News 11/18/16

Top News

Cerner CEO Neal Patterson makes a surprise appearance at the Cerner Health Conference in Kansas City on Wednesday, telling 15,000 attendees that he is getting stronger after being treated for soft tissue cancer and adding, “I realized God had a sense of humor. He put me in a place undergoing an EHR conversion.”

Patterson expressed his frustration as a patient: “I remember waiting four hours to get lab results. I asked a lady next to me in the waiting room how long she had been waiting, and her reply was seven hours. Seven hours! There’s no caring in that. It’s not like you have one doctor, one surgeon, a radiation oncologist, and a medical oncologist. It’s a team. It’s time for the patient to be part of the team.”

Patterson says he will resume his normal activities in January. He vowed to make Cerner’s EHR faster and safer and to include more patient participation, saying, “I know I was put in this position to make it better.”

Reader Comments

From LeftCoaster: “Re: QuadraMed. Employees say owner Harris laid off another 15 people this week, apparently focusing the cutbacks on the Affinity product that has only a handful of developers left. Harris purchased NextGen’s hospital business last year and sales activity has been dismal.” Unverified.

From MGMA Attendee: “Re: Athenahealth at MGMA. They had a huge amount of trade show real estate with a large number of corporate marketers marching the edges. At one point it was like 30 staff to zero attendees. I’m not sure if the intention was to intimidate the other EHR vendors, but their excess was ridiculous to the point my colleagues and I avoided it.” Unverified. MGMA’s 2016 exhibit hall floor plan shows Athenahealth with a 50×50 booth, more than quadruple the size of the next-largest exhibit. The MGMA 2017 floor plan indicates that the company will downsize to 50×40, still more than double the size of the next-largest spot. They have two booths at HIMSS, one at 4,200 square feet and the other 400, but that’s comparatively modest for HIMSS compared to Epic’s 7,700 square feet, Cerner’s 11,700, and HIStalk’s sprawling 100-square-foot shrine to corporate excess. To put it in perspective, Cerner’s HIMSS booth will cover more than one-fourth of an acre, and unlike their huge campuses, local and state governments aren’t subsidizing that super-expensive space.

From Acceler-8R: ”Re: our new accelerator. We would love to be featured on HIStalk.” Sorry, but I’m decelerating my accelerator coverage. Writing about accelerators and their barely-functional startups led by industry-inexperienced newbies is like holding a baby shower while the post-coital sheets are still wrinkled. I don’t like wasting the time of readers in breathily describing the now-endless number of accelerators and incubators that have exceeded the number of available good companies that have sound business models and proven leadership. I’ll wait to write about the Darwinian winners when they are closer to being ready for enterprise prime time.

From Twitterati: “Re: this rag’s list of HIT people with the most Twitter followers. HIStalk was omitted.” It’s the usual lame, easily compiled list presented in the infuriating slideshow form, requiring endless clicks by the three people in the US who actually care (other than those named). Some of the folks on the list don’t even work in health IT. By the magazine’s stated methodology, I would have come in at around #25 with 12,500 Twitter followers, although in their defense, they probably see me as a competing publication instead of just some guy noodling around on a spare bedroom keyboard.

From David Hasselhoff: “Re: Epic. They’re looking to hire a German translator. Wonder if they have a German client in the works?”

HIStalk Announcements and Requests

I’ve reached my annoyance tipping point with vendors who coyly call their sales to customers “partnerships,” which they clearly are not. From now on, if the words “partner” or “partnership” are included in a press release without saying specifically that the customer bought something from their vendor “partner,” I will exclude that announcement from my “Sales” section since I’m tired of trying to decipher vague press releases to figure out who sold what to whom. If you want to brag on a sale, then call it a sale. Above is my first example.

This week on HIStalk Practice: Greater Oregon Behavioral Health launches statewide telemedicine program. Arizona Connected Care rolls out new care management app. IHealth Innovations launches WRAP to help physicians transition to QPPs. Centerstone Tennessee selects predictive analytics tech from Faros Healthcare. ACO CVCHIP Board Chair Lerla Joseph, MD shares insight into the challenges practices face when it comes to reporting for value-based payment programs. Humana pays out $94 million to physicians for quality improvements. My Client Notes partners with E-Psychiatry to launch TelePastor. Westmed Medical Group Co-Medical Director Richard Morel, MD describes the group’s journey to launching a mobile patient portal.

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

Healthcare operations AI-driven dashboard vendor AnalyticsMD raises $13 million in a Series A funding round. The company’s website has a cool “Efficiency: how does your hospital rank” function that quickly displays in-depth publicly available information about any US hospital.

The CEO of network security vendor PacketSled resigns by mutual agreement after a unleashing a flurry of obscene and threatening Facebook comments involving President-Elect Trump. The company reported him to the Secret Service after a post in which he said, “I’m going to kill the President-Elect,” followed by another saying, “Bring it, Secret Service.” He gave specific details about his plan to buy a sniper rifle and stalk the White House, but later claimed his comments were just a private joke.

The Wall Street Journal reports that in 2014, 24-year-old Theranos employee Tyler Shultz tipped off authorities and the Wall Street Journal that the company’s technology was a sham. He’s the grandson of then-company director and former Secretary of State George Shultz. Theranos scolded him, at which time he resigned, but was accused by the company’s lawyer at a family event of disclosing trade secrets and violating his confidentiality clause. He says he was followed by Theranos-hired private investigators and was pressured to disclose the Journal’s sources for its series of critical articles. “Fraud is not a trade secret,” he says, even though his disclosure apparently created a family rift in which he speaks to his grandfather only through lawyers.

ContextMedia acquires AccentHealth, uniting two companies whose life’s work (other than leaving out spaces between the halves of their conjoined names) is creating point-of-care demand for budget-busting drugs during the inevitable long wait to see the doctor by pushing sponsored content at waiting room patients. My PCP stuck a tablet-based “educational” application in the exam room that looks like it might have been from ContextMedia, and despite my hour-long, boring wait, I wasn’t tempted to unmute it because I resent being marketed to as a patient in healthcare setting (which is nearly universal these days).

Tech-backed, consumer-friendly insurer Oscar continues to hemorrhage cash as it loses $45 million in Q3 in its New York, Texas, and California markets as high startup costs and medical losses mount even as the company exits some markets. Oscar, which is scrambling to distance itself from the dying ACA marketplace that could be killed off by President-Elect Trump, was ironically co-founded by  the brother of Trump’s son-in-law. The Kushner brothers were admitted to Harvard as the university weighed their cons (modest academic records) with their pros (their father, a convicted felon and disbarred lawyer worth $500 million, donated $2.5 million).

China’s Wuzhen Internet Hospital, launched less than a year ago, says it offers services from 260,000 doctors, 300 of them working exclusively for the company that was founded by Shanghai-based We Doctor and is valued at $3 billion. The hospital uses text, phone, and video messaging and will establish 32 branches across China by the end of 2016. It is building a cloud platform to store patient clinical and billing information, eliminating the common requirement in China that patients bring in their own paper records when receiving services. Patients pay $1.50 to $36 for a virtual visit.

Sales

New West Physicians (CO) chooses pMD for HIPAA-compliant messaging.

Island Hospital (WA) will upgrade to Meditech’s Web EHR.

Thresholds, which offers support to people with mental illness in Illinois, chooses FormFast FastFlow for automating its event tracking.

The CRISP HIE chooses Verato for patient matching.

People

Clinical Computer Systems hires Ron Repking (Glen Ellyn Web) as president. Owner and former president Kim Sell remains with the company, which offers the Obix Perinatal Data System, as CEO.

Rob Kill (Cogentyx Medical) joins Investment firm Frazier Healthcare Partners as an operating partner on the Growth Buyout team.

Announcements and Implementations

TransUnion Health integrates its Patient Financial Clearance solutions with Epic’s Prelude registration system for validation of patient demographic and financial data.

Vital Images will launch Vitrea Data Stream and an updated viewer at RSNA, providing a single account point for EHR enablement across multiple PACS.

Wolters Kluwer Health announces that its ProVation Order Sets now features bi-directional integration with Cerner and another unnamed EHR vendor that I would presume is Epic.

Government and Politics

CMS releases an API that will allow developers build applications that retrieve information from CMS’s Quality Payment Program measures.

A review of the seven previously proposed Republican changes to the Affordable Care Act says they range from outright repeal with no replacement to tweaks that retain the marketplace. The author concludes that all of the plans will make it worse for older, sicker people in charging them more to reduce the premiums for younger, healthier people to entice them to sign up. All of the proposed plans would increase the number of uninsured Americans. One idea I like is “continuous coverage,” which provides financial motivation for people to renew their policies each year or to immediately buy their own coverage after losing employer-provided insurance. One of the biggest disappointments of Obamacare is (other than the huge misstep in not addressing provider costs) that healthy people can still get away without buying insurance due to the toothless “individual mandate,” skewing the risk pool and sticking providers with their unexpected medical bills. Maybe the feds should just randomly assign every American to an insurance company to thwart cheaters and spread insurer risk evenly.

The federal government tells the state of Vermont to stop using Medicaid money to fund certain projects, among them the state’s health information technology fund that as a result will see its $2.9 million budget cut in half in 2018 and eliminated in 2019. One of its projects is the Vermont HIE.

Obamacare been berry, berry good to hospitals, whose profit margins reached a 30-year high of an average 7.3 percent in 2014, making it obvious why the AHA was happy to support more widespread insurance coverage that its members could bill.

Privacy and Security

From DataBreaches.net:

• A Florida man who created fictitious healthcare providers and billed $6 million in false insurance claims recruited patients willing to allow their information to be used in return for cash. He also used a patient eligibility service to enter consecutive member IDs until he hit valid ones, with the verification information then giving him the information he needed to generate fraudulent bills.
• In England, security experts find that seven NHS trusts spent nothing on cybersecurity in 2015. Their tests using public searches discovered misconfigured email servers, expired security certificates, and exposed login credentials.
• Emblem Health notifies its members that their Social Security numbers were accidentally printed in a mailing it sent.
• A marketing company hired by BCBS of New Jersey sends a benefit letter to 170,000 policy that includes the information of other individuals.

This month’s Protenus Breach Barometer finds that 36 healthcare breaches were reported to HHS or the media in October, with 664,000 patient records exposed due to known hacking and ransomware incidents. Several organizations lost patient data permanently after ransomware incidents. Insiders were responsible for 37 percent of October’s breaches, of which five were accidental and eight were intentional.

Innovation and Research

UCSF’s Center for Digital Health Innovation and GE Healthcare will work together to develop clinical diagnosis and management algorithms that will be applied to data from imaging systems and EHRs. It’s called a partnership, so your guess is as good as mine as to who’s making money from the deal.

Technology

Twitter enhances its twit filter to allow muting conversations that contain a specified keyword or hashtag, giving users a welcome method to continue following mostly-useful tweeters while suppressing their passionate but off-topic posts about sports and politics or their endless updates from a seemingly dull conference. Click your profile icon and then Settings to clean up your stream. I vaguely remember a few months ago suggesting this feature, also wishing for Twitter and Facebook enhancements to allow users to categorize their updates (work, politics, mindless cute videos, precious child updates) so I can keep following the parts that interest me without having to suffer through the rest. That’s a cleaner option than hoping they create separate accounts for work vs. everything else, although I’m not opposed to that either.

Fast Company cites sources saying that Apple is researching the possibility of monitoring Parkinson’s disease patients with its iPhone and Watch. However, it would only work for the subset of Parkinson’s patients whose symptoms include tremors and slow movement.

Other

The New York Times summarizes a NEJM article about patients who visit an in-network ED staffed by out-of-network doctors, which the study found happens in 22 percent of ED visits at an average patient cost of $900. The problem varies by area, with McAllen, TX EDs sending 89 percent of their patients surprise bills. The insurance trade group AHIP says it’s the job of hospitals to get their outsourced ED doctors to sign contracts with the same plans the hospital accepts. For once, I agree with the insurance companies.

In Canada, the corporate communications director of Stevenson Memorial Hospital is charged with several counts related to child pornography after police say he looked up the information of a minor female patient on the hospital’s computer system and tried to lure her into a sexual relationship.

The American College of Emergency Physicians parodies Cigna’s “TV Doctors of America” public service video from September 2016, with real-life ED doctors accusing the insurer of unfair coverage policies that exploit the federal EMTALA law that requires EDs to provide care regardless of the patient’s ability to pay. ACEP says Cigna should have spent the $9 million video cost on patients instead of on hiring actors who played TV doctors. Above are both videos for comparing and contrasting.

In India, patients complain that hospitals and pharmacies are refusing to accept 500 and 1,000 rupee bills that have been newly removed from circulation and replaced with a different bill design even though the government specifically allows them to accept the old currency. The government’s demonetization project makes the old, higher-value bills illegal in trying to stem corruption, black market exchange, and terrorism, meaning 500 rupee bills worth just $7.35 can no longer be used, although they can be exchanged until December 30 for the new notes and exceptions were granted for gas stations, hospitals, airlines, and crematoriums. One hospital says its business dropped 50 percent overnight, while another refused to release a patient’s body to the family until they could come up with cash in valid currency.

Several dozen laid-off IT employees of UCSF file discrimination complaints and threaten lawsuits after their jobs are outsourced to India-based companies. Experts note that the legal precedent isn’t favorable since other companies have successfully argued that they didn’t replace the employees individually — they restructured their departments and the outsourcing company hired the offshore workers.

Odd: a study finds that 76 of the known 127 reported “deaths by selfie” from March 2014 to September 2016 happened in India, where people spent their last seconds posing in front of an oncoming train, on a boat that tipped over, on the side of treacherous cliffs and rivers, and on the steps of the Taj Mahal. The US had just eight known deaths by selfie (or “killfie,” as the study authors say).

Sponsor Updates

• Iatric Systems proposes a YourTurn session on the help desk at HIMSS17.
• Deloitte includes ID Experts in its 2016 Technology Fast 500.
• LifeImage releases a new eBook, “CIO Perspectives on Enterprise Imaging.”
• IDC recognizes Medecision as a major population health management player.
• KLAS recognizes Direct Consulting Associates as a leading business intelligence provider in its Enterprise Healthcare BI 2016 Report.
• EClinicalWorks will exhibit at MAHP 2016 Annual Conference November 18 in Boston.
• The University of Wisconsin College of Engineering recognizes Healthfinch CEO and co-founder Jonathan Baran with the 2016 Early Career Achievement Award.

Blog Posts

• Realizing Clinical Benefits Part 4 – Race for the Finish Line … and Keep Going (Impact Advisors)
• Online Reviews Impact How Patients Select Hospitals and Doctors (Influence Health)
• Say “no” to silos in healthcare (Infor)
• Coordination and Communication Central to Value-based Care (Ingenious Med)
• The Story of One Bill (InstaMed)
• Declaration of Device Independence (Spok)
• The Point of it All for Point-of-Care Testing (InterSystems)
• Hold On Loosely (Iatric)
• Have you considered hands-on training for health IT? (Learn on Demand Systems)
• What is EDI (Electronic Data Interchange)? (Liaison Healthcare)
• Medicomp University Asia 2016 a Success (Medicomp Systems)
• Throwing out the Cookie Cutter: Understanding and Embracing Patient-Centered Care (Netsmart)
• Understanding Nanomedicine in the Context of Precision Medicine (Orion Health)
• Three Ways Technology Is Transforming Behavioral Healthcare Delivery (ECG Management Consultants)
• CMS Lowers Meaningful Use Reporting Period to 90 Days (E-MDs)
• Critical Initiatives for Digital Transformation in Healthcare (Evariant)
• Goodbye Obama(care), Hello Trump-what exactly? (Galen Healthcare Solutions)
• On the Road with John Halamka, Healthcare IT Observations (Hayes Management Consulting)
• Epic Upgrades: 3 Considerations When Deciding Between a Single or Double Upgrade (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 11/16/16

Top News

ONC issues a report on improving the usability of pick lists for choosing patients and medications in an ambulatory care setting that also includes an EHR self-assessment. It recommends that vendors and/or users:

1. Include a patient photo in their record to make sure the right patient was chosen.
2. Standardize drug names using the concept of an e-prescribing preferred drug description name.
3. Use pick list best practices, including display standards and proper validation and decision support checks.
4. Display a summary screen before accepting a pick list-chosen medication order.
5. Provide simple retract-and-reorder functionality and monitor its use to identify design problems.
6. Give patients their own medication lists as a second check.

Perhaps ONC should have edited the report more carefully since “prednisone” is repeatedly listed as “rednisone” in the section advocating standardized drug names. The example drop-down also misspells the trade name “Lamictal” as “Lamicatal” and the generic name “lamivudine” as “lammudine.” Even “aspirin” is misspelled as “asprin” in the sample visit summary.

Reader Comments

From FLPoggio: “Re: consultants. People who need them don’t know how to use them. People who know how to use them probably don’t need them.” That’s probably true – the organizations that hire consultants are often clueless, overworked doing the wrong things, and obsessed with protecting their fiefdoms. The last thing they want is change, which is why I would advocate that the person who hires the consultant be one notch higher than the people who will be most affected by their recommendations. IT strategy consulting should be engaged by whoever the CIO reports to, for example, and that’s the person who should make sure the recommendations happen.

From Killian Red: “Re: AMIA. I see a lot of suits in those tweeted photos!” I can never figure out why people wear suits to conferences, ensuring that they will be less comfortable, indistinguishable lemmings compared to that one enviably free-spirited guy who struts through the exhibit hall wearing shorts, tennis shoes, and a backpack, ignoring the raised sartorial bar and instead limboing happily under it in avoiding the corporate battle uniform. There’s not even anyone there to impress except peers from elsewhere. Some of the dimmest, most self-absorbed, and most dishonest hospital IT people I’ve known wore suits everywhere at work (even walking to the restroom or going out to lunch), which might validate the theory that anyone can get promoted by projecting a fabric-driven aura of marginal competence paired with excessive sycophantism and unchecked ambition. Like most of life, the best person doesn’t always win – often it’s the one who wants it more.

HIStalk Announcements and Requests

The industry is about to lapse into its usual Thanksgiving-to-New-Year’s coma, so before that happens and then we all get overwhelmed after January 1, I’ll make a final pitch to companies interested in sponsoring HIStalkapalooza. We still have prime spots left that will ensure the endless gratitude of attendees who will enjoy a fun evening thanks to your largesse, sort of like sending underprivileged hospital IT people to summer camp. I even agreed to hang out privately for a few minutes with the CEO of one sponsoring company who wants that for some dubious reason, so clearly it’s time to deal so I don’t have nightmares about writing that big check personally. Contact Lorre.

Webinars

None scheduled soon. Contact Lorre for webinar services. View previous webinars on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

Medical practice EHR/PM vendor CareCloud completes a $31.5 million Series C funding round, increasing its total to $103 million.

Non-ICU monitoring system vendor Stasis Labs, which provides a simple bedside display of six core vital signs and a tablet-based app for clinicians with red or yellow indicators, raises $5 million in a seed funding round. Its hardware is manufactured in India, while its software was designed in conjunction with Cedars-Sinai Medical Center.

Sales

UAB Medicine (AL) chooses KyruusOne and ProviderMatch for Access Centers to match patients with available providers to reduce long appointment wait times even while provider capacity is available.

Bayada Home Health Care will identify seniors in need of intervention using technology from Chicago-based PreparedHealth, which offers the enTouch healthcare social network and DINA digital nursing assistant.

Florida Health Care Coalition will offer its members quality and utilization performance reports from Quantros.

Announcements and Implementations

A new Peer60 report covering ideal imaging configuration finds that 72 percent of respondents have pursued an enterprise imaging approach in which the same company provides PACS, VNA, and viewer, mostly because they believe it offers better customer support. Sectra had the highest net promoter score among the enterprise imaging vendors. Just over one-fourth of enterprise imaging customers say they are considering switching vendors, with McKesson leading their mindshare. Among that minority of best-of-breed participants, nearly half would prefer an enterprise imaging approach instead, mostly to facilitate better integration, but nearly all of them say they get better functionality by choosing individual vendors and only 23 percent are actively pursuing replacing their systems with those from enterprise imaging vendors.

Cerner will integrate American Well’s telehealth solution with its HealtheLife patient portal. Amwell offers a $49 urgent care video visit with its own participating doctors, which appeals mostly to health plans and employers, but also offers health systems and practices the ability to launch their own telehealth practice.

Lexmark Healthcare launches a legacy data archive solution, expands its PACSgear suite to allow EHRs to capture and present DICOM content directly from devices, and releases a new version of its enterprise viewer.

The American Heart Association launches a precision medicine platform using Amazon Web Services that will allow clinicians and researchers to analyze data sets contributed by drug companies, research institutes, and universities.

University of Utah partners with South Korea-based Chung-Ang University to create new digital health innovations, including telehealth, that will be applied at CAU Hospital.

Government and Politics

A Health Affairs blog post says CMS’s hospital star rating system is “confusing at best and misleading at worst,” as some hospitals don’t have enough data for some quality categories and CMS reweights the remaining categories accordingly, often to their advantage.

CMS updates its Medicare drug spending dashboard and adds Medicaid spending as well. Four Medicare-covered drugs jumped more than 200 percent in a single year, with the price of blood sugar drug Glumetza increasing from $8 to $39. Medicaid saw a 1,264 percent hike in the price of anxiety drug Ativan, while taxpayers paid $9 billion for the hepatitis C drug Harvoni. Nine of the 20 drugs that had the biggest Medicaid price jumps are generics. 

The VA goes live with a new health enrollment web page without first clearing it with the agency’s lawyers, without training its enrollment specialists on its use, and with technical problems that locked or lost up to 65 percent of the applications filed. It is also not interoperable with the VA’s VistA. The VA turned the application back off and is routing applications manually. Whistleblowers claim the VA intentionally told veteran applicants that they were ineligible for VA care just to reduce the VA’s embarrassing backlog of pending applications.

Privacy and Security

From DataBreaches.net:

• A woman sues Charleston Area Medical Center for providing the medical information of her child to a pregnant acquaintance who the hospital misidentified as her.
• In Canada, Manitoba Health launches an investigation after discovering that a former employee looked up the names, birth dates, and address of patients so she could send them birthday cards.
• A Texas medical practice notifies several hundred patients that their records that were being stored for shedding were accidentally placed in the trash by its cleaning service.

Innovation and Research

The CDC awards a $930,000 grant to University of Missouri-Kansas City, Truman Medical Centers, and Children’s Mercy to compare the de-identified information of 47 million patients stored in Cerner HealthFacts with TMC’s own information to identify laboratory-related quality gaps.

Other

Major League Baseball will standardize the player medical information that teams exchange during trade talks following the 30-game suspension of  San Diego Padres General Manager A. J. Preller, who traded players with known medical issues that he hid from the receiving team by maintaining two sets of their electronic medical records.

Pediatrician Mona Hanna-Attisha, MD, MPH — who discovered Flint, Michigan’s lead poisoning crisis by mining patient data in Hurley Medical Center’s Epic system — will speak at TEDMED, November 30-December 2, 2016 in Palm Springs, CA. Several other healthcare-focused presenters are on the agenda.

Both sides in a New York Times pro-con discussion of mergers agree that hospital consolidation creates consumer-harming monopolies, citing successful FTC challenges presenting evidence that merged hospital competitors raise prices and lower quality.

Lake Health (OH) blames its $30 million loss on an IT conversion that cost more than expected. I assume it was Cerner Millennium since the health system announced that decision in May 2016, replacing the former Siemens Soarian.

The American Heart Association gives its people’s choice technology award to Twiage, which offers hospitals real-time triage and care coordination with incoming ambulances.

Sponsor Updates

• AirWatch VP Blake Brannon looks back at the company’s top innovations of 2016.
• Aprima will exhibit at the American College of Rheumatology conference November
• Catalyze President and Co-founder Mohan Balachandran speaks on the IBM Cloud Innovation Tour November 15 in San Francisco.
• Pater Back, CIO of Meditech customer Humber River Hospital in Toronto, Ontario, is named ITAC’s Canadian CIO of the Year in the public sector category for his work in creating North America’s first fully digital hospital.
• Besler Consulting releases a new podcast, “What will happen to the S-10?”
• Aprima offers a cloud-based faxing solution for its EHR.
• CoverMyMeds will exhibit at Ohio State University’s Wexner Medical Center’s annual Advanced Practice Conference November 18 in Columbus.
• Crossings Healthcare Solutions exhibits at the Cerner Healthcare Conference through November 17 in Kansas City, MO.
• Consulting Magazine includes Cumberland Consulting Group on its 2016 list of fastest growing firms.
• Sutherland Healthcare Solutions publishes a white papers, “Turning Data Into Information and  Moving Beyond Data for Data’s Sake,” and a case study titled “Helping Touchette Regional Hospital Enhance the Patient Experience and Increase Reimbursement.”

Blog Posts

• Integrating Behavioral Health Quality Measures (Arcadia Healthcare Solutions)
• The Truth About HITRUST – and Why It Should Become the Industry Standard (Catalyze)
• Optimization with Provider and Patient Experience (Culbert Healthcare Solutions)
• Realizing Clinical Benefits Part 4 – Race for the Finish Line…and Keep Going (Impact Advisors)

Contacts

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

Morning Headlines 11/15/16

Keynote Speaker: John Boehner

HIMSS announces former Speaker of the House John Boehner will keynote HIMSS17.

Cerner and American Well to Embed Telehealth Capabilities into Cerner EHR

Cerner will integrate telehealth services from American Well into its software, allowing providers working within the Millennium EHR to connect with patients over Cerner’s patient portal.

Obama administration disperses last of grants to fund health information exchanges

ONC issues a total of $2.4 million in grants to four state HIEs: Delaware Health Information network, Oregon Health Authority, Rhode Island Quality Institute, and the Utah Health Information Network.

MLB to standardize medical information in wake of A.J. Preller suspension

In the wake of Padres GM A.J. Preller being suspended for hiding medical information during trade talks, the MLB has agreed to a new standardized approach to medical data sharing.

Morning Headlines 11/14/16

Social Security and Veterans Affairs Partnership Means Faster Disability Decisions for Veterans

The Social Security Administration integrates its disability claims processing system with the VA, speeding up the claims approval process by granting SSA immediate access to medical documents.

Donald Trump, in Exclusive Interview, Tells WSJ He Is Willing to Keep Parts of Obama Health Law

During a Wall Street Journal interview, Donald Trump says that he will preserve some components of the ACA, such as the pre-existing condition exemption and the ability to keep children on a parents insurance plan until the age of 26.

Cerner uses employees’ DNA in pilot research; aims to use genetic info to improve health

Cerner is analyzing full DNA sequences donated  by 82 employees to help the company study how genetics impacts obesity, metabolic syndrome, osteoporosis, and depression.

Monday Morning Update 11/14/16

Top News

The Social Security Administration connects to the VA’s IT systems via the eHealthExchange, allowing it to retrieve the VA’s medical records of veterans applying for Social Security disability. It went live nationally on Friday, Veterans Day.

Reader Comments

From Nasty Parts: “Re: NextGen. Rumor here at UGM is that IKS Health is a potential suitor. Former NextGen and Quality Systems President Pat Cline sits on their advisory board and is CEO of Lightbeam Health Solutions. Maybe they are bringing the band back together – IKS, NextGen, and Lightbeam.” Unverified. UPDATE: Pat Cline’s passed along this comment: ““I am proud to be a member of the IKS Advisory Board but I am fully committed to and focused on Lightbeam Health Solutions and the continued growth of our company and the population health solutions we deliver to healthcare providers. While I believe that QSI/NextGen is a fine company, I am not involved in any acquisition discussions nor am I trying to open any such discussion. I’m squarely focused on the growth and success of Lightbeam so that we continue to deliver the value that our customers, investors, partners and employees expect.”

HIStalk Announcements and Requests

Most poll respondents think the medical practice of their most recent doctor is pretty well run. I asked for details and received these:

• Health IT Chic Extraordinaire says her Epic-using doctor at Palo Alto Medical Foundation and the Cerner-using hospital he sent her (it’s one of five hospitals in which he practices) had mismatched records due to lack of interoperability. She had to fill out the same medical history and medication questions at both, but the hospital’s discharge instructions missed a drug he prescribed immediately before on Epic. She also notes that on the day of surgery, all the information of her tests and other information had been repackaged into a three-ring binder, leading her to ponder if we’ve really come as far as we think.
• Betsy says her OB-GYN was clearly not interested in using practice’s EHR, and during her first visit, his tablet batteries ran out and he called in a MA to take sparse notes. She also observes that she always waited at least an hour (even if she was the second appointment of the day), the practice forgot prescriptions, and their phone tree was dysfunctional. They also collect all payments upfront but failed to return any excess after insurance paid.
• Susan is a big fan of her PCP’s office, which communicates well internally and externally and offers prompt appointments and walk-in sick hours.
• PatientX entered questions before the visit on the practice’s portal that the doctor brought up on his own, making the visit feel more like an ongoing health conversation rather than just a metrics-driven checklist.
• PharmarH had a tracheostomy and even though it’s documented, they always ask him or her to call them.
• Jill loves that the pediatric office where she takes her kids has transformed into a patient-centered medical home that offers same-day appointments and makes it a point to obtain the hospital’s infant records before the first visit.
• My recent experience with the front-office staff of my single-doc PCP (my first visit with her) was unimpressive with their indifference paired with inefficiency, both plainly obvious, and I questioned the choice of playing country music in the waiting room. I was herded off to the exam room a few minutes behind schedule and was told I was the next patient, but I still waited 75 minutes. I was about ready to walk out when the doctor wheeled in a mobile cart running Practice Fusion, apologized for the wait, cheerily introduced herself by first name with a big smile, and asked for and told stories (“I love stories,” she said) in wanting to hear my medical history as a narrative to which she listened intently without focusing on the laptop and she related the experience of other patients. It was a “getting to know you” session that was probably 10 percent relevant to my immediate medical needs (getting routine annual lab tests), but I left a big fan without feeling like a patient widget in her medical factory. It was almost like corralling a doctor at a party who actually wanted to chat about my medical needs. I suspect her documentation of my encounter (which lasted nearly an hour) was skimpy, but I have no doubt she will remember all the important parts regardless.

New poll to your right or here: do you expect the business if your employer under a Trump presidency to be better or worse? Click Comments after voting to explain.

The Greatest Generation of World War II is mostly gone now, but taking its place at the head of the next-to-die line is the ever-dwindling roster of the Greatest Entertainment Generation of the 1960s, as evidenced by last week’s death of poet-musician Leonard Cohen and “Man from UNCLE” Robert Vaughn, PhD. The cool thing about 1960s TV stars is that they hustled on whatever shows hired them for next to nothing, so you can spot them as small players on shows ranging from “The Twilight Zone” to “Wagon Train.” Unlike the rest of us, their digitally preserved work lives on forever and earns news fans daily, allowing people to feel irrationally but happily connected to an impossibly youthful Napoleon Solo forever fighting THRUSH and charming mini-skirted mods with suave indifference.

Last Week’s Most Interesting News

• Siemens announces plans to take its Healthineers medical business public.
• Experts and amateurs alike try to forecast the healthcare impact of the presidential election win of Donald Trump.
• McKesson confirms the layoff of 60 employees of its Charlotte, NC-based Enterprise Information Solutions business that includes Paragon, for which it previously took a $290 million write-down and expressed hopes of selling the business.
• Walgreens files a $140 million breach of contract lawsuit against lab company Theranos.
• ECRI Institute get a $3 million, three-year to study optimization of EHRs and avoidance of patient harm.

Webinars

None scheduled soon. Contact Lorre for webinar services. View previous webinars on our HIStalk webinars YouTube channel.

Here’s the video of one of our webinars from last week, “CMIO Perspective on Successful 25-Hospital Rollout of Electronic Physician Documentation.”

Acquisitions, Funding, Business, and Stock

Patient education vendor PatientPoint acquires MedCenterDisplay, which offers digital signage, apps, and marketing solutions.

Decisions

• Ellenville Regional Hospital (NY) will switch supply chain software from Medhost to Jump Technologies in February 2017.
• Cameron Memorial Community Hospital (IN) went live on Infor supply chain management in October 2016.

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

People

Virtual doctor visit provider MDLIVE hires Scott Decker (HealthSparq) as CEO, replacing demoted founder Randy Parker.

Government and Politics

President-Elect Trump moderates his previously scathing opinions of the Affordable Care Act, which he had promised to scuttle on his first day in office, and says he wants to keep the elimination of pre-existing conditions and the ability for parents to leave their children on their policies for extra years. He (hopefully) appears to be moderating his over-the-top and ultimately successful election hyperbole with more thoughtful actions. A Washington Post opinion piece describes the problems involved with replacing Obamacare:

To guarantee that people with pre-existing conditions can get affordable health insurance, you need to have rules requiring guaranteed issue and community rating. To keep insurance companies in business because of guaranteed issue and community rating, you need to have an individual mandate. And because poor people can’t afford health insurance, you need subsidies. Combine all three, and what you have, in a nutshell, is … Obamacare … Of course, if you want to scrap guaranteed issue, scrap community rating, scrap the individual mandate, and scrap the subsidies, as Republicans, propose, then you end up where the country was in 2008—with a market system that inevitably gives way to an insurance spiral in which steadily rising premiums cause a steadily rising percentage of Americans without health insurance … you can’t have all the good parts of a socialized system (universal coverage at affordable prices) without freedom-reducing mandates and regulations and large doses of subsidies from some people to other people. Anyone who says otherwise – anyone promising better quality health care at lower cost with fewer regulations and lower taxes—is peddling hokum.

President-Elect Trump announces that his HHS transition advisor will be Andrew Bremberg, JD, who served as HHS special assistant and chief of staff from 2001 to 2007.

A Washington Post opinion piece explains why the author will never join AARP – the organization is a powerful Washington lobbyist that claims to protect Medicare and Social Security while it actually “prevents any serious discussion of meaningfully reforming these programs, which are in great danger of becoming insolvent.”

Privacy and Security

From DataBreaches.net:

• An IT recruitment site announces that an unnamed person accessed one of its development servers that it later determined had not been properly secured by its contractor Capgemini, exposing the information of its job seekers to the Internet. The UK file alone contained the information of 780,000 people, with the possible total exposure being in the millions or tens of millions.
• An encrypted laptop containing the information of over 1,200 members of the Indiana Health Coverage program is stolen from the car of an HP Enterprise Services employee, but HPE disabled it remotely.
• Vanderbilt University’s counseling center exposes the contact information of 468 of its clients to each other when an employee emails a survey using :CC rather than :BCC.
• Kaiser Permanente notifies 8,000 members that a website upgrade’s new caching mechanism could have exposed their information to other people visiting the website at the same time.
• A Texas dermatology practice is hit with ransomware that the practice says it was able to remove.

Other

The local paper features a fun look back at Atomedic Hospital, the 1950s “futuristic hospital for the atomic age” for which prototypes were installed at demonstration sites, most notably the 1964 World’s Fair. The windowless, round, nuclear powered, and modularly constructed 28-bed hospital had an outer corridor for visitors, an inner circle for patient rooms, and a central core for services such as the OR, with patient rooms having doors at either end to allow moving them to the ICU within the central core. The low-cost, pre-packaged hospital was designed to make healthcare affordable. Patients would be served warmed frozen dinners with disposable dinnerware and disposable linen eliminated the need for a laundry. I Googled and found the Atomedic Foundation, which seeks to preserve the idea of quickly constructed, low-cost hospital buildings as envisioned by the original concept. Kaiser Permanente ran a history of the Atomedic Hospital idea last year even though it passed on the idea in 1961, mostly likely because of its high expense at $19,000 per bed and, perhaps most importantly, the fact that the federal government’s Hill-Burton program wouldn’t pay for it as they did for most of the hospital buildings that were erected in the 1960s.

Cerner participates in a study of 82 employee volunteers who turned over their DNA sequencing to the company, signaling Cerner’s continued interest in broadening its reach to healthcare service delivery.

In England, a doctor is jailed for possession of child pornography, which he attempted to hide by occasionally throwing his computers into a river.

Netsmart honors its veteran employees on Veterans Day with a nicely done video.

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 11/11/16

Top News

Siemens will IPO its $15 billion Siemens Healthineers medical business, offering an unspecified stake while remaining a long-term majority shareholder.

Siemens CEO Joe Kaesar says Healthineers has gone from “good to great” by allowing it to focus and the IPO will “make it a fascinating business.” He says the company will invest in molecular diagnostics and consulting services.

Siemens Healthineers is the German conglomerate’s most profitable business unit. It offers medical imaging, laboratory diagnostics, point-of-care testing, therapy systems, imaging and laboratory diagnostics software, and services.

Reader Comments

From Dell EMC Spokesperson: “Re: Fairview Health Services. The City Pages article was inaccurate and misleading across a wide range of facts, including the comments relating to the Dell EMC products. The Dell EMC products never went down or failed at any point. XtremIO was not the root cause of any incidents referenced in the article. Dell EMC values its strong partnership with Fairview and to serving as a top trustworthy and dependable partner from a technology, support, and strategic IT relationship perspective."

From Lever Puller: “Re: your article on election analytics. I loved it – you nailed down many reasons polls should be taken with a grain of salt. The media should take blame, too, for spending so much energy vilifying the eventual winner so that anyone who wanted to vote for him wouldn’t admit that to pollsters, throwing off their results.” Media people do indeed have their own agendas despite their claims of impartiality and they didn’t try very hard to hide it this time (that’s a big no-no when trying to gauge rather than influence opinion). My takeaways: (a) don’t believe any survey, clinical study, or product ranking until you’ve reviewed its methodology and the motivations of the authors; (b) choose carefully the people you allow to feed you predigested conclusions, especially if you plan to take important action from what they tell you; and (c) follow the money because the biases held by most companies and people are directly linked to their wallets. I’ll also add that actions are more important than words, so when a patient says they are medication-compliant or a company boasts that they have only ecstatic customers, ask to see their data proving it. What I was really saying in that article is that no amount of analytical firepower, even when correctly applied, can reliably predict the behavior of humans, especially when it pertains to their health. Meanwhile, if you really believe what people say instead of what they actually do, you should buy shares in UHAL and make a fortune from all the hand-wringers who swear they’re moving to Canada.

Meanwhile, polling expert Nate Silver says in an analytics debrief, “We got a lot of crap for pointing out that the polls showed a fairly close election and that a fairly ordinary polling error could shift the Electoral College to Trump. People just didn’t want to hear it,” adding that the actual polls weren’t too far off in predicting the popular vote that Clinton won so far (Arizona, Michigan, and New Hampshire apparently ran out of fingers and toes and are still counting). The Huffington Post, which gave Clinton a 98 percent chance of beating Trump, has apologized to Silver for criticizing his projections as the news site earned its permanent place in the digital Dewey vs. Truman spotlight.

From Survey Says: “Re: your article on election analytics. As always, quite good and spot on. You would think a bad miss like Election Night would drive both some introspection and hesitancy to pontificate. I suppose nature abhors a vacuum and people have space on their sites that needs fresh content.” I’m already tired of self-proclaimed health experts confidently telling us what to expect from a Trump presidency, even trying to fine-tune their fuzzy crystal balls down to the level of health IT while barely holding back their post-election bitterness and fear. Some of them appear to simply be parroting each other judging from the identical ideas and similar wording.

HIStalk Announcements and Requests

Today (Friday) is Veterans Day, which we set aside to honor everyone who has served in the US armed forces. If you spent time in uniform on US soil or elsewhere, in a combat role or not, thank you. Every service member experiences sacrifice, time away from family, the possibility of personal harm, and some degree of opportunity cost.

I was thinking about people who are said to have “died suddenly” versus the possibly more accurate “died unexpectedly,” although I’m not sure either phrase is any better than just “died.” Nobody knows when they’re going to die other than executed prisoners and suicide victims, so it’s otherwise always sudden and never expected.

This week on HIStalk Practice: Coordinated Care Oklahoma Chief Administrative Officer Brian Yeaman, MD gets excited about analytics and image sharing. Texas Association of Business CEO stumps for telemedicine. SRSsoft adds InteliChart tech to its practice software for specialists. ONC’s annual report to Congress shows patient engagement office progress. Practice Fusion receives funding from Orix Growth Capital. Glendale MRI Administrative Director Pamela Fletcher speaks to the value of pricing transparency when it comes to keeping up with the competition. BCBS of Kansas offers value-based contracts to Aledade Kansas. Jonathan Bush weighs in on next administration’s impact on healthcare. Northwest Physicians Network CEO Rick MacCornack highlights the value found in working with small technology startups.

Webinars

None scheduled soon. Contact Lorre for webinar services. View previous webinars on our HIStalk webinars YouTube channel.

Here’s the recording of this week’s webinar titled “How to Create Healthcare Apps That Get Used and Maybe Even Loved.”

Acquisitions, Funding, Business, and Stock

Agfa’s board will enter non-exclusive discussions with CompuGroup Medical about being acquired. CGM’s CFO said Wednesday, “It’s either up or out (for the hospital information system business). If you wanted to step up and become a high-profitability, high-growth player, the position that our friends in Agfa have would be the number one choice.” Meanwhile, I’m pondering why Agfa’s logo lists the company’s name twice.

Sunquest acquires Sandy, UT-based UniConnect, which offers software for molecular laboratories.

Sales

Carrus Hospital (TX) selects Nuance Power PDF to create, convert, and assemble PDF files.

Banner Health Network (AZ) chooses Evolent Health’s care performance management platform.

People

Mike Tarwacki (Forte Research Systems) joins Ability Network as SVP of sales.

Announcements and Implementations

A Red Hat survey finds that 82 percent of large healthcare organizations have fully implemented a mobile strategy, a much higher rate than non-healthcare business, and 80 percent of them say their ROI is positive. However, budgets aren’t keeping up with their development and maintenance plans. The biggest reported technical challenges are back-end integration and securing data access.

Government and Politics

A Health Affairs article says a Donald Trump presidency with Republican control over both houses can’t immediately kill the Affordable Care Act despite the President-Elect’s statement that he will ask Congress for its repeal the day he takes office. The article notes that such a proposal would likely be stopped by a Senate filibuster and adds that the ACA is so deeply ingrained into Medicare and other programs that it can’t simply be rolled back. However, funding for specific parts of “Obamacare” could be cut off, preserving features like coverage of pre-existing conditions, elimination of lifetime dollar caps, and age underwriting restrictions intact but leaving insurers to deal with their financial implications. The newly elected president will also need to quickly replace HHS’s many political appointees with people who might choose not to enforce regulatory requirements and could make it easier for states to pull out completely. The administration could also elect to drop its defense of ACA-related lawsuits, which could, as an example, immediately halt cost-sharing reduction payments to insurance companies in making marketplace participation undesirable to eliminate participation. Experts seem to agree that there’s little doubt that the Obamacare portion of the ACA will go away, with no firm proposals on the table to replace the health insurance carried by 20 million people.

Meanwhile, ACA sign-ups hit record levels the day after the election as people fretted less about skyrocketing premiums and more that the pre-existing condition policies could come back and leave them uninsurable.

Anad Sharma, the founder of iPhone health tracking app vendor Gyroscope, is among a group of California technology company executives who say they’ll financially back the so-called #Calexit fringe movement in which California would secede from the US in protest of Donald Trump’s election.

Former bad boy pharma exec Martin Shkreli follows through on his promise to publicly play his $2 million, one-copy-only Wu-Tang Clan album if Donald Trump were to win the election, calling Trump’s victory “fantastic.”

The VA will launch online appointment scheduling in January 2017, using a system developed internally by the VA along with Accenture Federal Services.

Privacy and Security

From DataBreaches.net:

• Broward Health (FL) is notified by law enforcement authorities that its patient facesheets were found at the home of an unidentified individual.
• The Eastern Colorado VA system says the names and diagnoses of 2,100 veterans were exposed when one of its employees emailed unencrypted documents to her personal email account.
• In Canada, the privacy commissioner of Newfoundland and Labrador orders Eastern Health to implement mandatory user log-outs and to consider proximity-based security after someone accesses patient information using the still-active Meditech session of a doctor who had left the area for rounds.

Other

The Madison paper covers a new bus service that targets Epic commuters with hardwood floors, free coffee, Wi-Fi, and a widescreen TV.

The USDA celebrates Allene Rosalind Jeanes, PhD (1906-1995), an agricultural chemist who was asked by a soft drink company to figure out why a batch of its root beer had thickened, leading her to develop a manufacturing process for the life-saving plasma substitute dextran. She and her team also discovered xanthan gum, used to thicken ice cream, medicines, and other products.

Weird News Andy is ‘appy this didn’t ‘appen in England since “first, do no ‘arm” wouldn’t be convenient. A plastic surgeon in China grows an artificial ear on a man’s arm that will eventually replace the one he lost in an accident.

Sponsor Updates

• Valence Health will exhibit at the AMGA Institute for Quality Leadership November 15-17 in San Francisco.
• Verscend will exhibit at the NHCAA Annual Training Conference November 16-19 in Atlanta.
• Optimum Healthcare IT is mentioned positively in the KLAS Healthcare Consulting 2016 report.
• Group health extends its ZeOmega contract and will upgrade to the latest version of its Jiva population health platform.
• ZirMed will exhibit at Wave 2016 November 17-18 in Austin.
• Hilo Medical Center (HI) moves procedure consents to Web-based forms and electronic signatures from Access.
• Zynx Health will exhibit at Cerner Health Conference 2016 November 12-16 in Kansas City, MO.
• Sunquest will exhibit at the Association for Molecular Pathology Annual Meeting November 10-12 in Charlotte, NC.
• Consulting Magazines names Impact Advisors VP Jenny McCaskey one of the “Women Leaders in Consulting” of 2016.
• NCQA recertifies 17 Medecision disease management programs.
• Imprivata, National Decision Support Company, and MedCPU will exhibit at Cerner Health Conference 2016 November 14-17 in Kansas City, MO.
• LogicStream Health will host a networking event for Cerner Health Conference attendees November 15 at the Drum Room.
• InterSystems will exhibit at AMP’s annual meeting November 10-12 in Charlotte, NC.
• Intelligent Medical Objects, Meditech, and Streamline Health will exhibit at the AMIA 2016 Annual Symposium November 12-16 in Chicago.
• Kyruus will host its annual ATLAS Conference November 14-15 in Boston.
• The Kansas City Business Journal profiles Netsmart.
• Obix Perinatal Data System will exhibit at the HIMSS Midwest Fall Technology Conference November 13-15 in Bloomington, MN.
• Experian Health will exhibit at HFMA North Dakota November 12-13 in West Fargo.
• The SSI Group will exhibit at the 2016 HFMA Mid-Atlantic Region Meeting November 13-16 in Asheville, NC.
• SK&A publishes a new report, “Top 50 Free-Standing Surgery Centers.”

Blog Posts

• What is Ransomware and How to Protect Against It (TierPoint)
• Key Takeaways from the CHIME 2016 Fall CIO Forum (Infor)
• Let’s get it started! (Voalte)
• Choosing the Right SMS Provider 4 U (West Corp.)
• A Legacy of Care: Honoring Hospital Contact Center Operators (Spok)
• Top 5 Ways to Reduce and Manage Medical Necessity Denials (ZirMed)
• Assessing Data Breach Severity: Third-Party Incident Exposes Credit Card Data (ID Experts)
• Online Reviews Impact How Patients Select Hospitals and Doctors (Influence Health)
• And the Winner of the 2016 Election is … Big Data (Liaison Healthcare)
• Happy Employees Make Happy Patients (MedData)
• Countdown: Top 5 Reasons to Provide Price Estimates (Navicure)
• Gathering and Storing Healthcare Information: The First Step in the Journey Towards Integrated Care (Orion Health)
• Plug-in Payments: Why Practices Should Integrate Their Hardware, Software, and Processing Agreement into a Single Technology Platform (Patientco)
• Back from the Honeymoon (PeriGen)
• Leveraging SharePoint and Project for Collaborative Project Planning (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 11/9/16

Top News

The Charlotte, NC paper confirms the reader rumors I ran on October 28 that McKesson has laid off 60 employees in its Enterprise Information Solutions (Paragon) business.

Reader Comments

From Look Now: “Re: Shriners Hospitals for Children. Signed a contract with Cerner to implement their EDW solution HealtheIntent across their 21 hospitals live on Millenium. Project started this week.” Unverified.

Webinars

November 9 (Wednesday) 1:00 ET. “How to Create Healthcare Apps That Get Used and Maybe Even Loved.” Sponsored by MedData. Presenter: Jeff Harper, founder and CEO, Duet Health. Patients, clinicians, and hospital employees are also consumers who manage many aspects of their non-medical lives on their mobile devices. Don’t crush their high technology expectations with poorly designed, seldom used apps that tarnish your carefully protected image. Your app represents your brand and carries high expectations on both sides. This webinar will describe how to build a mobile healthcare app that puts the user first, meets their needs (which are often different from their wants), creates “stickiness,” and delivers the expected benefits to everyone involved.

Contact Lorre for webinar services. View previous webinars on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

NantHealth reports Q3 results: revenue up 76 percent, EPS –$0.30 vs. –$0.24, beating earnings expectations but falling short on revenue.

Siemens Healthineers acquires Conworx Technology, a Berlin-based developer of point-of-care testing device interfaces.

Clinical communication platform vendor Doc Halo opens its new corporate headquarters in Cincinnati, OH, committing to adding 65 positions in the next few months.

Silicon Prairie News profiles Kearney, NE-based provider management software vendor Phynd, which chose that location because its software developer Expanxion is located there.

Walgreens files a $140 million lawsuit against Theranos, claiming that the lab company violated confidentiality agreements about their partnership to offer lab testing in Walgreens drugstores in Arizona. Theranos responded by saying that Walgreens mishandled the partnership and says it will “hold Walgreens responsible to the damage it has caused to Theranos and its investors.”

Sales

Grand River Hospital (Ontario) selects Wellsoft’s EDIS.

People

Ann Mendlowitz (Leidos Health Consulting) joins Orchestrate Healthcare as VP of EMR consulting services.

Telehealth technology vendor Zipnosis hires Scott Brown (Ulfbehrt Software Systems) as CTO.

Announcements and Implementations

ECRI lists its “Top 10 Health Technology Hazards for 2017:

1. IV pump errors (hardware failure, staff overriding safety features, and nurse programming mistakes).
2. Improper cleaning of reusable instruments.
3. Missed ventilator alarms due to alarm fatigue or notification failures.
4. Undetected opioid-induced respiratory depression.
5. Infection risks from cardiothoracic surgery heater-cooler systems.
6. Software management gaps.
7. Radiation exposure to clinicians working in operating suites that have built-in imaging systems.
8. Automated medication dispensing cabinet setup and use errors.
9. Surgical stapler misuse and malfunction.
10. Device failures caused by cleaning products and practices.

Burke Mamlin, MD and Paul Biondich, MD of Regenstrief Institute will receive AMIA’s Donald A.B. Lindberg Award for Innovation in Informatics this week for their work in developing and using open source software in developing countries.

New York – Presbyterian adds video visit services to its app, offering virtual visits and the ability to ask an ED physician about minor illnesses that may or may not require an in-person ED visit.

Government and Politics

ONC publishes its annual report to Congress.

A JAMA opinion piece by two top FDA officials and CMS Acting Administrator Andy Slavitt says FDA and CMS are coordinating FDA’s approval of drugs with CMS’s decision to pay for them. They urge that clinical trials include diverse populations; that healthcare delivery data from EHRs, claims, and registries be used to reduce the cost of generating evidence and to study more representative populations, and that public-private collaboration groups such as PCORI lead efforts to integrate broader evidence generation into practice.

In New Zealand, the Ministry of Health hires an Accenture-led consortium to help it create a business case for a national EHR.

Privacy and Security

Madison County, IN officials will pay the ransom demanded by an unknown hacker when their systems are taken offline by ransomware. The county’s insurance company recommended payment and will cover part of the cost. Some county offices went back to paper, while others closed due to lack of computer access.

Other

A New York Times article questions whether the US really has a doctor shortage despite low numbers of practicing physicians and medical school slots. Instead, it says, we have a distribution problem in which doctors prefer to live in big cities (often where they trained and are paid more by Medicare for practicing there) and we have too many specialists as high medical school debt steers new graduates into more lucrative areas of practice. The article offers solutions: (a) train more doctors or allow more to immigrate; (b) decrease the number of specialty residency positions and pay primary care doctors more; (c) improve the efficiency of the healthcare system, changing regulations and licensing to use more mid-level practitioners. 

Ram Raju, MD, CEO of the financially hemorrhaging New York Health and Hospitals, will resign.

The annual physician compensation survey of ECG Management Consultants finds that the income of PCPs and specialists increased by 1.5 percent and 3.6 percent, respectively, in the past year. Most respondents say their compensation models will incorporate value-based metrics such as quality, patient satisfaction, panel size, and adherence to evidence-based medicine.

In Australia, the first three sites to go live on the Allscripts-powered EPAS system go down for nine hours when a software module “consumed the bulk of all the computer resources.”

Sponsor Updates

• Aprima will exhibit at the Practice Management Institute November 9-11 in Las Vegas.
• Catalyze CEO Travis Good will present at Voalte’s VUE16 user conference November 9-11 in Sarasota, FL.
• Medicomp Systems recaps its annual training event that was held October 3-7 in Bangkok, Thailand.
• Besler Consulting releases a new podcast, “The relationship between EMR and physician documentation.”
• CoverMyMeds COO Michelle Brown will speak at the BioOhio Women in Bioscience Conference November 9 in Columbus.
• Visage Imaging will demonstrate its Visage 7 Enterprise Imaging Platform at RSNA later this month.
• Wolters Kluwer redesigns its UpToDate online clinical decision support website to give clinicians who can’t use the company’s app a robust, Web-based alternative.
• Impact Advisors VP Jenny McCaskey is named is named to “Women Leaders in Consulting.”
• Crossings Healthcare Solutions will exhibit at Cerner Health Conference 2016 November 14-17 in Kansas City, MO.
• Cumberland Consulting Group’s Lori Nobles will present at the NCHIMA Mid-Year Workshop November 11 in Concord, NC.
• The success of National Decision Support Company CareSelect Imaging users will be highlighted at Cerner Health Conference 2016 November 14-16 in Kansas City, MO.
• Direct Consulting Associates and HealthCast Solutions will exhibit at the HIMSS Midwest Fall Conference November 13-15 in Bloomington, MN.
• Dimensional Insight and Extension Healthcare will exhibit at the HIMSS South Florida InteGrate Conference November 14-15 in Davie, FL.
• EClinicalWorks will exhibit at the Kentucky Primary Care Association 2016 Conference November 9-11 in Lexington.
• Impact Advisors publishes a white paper titled “The MACRA Final Rule: Key Takeaways on MIPS and Advanced APMs.”
• Healthwise’s Leslie Hall will present at Partnering for Cures November 13-16 in New York City.

Blog Posts

• E-Prescribing Has Arrived But It Really Has Not Taken Off – Yet (First Databank)
• #IDoR: Reaping the benefits of collaboration and long-term partnerships (Agfa Healthcare)
• The State of Healthcare in Massachusetts (Arcadia Healthcare Solutions)
• MACRA Final Rule: What You Need to Know (CareSync)
• Four Steps to Value (ECG Management Consultants)
• GRHD Optimizes TouchWorks V11 Notes and Transitions into ICD10 (Galen Healthcare Solutions)
• The Top 10 Reasons Transformation is the New Normal for Healthcare – Reason 5 (GE Healthcare)
• The Three C’s of Clinical Care – Clarity, Collaboration, and Communication (Hayes Management Consulting)
• Predictive Analytics NYC’s Key Word – Impactability (HBI Solutions)
• EMR Post Go-Live Support: Why You Need a Clinical Service Desk & Analytics (HCI Group)
• Robot Overlords in Healthcare? Not Likely. And Not Us. (Healthfinch)

Contacts

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

Monday Morning Update 11/7/16

Top News

The Gordon and Betty Moore Foundation awards the non-profit ECRI Institute and its Partnership for Health IT Patient Safety a $3 million, three-year grant to study ways to optimize EHRs while avoiding patient harm.

The foundation said in the announcement, “With the increasing presence of health IT in all aspects of health care, we need to remain mindful of safety issues that are unintended consequences of this new technology. We are happy to see the Partnership advising health IT developers, users, and policymakers on how to optimize technology and avoid patient harm.”

The Partnership previously analyzed patient safety incidents that were reported to ECRI’s patient safety organization and issued recommendations for using copy-and-paste in EHRs. Its advisory panel includes experts such as David Bates, MD, MSc; Peter Pronovost, MD, PhD; Hardeep Singh, MD, PhD; Dean Sittig, PhD; and Paul Tang, MD, MS.

HIStalk Announcements and Requests

Only 20 percent of poll respondents think FHIR will have a lot of impact on interoperability. Cosmos, who works for an EHR vendor, says APIs are like wall sockets in that you can plug in anything and it just works even if you don’t know anything about electricity, with the potential that FHIR can power a new generation of plug-and-play connected health tools. Mobile Man says interoperability has never been a technology problem and ManAboutTown agrees that interoperability will occur only as healthcare’s business models change. Furydelobongo suspects he or she won’t live long enough to see true interoperability where information flows to the point an entry in System A shows up in System B as though it were natively entered there, opining that a unified view isn’t enough. HIT Geek provided a thoughtful response:

FHIR is an API specification. It does not specify how data gets to the API, nor what happens after a corresponding API receives it. Being stateless, it does not support a workflow with state transitions, nor coordination of multiple related actors. The data vocabularies referenced in FHIR, such as clinical code sets, are not controlled within the FHIR standard. The underlying RESTful transport specifications for FHIR are also not controlled within FHIR. The corresponding EMRs, IHRs, and PHRs are outside of the standard, And it says nothing about the end-user interfaces needed to create, read, and update data. The policies and regulations envelope for FHIR is a political and organizational crazy quilt, inhibiting interoperability even if FHIR supports it. Similar things could be said about HL7 v2 and v3, including CDA. While FHIR promises to resolve some technical issues, and that’s certainly a necessary piece of the puzzle, we still have a lot else to do. The referenced and supporting standards for FHIR are relatively easy to coordinate, but will require ongoing effort. FHIR itself will need to evolve to incorporate changes in health care data, also with ongoing effort. Permanent sources of funding for the work, and willing participants, are needed. Volunteerism needs to be obtained from a wider set of sources and disciplines, including patients. Dealing the crazy quilt is the most difficult problem. It’s a whack-a-mole with more moles than whackers.

New poll to your right or here: how well managed did the medical practice where you most recently seen appear to be? Dr. Jayne loves hearing first-person stories, so click Comments after voting and describe what you experienced. 

Jenn is working on a story about telemedicine and would like to hear from doctors who have provided those services. Let me know if you have time for a quick chat (anonymously if you’d rather). We know what a video or telephone visit is like for a patient, but what’s involved on the other side?

Thanks to Optimum Healthcare IT, Validic, and Healthwise for signing up as sponsors of HIStalkapalooza on Monday of HIMSS week. Contact Lorre to join them – I appreciate the help in covering the cost and we can accommodate most any budget.

Mrs. W says her South Carolina fifth graders used the math games we providing in funding her DonorsChoose grant request to prepare for state testing, adding, “This was by far the most fun and pumped up math review that I have ever been able to lead thanks to your generous donation … Every day they would ask as they walked into class if we were going to get to play the math games that we received thanks to our donor on DonorsChoose.”

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

Listening: new from Deap Vally, all-female grunge that sounds sort of like Janis Joplin covering Black Sabbath in Courtney Love’s basement. Also: new from Nick Cave & The Bad Seeds.  

Last Week’s Most Interesting News

• McKesson, Allscripts, and Cerner post disappointing quarterly results.
• NTT Data completes its acquisition of Dell Services.
• CMS publishes changes to the EHR Incentive Program that will allow returning participants to use a 90-day reporting period.
• Athenahealth lays off nearly 150 employees.
• A hospital in Canada pays doctors extra to keep using its Cerner system after they voice patient safety and productivity concerns.
• CompuGroup Medical announces its interest in acquiring Agfa.

Webinars

November 8 (Tuesday) 1:00 ET. “A CMIO’s Perspective on the Successful 25 Hospital Rollout of Electronic Physician Documentation.” Sponsored by Crossings Healthcare. Presenter: Ori Lotan, MD, CMIO, Universal Health Services. UHS rolled out Cerner Millennium’s electronic physician documentation to its 6,000 active medical staff members — 95 percent of them independent practitioners who also work in competitor facilities — across 25 acute care hospitals. UHS’s clinical informatics team used Cerner’s MPage development toolkit to improve the usability, efficiency, communications capability, and quality metric performance of Dynamic Documentation, embedding clinical decision support and also using Nuance’s cloud-based speech recognition product for the narrative bookends of physician notes. This CMIO-led webinar will describe how UHS achieved 70 percent voluntary physician adoption within one month of go-live, saved $3 million in annual transcription expense, and raised EHR satisfaction to 75 percent. It will include a short demonstration of the software that UHS developed to optimize the physician experience.

November 9 (Wednesday) 1:00 ET. “How to Create Healthcare Apps That Get Used and Maybe Even Loved.” Sponsored by MedData. Presenter: Jeff Harper, founder and CEO, Duet Health. Patients, clinicians, and hospital employees are also consumers who manage many aspects of their non-medical lives on their mobile devices. Don’t crush their high technology expectations with poorly designed, seldom used apps that tarnish your carefully protected image. Your app represents your brand and carries high expectations on both sides. This webinar will describe how to build a mobile healthcare app that puts the user first, meets their needs (which are often different from their wants), creates “stickiness,” and delivers the expected benefits to everyone involved.

Contact Lorre for webinar services. View previous webinars on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

From the Allscripts earnings call:

• Sales dropped off unexpectedly as clients held off purchases and upgrades in waiting for CMS to publish its final MACRA rule, although the company does not expect MACRA itself to drive incremental software sales.
• Netsmart’s bookings were down from the previous quarter, which the company attributes to seasonality and deal delays.
• RCM services bookings were up 90 percent quarter over quarter.
• The company sees big opportunity in selling RCM services to its ambulatory EHR customers.

Meal planning app vendor Zipongo raises $18 million in a Series B funding round, increasing its total to $28 million. The founder and CEO is Jason Langheier, MD, MPH.

Leidos posts Q3 results: revenue up 44 percent, adjusted EPS $1.25 vs. $0.74, beating earnings expectations but falling short on revenue. Chairman and CEO Roger Krone mentioned the DoD’s MHS Genesis project in explaining that it will contribute lower revenue next year:

I want to make sure that you understand what we said is that relative to revenue, we don’t see the program being delayed. What we’re doing is we’re actually maturing some of the software, we’re conducting some more tests, we’re doing some cyber scans. And so the installation at the first facility will be a few months later than we had anticipated, but the level of activity is essentially the same. And the entire program if you think about deployment to all of the facilities within the Department of Defense will essentially remain on track. So we’ll be a little bit later on the first couple facilities, but we expect to pick that back up as we go into the implementation phase.

Sales

The Joint Commission chooses Clinical Architecture’s Symedical terminology management platform for semantic normalization, mapping, and value set creation.

Get Real Health will use technology from Validic to add patient-generated health data to its patient engagement offerings.

Decisions

• Missouri Delta Medical Center (MO() will replace Infor with Premier for supply chain management in March 2017.
• UMass Memorial Medical Center (MA) is underway with a PACS change from Philips to Agfa.
• Throckmorton County Hospital (TX) changed EHR and revenue cycle systems from CSS Health Technologies to CPSI Evident in January 2016.

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

People

Lisa Stump is promoted to SVP/CIO of Yale New Haven Health System after holding the interim role since November 2015.

Government and Politics

CMS Acting Administrator Andy Slavitt in a Friday speech to a pharma group expresses his candid opinion about drug prices:

You know, last year when I spoke here, the price increases at Turing were making news, and I told you I didn’t want this industry to be defined by its worst actors. I defended the industry then, but the more data that’s revealed, the more bad actors you find, and I’m telling you now: it’s too many … Drug costs have become the health policy issue Americans are most anxious to see us act on, and we have a responsibility to them to explore all the options available us to make their medications more affordable. I hear occasionally from some that life sciences needs to tell its “value story” better. Perhaps. But it also needs to do the math. If something is growing by 11 percent, unless it’s causing something else to decrease by 12 percent, it’s not going to last forever. The reality is that in the next few years these costs will put unsustainable pressure on the Medicare program and action is going to be necessary to address them.

China-based laboratories are feeding America’s drug addiction by creating new designer opioids faster than the Drug Enforcement Administration can declare them illegal, allowing addicts to buy them semi-legally and inexpensively over the Internet without seeking out street dealers. Several hundred people have died from known popular drugs like U-47700 and various forms of fentanyl. The labs get their recipes from old drug company research papers that describe painkillers that were never marketed. Ironically, U-47700 was studied by drug company Upjohn as a less-addictive painkiller but was never developed because it had the same addictive properties and side effects as other opioids, exactly what the copycat chemists want.

Privacy and Security

In England, Papworth Hospital describes its near-miss with ransomware infection after an employee clicks on a malicious email link, allowing the malware to spread via file shares. The ransomware started encrypting the hospital’s files just after its midnight backup had completed, allowing it to quickly restore its systems from its fresh copy. The hospital changed to hourly incremental backups using tape since ransomware often encrypts backups digital backups along with everything else.

Technology

I’m not sure I need to replace my old iPhone 5, but Wired magazine says the Google Pixel is the best smartphone on the market, giving the company perfect timing as Samsung goes up in smoke and Apple putters around with yawn-inducing iPhone tweaks. The Pixel comes with a “Quick Switch Adapter” for moving everything over, includes deep Google integration, charges for seven hours of use in just 15 minutes, offers Google Assistant that sounds smarter than Siri, and provides a best-in-class camera. I may have to check it out at Best Buy since AT&T isn’t selling it yet.

Other

Medical device manufacturer Medtronic donates $5 million to the Patient Safety Movement Foundation to help the organization pool de-identified patient data collected from the devices sold by several companies to improve patient safety via predictive analytics.

MD Anderson Cancer Center will lose $450 million in FY2017 following a $267 million loss in FY2016, according to an internal report obtained by The Cancer Letter. The report blames four factors, starting with the cost of its Epic implementation.

Coulee Medical Center (WA) cancels its Meditech upgrade when the project’s cost swells from the budgeted $1.3 million to at least $4 million. The 25-bed hospital says it didn’t understand the extra costs required for third-party software, with the CEO likening the project to buying “a car without an engine, brakes, or exhaust.” The hospital will keep its existing Meditech system even though it’s on the hook to pay licensing fees for the new system it won’t use.

The local paper says the switch from Hitachi to EMC storage at Fairview Health Services (MN) has caused three crashes of Epic in the past year, the most recent lasting 10 hours.

A new Peer60 reports finds that 90 percent of hospitals have an analytics strategy, but it ranges from a piecemeal approach with multiple vendors to homegrown systems to a single enterprise approach. The short-term replacement market for data visualization and enterprise analytics is significant, but consulting services and data warehouses have less short-term demand. Health Catalyst and Cerner are the strongest healthcare-specific vendors.

A researcher develops a tool to identify which drug companies and universities aren’t publishing the results of their clinical trials, which it determined by matching the studies registered on ClinicalTrials.gov with results published there or in PubMed-covered journals.

The US Marine Corps profiles use of its TMIP-MC battlefield EHR, recently testing during the DoD’s Global Medic joint patient movement and medical field training exercise at Fort McCoy, WI. Information from the training exercise will be used in designing its MHS Genesis replacement.

Sutter Health notifies San Francisco area employers that it won’t offer in-network prices to their employees unless the companies sign an arbitration clause that waives their right to sue Sutter over pricing issues. Healthcare software vendor Castlight Health received one of the letters from its plan administrator Anthem (above) even through it is self-insured and has no direct relationship with Sutter. Castlight’s general counsel says Sutter is flexing its market dominance with prices that are 25 percent higher than those of other hospitals. Castlight hasn’t decided if it will sign the letter, but says declining to do so would allow it to “maintain our flexibility in fighting against what we consider to be difficult, anti-consumer provisions in provider networks.”

Southampton Hospital (NY) bans political conversations in its cardiac rehab gym following an incident in which a treadmill-using patient was stuck between two people arguing over Trump versus Clinton for 15 minutes.

Sponsor Updates

• Smart Business Magazine includes TeleTracking COO Diane Watson in its “Smart 50” list of executives.
• TierPoint gains traction in new Gartner DRaaS report.
• Valence Health will exhibit at the Children’s Hospital Association Annual Leadership Conference November 7-9 in Phoenix.
• KLAS rates Voalte a top platform vendor for improved care team communication.
• Huron Consulting Group representatives will present at the Children’s Hospital Association Annual Leadership Conference November 7-9 in Phoenix.

Blog Posts

• Jellyfish, Sharks, ERs and Too Many Paper Forms (Access)
• DxCG is a top performer in the new Society of Actuaries Study (Verscend)
• 3 Things I Learned at AHIMA This Year (VitalWare)
• How to Deliver a Better Contact Center User Experience (West Corp.)
• Health IT security in the age of criminal cyber hacking (Xerox)
• Getting a head start: Now is the ideal time to jump on MACRA quality reporting (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 11/4/16

Top News

Allscripts posts Q3 results: revenue up 11 percent, adjusted EPS $0.14 vs. $0.13, missing analyst expectations for both. The company also issued disappointing earnings guidance.

Allscripts shares are down 17 percent in the past year and have dropped 44 percent in the past five years. The company’s market value is $2.16 billion.

Netsmart contributed $38 million in revenue for the quarter. Allscripts and a private equity firm acquired the behavioral EHR vendor in April 2016 for $950 million and merged it with the homecare software business of Allscripts with the expectation of generating $250 million in annual revenue and $60 million in annual profit, although the Allscripts ownership stake was not specified. Netsmart acquired LTPAC EHR vendor HealthMEDX on October 27, 2016 for $36.3 million in cash.

Allscripts competitor Cerner also posted disappointing results this week.

Reader Comments

From JB: “Re: data blocking. A Politico piece claims Epic and EClinicalWorks are impeding the sharing of data with public and specialty registries. It’s surprising that EMR suppliers aren’t going full-tilt toward open practices given regulatory pressures and pending VA procurement.” Epic says it has a problem with the for-profit companies behind medical association registries that also sell analytics software and apparently patient data. Epic and Practice Fusion say they will submit CCDs, but registry companies complain that CCDs don’t include all the information they need and a fully automated process would require EHR vendor customization. As is always the case, the patient is excluded from the vendor-vendor bickering even though the data in question (although not necessarily the benefit from its use) is theirs. The largely overlooked open.epic.com lists the public health registries to which Epic offers standard integration. There’s also the question of whether specific EHR vendors don’t allow submission of data at all (which is apparently sometimes true in Epic’s case) or simply charge EHR users extra to do so (like EClinicalWorks). Epic is the crown jewel since its refusal to participate means that large academic and government projects (including the FDA’s planned medical device monitoring program) are missing the information of the largest health systems. A point to note: correctly or not, I’ve never seen Cerner mentioned even once as a problem – it’s nearly always Epic and EClinicalWorks that come up, such as in the AMA’s proposed policies to be discussed in its upcoming meeting that call out those vendors specifically (see above).

From David Watson: “Re: Memorial Health System in southeastern Ohio. We have deployed Meditech 6.15, including ambulatory, of which we are Meditech’s largest client. Physicians and staff alike have joined together with a small army of technology folks committing hundreds of hours to design, build, test, and validate a comprehensive solution. We appreciate their dedication to delivering a system that enhances MHS’s ability to provide exceptional patient care.” Congratulations to MHS and David, who joined the system in July after coming over from Duke.

From Chatty Kathy: “Re: online chats. I would like to see HIStalk provide scheduled ones for readers to share information.” I’m not a fan of Twitter for that purpose since it’s kind of kludgy, but perhaps other tools exist – YouTube and Facebook Live for video chats, GoToWebinar or conference calls for voice chats, and probably something other than Twitter for text chats. I’m skeptical at the level of demand for something like that since Twitter and Facebook seem to draw mostly people who aren’t decision-makers or influencers who just supportively stroke each other’s egos, but I’m open to ideas. My best one to use a moderated GoToWebinar session (one recognized speaker at a time) with the conversation transcribed afterward.

HIStalk Announcements and Requests

I admit as a card-carrying curmudgeon that I don’t understand why people identify emotionally with sports teams as though they are more than just their paying customers (except maybe for the community-owned, non-profit Green Bay Packers). The most brilliant marketing strategy in history was to brand companies that hire athlete-entertainers with city names, which profitably confuses locals into mustering misplaced civic pride in saying “we won” instead of the accurate “they won while I watched” (I’ll skip my usual porn analogy). Still, Cubs fans seem pretty excited, so perhaps their lives are now complete and at least Facebook will become nearly tolerable again once the World Series and the election are over. I lost what little interest I had when I heard that Charlie Sheen wouldn’t be allowed to reprise his “Wild Thing” Rick Vaughn character to motivate the Indians, although apparently there were some Jobu sightings.

I’m looking at tweets and streaming video as Robert Herjavec of “Shark Tank” (and founder of two IT security companies) presents at the CHIME Fall CIO Forum in Phoenix. He’s going to be a winner at HIMSS17, along with his co-star Kevin O’Leary. I watch “Shark Tank” only when traveling since as a cord-cutter I can’t get it, but those guys (and their fellow sharks) are insightful and entertaining. The recently released book by the “nice shark” gets pretty good reviews on Amazon, although the “look inside” preview shows mostly the wide-margin, collaborator-written chattiness that boosts page count without necessarily imparting additional wisdom. The CHIME tweets also make it obvious that, as is the case with HIMSS, vendors get a lot of influence, podium time, and questionably designated awards in return for their financial support. The CHIMErs were set to rock out (air quotes optional) Thursday night to Foreigner, featuring the band’s one remaining 71-year-old member from its late-1970s heyday. The best thing I can say about Foreigner is that at least they aren’t Journey.

This week on HIStalk Practice: AdvancedMD includes telemedicine capabilities in its new technology suite. Humana adds EliteHealth primary care practices to its Medicare network. Navicure’s Jeff Wood believes healthcare consumerism is finally taking off. Frederick Primary Care Associates joins Privia Medical Group. Manna Health Professional Services rebrands. MedStar National Rehabilitation Network selects WebPT tech. CMS figures out a way to pay PCPs for more time spent with patients and better coordinated care.

Webinars

November 8 (Tuesday) 1:00 ET. “A CMIO’s Perspective on the Successful 25 Hospital Rollout of Electronic Physician Documentation.” Sponsored by Crossings Healthcare. Presenter: Ori Lotan, MD, CMIO, Universal Health Services. UHS rolled out Cerner Millennium’s electronic physician documentation to its 6,000 active medical staff members — 95 percent of them independent practitioners who also work in competitor facilities — across 25 acute care hospitals. UHS’s clinical informatics team used Cerner’s MPage development toolkit to improve the usability, efficiency, communications capability, and quality metric performance of Dynamic Documentation, embedding clinical decision support and also using Nuance’s cloud-based speech recognition product for the narrative bookends of physician notes. This CMIO-led webinar will describe how UHS achieved 70 percent voluntary physician adoption within one month of go-live, saved $3 million in annual transcription expense, and raised EHR satisfaction to 75 percent. It will include a short demonstration of the software that UHS developed to optimize the physician experience.

November 9 (Wednesday) 1:00 ET. “How to Create Healthcare Apps That Get Used and Maybe Even Loved.” Sponsored by MedData. Presenter: Jeff Harper, founder and CEO, Duet Health. Patients, clinicians, and hospital employees are also consumers who manage many aspects of their non-medical lives on their mobile devices. Don’t crush their high technology expectations with poorly designed, seldom used apps that tarnish your carefully protected image. Your app represents your brand and carries high expectations on both sides. This webinar will describe how to build a mobile healthcare app that puts the user first, meets their needs (which are often different from their wants), creates “stickiness,” and delivers the expected benefits to everyone involved.

Contact Lorre for webinar services. View previous webinars on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

Recondo Technology raises $16 million in debt and capital funding to further develop API-enabled RCM, expanded claims statusing, and authorization automation.

From the Cerner earnings call:

• The company’s revenue shortfall was due to lower technology resale and software sales.
• Cerner expects to spend $30 million on a Q4 voluntary separation plan, estimating that 2 percent of employees will be affected. The company advises that “this should not be viewed as a layoff or a sign that we don’t expect to grow.”
• The company expects strong contributions from RCM and population health management technology, adding that HealthIntent mostly involves small contracts since most providers aren’t at risk for most of their populations.
• Cerner says it earned a noteworthy ambulatory win in displacing Athenahealth for ambulatory EHR and business services at what the company believes is Athenahealth’s largest customer, also replacing Athena at two other sites.
• The company blames lower software sales on the lack of MU-driven urgency among prospects, along with lower contributions from ITWorks and RevWorks.
• Cerner believes its DoD project gives it a strong competitive advantage if and when the VA decides to replace VistA.
• The company says its DoD revenue is steady but not significant, but completion of milestones in 2017 will add some modest-sized additional bookings.
• Cerner says population health represents a “very little piece of bookings growth” and that those deals of $5 million and under don’t change the overall bookings number much.

Tokyo, Japan-based NTT Data completes its $3.1 billion acquisition of Dell Services, renaming the business NTT Data Services. It was the former Perot Systems, acquired for $3.9 billion in 2009 by Dell, which apparently either overpaid or underperformed in bleeding off a large chunk of its value before offloading it to buy EMC.

Analytics vendor Inovalon (known as MedAssurant until 2012 and acquirer of Avalere Health) reports Q3 results: revenue flat, adjusted EPS $0.10 vs. $0.09, beating revenue expectations but falling short on earnings. Shares rose sharply on the news, but are still down 24 percent in the past year.

Israel-based equity crowd-funding organization OurCrowd launches a $50 million digital health fund with Johns Hopkins that will invest in early stage Israel-based companies. Accredited investors can invest as little as $10,000 in each company with pre-emptive rights to future fundraising.

Sales

Inspira Health Network (NJ) chooses Cerner Millennium, HealtheIntent, and remote hosting, replacing the former Siemens Soarian.

Penn State Health’s Hershey Medical Center (PA) will implement Cerner Millennium Revenue Cycle.

St. Claire Regional Medical Center (KY), Mary Rutan Hospital (OH), and Bella Vista Hospital (PR) will upgrade to Meditech’s Web EHR.

The DoD’s Dental Information Systems Center chooses the Dicom Systems Unifier Archive VNA.

In England, University College London Hospitals NHS Foundation Trust chooses Epic to replace GE Healthcare Centricity, citing interoperability as a key factor going with Epic instead of Cerner.

Announcements and Implementations

Great Lakes Health Connect will offer researchers access to “remnant specimens” from lab tests by matching them with patients who match their requests and who have consented to make their de-identified information available.

Catalyze participates in the HITRUST CSF Inheritance Program that allows its customers to demonstrate their security measures without doing their own testing.

Fortified Health Solutions renames itself to Fortified Health Security and launches new offerings of a virtual information security program, managed loss data prevention, and security event monitoring.

Telemedicine provider HealthTap announces an app developer platform that connects to telemedicine, health data exchange, CRM, and content. The company is also working on a blockchain product.

Mount Sinai Health System (NY) launches Rx Universe, a catalog of curated, evidence-proven mobile health apps that physicians can prescribe. The health system has launched a company, Responsive Health, that will license the app prescribing platform to other health systems.

Government and Politics

I’m really going to miss Acting CMS Administrator Andy Slavitt when he leaves the job in January. His comment above came when he was asked  why the drug industry is the only group complaining about a national test of a YMCA diabetes prevention program. He also describes healthcare cost issues in Thursday remarks to the American Academy of Actuaries:

Transparency into costs is important in a world where more people are paying their own premium. Hospital profits in many cases are double or more what they were before the ACA. Drug costs are growing at record levels. And there are more endemic issues like the costs of untreated chronic diseases like diabetes or the large “tax” the fee-for-service system imposes on us when care isn’t coordinated or when bad quality is delivered. While people may not equate these costs or inefficiencies to the premiums they pay each month, we need to make those connections clear that this is where the real work needs to happen.

ONC names the 10 Phase 1 winners of its Move Health Data Forward Challenge, which calls for using APIs to enable consumers to share their information with providers and family members. I started to list the 10 and what they offer until I realized I had never heard of any of the companies and the products all sounded the same. Anyway, the 10 will be narrowed to five finalists in the next round and then one or two winners of the final phase.

Privacy and Security

From DataBreaches.net:

• The city of El Paso, TX is scammed out of $3.3 million when officials pay a phishing hacker posing as a vendor.
• In Canada, Winnipeg Regional Health Authority reports the latest of several incidents in which paper patient records were stolen from locked cars and offices.
• Victims of Anthem’s 2015 data breach file a class action lawsuit seeking information on the Office of Personnel Management’s security audit, after which Anthem was rumored to have refused to perform the recommended security tests.
• An employee of the New Zealand Nurses Organisation sends its 47,000-member database to a hacker whose spear phishing email was disguised to look as though it came from its CEO.

A corporate lawyer sues a Miami, FL hospital for allowing its telemarketing company MedAssist to call his mother with recorded marketing messages every seven days following her hospital visit. MedAssist says its messages are informational and that the hospital’s patient waiver includes their consent to receive robocalls. The lawyer is seeking class action status.

Technology

The New York Times covers end-of-life tech startups that are trying to bring technology into the tech-resistant “death care” industry. Investor-funded companies are offering TurboTax-like products for estate planning, online funeral home directories, post-death task automation for families, and online advance directives.

Forbes profiles Magic Leap, a secretive startup valued at $4.5 billion that is developing a next-generation computer interface, a head-mounted display that projects directly onto a user’s retina to create a mixed-reality environment. They’re targeting the consumer market, but possible healthcare uses are extensive (the founder earned a master’s in biomedical engineering). The video above – recorded directly from Magic Leap – shows the possibilities in perhaps showing a patient’s medical record while talking to them, reviewing surgical information in the OR, or reviewing medical literature while rounding.

An analysis finds that Microsoft’s IE and Edge browsers have lost 331 million users so far this year, dropping the company’s browser market share from 44 percent to 23 percent even though those products are bundled with Windows. Google’s Chrome jumped from 35 percent to 55 percent market share. Firefox users (including me) held steady at around 11 percent, while Apple’s Safari represented around 5 percent.

Other

Facebook panders to drug companies with big advertising budgets in creating a new automatic scrolling for long lists of side effects, allowing drug companies to turn off comments on pages that promote their products to relieve them of their FDA responsibility to report any unverified side effects that patients might enter, and creating condition-specific community pages that drug companies can sponsor to promote their product. Facebook put together a team just to work with drug companies, explaining, “This was borne out of tons of interest we were getting from pharmaceutical advertisers to figure out Facebook.”

A South Florida woman complains that Boca Regional Regional Hospital charged her $7,000 for delivering her baby even though she gave birth in the hospital parking lot before she could get inside. Laypeople will miss the RCM aspect of the story – she didn’t get the bill until seven months later.

An attorney sues the Popeyes fried chicken restaurant for including only a spork in his drive-through order, claiming that be choked for lack of a plastic knife. In an update, the attorney drops his suit following “extreme comments directed to me and my family.”

Sponsor Updates

• Intelligent Medical Objects will offer a free workshop titled “Terminology: The Secret to Leveraging your EHR for MIPS and MACRA” at AMIA 2016 on November 12, with non-AMIA attendees invited to participate as well.
• Gartner lists Medecision as a representative vendor of PHM platforms for providers in its latest “Market Guide for Healthcare Provider Population Health Management Platforms.”
• KLAS recognizes Uniphy Health for accomplishments in secure messaging in its report, “Secure Communication 2016: Vendors Transitioning to Secure Communication Platforms.”
• The Tampa Bay Technology Forum recognizes CareSync as 2016 Technology Company of the Year.
• Ingenious Med releases a major update to its IM1 patient encounter solution, adding real-time care team member interaction.
• Iatric Systems, Imprivata, InterSystems, MedCPU, Nordic exhibits at the CHIME Fall CIO Forum through November 4 in Phoenix.
• InstaMed, Intelligent Medical Objects will exhibit at the NextGen One UGM November 6-9 in Las Vegas.
• Kyruus will exhibit at HCIC November 7-9 in Las Vegas.
• MedData will exhibit at the HFMA Region 9 Annual Conference November 6-9 in New Orleans.
• Meditech will exhibit at the American Association of Physician Leadership 2016 Fall Institute November 4-8 in Chandler, AZ.
• NTT Data will host an Innovation Summit November 10 in Charlotte, NC.
• Obix Perinatal Data System will exhibit at the South Carolina HIMSS Annual Fall Conference November 9-10 in Columbia.
• KLAS recognizes PatientSafe Solutions as one of the strongest platform options for care team communication in its 2016 Secure Communication Report.
• PatientKeeper and Summit Healthcare will exhibit at HealthAchieve November 7-9 in Toronto.
• The Institute of Healthcare Consumerism features PokitDok on Healthcare Consumerism Radio.
• The SSI Group and Streamline Health will exhibit at the HFMA Region 9 Annual Conference November 6-8 in New Orleans.

Blog Posts

• What Will MIPS and MACRA Cost You? (Medicomp Systems)
• Realizing Clinical Benefits: Part 2 – Identifying Benefits (Impact Advisors)
• Ransomware in the Healthcare Space (ID Experts)
• Securing the perimeter: A national cyber security awareness month Q&A (Imprivata)
• 3 Questions You Need to Ask When Developing Your Healthcare Marketing Strategy (Influence Health)
• Secure Texting’s Evolution (Spok)
• Five True Tales of Terror: How Liaison Solves Customers’ Spookiest Integration and Data Management Problems (Liaison Healthcare)
• New FHIR Integration Helps Hospitals Connect Imaging Data Across Disparate Systems (LifeImage)
• Bundled Payments and Radiology (National Decision Support Company)
• Putting the “Precision” in Precision Medicine (Orion Health)
• How much time on charting (PeriGen)
• Addressing the Disruption in Provider Data Caused by Clinically Integrated Networks and Value-based Care (Phynd Technologies)
• Top 10 Takeaways from the MACRA Final Rule (Point-of-Care Partners)
• Criminal Insider Reach Extends Far Beyond Credit Card Fraud (Protenus)
• Patient Friendly Billing in Context (Sagacious Consultants)

Contacts

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

News 11/2/16

Top News

CMS publishes changes to the EHR Incentive Program that will allow returning EPs, hospitals, and CAHs to use any continuous 90-day reporting period between January 1 and December 31 for both 2016 and 2017.

CMS will also eliminate the clinical decision support and CPOE objectives and measures for hospitals and CAHs attesting under the Medicare EHR incentive program.

CMS says it is finalizing the process for a one-time EHR hardship exception for the Medicare EHR Incentive Program for certain eligible professionals for EPs who participate in the EHR incentive program in 2017 who will transition to MIPS in 2017.

Reader Comments

From Pilsner: “Re: Epic’s posted study showing the change in operating margins after switching from Cerner to Epic. The data are minimally cited and the methodology is not documented. It gives Moody’s as the source, but Moody’s rates only 441 hospitals and therefore the graph must not include all hospitals that implemented Cerner and Epic from 2004 through 2015.” I would be curious about how many hospitals this graphic represents. I’m also skeptical that a change in systems was the cause of the improvement as opposed to other, more impactful changes that coincided with that change (such as being acquired by a Epic-using health system that instituted its own superior revenue cycle practices). Also, the stated average margin improvement from 3.19 percent to 6.45 percent happened over years in which hospital margins improved in general and covered hospitals that could, by definition, afford Epic. There’s too little information to infer further, but Epic’s non-marketing team has done a nice job making a compelling point without providing the details in trying to discount the headlines describing hospitals whose Epic project expense got them in trouble.

From Master Blaster: “Re: [company name omitted]. Can you please remove the rumor you ran about us?” I sometimes get requests to take down a rumor, but I don’t do that, instead offering the company a chance to provide a response or to confirm/deny, which they generally decline to do. Invariably the rumor the company wants removed turns out to be accurate and they just wanted more time to spin it publicly. It’s the same when health system CIOs email me to rather sternly suggest that I contact them before mentioning items from public records indicating the cost and status of their big implementation projects – that information doesn’t seem to require IT clarification, but they’re always welcome to provide a comment. My conclusion after doing this for 13 years: everybody loves to read rumors except those that pertain to them, which instantly transform me from a must-read news-breaker to an irresponsible trouble-maker.

FHIR

Grahame Grieve provides a response to a reader’s question and my comments regarding FHIR.

World peace — we’ll do that next year. This year we sat it out because we wanted to handicap ourselves. (more seriously, Mr. H already quoted me about this).

From the original question, "After years of implementing HL7 and being able to do just about anything with an HL7 message," well, there’s all sorts of things you can’t do with HL7 v2, and ways you can’t do it, but for all the things you can do with HL7 v2, FHIR is an incremental improvement, not world shaking. But even there — testing, conformance, infrastructure — there’s still a lot in the increment. 

"FHIR without discipline could turn out the same way if customers don’t demand better." Yes, but also vendors understand where the other approach ends up. We’ve lived it, and in today’s social media world, we can do better for much less. So it costs less to be disciplined, and as you said, there are other reasons to get it right this time.

"Providers understandably have no incentive to exchange data with their competitors." But banks exchange data with the customer, etc. Why? In fact, there are reasons to exchange some data, some times. It’s not a binary all-or-nothing, and some providers are keen to do it. Because of cost minimization, for example. And while data sharing might allow patients to shop between systems, it can also allow systems to shop to patients previously locked in. (more about this).

For these reasons, we — the FHIR team — believe that now is a great time to spend our effort creating a better way, and we live in hope that it will make a difference for patients across the world.

HIStalk Announcements and Requests

Ms. M reports that she’s using the iPad we provided in fulfilling her DonorsChoose grant request to assign specific reading interventions to her Texas first graders. She is also having the students record themselves as they work through the writing process, followed by taking a picture of their work and recording themselves talking the problems out.

Webinars

November 8 (Tuesday) 1:00 ET. “A CMIO’s Perspective on the Successful 25 Hospital Rollout of Electronic Physician Documentation.” Sponsored by Crossings Healthcare. Presenter: Ori Lotan, MD, CMIO, Universal Health Services. UHS rolled out Cerner Millennium’s electronic physician documentation to its 6,000 active medical staff members — 95 percent of them independent practitioners who also work in competitor facilities — across 25 acute care hospitals. UHS’s clinical informatics team used Cerner’s MPage development toolkit to improve the usability, efficiency, communications capability, and quality metric performance of Dynamic Documentation, embedding clinical decision support and also using Nuance’s cloud-based speech recognition product for the narrative bookends of physician notes. This CMIO-led webinar will describe how UHS achieved 70 percent voluntary physician adoption within one month of go-live, saved $3 million in annual transcription expense, and raised EHR satisfaction to 75 percent. It will include a short demonstration of the software that UHS developed to optimize the physician experience.

November 9 (Wednesday) 1:00 ET. “How to Create Healthcare Apps That Get Used and Maybe Even Loved.” Sponsored by MedData. Presenter: Jeff Harper, founder and CEO, Duet Health. Patients, clinicians, and hospital employees are also consumers who manage many aspects of their non-medical lives on their mobile devices. Don’t crush their high technology expectations with poorly designed, seldom used apps that tarnish your carefully protected image. Your app represents your brand and carries high expectations on both sides. This webinar will describe how to build a mobile healthcare app that puts the user first, meets their needs (which are often different from their wants), creates “stickiness,” and delivers the expected benefits to everyone involved.

Contact Lorre for webinar services. View previous webinars on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

Cerner reports Q3 results: revenue up 5 percent, adjusted EPS $0.59 vs. $0.54, missing analyst expectations for both. Shares dropped 2 percent at Tuesday’s close and were down another 6 percent in early after-hours trading. The company announced plans to offer a voluntary separation plan for eligible employees.

Telemedicine technology vendor Avizia closes its $17 million Series A funding round with a $6 million investment that includes the participation of New York-Presbyterian.

Meditech posts Q3 results: revenue down 7 percent, EPS $0.68 vs. $0.37. Product revenue declined 26 percent while service revenue increased 2 percent, but a 47 percent drop in sales costs boosted net income to $25.5 million.

Vital Images will acquire Karos Health, which offers “deconstructed PACS” diagnostic image viewing and sharing tools.

Private equity firm Blackstone Group will acquire hospital physician staffing outsourcer Team Health for $6.1 billion. The company was previously owned by Blackstone, which paid $1 billion for it in 2005 and then took it public in 2009. Team Health turned down a $7.6 billion acquisition offer last year after running up a pile of debt to finance the acquisition of a competitor that didn’t really work out.

Sunquest owner Roper Technologies announces Q3 results: revenue up 7 percent, adjusted EPS $1.63 vs. $1.61, falling short on revenue expectations but beating on earnings. The company said in the earnings call that Sunquest’s revenue is two-thirds recurring and therefore new orders aren’t usually that important, but the Lab 8.0 release and a new blood bank solution will cause a record number of Q3 orders. 

A federal appeals court affirms dismissal of Fair Warning’s patent lawsuit against Iatric System regarding Iatric’s technology to detect fraud and misuse of PHI.

Sales

Baylor Scott & White Health will use technology from Pager to provide nurse triage services to patients seeking services.

People

Aetna promotes Patrice Wolfe to CEO of Medicity, where she will also be responsible for the company’s population health management technology products that include Healthagen Outcomes and HDMS.

Long-term care technology vendor MatrixCare hires Gary Pederson (Richland Advisors) as SVP of life plan community solutions.

Healthgrades promotes Andrea Pearson to EVP and chief marketing officer, Christian Dwyer to EVP of product management, and Chris Catallo (not pictured) to GM of hospital solutions.

Athenahealth hires Diane Holman (TE Connectivity) as chief people officer.

Announcements and Implementations

Health services price comparison vendor HealthSparq adds tools so that health insurers can offer their members financial rewards for choosing cost-conscious options, send them secure messages, and send them claims-based alerts to offer money-saving suggestions.

A Spok-sponsored, CHIME-administered survey of 100 CIOs finds that 81 percent name improving data security as their #1 priority over the next 18 months, while the top workflow they hope to improve with technology is care team coordination for treatment planning. Two-thirds are actively implementing secure messaging.

CareCloud will integrate population health management tools from Lightbeam Health Solutions into its EHR/PM.

Availity announces that its health information exchange technology will support the FHIR standard for eligibility, labs, diagnoses, medical attachments, and ADT and is developing a provider solution for member lookups.

Government and Politics

Healthcare.gov was apparently again overloaded on the first day of open enrollment, but at least the site provided a polite waiting room message instead of just timing out. I put myself in yesterday to compare to today’s new prices for 2017 and the premium for my theoretical coverage would be jumping 68 percent from 2016. I can say with confidence after looking up premiums for different parts of the country that a lot of self-employed folks who earn too much for federal taxpayer subsidies are going to be paying $1,000 per month or more for Silver-level coverage with a $3,500 deductible and $7,150 out-of-pocket maximum. Another option, I suppose, would be to purchase individual coverage directly from the insurance companies that offer it, but I don’t know if that would be a better deal than the exchange. A Wall Street Journal article says Arizona is the best example of the ACA’s problems in that most counties are down to only one insurer, premiums for some plans will more than double, and higher costs and cutbacks in the federal risk corridor program have caused nearly all of the insurers to pull out.

CMS awards its next round of Recovery Audit Contractor (RAC) contracts.

Privacy and Security

In England, the three hospitals of the North Lincolnshire and Goole NHS Foundation Trust cancel appointments and elective procedures as they go back to paper following an attack by an unspecified computer virus. The hospital hopes to restore its systems Wednesday following Sunday’s attack. They deny that ransomware is involved.

From DataBreaches.net:

• In England, a former hospital administrative employee is prosecuted for accessing the medical records of her former girlfriend and her partner.
• Three former district managers of drug company Warner Chilcott are sentenced for healthcare fraud and HIPAA violations trying to boost sales of the company’s osteoporosis drugs by using patient information to fill out prior authorization forms. The company’s drugs, Atelvia and Actonel, require doctors to justify why less-expensive generic drugs can’t be used, so the drug reps completed and submitted the forms using boilerplate text that was often unrelated to the patient’s condition. The company’s former president was arrested and charged with paying kickbacks last year (including bribing high-prescribing doctors with “honoraria” for speaking at events with no educational component) but was acquitted. Warner Chilcott paid $125 million to settle its criminal and civil liability and was acquired for $5 billion by Actavis.

Other

Among the proposed policies to be discussed at the AMA’s Interim Meeting in Orlando November 12-15 is integrating mobile health apps and devices into everyday practice. A draft resolution that calls out Epic and EClinicalWorks as “data blockers” would ask federal and state governments to prohibit withholding patient information from non-affiliated physicians and asks AMA to support legislation that would limit EHR vendor interfacing fees. Another proposed item seeks federal legislation that would eliminate medical practice costs involved with converting patient data from a replaced EHR to a new one.

Weird News Andy notes that this story is a few months old, but still amazing. A 14-year-old girl returns to competitive ballet dancing after having her leg amputated above the knee due to osteosarcoma, when was then repaired by attaching her foot backward to her upper leg in an uncommonly performed procedure called rotationplasty to give her optimal mobility.

WNA may regret going for the feel-good story above since he likes OR-related oddities such as this. A patient undergoing cervical surgery is burned when the laser ignites her passed gas.

Sponsor Updates

• HCI Group posts a podcast titled “Epic Upgrades: Key Strategies and Cost Considerations.”
• Aprima will exhibit at the American College of Phlebology event November 3-5 in Anaheim, CA.
• CenterX, CoverMyMeds, Cumberlad Consulting Group, Dimensional Insight, EClinicalWorks, and HealthCast will exhibit at the CHIME Fall Forum November 1-4 in Phoenix.
• CompuGroup Medical will exhibit at the National Association of Community Health Centers FOM/IT Conference November 2-4 in Las Vegas.
• Elsevier Clinical Solutions will present at the US News & World Report Healthcare of Tomorrow Conference November 2-4 in Washington, DC.
• Evariant will exhibit at the Healthcare Internet Conference November 7-9 in Las Vegas.
• KLAS names PerfectServe’s Synchrony as a top-performing care team communication platform.
• Extension Healthcare will exhibit at the HealthAchieve Conference November 7-9 in Toronto.
• Healthfinch will sponsor DevOp Days November 2 in Madison WI.
• Healthwise will exhibit at Wellcentive’s annual UGM November 2-4 in Atlanta.

Blog Posts

• Meditech’s EHR Steers Avera McKennan ED Nurse Navigator Program to $475,000 Annual Savings (Meditech)
• Finding money in healthcare (Infor)
• Top 5 Predictions for Private Practices at MGMA (AdvancedMD)
• Weaving Hospital Variation (Arcadia Healthcare Solutions)
• Compliance Isn’t Enough: Improving Governance, Risk Management, Compliance (Caradigm)
• Keep Updating Your Skills (CTG)
• EHR Capture of Outpatient Evaluation and Management Services (Culbert Healthcare Solutions)
• 8 Etiquette Tips for a Lunch or Dinner Interview (Direct Consulting Associates)
• Three Ways to Prepare for MACRA Data Submission (ECG Management Consultants)
• Make Tracks for Texas! (EClinicalWorks)
• The Final Countdown: MACRA Edition (Galen Healthcare Solutions)
• 5 Benefits of Increased Patient Engagement You May Not Know (Hayes Management Consulting)
• Building Stronger Relationships of Care (Healthwise)

Contacts

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

Monday Morning Update 10/31/16

Top News

McKesson’s poor earnings report, released after the stock market’s close Thursday, resulted in a Friday shareholder bloodbath as MCK shares shed 23 percent of their price and continued to slide in after-hours trading Friday.

The company’s $290 million EIS write-down was barely mentioned in the analyst call since technology isn’t a key McKesson business; it’s dumping out of healthcare IT anyway; and its failures there are insignificant compared to its exposure to a changing pharma market, uncertainty about which hit the shares of all its drug distributor competitors as well.

Drug companies can credit the unapologetically capitalistic Martin Shkreli — whose drug pricing practices at Turing Pharmaceutical created a public backlash — for their potentially less-profitable future.

Pharma is scared to death of California’s Proposition 61, which if passed will require that state agencies pay no more than the VA’s heavily discounted price for a given drug. Drug companies have spent $100 million trying to defeat it.

Reader Comments

From HL7 Interface Engineer: “Re: FHIR. Sorry to vent, but after years of implementing HL7 and being able to do just about anything with an HL7 message, FHIR can’t solve the underlying problem of trying to connect old EHR systems as each uses the fields differently. Real-life examples I’ve experienced: (a) connecting a system with a 23-character patient ID with one holding only 12; (b) systems that may or may not allow spaces between first and middle names; and (c) a system vendor that wants ADT^A16 (pending discharge) and ADT^25 (cancel pending discharge) transactions and our system can’t send either one. Hoping someone at HIStalk will understand and either validate my feelings or explain why I’m wrong.” I don’t think  you are wrong, although that’s not what the non-techies who naively believe that FHIR will create world peace want to hear. My thoughts:

1. Providers understandably have no incentive to exchange data with their competitors, no different in healthcare than any other big-money industry. If customers don’t care, neither will their vendors. You can’t create interoperability demand by simply developing new standards or asking for it as a downstream customer (patient). Providers would lose more business in sharing data with their competitors than they would just declining to do so since it’s not usually a patient must-have.
2. Dissimilarly designed systems make it hard to even batch-convert data, much less handle real-time, bi-directional data exchange where errors cause missing data elements that might impact patient care.
3. HL7 as a standard was successful, but could have been even more so if vendors hadn’t kludged their systems (and thus HL7 messages with endless custom extensions) as a lazy, check-the-box way to approximate interoperability support without enthusiasm. FHIR without discipline could turn out the same way if customers don’t demand better.
4. The value of interoperability isn’t to the EHR or ADT systems, but rather to those systems that want their information. That stifles innovation as the smaller, newer vendor can’t get a hospital foothold without integrating with core systems and their foot-dragging vendor. The bigger, more expensive, and older system is always the transaction boss because it’s the most entrenched at a given customer site.
5. ADT transactions are standard, but even then exceptions exist, such as those you mentioned. ADT is easy compared to clinical domains. Healthcare is a lot more complex than financial transactions that were based on standard accounting practices.
6. Exceptions always come up due to unsynchronized upgrades among systems or corner cases, meaning someone has to monitor the error logs. That’s easier for a hospital’s IT department than a small practice with no technical resources.
7. Paradoxically, the inflated expectations for FHIR may make it successful since everybody from the federal government to insurers and researchers is pressuring its use, giving vendors less ability to ignore it. I don’t have the expertise to say whether it’s better or worse than HL7, but we’re a lot smarter about interoperability now than back in the late 1980s when HL7 combined with interface engines instead of point-to-point custom interfaces was considered the holy grail of system-to-system communication. Maybe we’ll learn from those mistakes and do better given a blank slate. The witless punsters that put FHIR in their headlines (for which it is inarguably sexier than calling it HL7 Version 4) highlight the value of FHIR as a public relations and political tool rather than a technical one.
8. Interface engineers got us through the days when best-of-breed systems ruled the earth and hospitals had to patch them together within their four walls. The change to single-source systems has moved the battleground outside those walls, where instead of tying together departmental systems whose vendors are equally motivated to make it work, the challenge is making competing and vastly different EHRs talk to each other in an equally competitive and inherently distrustful provider environment, something even clever engineering can’t fix.

HIStalk Announcements and Requests

Epic’s supposedly non-existing marketing program is the most effective of all inpatient EHR vendors, according to poll respondents.

New poll to your right or here, triggered by the reader’s comment above: what impact will FHIR have on interoperability? Those taking the non-committal choice of “some” might want to click the comments link after voting to explain so that we know that you have modest expectations rather than limited knowledge.

Welcome to new HIStalk Platinum Sponsor Haystack Informatics. The Philadelphia-based company’s security technology, created at Children’s Hospital of Philadelphia, detects hospital employee EHR snooping. Healthcare security professionals warn that insider breaches are the greatest single privacy threat, beyond the more highly publicized hacker or ransomware incidents. Instead of fixed rules, the company’s dynamic and static anomaly detection engines learn normal user behavior and call out exceptions, providing investigation workflow those incidents as well as for lost laptops, theft, and improper disposals, creating the necessary documentation for the compliance department and OCR. I sponsored their recent webinar that addressed insider threats. I was slow to notice that the company’s name comes from “a needle in a haystack,” which I assume references those few nefarious insiders among the majority of employees and staff who do nothing wrong. Thanks to Haystack Informatics for supporting HIStalk.

I found a YouTube overview of Haystack Informatics featuring CHOP AVP/CMIO Bimal Desai, MD, MBI, who is also the company’s co-founder.

Listening: new from AFI (an initialism for A Fire Inside), a hard-rocking, punk-leaning four-piece from Ukiah, CA that hasn’t changed members since 1998. They’re hard to categorize, but easy to listen to. The new single is a lot more richly polished and smooth than some of their earlier stuff.

I was thinking that instead of everyone racing for the cure or wearing pink in October for breast cancer awareness in a self-congratulatory show of support, perhaps those dozen or two Americans who aren’t already aware of it could instead wear pink and we could just take them offline individually to explain and invest the extra time and energy into public health projects.

Last Week’s Most Interesting News

• McKesson turns in bad quarterly numbers, lowers guidance, sees shares shed nearly 25 percent of their value, writes down $290 million on its Enterprise Information Systems (EIS, which includes Paragon) business, and lays off an unspecified number of EIS employees.
• Vocera acquires Extension Healthcare.
• Netsmart acquires HealthMEDX.
• Apple’s 15-year streak of increasing sales is broken due to falling iPhone demand.
• Athenahealth misses quarterly revenue expectations and admits that its promised 30 percent bookings growth is no longer like to be achieved due to a changing (i.e., non-Meaningful Use-driven) market.

Webinars

November 8 (Tuesday) 1:00 ET. “A CMIO’s Perspective on the Successful 25 Hospital Rollout of Electronic Physician Documentation.” Sponsored by Crossings Healthcare. Presenter: Ori Lotan, MD, CMIO, Universal Health Services. UHS rolled out Cerner Millennium’s electronic physician documentation to its 6,000 active medical staff members — 95 percent of them independent practitioners who also work in competitor facilities — across 25 acute care hospitals. UHS’s clinical informatics team used Cerner’s MPage development toolkit to improve the usability, efficiency, communications capability, and quality metric performance of Dynamic Documentation, embedding clinical decision support and also using Nuance’s cloud-based speech recognition product for the narrative bookends of physician notes. This CMIO-led webinar will describe how UHS achieved 70 percent voluntary physician adoption within one month of go-live, saved $3 million in annual transcription expense, and raised EHR satisfaction to 75 percent. It will include a short demonstration of the software that UHS developed to optimize the physician experience.

November 9 (Wednesday) 1:00 ET. “How to Create Healthcare Apps That Get Used and Maybe Even Loved.” Sponsored by MedData. Presenter: Jeff Harper, founder and CEO, Duet Health. Patients, clinicians, and hospital employees are also consumers who manage many aspects of their non-medical lives on their mobile devices. Don’t crush their high technology expectations with poorly designed, seldom used apps that tarnish your carefully protected image. Your app represents your brand and carries high expectations on both sides. This webinar will describe how to build a mobile healthcare app that puts the user first, meets their needs (which are often different from their wants), creates “stickiness,” and delivers the expected benefits to everyone involved.

Contact Lorre for webinar services. View previous webinars on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

Athenahealth lays off nearly 150 employees in consolidating its R&D function, with 102 employees dismissed in San Francisco and 40 in Atlanta as the company focuses R&D in Watertown, MA; Austin, TX; and India.

Germany-based medical software vendor CompuGroup Medical formally notifies Agfa of its interest in acquiring the medical imaging company. CGM’s market cap is $2.1 billion, while Belgium-based Agfa’s is around $625 million.

Decisions

• Drew Memorial Hospital (AR) went live with Paychex time and attendance in September 2016.
• Memorial Hospital at Craig (CO) went live with Kronos time and attendance in October 2016.
• Hardin Medical Center (TN) will go live with Kronos HR, time and attendance, and payroll on January 1, 2017.

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

Announcements and Implementations

Audacious Inquiry releases CAliPHR (CQM Aligned Population Health Reporting), an open source CQM calculation tool to support provider participation in federal and state incentive programs and value-based payment systems, available on Github.

A new Peer60 report looks at healthcare IT trends in the UK, identifying as the top concern the shortage of doctors and nurses, with 76 percent of respondents saying Brexit is hurting their staffing. Net promoter scores are terrible for both EPR and PAS, but limited replacement activity (as well as equally poor scores across vendors) suggests a reluctant acceptance of the status quo.

Government and Politics

The Ohio State Medical Association complains that the state’s medical board overreacted in sending a sternly worded letter to the state’s doctors, one-third of whom were not using the Ohio doctor-shopping database as the board requires. The top 25 doctors who weren’t looking up patients before prescribing opioids averaged 30 such prescriptions per month, while one doctor prescribed narcotics for 705 patients in one month without using the database at all. The letter had the intended effect of spurring sign-ups, also resulting in subpoenas for seven non-participating dentists for unspecified issues.

Privacy and Security

From DataBreaches.net:

• A man treated for life-threatening injuries in a hospital’s ED says he will sue the hospital after one of its employees took photos of him that were later sent to him by someone claiming to be a friend of a nurse there.
• The information of 1.3 million Australian citizens is exposed when a security researcher finds that the Red Cross’s donor record SQL database is accessible to Internet searches.
• A report finds that messages sent to unsecure alpha pagers (like those still used widely by hospitals) can be easily intercepted, noting particularly that the US is the only country where detailed alert messages are automatically sent by nuclear power plant monitoring systems. The report recommends encryption, data authentication, and limiting how email-to-pager messages are managed.

Technology

Apple finally announces a refreshed MacBook Pro line four years after its last update, creating little excitement given that the big innovation (details of which had already leaked out) was an on-screen Touch Bar along with the usual “thinner, lighter” one-upmanship. The entry-level price would buy a handful of Windows laptops or a dozen Chromebooks. Apple might want to invest some of its giant cash reserves in trying to clone Steve Jobs, who would surely not have taken the stage to do his “one more thing” bit with Apple’s unexciting, grindingly incremental improvements. You know it’s bad when the biggest takeaway from the iPhone announcements was the elimination of the headphone jack and the biggest from the MacBook announcements was that the headphone jack remains.

Other

Money-losing Nevada Regional Medical Center (MO) provides an interesting glimpse into the odd ways Medicare pays providers. The hospital buys one medical clinic and plans to purchase another because they are designated as rural health clinics, meaning Medicare pays 2.5 times the amount the hospital would make from an inpatient or regular clinic patient. The hospital’s three rural health clinics are its highest-margin business lines courtesy of Medicare’s financial incentives to keep people out of the ED.

Everybody knows John Halamka as a pre-eminent health IT spokesperson with endless energy and enthusiasm, but I enjoy even more his writings as a gentleman farmer and animal sanctuary operator, evidence of which I submit from his latest Unity Farm Journal:

Before I left, I cut a road from the barnyard to the new aviary area and around the back of the alpaca paddock to the edge of the new sanctuary property we’re acquiring next door. In my absence the gravel for that road arrived, so we now have a new area to drive over with farm equipment. I’ve called it Sanctuary Road … This weekend I’ll be busy doing animal care — trimming alpaca toenails, running with the dogs, giving the pigs the belly rubs they’ve been missing. I’ll be crushing and fermenting 500 pounds of apples. I’ll be racking the cider I fermented before I left. The work on the farm is invigorating and I will not miss sitting in economy seats while the person in front of you leans back all the way.

In Canada, Island Health’s Nanaimo Regional General Hospital offers its doctors extra pay for “the extra burden the new electronic health record has placed on many physicians during the roll-out phase of IHealth.” The hospital’s doctors previously reverted back to paper charts, citing patient safety and workload concerns with its newly implemented Cerner system.

Doctors in United Arab Emirates complain that their hospital employer is docking their pay for clocking in minutes late, even when they work past their quitting time. The HR people tell them it’s an automated system and there’s nothing they can do. The doctors also note that right before orientation day, the hospital decided not to hire residents and interns even though the government pays their salaries.

The folks at Epic, many of whom aren’t many years removed from trick-or-treating under the watchful eyes of their parents, have trotted out their Halloween-themed web decorations.

Sponsor Updates

• Experian Health will present “Denial: It’s Not Just a River in Egypt!” at AAHAM WA November 10 in Spokane.
• PatientMatters will present at the Missouri Hospital Association Annual Convention November 2-4 in Osage Beach.
• AdvancedMD will introduce an all-in-one cloud site (scheduling, billing, EHR) at MGMA, also adding fully integrated telehealth capabilities and an expanded AdvancedPatient.
• The SSI Group will exhibit at GC3 HIMSS November 3-4 at the Beau Rivage Resort & Casino in Biloxi, MS.
• SK&A publishes a new report on “Provider Move Rates.”
• The American College of Pathology names Aprima a certified ACP PRO Venous Registry EHR vendor.
• Valence Health will exhibit at the National Association of Medicaid Directors November 6-8 in Arlington, VA.
• Voalte will host its second annual user conference November 9-11 in Sarasota, FL.
• Built in Chicago names ZirMed to its list of 2016 Top 100 Digital Companies.

Blog Posts

• Plug-in Payments: Why Practices Should Integrate Their Hardware, Software, and Processing Agreement onto a Single Technology Platform (Patientco)
• America’s Annual Costume Party (PatientKeeper)
• How to Optimize Revenue Cycles for Value-Based Healthcare Systems (PokitDok)
• Why healthcare providers must still take unstructured data into account (Lexmark Healthcare)
• New Rule Strengthens Certification Oversight and Accountability for EHRs (Point-of-Care Partners)
• Tackling Your Physician Office Integration (Summit Healthcare)
• Interoperability in Action: ONC Visits St. Louis (Surescripts)
• Offsite Backups Are Not a Disaster Recovery Plan (TierPoint)
• The Keys to a Successful Quality Improvement Program (Verscend)
• What Nurses Really Think: Insights from ANCC MagCon 2016 (Versus Technology)

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 10/28/16

Top News

McKesson announces Q2 results: revenue up 2 percent, EPS $1.35 vs. $2.65, missing expectations for both. The company also lowered guidance.

McKesson will take a $290 million write-down of its Enterprise Information Solutions (Paragon) business due to “a decline in estimated cash flows” and says it is still seeking a buyer for it. As recently announced, it will retain only EIS and RelayHealth once it has divested its other health IT businesses into a new joint venture company to be formed with Change Healthcare, with closing expected in the first half of 2017 pending anti-trust review.

Technology Solutions revenue was down 6 percent with a loss of $174 million.

MCK shares dropped 13 percent in after-hours trading immediately following the announcement. They were already down 14 percent in the past year.

Reader Comments

From Hush Hush Sweet Charlotte: “Re: McKesson. Apparently it’s really hard to send out a super confidential list of McKesson employees who are getting canned to the executive team without sending it to every employee in the business unit.”  A McKesson admin apparently mistakenly emails upcoming layoff details, including names and communication plans, to the whole business unit instead of just the executives. Anonymous commenters suggest that the Charlotte, NC-based Paragon group was hit hard Wednesday, especially in lab and ancillaries, but that’s not confirmed. An HIStalk reader says one-third of the EIS workforce was let go, some effective immediately and some “held hostage for severance benefits if they stay through March 2017.” McKesson was already trying to unload its EIS division — of which Paragon is key element along with other old systems like Star and HealthQuest – as part of its plan to get out of the health IT business by transferring the non-EIS assets to a new company formed with Change Healthcare. McKesson just announced a new version of Paragon this week, which probably gave the unfortunate salespeople a rare positive talking point right before the layoff rumors leaked out.

From LeftCoaster: “Re: CPT codes. The AMA fought hard to to keep ICD-10 from being implemented. The original ICD-10 PCS code scheme developed for the US contained codes that would have theoretically replaced CPT codes (both inpatient and outpatient procedures). We’re left with a mishmash of coding schemes with CPT for outpatients and ICD-10 PCS for inpatients.” Unverified.

From Persnicker: “Re: your (or is that ‘you’re’) favorite HIMSS publication. It’s not cool that it can’t spell ‘its.’” Americans just keep getting dumber in confusing the contraction “it’s” with the possessive “its.” I see that mistake every day, with a misuse rate of at least 50 percent. Looking at the half-full glass, I know I can immediately stop reading since I won’t trust whatever else the careless author is attempting to communicate.

HIStalk Announcements and Requests

I’ve used Bitdefender for PC security for years, and as I installed the latest upgrade to the 2017 version, I was thinking about how smooth the process is (even though years ago I initially resisted the idea of paying for ongoing AV protection as a subscription). Too bad healthcare software usually doesn’t work like this. It’s a smart, smooth, background installation; it installs in auto-pilot mode with no tinkering required; it hides its underpinnings from the user; it provides a Web-based dashboard for managing the devices covered under the subscription (up to five in the version I have); and it now includes ransomware protection. AV protection will never be fun, but Bitdefender is at least close to painless and it’s a pretty good deal at around $50 per year for up to five devices. I had high hopes for its $99 Bitdefender Box security appliance, but reviews are awful and the company doesn’t seem to talk it up much.

This week on HIStalk Practice: New AAFP President John Meigs, MD deems MACRA, opioid abuse prevention, and workforce development his top areas of focus in the coming year. Seward Community Health Center preps for Epic go live. Signia develops telemedicine app for hearing aid users. CMS keeps the MACRA flexibility options coming. Alliance Physical Therapy pilots Docity telemedicine software. The American Red Cross and Teladoc collaborate on telemed for natural disaster victims. Athenahealth shifts gears in light of disappointing sales figures. The HIStalk Must-See Exhibitors Guide for MGMA 2016 goes live.

Webinars

November 8 (Tuesday) 1:00 ET. “A CMIO’s Perspective on the Successful 25 Hospital Rollout of Electronic Physician Documentation.” Sponsored by Crossings Healthcare. Presenter: Ori Lotan, MD, CMIO, Universal Health Services. UHS rolled out Cerner Millennium’s electronic physician documentation to its 6,000 active medical staff members — 95 percent of them independent practitioners who also work in competitor facilities — across 25 acute care hospitals. UHS’s clinical informatics team used Cerner’s MPage development toolkit to improve the usability, efficiency, communications capability, and quality metric performance of Dynamic Documentation, embedding clinical decision support and also using Nuance’s cloud-based speech recognition product for the narrative bookends of physician notes. This CMIO-led webinar will describe how UHS achieved 70 percent voluntary physician adoption within one month of go-live, saved $3 million in annual transcription expense, and raised EHR satisfaction to 75 percent. It will include a short demonstration of the software that UHS developed to optimize the physician experience.

November 9 (Wednesday) 1:00 ET. “How to Create Healthcare Apps That Get Used and Maybe Even Loved.” Sponsored by MedData. Presenter: Jeff Harper, founder and CEO, Duet Health. Patients, clinicians, and hospital employees are also consumers who manage many aspects of their non-medical lives on their mobile devices. Don’t crush their high technology expectations with poorly designed, seldom used apps that tarnish your carefully protected image. Your app represents your brand and carries high expectations on both sides. This webinar will describe how to build a mobile healthcare app that puts the user first, meets their needs (which are often different from their wants), creates “stickiness,” and delivers the expected benefits to everyone involved.

Contact Lorre for webinar services. View previous webinars on our HIStalk webinars YouTube channel.

Here’s the recording of “Data Privacy/Insider Threat Mitigation: What Hospitals Can Learn From Other Industries” from earlier this week.

Acquisitions, Funding, Business, and Stock

Medical device vendor Zimmer Biomet – which is developing a remote rehabilitation platform — acquires RespondWell, which provides post-surgical patients with physical therapy programs.

Quality Systems (NextGen, Mirth, and QSI Dental) releases Q2 results: revenue up 1 percent, adjusted EPS $0.23 vs. $0.21, beating analyst expectations for both. CEO Rusty Frantz declined to comment on rumors that the company is shopping its NextGen business. EHR vendor HealthFusion, which Quality Systems acquired a year ago for $190 million, had $5 million in bookings and $10 million in revenue.

Insurer Anthem will create 2,000 jobs at its new software development center in Atlanta.

Government contractor Cognosante acquires BITS, which provides services to the VA and DoD. BITS is involved with the VA’s open source technical support contract.

Spok reports Q3 results: revenue down 2 percent, EPS $0.20 vs. $0.20.

Vocera acquires Extension Healthcare for $55 million in cash. I reported the retrospectively correct rumor of Nasty Parts on October 19.

Netsmart acquires long-term and post-acute care EHR vendor HealthMEDX.

Sales

The Ohio State University Wexner Medical Center chooses Kyruus ProviderMatch for patient-provider matching and appointment access.

Vanderbilt Bone and Joint will use MyHealthDirect for Epic-integrated patient self-scheduling.

Sacred Heart HealthCare (PA) chooses Dbtech for document management.

People

Ascension promotes Gerry Lewis to SVP/CIO and CEO of Ascension Information Services.

Contract management software vendor TractManager names Trace Devanny (Nuance Healthcare) as CEO.

Mark Costanza (Lumeris) joins Nordic as chief client officer.

Announcements and Implementations

An actuarial study finds that Forecast Health’s predictive models are more accurate than those of its competitors in identifying potentially high-cost patients for early intervention. The Durham, NC-based company developed its analytical model with UNC Health Care.

Athenahealth lists Healthfinch’s Swoop prescription refill management app on its marketplace.

Stanson Health’s new clinical decision support release includes evidence-based rules for atrial fibrillation, comprehensive joint replacement, Medicare Advantage star ratings, antimicrobial stewardship, and opioid management.

Influence Health announces a new cloud-based experience management solution for healthcare marketers.

Government and Politics

The NIH’s translational sciences group awards nine universities a $6.3 million grant to integrate the PROMIS patient-reported outcomes assessment with EHRs (including Epic and Cerner) so that the questionnaire omits irrelevant questions.

Less than half of the 22 million people that were expected to buy health insurance via the exchanges have actually done so, with the smaller number of enrollees – most of them self-selected because they’re sicker – driving insurers to drop their participation. The risk insurance program that protects insurers from signing up a disproportionate number of sicker policyholders will end this year since the original ACA legislation mistakenly assumed that the marketplace would have stable, high enrollment by now.

Innovation and Research

The local paper profiles non-profit Fogarty Institute for Innovation, which works out of El Camino Hospital (CA). Diagnostic image manipulation system vendor EchoPixel, whose product was probably the coolest thing I saw at the last HIMSS conference, is among the companies involved. Founder Thomas Fogarty, MD is a cardiovascular surgeon who invented the balloon catheter, founded 45 medical device companies, and holds 165 surgical instrument patents. He also owns Thomas Fogarty Winery and Vineyards, which he started in 1981.

Technology

Google cuts staff and dials back the continued rollout of its Google Fiber broadband service that is available in eight cities. Fiber deployment requires digging up streets to lay cable, but Google has acquired Webpass, which uses fiber-connected antennas that would allow Google to expand faster at a lower cost. Webpass, offered only in six metro areas, offers 1 gigabyte residential service for $60 per month. The downside is that it focuses on apartment buildings and condos with at least 10 units since a central antenna must be installed.  Some Webpass reviewers also complain of the “Netflix effect” in which speeds slow to a crawl between 6:00 and 10:00 p.m.

Cleveland Clinic names FHIR as one of its top 10 medical innovations for 2017.

Other

The Orlando paper covers Sanford Burnham Institute, a California-based research organization that was supposed to create the centerpiece of a Lake Nona life sciences complex called Medical City that failed despite having spent $350 million worth of public and private incentives. The VA and Nemours Children’s Hospital committed to building there and University of Central Florida put its medical school in Lake Nona despite its distance from the main campus and local hospitals. University of Florida just declined to take over the Lake Nona operation of the Institute, making it likely that it will shut down entirely.

The Johns Hopkins Hospital (MD) launches a Capacity Command Center that was designed and built by GE Healthcare. It uses engineering and predictive analytics to manage patient movement and experience, fed by alerts from 14 IT systems. The hospital reports faster inboarding of transfers, faster bed assignment for ED patients, improved morning discharges, and reduced OR transfer delays.

In Nepal, government hospitals say they can’t expand outpatient hours from 10:00 a.m. to 5:00 p.m. because their doctors skip work during the day for jobs in private clinics. Paying them extra and forcing them to clock in and out didn’t help, so hospitals have decided to publicly post each doctor’s hours on his or her nameplate, hoping patients will complain if their doctor has ducked out to moonlight.

This case should keep jurors awake. A New Orleans plastic surgeon accused of raping his former wife and recording unconscious patients without their consent sues his former business partner for cashing $3.8 million in unauthorized checks. In an unrelated incident, the former partner is charged with crashing his Lamborghini into a wall at 118 miles per hour while intoxicated, killing his passenger. He accuses the surgeon of using him to pay $375,000 in severance for an employee with whom the surgeon was carrying on a sexual relationship.

Weird News Andy opines that a UK woman’s 132-pound “tumour” (as reported in an English newspaper) is actually a “fourmour” and maybe even a “fivemour.”

Sponsor Updates

• EMDs will offer its customers claims financing from Provider Web Capital.
• Optimum Healthcare IT publishes a white paper titled “Community Connect – Expanding Epic into the Community.”
• CDW Healthcare recognizes Orion Health’s blog as a “Top 50 Health IT Blog.”
• The Institute for Critical Infrastructure Technology welcomes Protenus co-founders Robert Lord and Nick Culbertson as the newest ICIT Fellows.
• Dimension Insight achieves top ranks in BARC’s The BI Survey 16.
• The ECG Management Consultants 2016 Pediatric Subspecialty Physician Compensation Survey shows continuing upward compensation trend.
• EClinicalWorks kicks off 2016 national conference with over 4,000 attendees.
• HCS will exhibit at the 2016 LeadingAge Annual Meeting and Exposition October 30-November 2 in Indianapolis.
• HealthCast will exhibit at the 2016 CHIME Fall Forum November 1-4 in Phoenix.
• Impact Advisors and InterSystems will exhibit at the CHIME16 Fall CIO Forum November 1-4 in Phoenix.
• LiveProcess will exhibit at the New England Rural Health Roundtable November 2-4 in Southbridge, MA.
• LogicStream Health will exhibit at the AMDIS Fall Symposium November 3-5 in Phoenix.
• Meditech celebrates Canadian Patient Safety Week.
• Netsmart will exhibit at the New Mexico Association for Home and Hospice Care Annual Conference November 3 in Albuquerque.
• Obix Perinatal Data System will exhibit at the Riverside Methodist Hospital Perinatal Conference November 3 in Dublin, OH.OCLC

Blog Posts

• The Change Agent: Meet Spok’s New CMO (Spok)
• You’ve Signed Epic: Now What? (HCI Group)
• My thoughts on being ‘just a nurse’ (Infor)
• 5 Ways to Ruin an Interview Without Being Late (Direct Consulting Associates)
• Overcoming 5 Data Challenges Preventing Effective Physician Alignment (Evariant)
• The Nightingale Principle Today: using technology to improve patient safety (Extension Healthcare)
• Considerations Surrounding Data Migration Gap Loads (Galen Healthcare Solutions)
• Payment Posting: A Crucial Link to Effective Revenue Cycle Management (Hayes Management Consulting)
• Healthcare Improvement Moving Both Fast & Slow: IHT2 NYC Reflections (HBI Solutions)
• Post EMR Implementation: BAU, Goals, and HIMSS Stage 7 (HCI Group)
• 3 Tips to Keeping a Startup Culture in Your Organization (Healthgrades)
• Is LeSS Really More? An Introduction to SAFe and LeSS. (Healthlink Advisors)
• Ask a Nurse: All Patients Deserve Clear Communication (Healthwise)
• Cyber Attacks Get Creative in 2016: New Types of Attack and New Attackers (ID Experts)
• Breast Cancer Awareness Month: EHRs and Preventative Care (Impact Advisors)
• 5 Reasons You Can’t Manage Your Local Listings Alone (Influence Health)
• Adventures in EHR Land: Misplaced Patient Identities (InterSystems)
• After Our Biggest Quarter Ever, Liaison Reflects on the Most Important Award of All (Liaison Healthcare)
• LifeImage 5.0 Debuts with Powerful New Features (LifeImage)
• A PAMA Consultation (National Decision Support Co.)
• Nordic recapitalization: 5 questions with Chief Consulting Officer Vivek Swaminathan (Nordic Consulting)
• The Near Death of the US Healthcare Software Channel (NVoq)
• What Can Health IT Learn from Detroit? (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 10/27/16

Why the Key Indicators to Watch on Health-Care Marketplaces Come in 2017

Kaiser Family Foundation president and CEO Drew Altman addresses premium increases and a drop off in plan options on ACA marketplaces.

Copycat enrollment websites hamper ACA sign-up efforts

A proliferation of websites competing with Healthcare.gov are causing concern for regulators working to ensure that the ACA open enrollment period runs smoothly.

Northwestern leads consortium to integrate patient-reported outcomes into electronic health records

NIH awards Northwestern University a $6.3 million grant to begin integrating patient reported outcomes into EHR systems, with both Cerner and Epic signed on to support the effort.

News 10/26/16

Top News

AARP sues the federal government over newly issued rules that allow companies to offer employees in their wellness programs big health insurance premium rebates, saying rebates of that magnitude become coercive rather than voluntary and that employees will be forced to give their employers medical and genetic information that could be used to discriminate against them.

The Equal Employment Opportunity Commission manages the rules for employer wellness programs. Previous rules did not define the term “voluntary” or specify the types of medical exams or questionnaires employers were allowed to require of their participating employees.

The new rules allow covered entities to receive the information of wellness program participants only in an aggregate form that does not disclose the identity of specific individuals. It also prohibits employers from requiring participants to agree to share their information with other organizations as a condition of their participation.

AARP questions whether programs are allowed to require participants and their spouses to complete a health risk assessment or undergo biometric testing that would expose their private information. AARP’s members are more likely to suffer from less-obvious medical conditions that could be disclosed by their participation.  

Reader Comments

From Joy Division: “Re: NextGen Healthcare. An email was sent to all team members asking them to keep their heads down and work instead of speculating on the efforts with UBS Bank to find a buyer for the company. Most believe that Rusty Frantz was hired as CEO for just that reason.” An investor’s report from last week says NextGen parent Quality Systems has hired UBS to explore a sale and has conducted several presentations to interested parties.

From Magic Spell: “Re: patient engagement and technology. An OB/GYN practice in Arizona forces patients to arrive 1.5 hours early to fill in a lengthy DigiChart patient portal questionnaire to populate information that should already be there. Otherwise, they deny the services. The message that technology makes everyone’s life easier and helps engage patients could not be more displaced.”

From Cash Cow: “Re: CPT codes. The AMA has a lock on the coding system through a copyright and protects it as a cash cow. They insist on a seat license, which works for software but not applications that would meet an occasional or episodic need. You can’t provide a look-up service to find the numerical code or description without violating copyright or paying for an annual seat license for each unique user.” AMA charges $15.50 per user per year (named users, not concurrent). Several years ago, a court found that AMA misused its copyright in licensing CPT to CMS (it was HCFA back then) only if CMS agreed to not use competing coding systems, giving AMA a monopoly. A 2001 review by the Senate estimate that AMA earns at least $71 million per year in CPT sales and royalties, far more than it takes in from member dues.

HIStalk Announcements and Requests

I mentioned that last weekend’s health IT news was slow, so Brian Ahier provided some broader-picture material he’s reading:

• DARPA investigates the use of blockchain to secure the country’s most sensitive information.
• A research report forecasts a slight increase in wearable deals this year, but a big jump in VC funding mostly due to a single investor, mega-powered Magic Leap.
• The White House publishes a report covering the future of artificial intelligence.

Acronyms often overlap across industries and here’s a good example: EHR is Heineken’s shortcut for its “Enjoy Heineken Responsibly” branding campaign.

Webinars

November 8 (Tuesday) 1:00 ET. “A CMIO’s Perspective on the Successful 25 Hospital Rollout of Electronic Physician Documentation.” Sponsored by Crossings Healthcare. Presenter: Ori Lotan, MD, CMIO, Universal Health Services. UHS rolled out Cerner Millennium’s electronic physician documentation to its 6,000 active medical staff members — 95 percent of them independent practitioners who also work in competitor facilities — across 25 acute care hospitals. UHS’s clinical informatics team used Cerner’s MPage development toolkit to improve the usability, efficiency, communications capability, and quality metric performance of Dynamic Documentation, embedding clinical decision support and also using Nuance’s cloud-based speech recognition product for the narrative bookends of physician notes. This CMIO-led webinar will describe how UHS achieved 70 percent voluntary physician adoption within one month of go-live, saved $3 million in annual transcription expense, and raised EHR satisfaction to 75 percent. It will include a short demonstration of the software that UHS developed to optimize the physician experience.

November 9 (Wednesday) 1:00 ET. “How to Create Healthcare Apps That Get Used and Maybe Even Loved.” Sponsored by MedData. Presenter: Jeff Harper, founder and CEO, Duet Health. Patients, clinicians, and hospital employees are also consumers who manage many aspects of their non-medical lives on their mobile devices. Don’t crush their high technology expectations with poorly designed, seldom used apps that tarnish your carefully protected image. Your app represents your brand and carries high expectations on both sides. This webinar will describe how to build a mobile healthcare app that puts the user first, meets their needs (which are often different from their wants), creates “stickiness,” and delivers the expected benefits to everyone involved.

Contact Lorre for webinar services. View previous webinars on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

Cancer care planning software vendor Carevive Systems raises $7.2 million in a Series B funding round.

Apple’s 15-year streak of increasing annual sales is broken as falling iPhone sales reduce revenue by 9 percent.

Sales

St. Elizabeth Healthcare (OH) chooses Evariant’s marketing and physician engagement platforms.

People

The Nemours Foundation names Marc Probst (Intermountain Healthcare) to its board.

Announcements and Implementations

McKesson announces a new release of its Paragon EHR.

The Harvard public health school will offer a two-module, $7,210 program in “Leadership Strategies for Information Technology in Healthcare” in January and May whose faculty includes such notables as John Glaser, PhD; John Halamka, MD, MS; Joseph Kvedar, MD; Ken Mandl, MD, MPH; Blackford Middleton, MD, MPH; Dan Nigrin, MD, MS; Sue Schage, MBA; Dean Sittig, PhD; and Micky Tripathi, PhD. 

DocGraph releases a six-year Medicare cancer dataset. 

Government and Politics

Politico Morning eHealth reviews Q3 lobbyist spending:

• AHA $4.05 million
• AMA $3.87 million (part of that was spent to oppose a bill that would expand the military’s use of telemedicine, which AMA says would create a national medical license)
• Athenahealth $140,000
• Cerner $40,000
• CHIME $10,000
• Epic $36,000
• Health IT Now $40,000
• McKesson $220,000

FDA will offer a December 5 workshop to solicit recommendations on how to improve hospital-based medical device surveillance systems and the incorporation of unique device identifiers in EHRs.

Privacy and Security

Cybersecurity analysts say that patient information stolen in healthcare breaches is so readily available on the Dark Web that prices have dropped, with a full patient ID package fetching only $20 to $50 instead of last year’s $75 to $100.

An incorrectly configured master server in Guilford County, NC exposes the county’s EMS systems to the Internet. The server was running the Rsync file synchronization utility.

Technology

Amazon’s Jeff Bezos says the company isn’t working on specific healthcare uses for its Alexa virtual assistant, but that people there are thinking about it. He says, “I think healthcare is going to be one of those industries that is elevated and made better by machine learning and artificial intelligence and I actually think Echo and Alexa do have a role to play in that,” but cautions that even Amazon isn’t big enough to solve healthcare problems without the help of hospitals, doctors, and nurses.

Other

A study of 128,000 people with sleep apnea finds that they are more likely to continue their positive airway pressure therapy when they are remotely monitored via wireless sensors or track their progress using ResMed’s app.

A review of Medtronic’s upcoming MiniMed artificial pancreas says the problem is far from solved since the device works only with one expensive type of insulin; the user still has to count calories, perform finger stick readings, and administer their own bolus doses; and patients have to worry about pump and sensor errors. A professor who helped develop the device says it’s not a cure for diabetes and admits that it is “still a pain in the butt.”

An Open Notes article in The American Journal of Medicine offers caregivers tips for creating documentation that will benefit the patient as well.

In Australia, the family of a 72-year-old patient sues the hospital where he died of the effects of a burst bladder after nurses accidentally attached an oxygen line to his urinary catheter. The family also says that caregivers were unable to determine the man’s “do not resuscitate” status because the hospital’s EPAS system failed to retrieve it.

Sponsor Updates

• Netsmart and community care leaders connect the mind, body, and communities at Connections2016.
• Bernoulli will host a focus group at the CHIME16 Fall CIO Forum November 1-4 in Phoenix.
• Besler Consulting releases a new podcast, “Trends in HIM.”
• Meditech recaps its Physician and CIO Forum.
• Strata Decision Technology recaps the highlights of its recent client summit.
• IDC names Caradigm a leader in its MarketScape for Population Health Management.
• TransUnion Healthcare publishes a white paper titled “Recommended Resources for Hospital CFOs: Top 10 CFO Concerns about Revenue Cycle Management (And How to Address Them).”
• CTG publishes a white paper titled “How Today’s Healthcare Regulatory Alphabet Soup is Driving the Need for Optimization.”

Blog Posts

• KLAS Recognizes Aprima as a High-Performing Provider of RCM Services (Aprima)
• Talking with Physicians About Value-based Care (Arcadia Healthcare Solutions)
• Implementation of Value-Based Care Models On the Rise (Forward Health Group)
• Breast Cancer Awareness Month: EHRs and Preventative Care (Impact Advisors)
• HITRUST Inheritance: The most important compliance announcement of the year (Catalyze)
• How Bundled Payments is Driving Care Transformation and Patient Engagement (Caradigm)
• ECG Management Consultants Expands Technology Services With Kurt Salmon Merger (ECG Management Consultants)
• Taking Every Patient Request to Heart (CareSync)
• October: American Pharmacists Month (CoverMyMeds)
• The Consumerization of Healthcare IT Has Only Just Begun (CTG)

Contacts

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

Counting the Costs of a Data Breach

Fallout from a data breach affects much more than a provider’s bottom line. HIStalk looks at the impact ransomware attacks have on provider credibility and patient loyalty, plus offers tips on shopping for identity theft protection services.
By @JennHIStalk

Data breaches continue to make headlines, and while health IT system infiltrations may not garner as much press as those allegedly perpetrated by Russian hackers, they have providers and patients on edge all the same.

Much has been made of the breaches themselves – how attackers got in, how much ransom was paid, resultant HIPAA violations, etc. – yet little focus has been placed on the post-breach cleanup, which has perhaps the greatest impact on patients and the reputation of healthcare organizations.

In attempting to handle the aftermath, providers typically send out communications with language similar to that included in Rainbow Children’s Clinic’s (TX) recent letter to the 33,368 patients affected by an August ransomware attack on its servers:

Notification letters mailed today include information about the incident and steps potentially impacted individuals can take to monitor and protect their personal information. Rainbow Children’s Clinic has established a toll-free call center to answer patient questions about the incident and related concerns. The call center is available Monday through Friday from 8:00 am to 8:00 pm, Central Time and can be reached at 1-844-607-1700. In addition, out of an abundance of caution, Rainbow Children’s Clinic is offering potentially impacted individuals monitoring and identity theft resolution through Equifax at no cost. Additional information and recommendations for protecting personal information can be found on the Rainbow Children’s Clinic website at www.rainbowchildrens.com.

The establishment of call centers, websites, and free identity theft resolution for affected individuals may seem logical, but they all come at a cost that some providers just can’t afford. Athens Orthopedic Clinic (GA) has suffered a tremendous amount of community fallout in the wake of a June ransomware attack that affected 200,000 patients. Patients have taken to the local paper and social media to voice their frustrations with not being told immediately about the breach and to condemn the clinic for not offering to pay for credit monitoring.

“Many patients are upset and frustrated with the situation,” AOC CEO Kayo Elliott said in a statement. “And of course, they wish we could pay for extended credit monitoring. So do we. We truly regret that we are unable to do so, as we are not able to spend the many millions of dollars it would cost us to pay for credit monitoring for nearly 200,000 patients and keep Athens Orthopedic as a viable business. I recognize and am truly sorry for the position this puts our patients in.”

The mea culpa continued with an op-ed authored by AOC surgeon Chip Ogburn, MD who pleaded with the community for understanding and brought to light the impact AOC’s cleanup methods have had on its reputation. “We are upset with the potential mark this leaves on the credibility and integrity of our clinic,” he wrote in the Athens Banner-Herald. “For 50 years we have endeavored to provide Athens with the highest level of orthopedic care and are even more committed to that promise today.”

Despite AOC’s public-relations efforts, it’s been reported that two law firms are investigating the possibility of pursuing class-action lawsuits against the clinic. Such PR nightmares, while a potentially business-ending burden for AOC, highlight the importance other providers need to place on preparing for such attacks. And while security assessments should be done and protections put in place, clean-up costs like credit monitoring services must be taken into account, too. Preparing for, dealing with, and cleaning up data breaches seem to have become a cost of doing business.

Providers Get Proactive With Identity Theft Protection Services

As with any type of data breach, patients are typically directed to the credit-monitoring and reporting services of three institutions – TransUnion, Equifax, and Experian. While they aren’t the only companies that offer identity protection services, they are the most well known.

“TransUnion and other credit bureaus are resources for monitoring and protecting credit,” explains Gerry McCarthy, president of TransUnion’s healthcare solutions. “Our monitoring services include fraud alerts for any credit changes, access to live professionals to discuss any credit issues, and optional identity restoration services. In the event of a breach, providers will work with TransUnion and the other credit bureaus to set up monitoring services for affected patients.”

“We are starting to see proactive contracting with our healthcare customers who already utilize our RCM services,” he adds. “They are preparing to act quickly in case of a breach. Our credit and credit-monitoring usage by healthcare organizations has increased dramatically over the past two years. We believe this will be a standard service offered in both healthcare and other industries that deal in both consumer healthcare and financial data.”

Michael Bruemmer, vice president of consumer protection at Experian Consumer Services, backs up McCarthy’s provider utilization figures. “Last year, we serviced about 3,600 different data breaches and 40 percent of them involved healthcare, including pharma, payers, and business associates,” he says. “We’re seeing the biggest growth in smaller entities tied to a rise in ransomware. About 25 percent of our clients that we’ve been involved with in these circumstances have actually paid the ransom.”

With such an increase, Bruemmer is certain that proactive identity theft protection services will soon become a regular cost of doing business, and perhaps even a customer service / loyalty differentiator. He cites the Blue Cross Blue Shield Association as an example: “They announced last August that all of their plans – 34 separate BCBS entities around the country – will provide free identity theft protection for any of their current members if they want to sign up. This would be in advance of a breach. That was something that the association got behind, and I think that’s a great leading example of where identity theft protection is going to be used as a preventative measure for all patients, employees … even BAs and their staff. If a breach happens after that, they don’t have to scramble and go through the process because people already signed up for it.”

“I think it’s important for patients, especially if they’re switching providers or reviewing their physician’s annual privacy policy, to start asking questions like, ‘Where do you have my records? Where are they being stored? What security practices do you have in place? If something bad were to happen, would you respond?’ I think those are fair questions to ask with any type of provider, whether it’s your dentist, doctor, or pharmacist, let alone your insurance company.”

Shopping Around

Providing such services ahead of a breach sounds nice in theory, but how viable of a solution is it for the average provider, especially independent practices that operate with little cash on hand? Bruemmer explains that Experian’s pricing is based on a number of factors.

“We have a rate card that we publish out to clients that request it,” he says. “It’s an a la carte menu with prices tiered from quantity one up to the millions of people that could be affected. There are various pricing tiers and it is by each service. You have a cost for notifications, a cost for call center, and then a cost for the product itself. It depends on the circumstances, because in most cases, you’re going to be pricing by the number of people that actually sign up for a product. Let’s say there are 10,000 people affected by a breach. We would charge a wholesale rate for identity theft protection for only those people who subscribe to that protection. We then bill that back to the client who paid for this on behalf of the patients at the end of the breach.”

Aside from price, Bruemmer suggests that providers look at a credit-monitoring company’s experience, performance record, and response time when shopping around for such services. “They should be asking, how many breaches have you serviced? Have you serviced more complex breaches? Will you service small breaches? And then they should look at the performance record by asking, how big a breach have you serviced? What’s your customer satisfaction rating? Do you have any complaints? Any Triple A ratings from the Better Business Bureau?”

“Those are the typical things to look for,” he explains. “The third most important differentiator is response time, because the clock is ticking after a breach is discovered. The response time to a breach – determining how many people were affected and what type of information was compromised – to become legally compliant is important. The fourth factor is actually price, or the price-value relationship.”

Don’t Forget to Use It

Bruemmer stresses that once a provider has invested in such services, it’s important that their affected patients actually use them. “My advice for patients is to, first of all, read the notification letter, email, or visit the website of your provider. Second, take advantage of the services made available to you free of charge. There’s no reason not to sign up for it. Some consumers worry about giving us their information, but we’ve already got things like their Social Security numbers. We don’t allow fraudsters to get in. Last but not least, be curious about things that might happen and ask questions. I’ve already mentioned the questions you’ll want to ask a new provider, but also watch out for any new accounts, any unsolicited emails or letters that you might not normally receive. Those might be early indicators that someone is trying to get more pieces of your identity or use your identity against you. The more curious you are, the easier it is to spot these things. It goes without saying that you should pay attention to the free credit monitoring report or Dark Web service alerts included as part of your provider’s identity theft protection package. We have some people that sign up for the service and they never look at their alerts, which is just unconscionable.”

Be Proactive to Keep the Doors Open

Providers eager to avoid AOC’s predicament should, as McCarthy stresses, “be proactive and ensure they have contingency plans to protect patient information in case of a data breach. This includes having a relationship with a credit monitoring service to protect that information, the long-term identity of patients, and their credit.” It seems that in this digital day and age, taking such proactive measures might also just save a provider’s reputation.

Monday Morning Update 10/24/16

Top News

Friday’s major Internet outage appears to have been the result of a cyberattack launched by a botnet that targets Internet-connect devices. A scan last week found 11.3 million IP addresses of infected devices, many of them DVRs and IP cameras manufactured by China-based XiongMai Technologies.

The distributed denial-of-service attack was launched against Internet routing company Dyn, which is one of several that host the Domain Name System that translates text Web addresses to IP addresses.

Some speculate that Friday’s outage may have been a test to see if US election technology could be disrupted on November 8.

I saw no mention of hospitals that were affected, although it’s likely some were.

HIStalk Announcements and Requests

Few poll respondents say their organizations are doing anything to prepare for Medicare’s 2019 switch of patient ID numbers. Glen says the change seems like “bureaucratic masturbation” since it won’t improve his care or reduce costs, but the point is that Medicare cards will no longer enable identity theft by exposing Social Security numbers.

New poll to your right or here: which inpatient EHR vendor’s marketing program is most effective?

Last Week’s Most Interesting News

• Athenahealth’s Q3 results beat earnings expectations, but fall short on revenue.
• HIMSS announces IBM CEO Ginni Rometty as the HIMSS17 opening keynote.
• St. Joseph health (CA) pays $2.14 million to settle HIPAA violations in which a misconfigured server containing Meaningful Use data exposed patient information to Internet searches.
• Shares of IRhythm Technologies, which offers continuous skin patch monitoring of cardiac arrhythmias, jump 53 percent on the company’s IPO day.
• Industry groups respond mostly positively to the newly issued MACRA final rule.
• FDA approves an ultrasound sensor for Android smart phones developed by Philips.

Webinars

October 25 (Tuesday) 1:30 ET. “Data Privacy/Insider Threat Mitigation: What Hospitals Can Learn From Other Industries.” Sponsored by HIStalk. Presenters: Robert Kuller, chief commercial officer, Haystack Informatics; Mitchell Parker, CISSP, executive director of information security and compliance, Indiana University Health. Cybersecurity insurers believe that hospitals are too focused on perimeter threats, ransomware, and the threat of OCR audits instead of insider threats, which are far more common but less likely to earn media attention. Attendees will learn how behavior analytics is being used to profile insiders and detect unusual behaviors proactively and to place privacy/insider risk within the risk management matrix.

November 8 (Tuesday) 1:00 ET. “A CMIO’s Perspective on the Successful 25 Hospital Rollout of Electronic Physician Documentation.” Sponsored by Crossings Healthcare. Presenter: Ori Lotan, MD, CMIO, Universal Health Services. UHS rolled out Cerner Millennium’s electronic physician documentation to its 6,000 active medical staff members — 95 percent of them independent practitioners who also work in competitor facilities — across 25 acute care hospitals. UHS’s clinical informatics team used Cerner’s MPage development toolkit to improve the usability, efficiency, communications capability, and quality metric performance of Dynamic Documentation, embedding clinical decision support and also using Nuance’s cloud-based speech recognition product for the narrative bookends of physician notes. This CMIO-led webinar will describe how UHS achieved 70 percent voluntary physician adoption within one month of go-live, saved $3 million in annual transcription expense, and raised EHR satisfaction to 75 percent. It will include a short demonstration of the software that UHS developed to optimize the physician experience.

November 9 (Wednesday) 1:00 ET. “How to Create Healthcare Apps That Get Used and Maybe Even Loved.” Sponsored by MedData. Presenter: Jeff Harper, founder and CEO, Duet Health. Patients, clinicians, and hospital employees are also consumers who manage many aspects of their non-medical lives on their mobile devices. Don’t crush their high technology expectations with poorly designed, seldom used apps that tarnish your carefully protected image. Your app represents your brand and carries high expectations on both sides. This webinar will describe how to build a mobile healthcare app that puts the user first, meets their needs (which are often different from their wants), creates “stickiness,” and delivers the expected benefits to everyone involved.

Contact Lorre for webinar services. View previous webinars on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

From the Athenahealth earnings call following a revenue miss that sent shares down nearly 6 percent on Friday:

• The company added a record 5,092 providers in Q3.
• The company’s expected 30 percent bookings growth for the year is behind “as the lack of sense of urgency in the market has elongated the sales cycle” and Epocrates revenue was lower.
• Jonathan Bush says the MIPS program changes provider focus to “the operational cost of managing quality” and closes out the focus of the past six years, requiring a change in product approach.
• Bush says the company is building a new EDI platform that will be more reliable, more stable, and less expensive for adding new network connections.
• Bush said when asked about revenue growth and hiring, “You could look at the provider adds … as the great men of Monty Python like to say, I’m not dead, actually feeling much better.”
• University of Toledo is still the company’s only larger-hospital inpatient EHR customer.
• Bush says there’s not value-based care being delivered despite a lot of talk. “Obamacare was extremely incremental this idea of an ACO that takes the first two percent itself and gives you half of the incremental savings 18 months after you generate them when it is done calculating them. Even if the calculation is wrong, you still have to accept it. If you generate savings for three years, they reset your base at the new lower number. It is a crap game to play, so not many people really play it. There are a few companies that are standalone, independent to the hospital systems, that have more to gain. The economic rents doesn’t come out of their own. The other problem is most of the ACOs that are affiliated with us know that the savings would come out of the hospital.”
• Bush summarized, “The big news, of course, is that I have been promising to tell you if I ever thought that there was no chance of making 30 percent bookings growth, I never had to because there is always a chance. There is no chance. The reasons behind it are fundamental shift in the market, a shift that inspires us and that gives us more confidence in our ability to differentiate ourselves from traditional software, install it and run the traditional way.”

Decisions

• Jennie Sealy Hospital (TX) switched from GE PACS to Philips in August 2016.
• Little River Memorial (AR) will change payroll and time attendance from Healthland to ADP in January 2017.
• Rockcastle Regional Hospital (KY) went live with Kronos HR, time and attendance, and payroll in September 2016.

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

Announcements and Implementations

Brigham and Women’s Innovation Hub and Evidation Health will work together to measure the impact of digital health solutions on outcomes.

Privacy and Security

From DataBreaches.net:

• Baystate Health (MA) says five of its employees clicked on a phishing email link disguised as an internal memo, giving hackers access to their accounts that contained emails with the information of 13,000 patients.
• Seattle Indian Health Board notifies 800 patients that a breach of an employee’s email account exposed their information to an unknown hacker. The organization says it will “implement more structured password management and control measures” and is working on a project to “move all staff to a more secure email system.”

Other

Mayo Clinic and Arizona State University will build a new medical school adjacent to Mayo Clinic Hospital in Scottsdale, AZ that will also offer a certificate and master’s degree in the science of healthcare delivery. The organizations also plan to open a medical technology innovation accelerator. Groundbreaking is scheduled for 2017.

In Ireland, a hospital blames a system upgrade for sending doctors lab results that had been performed up to 20 years ago.

Sponsor Updates

• Agfa HealthCare’s enterprise imaging will participate in RSNA’s Image Sharing Validation Program.
• Experian Health will exhibit at the HFMA First IL Fall Summit October 24-25 in Oakbrook Terrace.
• HIMSS names Patientco CEO Bird Blitch chair of its Revenue Cycle Improvement Task Force.
• PatientMatters will exhibit at the Arizona Hospital and Healthcare Association Annual Meeting October 26-28 in Marana.
• TierPoint joins the Amazon Web Services Partner Network.
• Verscend will exhibit at AHIP Medicare and Medicaid October 23-27 in Washington, DC.
• Visage Imaging will exhibit at the SIIM Wisconsin Regional Meeting October 24 in Madison.
• ZeOmega will exhibit at the AHIP National Conference on Medicare, Medicaid & Duals October 23-27 in Washington, DC.
• ZirMed will exhibit at the National Association for Home Care & Hospice Annual Meeting October 23-25 in Orlando.

Blog Posts

• Out-of-Pocket Healthcare Costs Increase in 2016 (Patientco)
• Curing Unhealthy IT (PatientKeeper)
• Two cool systems that talk (PeriGen)
• CMS releases MACRA final rule … here’s our take (Infor)
• Why Maintaining an Effective Healthcare Provider Data Management Program is Critical (Phynd Technologies)
• Making the Most of Your Data with Population Health Management (PMD)
• Surescripts Unveils New Patient Record Locator Service (Point-of-Care Partners)
• Illuminating a Black Box in Healthcare: Translating HIPAA Auditing Requirements, Access Logs, and System Logs (Protenus)
• Denials Management: It Takes a Village, or at Least All of the Hospital (Sagacious Consultants)
• Ransomware Increasingly Seen in Healthcare IT (Summit Healthcare)
• Talking Technology & Health IT with CVS Pharmacy (Surescripts)
• What You Missed at TeleCon16 (TeleTracking)
• Joint Commission Launches Workplace Violence Prevention Tool (Versus Technology)
• Welcome to the Edge of Disruption (VitalWare)
• The Mind-Body Connection (West Corp.)
• Who will Patients Vote for This Open Enrollment Season? (Xerox)

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 10/21/16

Top News

Athenahealth announces Q3 results: revenue up 17 percent, adjusted EPS $0.35 vs. $0.15, beating earnings expectations but falling short on revenue.

ATHN shares dropped slightly on the news. They’re down 7 percent in the past year.

Reader Comments

From CMIO: “Re: Text2Codes. It’s a pretty cool web app that extracts / annotates ICD-10 and CPT codes from copied and pasted free text.” The Web-based tool offers a free trial.

From Excretory Gland: “Re: NIST/HHS conference on security. If the feds can’t get this one correct, what hope do we have?” A Twitter search of the misspelled hashtag turns up thankfully few recent instances of its recommended use.

From Media Maven: “Re: press party at HIMSS. I see HIStalk on the list as attending an event in which companies pay to speed-date members of the press.” I’ve never heard of the event. I’m not a fan of paying a third party to earn face time with so-called journalists who are mostly interested in scarfing down free drinks in return for a vague obligation to promote those companies that would otherwise not earn their attention. The promoter, oddly enough, is “a lifestage media and marketing company focused on parents and families.” Sounds like a waste of vendor money to me, a questionable display of journalist ethics, and something I will avoid entirely.

HIStalk Announcements and Requests

Here’s a DonorsChoose donation opportunity for CIOs and other hospital senior IT professionals. An anonymous HIStalk supporter will donate $10 for each response (up to 200) to a short survey covering hospital cybersecurity. Respondents will also receive a copy of the results. Senior hospital IT executives with cybersecurity responsibilities can complete the survey  in 5-7 minutes. Thanks for supporting DonorsChoose.

This week on HIStalk Practice: South Florida Behavioral Health Network selects ODH’s Mentrics behavioral population health management technology. GE announces the winning communities of its HealthyCities Leadership Academy Open Innovation Challenge. Acuity Eye Specialists goes live with CareCloud. ICD-10 still gives some practices (and payers) problems. Westmed Medical Group selects Bridge Patient Portal capabilities. Pyramid Healthcare taps Qualifacts for behavioral health tech. Florida stakeholders reignite telemedicine talks. CDPHP and CapitalCare Medical Group launch Acuitas Health. Culbert Healthcare Solutions President Brad Boyd focuses on restructuring physician compensation in a value-based world.

Webinars

October 25 (Tuesday) 1:30 ET. “Data Privacy/Insider Threat Mitigation: What Hospitals Can Learn From Other Industries.” Sponsored by HIStalk. Presenters: Robert Kuller, chief commercial officer, Haystack Informatics; Mitchell Parker, CISSP, executive director of information security and compliance, Indiana University Health. Cybersecurity insurers believe that hospitals are too focused on perimeter threats, ransomware, and the threat of OCR audits instead of insider threats, which are far more common but less likely to earn media attention. Attendees will learn how behavior analytics is being used to profile insiders and detect unusual behaviors proactively and to place privacy/insider risk within the risk management matrix.

November 8 (Tuesday) 1:00 ET. “A CMIO’s Perspective on the Successful 25 Hospital Rollout of Electronic Physician Documentation.” Sponsored by Crossings Healthcare. Presenter: Ori Lotan, MD, CMIO, Universal Health Services. UHS rolled out Cerner Millennium’s electronic physician documentation to its 6,000 active medical staff members — 95 percent of them independent practitioners who also work in competitor facilities — across 25 acute care hospitals. UHS’s clinical informatics team used Cerner’s MPage development toolkit to improve the usability, efficiency, communications capability, and quality metric performance of Dynamic Documentation, embedding clinical decision support and also using Nuance’s cloud-based speech recognition product for the narrative bookends of physician notes. This CMIO-led webinar will describe how UHS achieved 70 percent voluntary physician adoption within one month of go-live, saved $3 million in annual transcription expense, and raised EHR satisfaction to 75 percent. It will include a short demonstration of the software that UHS developed to optimize the physician experience.

November 9 (Wednesday) 1:00 ET. “How to Create Healthcare Apps That Get Used and Maybe Even Loved.” Sponsored by MedData. Presenter: Jeff Harper, founder and CEO, Duet Health. Patients, clinicians, and hospital employees are also consumers who manage many aspects of their non-medical lives on their mobile devices. Don’t crush their high technology expectations with poorly designed, seldom used apps that tarnish your carefully protected image. Your app represents your brand and carries high expectations on both sides. This webinar will describe how to build a mobile healthcare app that puts the user first, meets their needs (which are often different from their wants), creates “stickiness,” and delivers the expected benefits to everyone involved.

Contact Lorre for webinar services. View previous webinars on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

Allscripts acquires CarePort, which connects acute care providers to post-acute care providers. Terms were not disclosed. The company had raised $3.13 million in four funding rounds.

IRhythm Technologies, which offers continuous skin patch monitoring and data analysis of cardiac arrhythmias, prices its IPO shares at $17.00, valuing the company at $300 million. First-day trading on Thursday saw shares jump 53 percent.

Decision analytics vendor TrendShift acquires population health management vendor Health Data Intelligence, which the Columbus, OH business paper described in a July 2016 profile as a four-employee company that had raised just $125,000.

Inhaler technology vendor Propeller Health raises $21.5 million in a Series C funding round, increasing its total to $50 million.

The Partners Connected Health Symposium and HIMSS-owned Personal Connected Health Alliance will combine their conferences into a single Connected Health Conference next year, with Joe Kvedar, MD serving as program chair. HIMSS, its mHealth Summit, and Continua Health Alliance were rolled into PCHA in April 2014. HIMSS hired Patty Mechael, PhD as EVP of PHCA in June 2016.

Sales

Midland Health (TX) chooses Cerner’s clinical, financial, and population health management systems. They will apparently replace Medsphere’s OpenVista.

In England, King Edward VII’s Hospital chooses the modular enterprise imaging solution of Vital Images.

People

Brattleboro Memorial Hospital (VT) promotes Steve Cummings, BSN, MBA to VP of information and support services and Jon Farina to chief compliance and security officer. Both were involved in the hospital’s Cerner implementation.

Enterprise mobility solutions vendor Kony hires Cem Tanyel, MBA, MSc (TriZetto) as EVP/GM of global services.

Announcements and Implementations

Allscripts adds licensed health information from Healthwise to its EHR products via Infobutton integration.

HIMSS again awards the prized first-day conference keynote slot to a vendor executive, this time IBM CEO Ginni Rometty. I expect the Watson hype to be thick since the company has bet the Big Blue farm on selling it into healthcare. HIMSS hasn’t announced its Thursday political keynote speaker, but Mr. Wonderful and Robert from “Shark Tank” will close the show Thursday long after most attendees have departed, which is a shame since they’ll be the most interesting.

Accenture Federal Health Services contracts with Sutter Health and Validic to guide an ONC-funded pilot project to study how patient-generated health data can be delivered to care teams and researchers to improve outcomes.

ENHAC will replace its privacy and security accreditation criteria with HITRUST CSF provisions and controls, allowing EHNAC to offer both its own accreditation as well as that of HITRUST CSF.

Kareo adds prescription drug cost comparison information and coupons to its Kareo Clinical EHR using information from GoodRx.

Privacy and Security

September’s breach report from Protenus finds that while an average of 25 breaches per month occurred in the first half of 2016, the number has jumped to 39 per month for July, August, and September. Forty-one percent of September’s breaches were insider incidents, of which over half were intentional. Thirty-two percent of the September breaches were due to hacking, with five victims specifically stating they were hit with ransomware.

From DataBreaches.net:

• The email accounts of Hillary Clinton’s campaign chairman John Podesta and former Secretary of State Colin Powell were breached by hackers believed to be working for the Russian government when both men clicked on a phishing email (disguised as a Google password theft warning) that contained a Bitly-shortened link pointing to a URL that embedded their encrypted Gmail account information. Their exposed emails ended up on WikiLeaks.
• A medical practice in Canada is hit with ransomware, with no report of whether the ransom was paid.
• A laptop stolen from a benefits management company exposes the insurance information of 7,242 people, although the files contained only basic demographic information.

Innovation and Research

ONC awards Keith Marsolo, PhD of Cincinnati Children’s a one-year, $378,000 interoperability grant to develop standards and methods to populate clinical research systems with EHR information. Marsolo’s team hopes to create one-click access from the EHR to externally hosted electronic case report forms systems, pre-populating standard data elements.

Technology

Rush University Medical Center says use of RTLS at its Rush River North physician practice has reduced patient wait times in a pilot project of 350 patients. Patients are tracked throughout their visit via RTLS badges, with alerts sent to providers if they’ve waited longer than 10 minutes. The system also tracks equipment and notifies staff when rooms need cleaned.

Non-profit Trek Medics International offers Beacon, an SMS-based emergency medical dispatch system for countries that don’t have 911-type service. It allows requests for emergency assistance to be directly routed to any nearby trained responder. The company says most countries have the key components needed — young adults with phones and cars – and communities can create their own grassroots service. They’re working in Dominican Republic and Tanzania.

Other

An MIT study finds that people newly covered by Medicaid not only don’t cut back on their ED usage, but actually increase it significantly for at least the first two years, disputing the belief that insured patients would see primary care doctors instead of using the ED for routine care. The study found that the newly insured had a 13.2 percent higher likelihood of making visits to both an ED and primary care doctor, suggesting that the two types of visit are “more complementary, not more substitutable.”

In India, the owner of a 1,000-bed hospital in which 22 patients died in a fire is arrested along with four hospital officials. The politically connected owner started a university with schools of medicine, dentistry, nursing, and biotechnology. The hospital did not have a mandatory fire certificate.

The Charlotte newspaper profiles the ED usage reduction efforts of Community Care of North Carolina, which mined the Medicaid ED bills of Charlotte-area hospitals to identify the 100 most frequent ED users (at #1 was a homeless alcoholic who made 223 ED visits in 15 months). Most of the frequency flyers had behavioral health issues and some were visiting multiple EDs, with one patient being seen in three EDs in a single day. The team that started monitoring high-risk patients to help them find primary care doctors and obtain social services won the Hearst Health Prize for significantly reducing unnecessary ED and inpatient visits. The program faces shutdown, however, after North Carolina’s Medicaid reform left it without a contract.

A new Ohio law requires providers to provide a written estimate of charges, expected insurance payments, and the patient responsible portion of the bill 48 hours before providing non-emergency services. It also requires insurers to respond promptly to the inquiries of providers who need to know what insurance will pay so they can tell their patient.

A reporter’s review of “our addiction to medical hype” finds that “we reporters feed on press releases from journals and it’s difficult to resist the siren call of flashy findings” even though only 3,000 of the 50,000 medical journal articles published each year are of adequate quality for patient care use. The article quotes sources indicating that $200 billion in worldwide research spending is wasted on poorly designed or redundant studies.

Weird News Andy says a patient featured in a journal case study didn’t have a ghost of a chance. A man who eats a hamburger doused with ghost pepper puree and then tries to quench the fire by quickly drinking six glasses of water ends up with a torn esophagus from the ensuing vomiting. WNA provides helpful advice: “If it looks like one of Satan’s organs has prolapsed, you might want to reconsider eating it.”

Sponsor Updates

• HCI Group will sponsor a session at the Health Informatics New Zealand conference November 1-3 in Auckland.
• Ingenious Med will exhibit at Anesthesiology 2016 October 22-26 in Chicago.
• InterSystems will exhibit at the Partners Connected Health conference October 20-21 in Boston.
• Intelligent Medical Objects will exhibit at the EClinicalWorks National User Conference October 20-24 in Orlando.
• Frost & Sullivan recognizes Influence Health with its 2016 award for enabling technology leadership.
• Learn on Demand Systems donates servers and other hardware for computer science student use at Hillsborough Community College.
• AHIMA will use Meditech’s EHR in its Virtual Lab to train and test future medical professionals.
• Medicomp Systems releases a video describing the ways in which its technology can help providers transition to MACRA.
• Netsmart will exhibit at the National Association of Home Care’s annual meeting October 23 in Orlando.
• Obix Perinatal Data System will exhibit at AWHONN New Hampshire October 24 in Dover.

Blog Posts

• SQL Tip: The Good, the Bad, and the Ugly of TOP X (Iatric Systems)
• 5 Reasons Risk Assessments are Now Important than Ever (ID Experts)
• MIPS/MACRA Final Rule – Key Takeaways (Impact Advisors)
• Treat Patients Like Consumers to Drive Revenue (Influence Health)
• What Healthcare CIOs Need to Know: An Interview with InstaMed’s Security Experts (InstaMed)
• Putting the “Patient” Back in “Patient Access” (Kyruus)
• Pharma Lifecycle Plagued with Integration and Data Management Challenges (Part VII – Sentiment) Liaison Healthcare
• The Biggest Myth about Consumerism in Healthcare … And Critical Strategies to Meet Your Patients’ Expectation (Navicure)
• We’re Helping Clinician Have the Interoperability They Need (Orchestrate Healthcare)
• Two Legs Good, Four Legs Better: Why CRISPR will Change Everything (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.