.” Sponsored by Sutherland Healthcare Solutions. Presenters: Jack Phillips, CEO, International Institute for Analytics; Graham Hughes, MD, CEO, Sutherland Healthcare Solutions. The digital era is disrupting every industry and healthcare is no exception. Emerging technologies will introduce challenges and opportunities to transform operations and raise the bar of consumer experience. Success in this new era requires a new way of thinking, new skills, and new technologies to help your organization embrace digital health. In this webinar, we’ll demonstrate how to measure your organization’s analytics maturity and design a strategy to digital transformation.

Acquisitions, Funding, Business, and Stock

Canada-based Constellation Software’s subsidiary Harris continues its acquisition spree by buying iMDsoft. Its previous acquisitions include Picis, QuadraMed, MediSolution, DigiChart, and NextGen’s hospital systems business. 

In Australia, the builder of the unfinished Royal Adelaide Hospital is preparing to sue the state government, claiming it has delayed the hospital’s scheduled April 2016 opening to cover up problems with its overdue and over-budget Allscripts-powered EPAS system. The health minister says an independent auditor previously dismissed those same claims.

Austin, TX-based doctor-patient texting app vendor Medici raises $24 million. It pitches itself to doctors with, “Get paid to text with your patients on your schedule.” The 13-employee company tries to create buzz by calling itself the “Uber of healthcare” and “WhatsApp with your doctor.” Hopefully the example screenshot above isn’t representative of the degree of clinical thoroughness involved with those convenient, billable text exchanges.

Orion Health announces first-half 2017 interim results: revenue up 9 percent, operating loss $12 million vs. $19 million in the first half of 2016. Shares dropped 18 percent to a record low on the news and are down 64 percent since the company’s 2014 IPO. While revenue is up, losses are down, and the company projects profitability in 2018, Orion’s cash position has dropped to $17 million after a net cash outflow of $23 million in the first six months of the fiscal year. The company has also expressed some concern that its predominantly US customer base might defer decisions following the presidential election, but it believes healthcare IT initiatives have bipartisan support.

Wall Street Journal owner Rupert Murdoch is likely to lose most of his $200 million investment in Theranos, whose downfall was ironically triggered by investigative articles published by his own paper. Many big, later-stage Theranos investors were individuals and families with little connection to the usual VC vetting process who watched the company’s $9 billion valuation drop to nearly zero. Meanwhile, two more investors file lawsuits against the company claiming they were misled, one of them seeking class action status.

Sales

NorthShore University Health System (IL) and Valley Children’s Healthcare (CA) choose Phynd’s provider management system.

New York-Presbyterian Hospital (NY) chooses Mobile Heartbeat’s clinical communications system.

People

Teleradiology services vendor Virtual Radiologic promotes Shannon Werb to president/COO, replacing departing CEO Jim Burke.

Announcements and Implementations

Community Health Network (IN) expands its use of Kyruus ProviderMatch to its new consumer website.

Boston Children’s Hospital (MA) and GE Healthcare will work together to develop brain scan interpretation software that will be available via GE’s Health Cloud.

Phynd releases version 2.0 of its Unified Provider Management system.

Philips, following GE Healthcare’s lead, will develop medical software for its imaging systems, with its CEO telling investors, “The world does not need much more capacity in scanners, but is especially in need of better interpretation of data” for improving diagnosis.

The VA will partner with artificial intelligence vendor Flow Health to analyze the VA’s 20-year database to identify disease markers, suggest treatments, and discover the influence of genetics on risk, diagnosis, and treatment.

Nationwide Children’s Hospital (OH) and SeizureTracker.com release a seizure diary app for the Apple Watch that allows people to record their seizure data and video, share it with their doctors, and contribute it to a research database.

Marketing and customer service software vendor Pegasystems offers FHIR-powered APIs to connect with its healthcare applications.

Clinical Architecture adds Advanced Clinical Awareness Suite to its new Symedical terminology management platform release, which normalizes patient data from multiple EHRs or virtual medical record formats and applies inference rules to suggest diagnoses, recommend orders, or provide advice or alerts.

Government and Politics

A pending Medicare rule change would require hospitals to discuss nursing home quality data with inpatients who are about to be discharged to one of those facilities. Current Medicare patient choice requirements prohibit hospitals from doing anything more than just handing over a list of nearby facilities that have space available. Hospitals like the idea because they can be penalized for readmissions caused by poor nursing home care.

Kaiser Health News reports that a record 1,455 lobbyists representing 400 companies are trying to convince members of Congress to either pass or reject the 21st Century Cures Act in voting this week, which would increase NIH funding, devote funds to address the opioid crisis, and change the FDA’s drug and device approval standards. Even the US Oil and Gas Association is involved since the Cures Act would be paid for by selling oil from the government’s Strategic Petroleum Reserve. The drug company trade association PhRMA has spent $25 million to support the bill, which would get their expensive drugs to market faster and would also reduce their requirement to publicly report payments made to doctors via the OpenPayments database. The Cures Act still falls far short of the ACA’s record-setting lobbyist activity, when 1,200 companies mobilized their ear-whispering firepower seeking favorable treatment .

Privacy and Security

HHS OCR warns providers that phishing emails are being sent to HIPAA covered entities that include the HHS letterhead and the signature of OCR Director Jocelyn Samuels. The email includes a link that appears to direct readers to a document involving their inclusion in HIPAA audit, but it actually sends them to a cybersecurity firm’s website. HHS OCR says it takes “unauthorized use of this material by this firm very seriously.” I’m not sure in the absence of details whether HHS’s use of the term “phishing” in describing a disguised link is correct since it’s not clear whether the user is asked for confidential information, but obviously they aren’t happy about it.

Trend Micro reports that 35 healthcare organizations, 17 of them in the US, have been scammed in the past two weeks by cybercriminals who spoofed the CEO’s email account and ordered employees who manage wire transfers to send money to their bank accounts.

Innovation and Research

In Australia, Metro North Hospital and Health Service and Queensland University of Technology are building a dedicated 3D tissue-printing facility for the hospital’s OR, predicting that biofabrication can create personalized implants, help with robotic-assisted surgery, and improve surgical training.

Technology

The Gates Foundation funds the work of low-cost, rapid-result portable molecular diagnostics vendor QuantuMDx, which is fine-tuning its field tuberculosis testing system.

Other

NPR’s “All Things Considered” finds that biomedical research information is proliferating due to EHR rollouts and well-funded projects like the Cancer Moonshot, but nobody’s actually looking at all that big data. Reasons: the information is not all that robust and reliable due to variations in EHR database usage and much of the good stuff is recorded as free text. FDA Commissioner Rob Califf says the only way to validate the datasets is to get people to participate in studies that try them out, with increased study participation being the #1 FDA big data issue.

Stat profiles Myriad Genetics, which made $2 billion in the 17 years of patent exclusivity it enjoyed for its BRCA breast cancer genetic testing. With competitors offering similar tests for a few hundred dollars instead of the $4,000 that Myriad charges following their successful patent litigation, Myriad has instructed its salespeople to disparage those competitors that it labels as a “public health crisis.” An interesting review by members of the Free the Data consortium compared the results with those of its competitors and found little difference, although patient recommendations from all of them change over time as they gain more real-world data. The group was formed because Myriad refused to share its database with physicians and researchers, so Free the Data gathers the reports downstream directly from participating providers.

Patients at C.S. Mott Children’s Hospital (MI) will receive a custom cardboard virtual reality viewer that can run apps from their own smartphones, including a University of Michigan game day app, courtesy of a $50,000 grant from the Jim Harbaugh Foundation.

A radiologist’s JAMA opinion piece written with Eric Topol, MD suggests that radiologists should emulate pathologists in embracing technologies that can replace much of their work, often more accurately and always more efficiently, and retool their practices as “information specialists” whose job would change from extracting information to managing the information created by those technologies. The authors even suggests that perhaps the pathology and radiology specialties should be merged.

Sponsor Updates

• Catalyze releases a new podcast, “Why Healthcare Should Expand its View of FHIR.”
• Black Book announces the top ranked, end-to-end crisis management PR agencies.
• Forward Health Group is sponsoring the December 7-9 annual conference of the California Association of Public Hospitals and Health Systems in Pasadena.
• Besler Consulting releases a new podcast, “What healthcare policy might look like under the Trump administration.”
• Black Book lists the top 20 issues faced by healthcare PR and crisis management firms.
• CapsuleTech will exhibit at the National Forum on Quality Improvement in Healthcare December 4-7 in Orlando.
• CoverMyMeds sponsors the Healthcare Association of New York State’s Back to Basics Bootcamp November 29-30 in Tarrytown, NY.
• Cumberland Consulting Group will sponsor the Health Plan Alliance’s Informatics and Analytics Value Visit December 6-8 in San Antonio.

Blog Posts

• #RSNA16: Teleradiology Solutions – A simple definition, but many possibilities (Agfa Healthcare)
• 7 AirWatch Customers We Are Thankful for This Year (AirWatch)
• Nordic mentioned more than any firm for key success attributes in 2016 KLAS perception report (Nordic)
• Love Your Job? (Access)
• A Closer Look at the Evolution of Diabetes (Arcadia Healthcare Solutions)
• A Scary Call with a Happy Ending (CareSync)

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 11/28/16

Top News

The European Union Agency for Network and Information Security makes security recommendations for “smart hospitals” that rely on interconnected IT assets, especially those that are based on the Internet of Things, recommending that they:

• Establish effective enterprise governance for cybsersecurity, including performing a cost-benefit analysis for IoT components, developing a BYOD and mobile device policy, and identifying how each component connects to other components or to the Internet.
• Implement state-of-the-art security such as smart firewalls, network monitoring, intrusion detection, encryption, and authentication and authorization.
• Publish IT security requirements for IoT components.
• Create a community for hospitals to share security information.
• Have an independent firm to conduct penetration testing and auditing.
• Support the adoption of information security standards by hospitals and have hospitals certified by independent experts as meeting those standards.

HIStalk Announcements and Requests

LinkedIn dwarfs other social media sites for professional use by poll respondents, with Twitter coming in a far-distant second. New poll to your right or here: how interested are you in health IT news from outside the US?

Thanks to the following sponsors, new and renewing, that recently supported HIStalk, HIStalk Practice, and HIStalk Connect. Click a logo for more information.

It must be end-of-year housecleaning – I know of at least three companies that have quietly replaced their CEOs in the past couple of weeks. Announcements will be forthcoming, I assume.

Listening: new from New Zealand-based No Wyld, which crafts darned good haunting, catchy hip-hop rock. I’m also desk-drumming to the new release from Finland’s legendary rockers Remu and the Hurriganes, which has played no-nonsense, American-sounding, pre-Beatles bluesy rock and roll since 1971.

HIStalk reader Mike left health IT eight years ago, but still reads regularly to stay in touch. He sent a $500 donation to my DonorsChoose fund, which was magically magnified by matching money to fund these teacher grant requests:

• An iPad videography kit for documenting the engineering design process in Mr. C’s middle school class in San Jose, CA.
• Two tablets for Mrs. M’s second grade class in Newport News, VA.
• A programmable robot for the library of Mrs. E’s elementary school in Greenwood, SC.
• Science books and kits for Ms. M’s elementary school class in Kansas City, MO.
• Replacement bulbs for the Smart Board projectors of Ms. L’s seventh grade class in Brooklyn, NY.
• A listening center and dry erase boards for Ms. M’s elementary school class in Houston, TX.
• A BreakoutEDU pre-calculus problem solving kit for Mrs. S’s high school class in Independence, MO.
• A document camera for Mrs. W’s elementary school class in Phoenix, AZ.
• Computer speakers and a tablet for Mrs. D’s elementary school class in McKees Rocks, PA.
• Supplies to run a writing master class taught by an award-winning author at the library of Ms. H’s high school in Long Island City, NY.

Several of the teachers above emailed after receiving notice Sunday that I had placed the donation, with Ms. L describing how important something as simple as replacement projector bulbs can be:

Thank you so very much for your generous donation to my science classes. I would have been forced to change my entire curriculum if it was not for your help. Due to the struggling economy, it is difficult to supply the classroom with all of the necessary materials. The Smart Board projector is such a valuable education tool that you have returned life to once again. You truly did a wonderful thing. Your assistance means so much to me but even more to my students. Thank you from all of us.

Last Week’s Most Interesting News

• UMass pays $650,000 to settle HIPAA charges over a 2013 malware infection in one of its component organizations that was not properly defined as part of UMass’s hybrid organization status.
• HIMSS and CHIME form HIMSS-CHIME International to manage their programs outside of North America.
• The Gates Foundation funds a project in which Factom will create a secure, transportable, patient-managed medical record powered by blockchain technology.
• President Obama expresses concern about maintaining a cohesive society and democracy as technology empowers its developers but marginalizes the value of other types of work, citing radiologists potentially losing their jobs to artificial intelligence.
• A study finds that conveniently located retail clinics don’t reduce unnecessary ED visits for minor “treat and release” conditions.

Webinars

December 6 (Tuesday) 1:00 ET. “Get Ready for Blockchain’s Disruption.” Sponsored by PokitDok. Presenter: Theodore Tanner, Jr., co-founder and CTO, PokitDok. EHR-to-EHR data exchange alone can’t support healthcare’s move to value-based care and its increased consumer focus. Blockchain will disrupt the interoperability status quo with its capability to support a seamless healthcare experience by centralizing, securing, and orchestrating disparate information. Attendees of this webinar will be able to confidently describe how blockchain works technically, how it’s being used, and the healthcare opportunities it creates. They will also get a preview of DokChain, the first-ever running implementation of blockchain in healthcare.

December 7 (Wednesday) 1:00 ET. “Charting a Course to Digital Transformation – Start Your Journey with a Map and Compass.” Sponsored by Sutherland Healthcare Solutions. Presenters: Jack Phillips, CEO, International Institute for Analytics; Graham Hughes, MD, CEO, Sutherland Healthcare Solutions. The digital era is disrupting every industry and healthcare is no exception. Emerging technologies will introduce challenges and opportunities to transform operations and raise the bar of consumer experience. Success in this new era requires a new way of thinking, new skills, and new technologies to help your organization embrace digital health. In this webinar, we’ll demonstrate how to measure your organization’s analytics maturity and design a strategy to digital transformation.

Sales

ProMedica (OH) chooses Sectra’s cardiology imaging module.

People

AMIA selects incoming Regenstrief Institute President Peter Embi, MD, MS as chair-elect.

Announcements and Implementations

Massachusetts Governor Charlie Baker forms the Massachusetts Digital Healthcare Council to advise him on accelerating digital health innovation in the state.

Physical therapy telehealth platform vendor In Hand Health releases a new version of its patient engagement app that includes the ability for therapists to create video exercises on their smartphones, send them to individual patients, and track their exercise activity between visits. A 400-patient license for up to six physical therapists costs $800 per year.

Israel-based imaging analytics vendor Zebra Medical Vision announces a service in which patients can upload their medical images to receive an automated analysis for conditions such as osteoporosis, compression fractures, and emphysema, although the company notes that “our analysis does not replace a physician or a proper medical examination” and the service is not available in the US.

GE Healthcare announces several products at RSNA that include patient-controlled mammography pressure, an imaging collaboration suite, and enhancements to Centricity Solutions for Enterprise Imaging.

Privacy and Security

From DataBreaches.net:

• The Fancy Bears hacking group that previously published the medical information of US Olympic athletes publishes internal emails from doping organizations that it obtained by phishing, with some of those emails suggesting that certain athletes were blood doping or using cocaine to lose weight.
• CHI Franciscan Health warns an unspecified number of patients that a laptop stolen from an employee contains their medical information. The employee’s stolen backpack also contained a day planner in which the employee had recorded his or her user ID and password.
• A security magazine warns that hackers might not only steal data, but intentionally change information to either make the data owner look bad or to benefit from the effects the altered data will cause, such as in stock market manipulation. DataBreaches.net ponders whether the next generation of hackers might go beyond ransomware attacks and instead change some patient records and offer sell the provider a list of the “before” and “after” values so they can correct them.
• Thieves place skimming devices on ATMS in four New York City hospitals, using tiny cameras to collect credit card information that they used to steal $46,000 from at least 75 people.
• A Georgia surgical practice notifies patients that its server was breached repeatedly over a six-month period by a hacker using a compromised EHR vendor’s password.
• In Canada, Nova Scotia’s Information and Privacy Commissioner recommends implementing electronic referrals after investigating several incidents in which mental health referrals were faxed by practices to a private business instead of a mental health clinic due to misdialing. The commissioner also recommended that physician practices identify one person to send faxes, pre-set the clinic’s number in their fax machines, set a reminder to check regularly that the clinic’s fax number hasn’t changed, and use cover sheets.

A security expert’s test finds that his new Wi-Fi $55 security camera was infected with malware just 98 seconds after it was installed, attacked by a worm that used the hidden, hard-coded default login and password.

A man sues CNN for airing photos of him taken in a hospital as he recovered from a gunshot wound that he says was inflicted by his friend, former pro football player Aaron Hernandez.

Other

The Burlington, VT newspaper reviews the difficulty providers have had in attempting to launch services that compete with University of Vermont Medical Center, which uses its legal clout and political and business connections to protect its business interests. A group of eye doctors trying to open the state’s second ambulatory surgery center had their project killed by an antiquated certificate-of-need process and a developer’s lease that required them to ask another client of the developer — UVM Medical Center — for permission to build their surgery center,  which the hospital opposed. Another doctor who attempted to build a similar center was opposed by the Vermont Association of Hospitals and Health Systems, which complained that its members would be hurt financially and that a market-driven ASC would undermine payment reform. UVM Medical Center complained that the ASC wasn’t needed because hospitals already have adequate capacity, warned that the ASC would create its own demand, and questioned how the hospital would get the ASC’s medical records if its patients showed up in the hospital’s ED with complications after hours.

A Wall Street Journal report notes that drug companies are increasing prices for specific drugs in lockstep with those of competing products, with examples being Viagra and Cialis (now at around $50 per tablet vs. $20 in 2013) and insulin that now retails for over $400 per month. The practice isn’t illegal as long as the drug companies haven’t agreed in advance to pursue such a strategy. 

The cash crunch caused by India’s demonetization has driven a big uptick in telehealth visit volume as consumers seek services for which they can pay electronically.

Actor Chuck Norris, who I note with surprise is now 76 years old, describes improvements being made in the VA, specifically noting some of its technology projects:

In a 2015 briefing by VA Chief Information Officer Stephen Warren, it was pointed out that more than half of the VA’s proposed 2016 technology budget was earmarked toward delivering better outcomes for vets; to build out a tech infrastructure that supports customized health care tools for veterans. These tools were to include mobile and telehealth technologies, advanced electronic health records, and a new scheduling system. Also included was the beginning of a pilot program for a major 10-year investment in updating the VA’s aging telephone system. Warren described the programs as an enhanced part of “mission delivery” and a move to “veteran-focused outcomes versus an organizational-focused” outcomes. Progress on these efforts need to be reviewed and the public must be kept apprised.

Alabama internist Richard Snellgrove, MD is indicted for prescribing the opioids that killed 3 Doors Down lead guitarist Matthew Roberts in August 2016. Roberts was found dead in a Hampton Inn hallway with fentanyl patches applied to his body and filled Lortab and Xanax prescriptions in his backpack. The federal complaint cites a close friend who said Roberts was addicted to prescription painkillers and who told police, “If you want to arrest the drug dealer who killed [him], arrest his doctor.” The doctor, who had been described as a celebrity junkie who Roberts called “Snelly,” wrote a prescription for 240 methadone tablets for Roberts that cause other doctors to question his prescribing habits when they looked Roberts up in the state’s doctor-shopper database. The PDMP database also showed that the doctor wrote at least 31 controlled substance prescriptions for Roberts without a corresponding office visit, as evidenced by the lack of claims filed by the practice to his BCBS insurance.

Sponsor Updates

• Qpid Health and Visage Imaging will exhibit at RSNA November 27-December 2 in Chicago.
• Data Center Knowledge profiles TierPoint CEO Jerry Kent.
• AdvancedMD donates 600 necessity bags to Ronald McDonald House Charities.
• Agfa Healthcare and Elsevier Clinical Solutions will exhibit and present at RSNA November 27-December 2 in Chicago.
• Besler Consulting releases a new podcast, “Three Ways to Succeed Under Emerging Payment Models.”
• HIMSS features Caradigm’s Michelle Vislosky’s thoughts on population health management capabilities.
• EClinicalWorks releases a recap video from its annual conference.

Blog Posts

• Medicare’s New Payment Models and Technology’s Challenge to Keep Up (PMD)
• 5 Ways the Trump Presidency May Impact ONC (Point-of-Care Partners)
• Meaningful Use, Security Risk Assessments and HIPAA: How Do They Intersect? (Protenus)
• What won’t change with the election (and the next wave of health IT focus) (Nordic)
• Interoperability from Coast to Coast (Summit Healthcare)
• Taking the Pain Out of Prior Authorization (Surescripts)
• The Evolution of DxCG: Part Two (Verscend)
• Introducing the Versus Consulting Team (Versus Technology)
• Tapping into the EHR data flow to improve patient care (Infor)
• Customer Advocacy in Action (Vital Images)
• Why These VitalWare Employees are Thankful This Year (VitalWare)
• CMS OPPS 2017 Final Rule Shows Changes to Provider Based Status (ZirMed)
• 5 Mobile Apps I’m Thankful for This Year (AirWatch)
• How Do I Choose a Population Health Partner? (Arcadia Healthcare Solutions)
• CLE Team Participates in Gaming for a Cause (CoverMyMeds)
• 10 Reasons Why Value-Based Care Will Prevail in the Trump Administration (ECG Management Consultants)
• CMS Finalizes 2017 Physician Fee Schedule (E-MDs)
• Looking Beyond the EHR for True Patient Engagement (Evariant)
• Cancer Moonshot: Mini Blog Series (Galen Healthcare Solutions)
• Defining Your Terms: Do You Have the “Analytics” Solution You Really Need? (Hayes Management Consulting)
• Epic Community Connect: What Makes it so Beneficial for Healthcare Organizations? (HCI Group)

Contacts

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

News 11/23/16

Top News

UMass will pay $650,000 to settle HHS OCR HIPAA charges over a 2013 Trojan malware infection of a single workstation at its Center for Language, Speech, and Hearing that exposed the information of the PHI of 1,670 people.

OCR found that UMass had chosen a “hybrid” status — which requires it to designate in writing which of its components perform HIPAA-covered functions and which do not – but had failed to list the Center and some other components. UMass also failed to implement a firewall at the Center and had not performed a risk analysis at the time of the incident.

HIStalk Announcements and Requests

ST Advisors donated $500 to my DonorsChoose fund as part of their annual charitable giving, which through the magic of matching money funded these classroom projects:

• Strategic thinking, economics, and entrepreneurship games for Mrs. D’s middle school gifted class in Springdale, AR.
• Robotics programming kits for Mrs. F’s STEM high school class in Lincoln, KS.
• A microscope and other science materials for Mrs. M’s third grade class in Newport News, VA.
• A document camera for Mrs. R’s second grade English as a second language class in Englewood, NJ.
• Math manipulatives for Mrs. O’s second grade class in Kansas City, MO.
• A programmable robotics kit for Mrs. R’s third grade class in Brooklyn, NY.
• Headphones for Mrs. M’s school library in Bronx, NY.
• A Chromebook for Mr. G’s high school class in Bluejacket, OK.
• Math manipulatives for Ms. P’s middle school class in New Orleans, LA.

In addition, reader Bill sent a nice note and donation that funded a Kindle Fire and headphones for Ms. W’s kindergarten class in Los Angeles, CA.

I have another donation or two that I’ll apply later this week. Thanks to everyone who supports STEM learning in our schools. Watch this space for photos and teacher reports. I know the teachers are excited because I received emails from all of them within a few of hours of funding their projects, such as this one from Ms. W:

What an awesome way to start the day to know that an important project was funded by an awesome donor! Thank you from the bottom of my heart for your very generous donation! My students will be so excited to hear this news! They are so fired up about protecting the environment. This project will help further ignite that passion! Have an amazing and warm Thanksgiving.

Webinars

December 6 (Tuesday) 1:00 ET. “Get Ready for Blockchain’s Disruption.” Sponsored by PokitDok. Presenter: Theodore Tanner, Jr., co-founder and CTO, PokitDok. EHR-to-EHR data exchange alone can’t support healthcare’s move to value-based care and its increased consumer focus. Blockchain will disrupt the interoperability status quo with its capability to support a seamless healthcare experience by centralizing, securing, and orchestrating disparate information. Attendees of this webinar will be able to confidently describe how blockchain works technically, how it’s being used, and the healthcare opportunities it creates. They will also get a preview of DokChain, the first-ever running implementation of blockchain in healthcare.

December 7 (Wednesday) 1:00 ET. “Charting a Course to Digital Transformation – Start Your Journey with a Map and Compass.” Sponsored by Sutherland Healthcare Solutions. Presenters: Jack Phillips, CEO, International Institute for Analytics; Graham Hughes, MD, CEO, Sutherland Healthcare Solutions. The digital era is disrupting every industry and healthcare is no exception. Emerging technologies will introduce challenges and opportunities to transform operations and raise the bar of consumer experience. Success in this new era requires a new way of thinking, new skills, and new technologies to help your organization embrace digital health. In this webinar, we’ll demonstrate how to measure your organization’s analytics maturity and design a strategy to digital transformation.

Acquisitions, Funding, Business, and Stock

Oracle acquires domain name services provider Dyn, which was the subject of an October 21 distributed denial-of-service attack that rendered major websites unavailable to much of North America and Europe, for a rumored $600 million. Ironically, Dyn serves as the authority on Internet downtime and data blocking by monitoring web traffic and offering companies a rerouting service to make sure their visitors get through.

Symantec will acquire consumer identity protection LifeLock for $2.3 billion. LifeLock has paid more than $100 million in FTC fines for false advertising and reports found that its previous CEO, who was featured in endless ads listing his Social Security number with a challenge to hackers to try to steal his identity, was found to have had that identity stolen at least 13 times. At one point, the company’s main way of trying to prevent fraud was to place a red flag every 90 days on the credit files of its subscribers (who pay from $10 to $30 per month) as though someone might have compromised their accounts, with its reps calling Experian up to 15,000 times per day on their toll-free number and filing the same fraud alert that consumers could have requested on their own at no charge. Experian, which offers a competing service, sued and won.

Sales

Main Line Health (PA) selects Bernoulli for medical device integration as it transitions to Epic.

Spectrum Health (MI) chooses MModal for speech-driven clinical documentation.

In England, Royal Free London NHS Foundation Trust signs a five-year agreement for the Streams acute kidney injury event notification system from Google-owned DeepMind.

People

Canada-based mental health software provider Ehave hires Prateek Dwivedi (University Health Network) as president and CEO.

Announcements and Implementations

HIMSS and CHIME form HMISS-CHIME International, which will work together on their existing programs outside of North America. That raised my curiosity about CHIME’s finances. Its recent financial report shows total revenue of $6.5 million, of which $1.7 million came from conferences and sponsorship, $480,000 from dues, and $4 million from grants from what is labeled “Collegehlth Mgmt Exec Foundation,” which I assume is where the vendor checks are collected. There’s also the for-profit CHIME Technologies, which sells speaker services and provides vendors with advisory groups. CEO Russell Branzell earned $437,000 and his two EVPs made $162,000 each.

In Ireland, Cork University Maternity Hospital will go live on Cerner next week, with all 17 of the country’s hospitals expected to be live on Cerner by the end of 2017. Following that is the rollout of a single national EHR for oncology hospitals and another for acute care hospitals if funds are approved. Cerner is also providing national laboratory information system. Ireland prepared for single health record by implementing a universal patient identifier in August.

A new Peer60 report finds that 81 percent of respondents create patient reports using radiology speech recognition vs. the 12 percent that still send off dictation for transcription, with that number jumping to 96 percent of high-volume sites. Nuance was used by 85 percent of respondents, with the small remainder being divided among MModal, Dolbey, and Agfa. Nearly 75 percent of sites that aren’t already using speech recognition plan to do so, with the only holdouts being smaller sites. Net Promoter Scores are fairly high, making the replacement market unattractive.

The Mount Sinai Hospital (NY) goes live on a clinical research VNA from Vital Images that offers researchers a de-identified view of the fully detailed patient data used by clinicians on the same system.

Hardeep Singh, MD, MPH and the Houston VA Patient Safety Center win the VA’s research impact award for their work on delayed diagnoses, delayed test follow-up, and EHR safety.

Government and Politics

HHS Secretary Sylvia Burwell warns that a “repeal and replace” approach to the Affordable Care Act that would require years to offer a replacement program is really a repeal since it will cause collapse of the exchanges as the remaining insurer participants would pull out in 2018 in the uncertainty about what’s next. It would also leave 20 million people without insurance. Burwell is concerned that signups during open enrollment through December 31 may suffer because people are confused that the program is going away on Inauguration Day. Meanwhile, President-Elect Trump’s YouTube video in which he describes his highest priorities did not include repealing Obamacare, which he previously promised would happen the day he took office.

Technology

Drug maker Novartis says its Alcon eye care division will miss its goal of performing clinical trials on Google-designed smart contact lenses that can correct far-sightedness and measure blood glucose levels.

Other

The Wall Street Journal profiles the “fentanyl billionaire” whose company, Insys Therapeutics, is charged with bribing doctors to overuse its drug. John Kapoor, PhD, who’s worth around $2 billion, made his first fortune by spending $50,000 to buy a drug company selling an old AIDS drug, after which he quadrupled its price and netted $100 million when he sold the company. He then started Insys, which hired salespeople he called PhDs (poor, hungry, and dumb) who were paid little in base salary but who received a cut of every prescription issued by their doctor-clients, encouraging the reps to push high doses and large quantities. Two Alabama doctors are charged with making $40 million in illicit gains by prescribing $4.9 million worth of the drug for their Medicare patients alone in 2013-2014, also earning $271,000 in “speaking fees” from the drug company and millions more by having the prescriptions filled at a pharmacy they owned. One of the company’s reps, who was hired as a kickback to the doctor who confessed “a certain affection” for her, made $700,000 in two years from just the prescriptions written by the two doctors.

Stat ponders why President-Elect Trump recently met with drug billionaire Patrick Soon-Shiong, who is possibly under consideration to privatize Vice-President Biden’s cancer moonshot (which Soon-Shiong co-opted in forming his own Cancer MoonShot 2020 that mostly involves drug companies). Stat notes that not everyone is a Soon-Shiong fan, quoting a geneticist who summarizes, “A hype merchant propping up a lucrative empire with almost no real substance.” NantHealth shares have dropped 36 percent since their June 2016 IPO, while those of NantKwest are down around 75 percent since the company went public in July 2015.

In England, an NHS trust IT director pleads guilty to accepting a bribe to issue an ED software contract to the company of a local man who has also pled guilty.

ED physician Keith Pochick, MD pens a great, poetic opinion piece titled “Handheld electronic devices are the thieves of our meaningful moments,” describing a conference’s challenge to disconnect attendees from their smartphones:

On the second day, he invited us to turn off our handheld devices and put them into a basket at the front of the room. Most of us were able to do it, although quite a few participants needed to peek at their lifelines during breaks to ensure that the world was still spinning. Each of our respective loved ones knew exactly where we were, and would have had no trouble contacting us, yet the thought of “de-vicing” initially brought an incredible amount of angst. As the final two days of the conference developed, it became more and more liberating for me to be free from the chains of my digital master. While the conference wound down, we were each asked to list a few specific changes we’d make to enrich our lives and break behavior patterns which we believed were holding us back. I obviously couldn’t help but consider how many meaningful moments my constant accessibility and connectedness were stealing from me. I had become a slave to email, text messaging, instant Internet and YouTube access, and Facebook.

Cleveland Clinic CEO Toby Cosgrove disputes the many studies showing that hospital consolidation raises prices via their increased market power, saying instead that hospital mergers will prevent struggling facilities from closing by improving their efficiency. He also says that insurance must remain available for the 20 million people who buy theirs via the exchanges to prevent hospitals from having “major economic problems.”

New York-Presbyterian Hospital gave its former $3 million per year president another $6.4 million in severance when in September 2015 he abruptly resigned after having an extramarital affair.

Upworthy profiles “hippie turned doctor” Larry Brilliant, MD, MPH, who was motivated as one of only 60 attendees at a 1962, six-hour Martin Luther King, Jr. speech to later help cure smallpox, create the Seva eye charity that has restored sight to 4 million people, win a TED prize, and fight global pandemics. Brilliant’s just-released book is titled “Sometimes Brilliant: The Impossible Adventure of a Spiritual Seeker and Visionary Physician Who Helped Conquer the Worst Disease in History.” From his 2013 commencement speech to the Harvard School of Public Health:

As for my generation of young radicals, we had prejudged a mostly conservative profession, assuming they couldn’t be good doctors for being out of touch with the great social upheaval of the time, for not understanding the needs of the marginalized, not seeing the patterns and linkages between disease and poverty, the relationship between social justice and life expectancy, and how the battle then as now was about dignity and human rights. And here is the point as you go forward. Somehow, these two sides of our national health debate—one outward looking at social justice and inclusion and one inward looking inward at high quality patient care that is exclusionary—met then and must meet now on sacred ground, sharing the profound obligation and great joy of improving the health of the people …

Imagine that arc of history that Martin Luther King inspired is right here with us. The arc of the universe needs your help to bend it towards justice. It will not happen on its own. The arc of history will not bend towards justice without you bending it. Public health needs you to insure health for all. Seize that history. Bend that arc. I want you to leap up, to jump up and grab that arc of history with both hands, and yank it down, twist it, and bend it. Bend it towards fairness, bend it towards better health for all, bend it towards justice. That’s your noble calling of public health.

Sponsor Updates

• Huntzinger Management Group announces a strategic partnership with DCCS Consulting.
• GetWellNetwork announces that more than 100 hospitals are using its Marbella data collection tool for rounding and collecting patient and staff feedback, with 20 new customers added since July 2016.
• HCI Group posts a podcast titled “EMR Training: What Goes IN to Achieving High Levels of Adoption.”
• Sutherland Healthcare Solutions announces its investments in healthcare analytics that include development of its SmartHealthSolutions portfolio, the acquisition by its parent company of big data analytics firm Nuevora, and a partnership with IIA.
• Optimum Healthcare IT is named a top 10 RCM provider.
• Baptist Health South Florida realizes $45 million in increased appropriate reimbursement following its implementation of Nuance Clinical Documentation Improvement.

Blog Posts

• Diabetes: Top Three Medication Safety Concerns (Wolters Kluwer)
• Infusion Errors Top the 2017 ECRI Hazards Report (Iatric Systems)
• Meditech’s Web EHR Brings Integration Value to Wilma N. Vázquez Medical Center (Meditech)

Contacts

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

Morning Headlines 11/21/16

Factom, Inc. Receives Grant to Create Secure Medical Records Using its Blockchain Technology

The Bill and Melinda Gates Foundation issues blockchain vendor Factom a grant to build a tool to secure electronic medical records with blockchain technology.

NHS trusts overshoot maximum annual deficit in just six months

Six months into its fiscal year, the NHS has passed its permissible deficit for the year and is on pace to end the year $3 billion over budget.

What Does the Trump Presidency Imply for Healthcare and Healthcare IT?

John Halamka, MD discusses the impact President-elect Trump will likely have on health IT.

Association Between the Opening of Retail Clinics and Low-Acuity Emergency Department Visits

A study investigating the relationship between availability of local retail clinics and ED utilization finds no decrease in the use of emergency services for low-acuity conditions.

Monday Morning Update 11/21/16

Top News

The Bill & Melinda Gates Foundation awards a grant of unspecified value to blockchain technology vendor Factom to create a secure, transportable medical record using blockchain.

According to the company’s CEO, “Our goal with this new partnership is to demonstrate how global identity and record-keeping as a public utility is possible. We hope to show how individuals can manage important, private records like medical records using very simple tools and a lot of backend cryptography. My belief is that the blockchain will be used more and more over time for these aims. If we all follow these core beliefs, we will get to a very, very good place in this world.”

Reader Comments

From John: “Re: MGMA and HIMSS booth sizes. RSNA’s exhibit hall demonstrates where the real money is made.” RSNA’s exhibit hall floor plan shows that three companies bought space of 20,000+ square feet, or about a half acre: GE Healthcare, Philips, and Siemens Healthineers, with Toshiba and Hitachi not far behind. Providers who order excessive numbers of imaging studies to pay for the machines they bought are also underwriting that kind of excess, as are we taxpayers who are stuck with Medicare and Medicaid bills. In addition, every one of those big-booth vendors are foreign companies, taking the profits from our screwed-up healthcare system back to England, Netherlands, Germany, and Japan. The WHO health system performance ranking of their home countries is not only better than ours (coming in at #18, 17, 25, and 10, respectively, vs. our pitiful #37) but a lot less costly, a fact the starry-eyed RSNA attendees are not likely to appreciate since our ridiculous healthcare costs fund their nice incomes and conference attendance.

HIStalk Announcements and Requests

About 60 percent of poll respondents expect their companies to fare as well or better under a Trump presidency than now. CIO Looking says the ACA cost him his job because his financially stable community hospital was forced to join a larger health system, so he or she at least expects to be employed under a Trump presidency. HITgeek says the real problem is Congress and Trump’s appointments and urges people to take advantage of the Notice of Proposed Rule-Making comment period by adding thoughtful, fact-based responses.

New poll to your right or here: which social media services do you use professionally? “Use” means whatever you want it to mean – maybe you post content on a particular site or maybe you just check it out for business purposes occasionally.

We provided math manipulatives for Mrs. B’s first grade class in Texas by funding her DonorsChoose grant request. She reports, “With these games, we have been able to further our addition and subtraction skills. My students love playing these games and work very well together while playing them. Kids today need hands-on manipulatives that excite and motivate them to learn.”

Meanwhile, a generous vendor has provided significant matching funds to double the impact of donations (actually it’s more like quadruple in some cases since many DonorsChoose projects already include match offers). You can donate as follow:

1. Purchase a gift card in the amount you’d like to donate.
2. Send the gift card by the email option to mr_histalk@histalk.com (that’s my DonorsChoose account).
3. I’ll be notified of your donation and you can print your own receipt for tax purposes.
4. I’ll pool the money, apply the matching funds, and publicly report here (as I always do) which projects I funded, with an emphasis on STEM-related projects as the matching funds donor prefers.

Last Week’s Most Interesting News

• Cerner CEO Neal Patterson makes a surprise appearance at the company’s user conference, saying that his experience as a cancer patient has inspired him to make EHRs faster and safer and to incorporate more patient involvement.
• CMS releases an API that gives developers access to information from its Quality Payment Program.
• A new ONC report makes recommendations on the safe use of EHR pick lists for selecting patients and medications.
• The Social Security Administration connects its disability system with the VA’s medical records to speed up processing time for the applications of veterans.

Webinars

December 6 (Tuesday) 1:00 ET. “Get Ready for Blockchain’s Disruption.” Sponsored by PokitDok. Presenter: Theodore Tanner, Jr., co-founder and CTO, PokitDok. EHR-to-EHR data exchange alone can’t support healthcare’s move to value-based care and its increased consumer focus. Blockchain will disrupt the interoperability status quo with its capability to support a seamless healthcare experience by centralizing, securing, and orchestrating disparate information. Attendees of this webinar will be able to confidently describe how blockchain works technically, how it’s being used, and the healthcare opportunities it creates. They will also get a preview of DokChain, the first-ever running implementation of blockchain in healthcare.

December 7 (Wednesday) 1:00 ET. “Charting a Course to Digital Transformation – Start Your Journey with a Map and Compass.” Sponsored by Sutherland Healthcare Solutions. Presenters: Jack Phillips, CEO, International Institute for Analytics; Graham Hughes, MD, CEO, Sutherland Healthcare Solutions. The digital era is disrupting every industry and healthcare is no exception. Emerging technologies will introduce challenges and opportunities to transform operations and raise the bar of consumer experience. Success in this new era requires a new way of thinking, new skills, and new technologies to help your organization embrace digital health. In this webinar, we’ll demonstrate how to measure your organization’s analytics maturity and design a strategy to digital transformation.

Acquisitions, Funding, Business, and Stock

Salus Telehealth chooses a new board of directors following its merger last month with VideoMedicine.

Decisions

• Central Washington Hospital (WA) will switch from Cerner to Epic in 2017.
• St Joseph Memorial Hospital (IL) will switch from Meditech to Epic in mid-2017.
• Houston Methodist St. Catherine Hospital (TX) will switch from Meditech to Epic in February 2017.

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

Announcements and Implementations

A study finds that extended, continuous cardiac monitoring using the Zio system of IRhythm Technologies performs better than Holter monitoring in detecting arrhythmias. Patients wear the Zio Patch for 14 days, then mail it in for analysis. Shares in the company have jumped 23 percent since their October 20 IPO, valuing it at $644 million.

The University of Toronto profiles its researchers who tested their lab-on-a-chip measles and rubella screening technology at a refugee camp hospital in a remote part of Kenya. They created their system using 3D-printed components and open source hardware. The 15-member digital microfluidics team, which ranges from undergrads through post-docs, wants to create a rugged, solar-powered system that locals can transport on motorcycles and operate themselves.

The American Medical Association adopts principles regarding mHealth applications, acknowledging the need for clinical evidence to help weed out the unsafe ones. The principles are fairly predictable, including AMA’s insistence that apps maintain the physician-patient relationship and that doctors who provide services through the app be licensed in the state where the patient is located.

Government and Politics

John Halamka, MD weighs in on the impact of a Trump presidency on health IT. He predicts:

• Lowered taxes, simplified regulations, and moving Medicaid closer to individual states could spur innovation.
• Free market competition could increase.
• Health insurance exchanges will probably be an early target, but other parts of the ACA will live on.
• FDA scrutiny and enforcement may be dialed back.
• Funding for NIH, the Cancer Moonshot, precision medicine, and CMS’s Center for Medicare and Medicaid Innovation may be cut back.
• The transition to value-based purchasing and the rollout of the Quality Payment Program will continue.

President Obama describes the country’s technology-assisted employment challenges in an excellent post-election New Yorker article and interview:

But at some point, when the problem is not just Uber but driverless Uber, when radiologists are losing their jobs to A.I., then we’re going to have to figure out how do we maintain a cohesive society and a cohesive democracy in which productivity and wealth generation are not automatically linked to how many hours you put in, where the links between production and distribution are broken, in some sense. Because I can sit in my office, do a bunch of stuff, send it out over the Internet, and suddenly I just made a couple of million bucks, and the person who’s looking after my kid while I’m doing that has no leverage to get paid more than ten bucks an hour.

Privacy and Security

From DataBreaches.net:

• Live streaming video of patients having sleep studies performed by a California sleep clinic are found to be viewable online due to an improperly secured camera.
• A financial counselor at Hennepin County Medical Center (MN) is sentenced to probation for keeping cash co-pays and charging the amount to a different patient’s credit card.

Innovation and Research

Yale startup Spring, which offers a 10-minute machine learning-powered online questionnaire that suggests the best antidepressant for a given patient, wins the Harvard-Yale Pitchoff.

Other

Perhaps this headline’s error was a Freudian slip suggesting either hospital body area specialization or mediocrity.

In England, NHS trusts are running over their maximum allowed annual deficit six months into the fiscal year and despite an $1.1 billion emergency government infusion. The CEO of NHS Confederation blames budget cuts, especially in the areas of social care, mental health, and public health. On the positive side, 142 trusts reported a YTD deficit through Q2 vs. 182 in the same period last year and total expense has been reduced by 2.9 percent.

Drug maker Pfizer sues the Texas Health and Human Services Commission for providing Medicaid rebate data to to state lawmakers, saying the agency compromised the company’s trade secrets and will harm the state’s Medicaid program because Pfizer may stop offering the rebates if other large purchasers demand the same prices.

A study finds that nearby retail clinics don’t reduce the number of unnecessary ED visits for “treat and release” conditions such as flu, respiratory infections, and urinary tract infections. The authors note that their numbers may have been skewed by patients who wouldn’t have sought treatment at all until retail clinics came along, the number of patients seen in a retail clinic whose conditions required an ED visit anyway, and the fact that most of those clinics don’t accept Medicaid.

Sponsor Updates

• Xerox Healthcare features PokitDok in the first episode of its Health Future podcast.
• Catalyze CEO Travis Good, MD interviews Georgia Tech health informatics professor Mark Braunstein, MD in a podcast titled “Healthcare in the Age of Interoperability.”
• Voalte publishes a video of a mother describing her firsthand experience with the benefits of the company’s smartphones during her premature delivery.

Blog Posts

• Sneak Preview | Visage @ RSNA 2016 (Visage Imaging)
• Introducing Your Practice’s Last Fax Solution (Aprima)
• Post-election Outlook for Healthcare IT and Patient Payments (Patientco)
• Improve Revenue Cycle Management by Putting Patients First (PokitDok)
• Silo Busting with Enterprise Imaging (Lexmark Healthcare)
• How L&D Teams Use Protocols (PeriGen)
• Medicare’s New Payment Models and Technology’s Challenge to Keep Up (PMD)
• Reading the Tea Leaves: What Lies Ahead for Health IT in the Trump Administration? (Point-of-Care Partners)
• Phishing Attacks: A Hacker’s Gateway to Patient Health Records (Protenus)
• Patient Estimates and the Price of Transparency (Sagacious Consultants)

Contacts

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