News 9/13/17

Top News

Equifax faces ransom demands from a pair of hackers claiming responsibility for the data breach of 143 million customers. The group, which some believe to be fake, wants $2.6 million in bitcoin by September 15 in exchange for not making the data publicly available. They have even gone so far as to tug at heartstrings: “We are two people trying to solve our lives and those of our families. We did not expect to get as much information as we did, nor do we want to affect any citizen. But we need to monetize the information as soon as possible.”

Equifax has its hands full in terms of more legitimate fall-out from the breach. It reversed an earlier decision that forbid customers from joining a class action lawsuit in exchange for receiving a free year of credit monitoring after backlash from the National Consumers League and lawmakers in Washington, who are already calling for hearings. The company has also faced negative repercussions for the shoddy set up of a website for affected customers that some contend looks like a scam; not to mention three executives who sold $1.8 million in shares just a few days after breach was discovered.

Reader Comments

From ACD_Fan: “Re: RAND cost-of-care study. A just released study by RAND Corp. shows the cost of hospital care in Indiana compared to Medicare payment rates. One hospital, Parkview Health, is singled out as having ‘exceptionally high prices.’ This hospital has the highest cost of any hospital in the state by a wide margin. This is the same organization that has paid $3 million to have its name plastered on the local minor league baseball stadium. I’m glad I’m out of the healthcare business. It’s hard to feel good about your mission when you have to explain away some of these excesses.”

Webinars

September 13 (Wednesday) 1:30 ET. “How Data Democratization Drives Enterprise-wide Clinical Process Improvement.” Sponsored by: LogicStream Health. Presenter: Katy Jones, program director of clinical support, Providence Health & Services. Providence is demonstrating positive measurable results in quality, outcomes, and efficiency by implementing clinical process improvement solutions in arming operational and clinical stakeholders with unlocked EHR data. Providence’s army of process engineers use their self-service access to answer questions immediately and gain an understanding of how their clinical care delivery is impacting outcomes. The presenter will describe practical applications that include antibiotic stewardship, hospital-acquired infections, and comprehensive knowledge management.

September 28 (Thursday) 2:00 ET. “Leverage the Psychology of Waiting to Boost Patient Satisfaction.” Sponsored by: DocuTap. Presenter: Mike Burke, founder and CEO, Clockwise.MD. Did you know that the experience of waiting is determined less by the overall length of the wait and more by the patient’s perception of the wait? In the world of on-demand healthcare where waiting is generally expected, giving patients more ways to control their wait time can be an effective way to attract new customers—and keep them. In this webinar, attendees will learn how to increase patient satisfaction by giving patients control over their own waiting process. (Hint: it’s not as scary as it sounds!)

October 19 (Thursday) 12:00 ET. “Understanding Enterprise Health Clouds with Forrester: What can they do for you, and how do you choose the right one?” Sponsored by: Salesforce. Presenters: Joshua Newman, MD CMO, Salesforce; and Kate McCarthy, senior analyst, Forrester. McCarthy will demystify industry solutions while offering insights from her recent Forrester report on enterprise health clouds. Newman and customers from leading healthcare organizations will share insights on how they drive efficiencies, manage patient and member journeys, and connect the entire healthcare ecosystem on the Salesforce platform.

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

Acquisitions, Funding, Business, and Stock

Former CDC Director Tom Frieden, MD raises $225 million to launch a global health initiative that will tackle cardiovascular disease and epidemics. Backed by Bloomberg Philanthropies, the Chan Zuckerberg Initiative, and the Bill & Melinda Gates Foundation, Resolve will aim to save 100 million lives over the next 30 years.

Apple unveils its latest and greatest devices, including the iPhone 8, Apple Watch with wireless connectivity, and the iPhone X, which commemorates the company’s 10th launch of the phone and, at $1,000, its highest price point. The product updates follow on the heels of rumors (now confirmed) that the company is working with American Well and Stanford University to test the ability of the watch’s heart rate sensor to detect heart conditions.

People

Englewood Hospital and Medical Center (NJ) appoints Ravi Koganti (New York-Presbyterian Hospital) CIO and VP of IT.

Orchestrate Healthcare hires Ed Ricks (Beaufort Memorial Hospital) as VP of the Southeast.

Dave Rodger (Spotify) joins PatientPing as head of product.

Sales

University of Illinois officials agree to spend $62 million to implement Epic at UI Hospital in Chicago.

Hospitalist group Adfinitas Health (MD) selects Continuum Health as its RCM partner ahead of a planned expansion beyond its Mid-Atlantic region of operation.

HealtheConnections opts for data cleansing, quality analysis, and reporting tools from Diameter Health for its HIE participants across Central New York.

Announcements and Implementations

Magnolia Regional Health Center (MS) integrates Nuance’s Dragon Medical One speech-recognition and CAPD technology with its Meditech EHR.

In an effort to better coordinate care between local EMS services and its ED, PeaceHealth Southwest Medical Center (WA) implements Pulsara’s PreHospital Alerting Package.

Technology

Medical Information Records USA adds automated vital sign documentation from Neximatic to its cloud-based anesthesia information management system.

Government and Politics

Health Secretary Jeremy Hunt pledges to make app-based NHS medical record access, appointment scheduling, and prescription refills available to every patient in England by the end of 2018. The digital health initiative is part of the broader $5.6 billion 2020 program announced last year. Pilot programs of the new tools are already underway.

Thus far, the digital efforts of NHS don’t seem to include getting rid of the 130,000 pages it uses to the tune of nearly $8 million in costs each year. The Guardian reports that replacing the devices could save the system $3.5 million annually.

An ONC report on interoperability at skilled nursing facilities finds that 64 percent use EHRs, and 62 percent have interoperable networks in place that ensures electronic information is available from outside sources.

Job seekers have until September 18 to submit their applications for Digital Health Advisor with the FDA’s Center for Devices and Radiological Health.

HHS deploys its first team of federal responders to the Florida Keys, where it will establish a mobile medical unit and assist local providers with healthcare services. Local emergency officials estimate that at least 10,000 residents stayed on the islands during Category 4 Hurricane Irma.

CMS threatens to end Medicare and Medicaid funding for Mercy Hospital Springfield (MO) after reports surface of a male nurse punching and tackling a combative patient, and of a female patient being held in seclusion – an area the hospital dubbed an “acute-care area” – for 15 days. A CMS investigation into patient safety practices at the hospital earlier this year found that it failed to follow up on patient grievances and to report abuse. The hospital recently fired 12 employees after their behavior in “highly tense situations” became a cause for concern. It is also bringing in an interim leadership team from other Mercy facilities.

Privacy and Security

Children’s Hospital Colorado reports that a hacker has gained access to an employee email, resulting in the unauthorized exposure of the PHI of 3,400 patients. The unauthorized access did not affect patient health data. In a savvy marketing move, the hospital re-publicizes findings from a study earlier this year that show documentation in its Epic EHR has helped it achieve a 30-percent reduction in harm for HACs over the last five years.

Innovation and Research

A JAMIA analysis of online consumer ratings of 78 physicians finds no association between a physician’s average consumer score and their specialty-specific quality scores or value-based care.

Sponsor Updates

• Agfa Healthcare releases a new white paper, “Diagnosis – Communication – Care: Hardcopy technology for the digital age.”
• Aprima will exhibit at the American Academy of Pediatrics National Conference & Exhibition September 16-18 in Chicago.
• The Tampa Bay Business Journal includes AssesURHealth’s Tori Couch in its Up & Comers class of 2017.
• Besler Consulting releases a new podcast, “Update on the Medicare appeals backlog.”
• Cumberland Consulting Group will exhibit at the Healthcare Executive Group Annual Forum September 18-20 in Nashville.
• Dimensional Insight will exhibit at the 2017 Women’s Leadership Council Conference September 14-15 in Washington, DC.
• ECG Management Consultants and Intelligent Medical Objects will present at the 2017 IHA Leadership Summit September 13 in Lombard, IL.
• Elsevier Senior Architect of Clinical Solutions Tyler Lynch showcases students building a tool to simplify prescription scheduling at MedHacks17.
• EClinicalWorks will exhibit at AAP 2017 September 16-18 in Chicago.
• FormFast publishes a new case study featuring Duncan Regional Hospital.
• HCS will exhibit at the NALTH 2017 Fall Leadership Conference September 14-15 in Washington, DC.
• Impact Advisors will present on MIPS and MACRA as part of the Scottsdale Institute Teleconference September 19.
• EClinicalWorks publishes new case studies featuring CityMD and EssenMED House Calls.
• PatientPing releases a new video on coordinating patient care.

Blog Posts

• Modernize your patient experience with PatientPop (AdvancedMD)
• Lifting a Fork for Open Source (Datica)
• Benefits of Care Coordination: A Heart of CareSync Story (CareSync)
• Winners of the 2017 CoverMyQuest (CoverMyMeds)
• MACRA MIPS Basics and What You Need to Do Now (Culbert Healthcare Solutions)
• Data Sharing – Still Crazy After All These Years (ECG Management Consultants)
• 3 Benefits of a Data-Driven Approach to Billing Integrity (Hayes Management Consultants)
• The Path Forward for HIEs, and What I Learned at the SHIEC Annual Conference (Iatric Systems)
• The Essential Rules for Data Security (Influence Health)
• Disaster Recovery: 3 Higher Standards to Hold Your Vendors to for Data Protection (InstaMed)
• The Swiss Cheese Model of Patient Safety Errors: Closing the Holes with Message Accountability (Spok)
• Benefits to Optimizing Your Electronic Health Record (Leidos Health)
• Drug Labeling Inconsistencies Abound Regarding Sulfites as Preservatives (FDB)
• Three Concepts I Wish Everyone Understood About EHR Training (Impact Advisors)

Contacts

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

Monday Morning Update 9/11/17

Top News

HHS Secretary Tom Price, MD declares public health emergencies for Florida, Georgia, and South Carolina as Hurricane Irma surges through central Florida and the Tampa Bay area. Nearly 3.3 million homes and businesses in Florida are now without power. The storm marks the first time a tropical storm warning has ever been issued for Atlanta, which is expected to feel Irma’s windy and rainy aftershocks Monday.

Vice President Mike Pence has assured state officials that the federal government will be ready to mobilize relief teams as soon as the storm has safely passed. Those teams include 300 healthcare personnel flown in Saturday by the Air Force to Orlando, where the hurricane is expected to hit early Monday morning.

As is becoming the trend, several providers – including St. Vincent’s, Florida Hospital, Nemours Children’s Hospital, and Orlando Health in Florida – have stepped up to offer free virtual consults to victims of Irma. DrFirst has made its mobile iPrescribe prescription look-up tool free to select prescribers as well.

Greenway Health CEO Scott Zimmerman cancels the company’s annual user group conference set to take place this weekend in Orlando. Verscend Technologies also made the similarly tough yet necessary choice to cancel its customer event in Miami.

Reader Comments

From Van Helten: “Re: Data silos. Here’s an exclusive photo of one being installed at a hospital in Virginia.” 

HIStalk Announcements and Requests

Cash seems to be king when it comes to why hospitals don’t freely exchange patient information. Over half of respondents believe hospitals don’t share information because the business case for sending patient health data to competitors is lacking. Print Geek contends, “There should an option here for ‘lack of government leadership and intervention supporting interoperability.’ As much as it pains me to put more of healthcare in the hands of the fed, the banking and travel businesses seemed to figure it out themselves. Healthcare’s inability to solve this themselves screams for government intervention.” Clustered points out that, “There is a business case *not* to use shared data. Facilities can bill for repeating a procedure/test, if they don’t have access to the results (e.g., if an MRI exam was performed elsewhere). They can’t bill for requesting and receiving prior medical records. While that may sound irresponsible to a clinician, it certainly makes sense to the CFO/CEO of a hospital. We’re in the business of facilitating information sharing and we see it all the time (‘yet another piece of software that will help me decrease revenues’ – sometimes we can almost see the thought bubble).” Anonymous asks, “Aren’t ‘insufficient demand by patients’ and ‘lack of a business case’ hugely overlapping? Patients need to create the business case. If we had a health system where patients felt empowered to own their data, instead of feeling like Elaine in the Seinfeld episode where she just wants to be treated for her rash, I think the business case would be obvious.”

New poll to your right or here: Has a lack of interoperability ever hindered your or a loved one’s ability to receive healthcare services in the midst of or after a natural disaster? I’m thinking especially about hurricane evacuees who’ve wound up away from their homes for weeks or months. Please leave a comment as to what happened and how you resolved the situation. Your experience may end up helping those struggling to jump through the hoops of finding post-Harvey and (eventually) post-Irma healthcare.

This Week in Health IT History

One year ago:

• The NHS names 12 health IT “global exemplars” that will receive $13 million in health IT funding to establish best practices and a new digital health academy.
• The DoJ and FTC back Teladoc in the telehealth vendor’s legal battles with the Texas Medical Board, saying that the board’s restrictive telemedicine rules are anticompetitive and were not appropriately reviewed.
• France-based consulting firm Atos will acquire Anthelio Health Solutions for $275 million.
• Cleveland Clinic files plans to build a 205-bed private hospital in London’s upscale West End.
• HHS will provide $87 million to 1,310 safety net health centers for purchasing or upgrading EHRs.

Five years ago:

• ONC publishes a Health IT Dashboard that includes six views and 250 custom dashboards for states, ONC programs, and grantees.
• The board of Allscripts approves a $1.9 million 2012 incentive for CEO Glen Tullman.
• Elsevier acquires ExitCare, LLC, an enterprise-wide solution for patient education and discharge instructions.
• PE firm Thoma Bravo acquires Mediware for $195 million.

Ten years ago:

• Google unveils an upgraded version of Google Health that includes a cleaner interface and more focus on wellness.
• Stanford’s Lucile Packard Children’s Hospital appeals the $250,000 fine levied by the state’s health department when the hospital waited 11 days before reporting a stolen, PHI-containing laptop.
• MyChart comes to iTunes.
• Outpatient imaging center operator RadNet acquires Image Medical Corporation for $10.75 million in cash and notes.
• EHealth Ontario signs a $46 million contract with Canada-based CGI Group to develop and manage a diabetes management portal.

Last Week’s Most Interesting News

• STAT investigates IBM’s failure to develop Watson into a revolutionary technology for cancer care, highlighting the fact that its marketing blitz may have over-promised on the machine’s capabilities.
• The FDA launches a Digital Health Entrepreneur-in-Residence program to help develop and launch its Software Precertification Pilot.
• Equifax informs the public that a data breach discovered in late July could affect up to 143 million people.
• Fidelity National Financial will acquire emergency department clinical documentation and coding vendor T-Systems for $200 million in cash.
• Jeanne Lillig-Patterson, founder of the First Hand Foundation and wife of Cerner co-founder Neal Patterson, dies at the age of 59 after losing her battle with cancer.

Webinars

September 13 (Wednesday) 1:30 ET. “How Data Democratization Drives Enterprise-wide Clinical Process Improvement.” Sponsored by: LogicStream Health. Presenter: Katy Jones, program director of clinical support, Providence Health & Services. Providence is demonstrating positive measurable results in quality, outcomes, and efficiency by implementing clinical process improvement solutions in arming operational and clinical stakeholders with unlocked EHR data. Providence’s army of process engineers use their self-service access to answer questions immediately and gain an understanding of how their clinical care delivery is impacting outcomes. The presenter will describe practical applications that include antibiotic stewardship, hospital-acquired infections, and comprehensive knowledge management.

September 28 (Thursday) 2:00 ET. “Leverage the Psychology of Waiting to Boost Patient Satisfaction.” Sponsored by: DocuTap. Presenter: Mike Burke, founder and CEO, Clockwise.MD. Did you know that the experience of waiting is determined less by the overall length of the wait and more by the patient’s perception of the wait? In the world of on-demand healthcare where waiting is generally expected, giving patients more ways to control their wait time can be an effective way to attract new customers—and keep them. In this webinar, attendees will learn how to increase patient satisfaction by giving patients control over their own waiting process. (Hint: it’s not as scary as it sounds!)

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

Acquisitions, Funding, Business, and Stock

Wellsoft enlists consulting firm MedProjects to help market and implement its EDIS at St. Luke’s Medical Center in the Philippines as part of a broader push into the region.

Technology

With help from UPS, the Red Cross will begin test flights this week of a drone that will assess damage and potentially deliver aid to areas devastated by Hurricane Harvey. The deployment, which comes a year after the Federal Aviation Administration loosened up its restrictions on using drones for commercial activities, could lead to additional flights into areas affected by Hurricane Irma.

Users of DexCom continuous glucose monitoring products will soon be able to track their CGM data on FitBit’s Ionic smartwatch.

Navicure announces integration of its automated patient payment tool with Epic.

Smart Communications will integrate its communications management technology with Casenet’s TruCare population health and care management platform for payers.

Privacy and Security

University of Wisconsin-Madison’s Department of Family Medicine and Community Health notifies select patients that it violated HIPAA when it sent information about a quality improvement survey on a postcard rather than in a sealed envelope. The postcard referred to individual patient medications and family planning services.

Innovation and Research

A Truven Health Analytics survey finds cost to be the top reason patients don’t fill their prescriptions. A third of those surveyed look at drug costs before filling their prescription – a practice that decreases with age. Looking for lower prices, twelve percent have taken to filling their prescriptions outside of the US. Strangely, those with higher incomes and levels of education are more likely to miss a dose.

Henry Ford Macomb Hospital and the AMA see an increase in patient referrals to diabetes prevention programs six months into piloting a pre-diabetes registry developed with help from Epic.

Other

The New York Times looks at the ways in which emergency relief procedures for Hurricane Harvey compare with those of Katrina, highlighting the work done by Congress and FEMA in the intervening years to make sure resources, strategies, and playbooks were in place and trusted by community leaders well before Harvey spun its way into Texas and Louisiana. The author also points out the work HHS has done to make sure hospitals and nursing homes are better equipped and trained to evacuate, with the ultimate goal of only having to move residents once.

Surgeon, author, and speaker Atul Gawande, MD places blame for the opioid epidemic squarely on the shoulders of physicians, attributing the propensity of physicians like himself to unknowingly overprescribe to medical training that encouraged such practices:

“The cause in the opioid epidemic starts with getting a prescription of opioids from physicians. We weren’t recognizing — I certainly wasn’t recognizing — the extent to which we were putting people at risk. I think the key thing that has stuck in my mind was that when you go in for an operation, and you give a supply of opioid pills, that if people are on those pills for 7 days they have an 8 percent chance of one year later still being on those narcotic pills. It is huge. It is startling. I had no idea. Basically, I was like more is better, take some.”

Sponsor Updates

• West Corp. volunteers pack 8,790 meals in under an hour for Omaha Against Hunger.
• Bernard Tyson (Kaiser Permanente) joins Salesforce’s Board of Directors.
• Surescripts will exhibit at the AAFP Family Medicine Experience September 12-16 in San Antonio.
• Verego awards Sutherland its Corporate Social Responsibility certification.
• Wellsoft will exhibit at HIMSS AsiaPac17 September 11-14 in Singapore.
• ZirMed will exhibit at the CareVoyant User Group Conference September 13-15 in Schaumburg, IL.

Blog Posts

• Healthcare Accelerators for Startups (Redox)
• 5 Pieces of Advice for Female Entrepreneurs Who Have Been There, Done That (Salesforce)
• Hospital EHR Adoption Rates Rise, Don’t Necessarily Ease Information Flow (Definitive Healthcare)
• Patient Navigators and Your Hospital Revenue Cycle (The SSI Group)
• Cultivating Your Practice’s Unspoken Voice (Solutionreach)
• Clinical Technology. Does it have to be so disruptive? (Sphere3 Consulting)
• Automated workflows, current knowledge make precision medicine possible (Sunquest Information Systems)
• Thinking inside the box with a provider decision quadrant: monitoring provider network stability (Verscend Technologies)
• CRISPR-Cas9 Trials Target Cancer Cell Research (Definitive Healthcare)

Contacts

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

News 9/8/17

Top News

STAT investigates IBM’s failure to develop Watson into a revolutionary technology for cancer care, highlighting the fact that its marketing blitz may have over-promised on the machine’s capabilities – none of which have been formally documented in scientific papers. In development for six years, Watson for Oncology has been adopted by just a few dozen hospitals. HIStalk readers will likely remember MD Anderson’s decision to walk away from the technology late last year after spending upwards of $62 million on the project. Other complaints include advice that is biased towards American patients and caregiving methods; and expense, particularly as it relates to linking up the system to EHRs.

Reader Comments

From Harold & Kumar: “Re: United’s acquisition of Advisory Board. What’s United’s next move? An EHR vendor? Allscripts? Athena? If not an EHR, then Evolent? They seem to have a lot of cash and a long shopping list.” With a deal valued at a total of $2.58 billion, I’ll heartily concur that the piles of cash probably won’t lay around for long. I’ll invite readers to look into their M&A crystal balls and offer up their best predictions. It will be fun to look back and see who, if anyone, got it right.

From Just a Symbol: “Re: The state of journalism today. Typos are one thing, and we can surely forgive the occasional HER, but this headline takes the cake for lack of fact checking.” The New Delhi-based website bills itself as “a leading online news publication.”

HIStalk Announcements and Requests

This week on HIStalk Practice: Care Convene steps up Harvey relief efforts.  Vice President Pence swears in Jerome Adams, MD as US Surgeon General. The CDC doles out nearly $29 million to help states with PDMPs. Iora Health will care for WellCare’s Medicare Advantage patients. Dermatologist Jordan Miller equates the EHR’s impact on physician/patient relationships with that phone-obsessed friend who never makes eye contact. Weave Communications raises $17 million. HHS Secretary Tom Price, MD declares a public health emergency in Puerto Rico and the US Virgin Islands. HIStalk sponsors, submit your company’s details to the MGMA 2017 guide.

Welcome to new HIStalk Platinum Sponsor Lightbeam Health Solutions. The Irving, TX-based company offers end-to-end population health management solutions that reduce cost and improve patient management and coordination, including an enterprise data warehouse, analytics, risk stratification, HCC coding, quality measure optimization, physician engagement, care management, patient engagement, GPRO reporting, HIE, and cohort builder. One Texas ACO reports saving $28 million using Lightbeam’s tools and was one of just four ACOs nationally to achieve a 100 percent quality score. The company offers a free Population Health Made Simple series that describes how technology helps providers who are working under new payment models. Industry long-timer Pat Cline joined the company as CEO in 2012. Thanks to Lightbeam Health Solutions for supporting HIStalk.

Webinars

September 13 (Wednesday) 1:30 ET. “How Data Democratization Drives Enterprise-wide Clinical Process Improvement.” Sponsored by: LogicStream Health. Presenter: Katy Jones, program director of clinical support, Providence Health & Services. Providence is demonstrating positive measurable results in quality, outcomes, and efficiency by implementing clinical process improvement solutions in arming operational and clinical stakeholders with unlocked EHR data. Providence’s army of process engineers use their self-service access to answer questions immediately and gain an understanding of how their clinical care delivery is impacting outcomes. The presenter will describe practical applications that include antibiotic stewardship, hospital-acquired infections, and comprehensive knowledge management.

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

Acquisitions, Funding, Business, and Stock

Cognizant Technology Solutions plans to bring 75 healthcare-focused jobs to its office in Tampa, FL over the next three years.

Sales

Radiology and Imaging Specialists (FL) selects NextGate’s EMPI to reconcile over 1 million patient records.

Alliance Behavioral Healthcare selects ZeOmega’s Jiva population health management software for its 2,200 providers.

In Australia, South Western Sydney Primary Health Network opts for the dbMotion HIE tool from Allscripts to more easily exchange information between primary and acute care facilities.

Yale New Haven Health (CT) and Yale School of Medicine choose Appriss Health’s NarxCare solution to integrate their Epic EHR with Connecticut’s PDMP.

Freeman Health System (MO) signs on for CRM software from Influence Health.

LifeSpan (RI) selects cloud-based identity and access management technology from IDdriven.

Announcements and Implementations

Rehabilitation Hospital of the Pacific (HI) will upgrade its EHR from Harris Healthcare to include e-prescribing, among other features, and expand its use across ambulatory settings.

Surescripts and Allscripts partner to provide pharmacists in Texas and Louisiana free access to patient medication history data.

Union Hospital (OH) uses middleware from Iatric Systems to connect its smart infusion pumps with its Meditech EHR.

Citizens Medical Center (KS) wraps up department-wide deployment of speech-recognition tools and cloud-based image sharing capabilities from Nuance.

Technology

Meditech makes chemotherapy order templates from the National Comprehensive Cancer Network available in its Web EHR.

MedAptus develops new patient assignment software for nurses.

Casamba adds Kno2 health data exchange capabilities to its HealthWyse, TherapySource, and Smart EMR products for home health, hospice, SNFs, and outpatient clinics.

Government and Politics

The FDA launches a Digital Health Entrepreneur-in-Residence program to help develop and launch its Software Precertification Pilot. Applications are due September 29.

At the request of HHS, the National Quality Foundation issues a lengthy report on measuring EHR interoperability, as well as interoperability’s impact on “patient safety, costs, productivity, care coordination, processes and outcomes, and patients’ and caregivers’ experience and engagement,” outlining dozens of ways that interoperability could be measured and improved upon within the US.

The New York Times highlights the impact President Trump’s decision to end the Deferred Action for Childhood Arrivals program will have on the healthcare industry. Nearly 20 percent of DACA beneficiaries work in healthcare and education, filling positions like nursing assistants and home health aides – prime examples of roles that are facing a looming shortage of skilled workers.

Innovation and Research

A Health Affairs study finds that in 2016, 60 percent of the plans available on individual exchanges included provider networks where at least 25 percent of the local provider community was in network, contrary to growing concerns that network consolidation would lead to restricted access to care.

Scottish scientists develop a camera-like device that can “see” through the body. The camera, which detects sources of light in the body, was created to help physicians keep better track of medical equipment like endoscopes.

An NHS study of 444 people finds that escalating levels of severe health anxiety are placing unnecessary strain on the healthcare system, costing over £420 million in unnecessary outpatient appointments, tests, and scans. Researchers accuse Dr. Google and wearables of inciting this new state of cyberchondria.

People

Meditech South Africa appoints Charlotte Jackson group CEO.

Matt Parker (Connecture) joins HealthSparq as VP of product.

Correctional healthcare provider Corizon Health announces the immediate resignation of CEO Karey Witty. An operating committee of board members will take over in the interim.

Privacy and Security

There are just a few days left to register for Sensato’s Hacking Healthcare conference September 13-14 in Long Branch, NJ. The event will take place at the Ocean Place Resort & Spa – just steps away from the beach.

Lenovo will pay $3.5 million to 32 states that filed complaints related to the company’s preloading of advertising software onto its laptops without customer consent. The software also apparently captured personal data users shared with websites. The FTC filed a related civil complaint against the company over security vulnerabilities, and the two parties settled out of court earlier this week.

Equifax informs the public that a data breach discovered in late July could affect up to 143 million people. Stolen information could potentially include names, birth dates, SSNs, addresses, and some driver’s license and credit card numbers. Company officials point to hackers who “exploited a US website application vulnerability to gain access to certain files.”

Other

Weird News Andy says it pays to clean up after yourself: Investigators discover NIH employee Christopher Dame’s scheme to sell over $75,000 worth of stolen NIH equipment after he left an eBay receipt on the photocopier near his office. Dame admitted to stealing over 400 items from the agency over a four-year period, and has been sentenced to six months in federal prison.

This puts a new spin on the phrase “privacy breach:” Denver Health Medical Center suspends five nurses for three weeks after word spread through the hospital grapevine that the group had opened a body bag to look at a deceased male patient’s genitals. It soon surfaced that a similar incident had occurred before the patient’s death while he was incapacitated.

Sponsor Updates

• ECG Management Consultants will present at The Governance Institute – Leadership Conference September 10 in Colorado Springs, CO.
• EClinicalWorks and Healthfinch will exhibit at the AAFP Family Medicine Experience September 12-16 in San Antonio.
• Gartner includes Evariant in its “Hype Cycle for Healthcare Providers 2017” report.
• KLAS recognizes The HCI Group as the top healthcare IT consulting firm globally.
• Iatric Systems will exhibit at the HCCA Regional Conference September 8 in Boston.
• InstaMed partners with Bridge Bank to expand its credit facility.
• InterSystems will host its Global Summit 2017 September 10-13 in Palm Springs, CA.
• Intelligent Medical Objects will exhibit at HIMSS AsiaPac17 September 11-14 in Singapore.
• More than 900 healthcare professionals advance their education and network at the 2017 Aprima User Conference.
• MedData will exhibit at the Viva 17 Vascular Interventional Advances event September 11-15 in Las Vegas.
• Netsmart will exhibit at the MACMHP Annual Conference September 12 in Saint Paul, MN.
• Experian Health will exhibit at the HFMA SoCal conference September 10-12 in Los Angeles.
• FSU’s Jim Moran Institute for Global Entrepreneurship includes ROI Healthcare Solutions in its Seminole 100 list of fast-growing businesses owned by FSU alumni.
• Utah Business ranks Solutionreach twenty-fifth on its Fast 50 list of growing companies.

Blog Posts

• Predicting Readmission Risk in a Cardiac Population (ECG Management Consultants)
• Building a Denial Management System? Here’s Where to Start (Hayes Management Consulting)
• The Ecosystems That Fuel Health IT Investment (Healthcare Growth Partners)
• Functional and Handsome – Patient Instructions for Better Patient Recall (Healthwise)
• New Lessons on Patient Privacy Breaches and OCR HIPAA Settlements (Iatric Systems)
• Helpful everyday uses for SSO (Imprivata)
• Promoting a Hospital’s Best Products: Providers (Influence Health)
• The Business Value of Global Summit (InterSystems)
• Hurricane Irma Preparation (Learn on Demand Systems)
• CMS Emergency Preparedness for Nursing Homes and Long-Term Care (LiveProcess)
• Leverage data to improve healthcare consumer engagement (Experian Health)
• Opportunities for Care Coordination in the Emergency Department (PatientPing)
• How Blockchains Will Solve Healthcare IT’s Most Pressing Issues (PokitDok)
• Consultant’s Corner – Alexandra Rae (Huntzinger Management Group)
• 4 Advantages of a Consolidated Contact Center (Spok)
• Centralizing Patient Access Webinar Series – Key Takeaways (Kyruus)

Contacts

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

News 9/6/17

Top News

Jeanne Lillig-Patterson, the 59-year-old founder of Cerner’s First Hand Foundation, died Monday of cancer less than two months after death of her husband, Cerner Chairman and CEO Neal Patterson. She was diagnosed with metastatic breast cancer 10 years ago.

Neal Patterson died July 9 of cancer complications. He was 67.

First Hand impacted 300,000 lives in 93 countries and supported health screenings and educational programs that involve one-fourth of students in the Kansas City area.

Lillig-Patterson was Cerner employee #7, earning her the internal nickname “Double O Seven.” She got the job after responding to a 1980 ad by what was then Patterson, Gorup, Illig & Associates, which hired her for her ICD-9 coding background as a hospital admitting department employee. PGI was doing contract work for non-healthcare companies when it was hired by a pathology practice, with the founders, Lillig-Patterson, and other employees scrambling to write the COBOL code that would eventually form the PathNet laboratory information system. Lillig-Patterson suggested Cerner as the company’s name in 1984 after noticing the word in a language dictionary as a group led by Neal Patterson tried to come up with something more memorable than PGI.

Neal Patterson said of her at a 1999 company event in observing Lillig-Patterson’s planned retirement from Cerner, “She has done more jobs than any single person at Cerner. Jeanne began as our office manager and accountant. She started the account manager organization. She led the team converting our entire install base to a new platform, Classic 200 to Classic 300. She started the Cerner Health Conference. She ran professional services for one-half of the United States. She helped start the client-focused team organization, which was the predecessor to the regional branches, helping to start the client services organization. In the recent era, she started the First Hand Foundation and our community relations program. Jeanne is the soul of Cerner.”

Co-founder, board chair, and interim CEO Cliff Illig said in an internal email to Cerner employees Monday, “I would remind us all of the image of Jeanne and Neal walking through a hospital lobby carrying the bags that contained all of Jeanne’s medical records to another of her hundreds of doctors’ appointments. As Neal would want us all to recognize, it’s our job to get rid of Jeanne’s bags.”

The Pattersons had two children together – Cortney and Will – as well as Clay Patterson and Lindsey Patterson Smith from Neal Patterson’s prior marriage.

Reader Comments

From Generic Substi-Tooter: “Re: HIStalk. I’ve been a reader for six years. Just wanted to let you know that I appreciate the work you’re doing. Seems like you have a small staff helping as well, so tell them to keep up the good work. You definitely catch a lot of flak from readers about Epic or Cerner bashing, which is funny to read since I’m guessing many of those come from the company that’s had the bad press.” Thanks. People sometimes think the HIStalk team is substantial, so this is a good time to recap. I write every word on HIStalk except when I take time off, during which Jenn covers for me (she also writes HIStalk Practice). Lorre does everything that doesn’t involve writing, including webinars, with occasional help from Brianne. Lt. Dan writes the daily headlines, while Dr. Jayne’s contributions run twice each week. That’s everybody, maybe three FTEs total who each do our own thing without requiring a lot of collaboration. I started HIStalk in 2003 and have been accused nearly constantly since of bashing vendors who would prefer that health IT “news” consist entirely of their shiny, happy press releases that other sites run unchallenged. Like the industry itself, HIStalk can be rough around the edges, but I don’t push back from the computer at the end of the day until I’m reasonably proud of it.

Webinars

September 13 (Wednesday) 1:30 ET. “How Data Democratization Drives Enterprise-wide Clinical Process Improvement.” Sponsored by: LogicStream Health. Presenter: Katy Jones, program director of clinical support, Providence Health & Services. Providence is demonstrating positive measurable results in quality, outcomes, and efficiency by implementing clinical process improvement solutions in arming operational and clinical stakeholders with unlocked EHR data. Providence’s army of process engineers use their self-service access to answer questions immediately and gain an understanding of how their clinical care delivery is impacting outcomes. The presenter will describe practical applications that include antibiotic stewardship, hospital-acquired infections, and comprehensive knowledge management.

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

Acquisitions, Funding, Business, and Stock

Equity investor FNFV acquires ED clinical documentation and coding vendor T-System for $200 million in cash. FNFV plans “multiple acquisitions” to accelerate T-System’s growth.

In Australia, Citadel Group acquires oncology EHR vendor Charm Health from its venture capital owner.

Sales

Temple Health (PA) chooses Sectra PACS.

The VA selects Diameter Health’s CCD Analyzer to support clinical data quality surveillance.

Pharmacy benefits manager Magellan RX Management will offer its customers CoverMyMeds for electronic prior authorization.

People

Michigan Medicine names interim CIO Andrew Rosenberg, MD to the permanent role.

Christopher Rieder (Brookdale University Hospital and Medical Center) joins anatomic pathology practice company Aurora Diagnostics as CIO.

MedeAnalytics hires Kerry Martin (Cerner) as SVP of sales.

Jamie Coffin, PhD (SourceMed) joins genetic screening company Sema4 as president/COO.

Announcements and Implementations

Health Catalyst launches Data Operating System, the result of a $200 million development project that combines vendor-agnostic data warehousing, clinical data repositories, and HIEs into a single platform. Its attributes include reusable logic, real-time data streaming, ingestion of both structured and unstructured data, closed-loop EHR integration, microservice API architecture, machine learning, and an agnostic data lake. 

In South Korea, Gangnam Severance Hospital, Samsung, and virtual reality developer FNI will work together to developer virtual reality technology for mental health, including a VR-powered diagnostic tool.

Datica’s cloud platform for digital health apps earns HITRUST certification for security risk mitigation and PHI protection.

The executive clinic of The Greenbrier resort (WV) will partner with WVU Medicine, including adopting its Epic system.

Lovelace Health System (NM) completes its implementation of Epic.

Diagnostic imaging vendor RadNet partners with two Patrick Soon-Shiong controlled organizations – NantWorks and six-hospital Verity Health – with Verity Health taking over RadNet’s Breastlink business in California and all three organizations collaborating on clinical trials, data analytics, and AI-powered predictive modeling.

UnitedHealthcare announces PreCheck MyScript, which gives prescribers cost and coverage information at the point of prescribing and automates prior authorization for patients covered by the insurer’s health plans. The service being integrated with Allscripts EHRs and DrFirst.

Government and Politics

HHS OCR launches “Information is Powerful Medicine,” a campaign to let the public know that HIPAA gives them the right to view and obtain copies of their health information from their provider.

A New York Times report observes that HHS – which is legally responsible for overseeing the Affordable Care Act – is instead spending taxpayer money to oppose it in promotional videos and is constantly criticizing the law via anti-Obamacare tweets by HHS Secretary Tom Price. According to a law professor, “Here, it’s an agency trying to destroy its own program because it opposes it. It is inconsistent with the constitutional duty to take care that the law is faithfully executed.” The article also calls out the White House’s drastic cutback in insurer-paid funds for signup advertising and the removal of ACA information from the HHS.gov website.

Enteprise customer communications management solutions vendor Smart Communications will integrate its technology with Casenet’s TruCare population health and care management platform to allow health plans to deliver personalized communications to members and providers via their preferred channels.

Cerner creates an advisory group to guide its work on the VA’s EHR project, with members that include former Senator Bob Kerrey; former VA CIO Roger Baker; former HHS Acting Assistant Secretary for Health Karen DeSalvo, MD; former VA secretary James Peake, MD; and former VA Undersecretary for Health Jonathan Perlin, MD, PhD.

Privacy and Security

The Locky ransomware is being spread by a new technique in which a browser user is convincingly warned that a required PC font is missing, with the malware installing itself if the user clicks the update button.

Other

A Boston Globe report finds that rapidly expanding for-profit hospital chain Steward Health Care System has failed to file state-required financial, quality, and merger plan information and has not paid fines that were imposed for its lack of transparency. It has also stopped providing individual hospital data. A Harvard professor says the private equity-owned chain, which is going national, might be trying to hide the reality behind its claimed turnaround of its acquired Massachusetts hospitals.

A study published in Health Affairs finds that insurance company bargaining power has lowered the cost of hospital admissions and of some physician specialties (cardiology, radiology, and hematology-oncology services) in concentrated provider markets, but has not lowered PCP or orthopedist prices. The article concludes, “The policy dilemma that arises from our findings is that there are no insurer market mechanisms that will pass a portion of these price reductions on to consumers in the form of lower premiums.”

A Dallas medical testing laboratory accused by the federal government of a $100 million fraud scheme files a lawsuit to prevent state and federal agencies from revoking its laboratory licenses. Two of the principals of Next Health and Medicus Laboratories also face similar charges for their work at a now-bankrupt doctor-owned hospital chain that prosecutors say paid $40 million in bribes to generate $200 million in paid claims as an out-of-network provider. The executive of one of Next Health’s marketing contractors has been indicted in an unrelated case for giving soldiers Walmart gift cards in return for saliva and urine samples that were used to perform unnecessary tests for which Tricare paid, using a similar method to drum up business for Next Health by approaching people in Whataburger restrooms and offering them $50 gift cards for providing urine samples for a “wellness study.” One patient earned $600 for providing a dozen urine samples that were used to bill UnitedHealthcare Group $217,000, with the Next Health marketing rep bragging that he was earning $100,000 per month for brokering kickback payments to doctors. Next Health told patients they wouldn’t be billed for their part of the cost, fearing that their complaints would trigger an investigation.

In India, police are investigating the perinatal asphyxia deaths of 30 children at a state-run hospital after families complain that the hospital did not give the babies oxygen. This follows a previous incident where 60 children at another hospital died after oxygen supplies were reportedly cut off due to non-payment of the oxygen supply company’s bills.

Here’s another 30-year look back from Vince, who describes the health IT news of September 1987 and what it means today. He would love to hear stories from fellow pioneers, especially if they dig into their own closets for yellowing industry ephemera.

Sponsor Updates

• Agfa HealthCare publishes a new case study, “Hashemite University leads the way with first ‘Instant DR’ in Jordan.”
• Besler Consulting will present at the NJ HFMA Regulatory & Reimbursement Educational Program on September 12 in Edison.
• Datica releases a new podcast, “Emerging Healthcare Data Challenges from Patient-Centric Technologies.”
• Besler Consulting releases a new podcast, “Patient access strategies to improve collections.”
• CompuGroup Medical will exhibit at PainWeek September 5-9 in Las Vegas.
• CoverMyMeds will exhibit at the AAFP Family Medicine Experience September 12-16 in San Antonio.
• Cumberland Consulting Group will exhibit at the MDRP 2017 Summit September 11-13 in Chicago.

Blog Posts

• Only You Can Prevent Ransomware Attacks (Optimum Healthcare IT)
• Do You Understand MIPS? Prove It! (AdvancedMD)
• Facing down the largest breaches of 2017 with Datica’s open-source policies (Datica)
• Implementing Value-Based Care: A Top Concern of Health System CEOs (CareSync)
• What to Consider as You’re Starting to Measure Population Health (Dimensional Insight)

Contacts

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

Monday Morning Update 9/4/17

Top News

An article in Wired says that despite widespread use of electronic medical records, people with medical needs aren’t faring any better after Hurricane Harvey than following Hurricane Katrina in having their medical history available to first responders and new providers.

The article blames lack of interoperability and EHR downtime caused by flooding and power outages.

The author describes PULSE (Patient Unified Lookup System for Emergencies), an HHS-funded pilot project to create a data-sharing network that can be activated in a crisis. A January 2017 HHS announcement describes the California pilot that uses technology from Audacious Inquiry:

PULSE is currently being built to facilitate exchange during a declared emergency by extending interoperability across disparate technologies to support health information exchange. PULSE will allow Alternative Care Facilities (think of these as aid stations or MASH units set up during an emergency) so that EMS and authenticated volunteer providers can quickly get access to often life-saving data, when and where they need it. In the future, the PULSE system could facilitate patient lookup capability in an ambulance.

During a recent demonstration by Audacious Inquiry, the contractor that developed the PULSE technology, the program’s benefits become readily apparent. In the event of an earthquake, or forest fire (like the one that recently ravaged Eastern Tennessee), first responders (defined under PULSE as any of six provider types, including doctors, nurses and EMTs) can query PULSE with standard eHealth exchange patient demographics—including name, date of birth, and gender.  PULSE then sends out data tendrils to California-based HIEs, health systems and hospitals, for instance, looking for a match to the query. PULSE then enables first responders to see recent care notes from treating providers – including hospital discharge summaries and the Consolidated Clinical Documents (CCDs).

As PULSE is being developed, we have tried to ensure that it can be a model for other states to use. To support future scalability, PULSE is utilizing industry standards when communicating with HIEs and hospitals.

HIStalk Announcements and Requests

Poll respondents are OK with — clinicians with or without formal informatics credentials — calling themselves “informaticists” and are equally accepting of non-clinicians who have earned a graduate degree in informatics, but draw the line at a non-clinicians whose only credential is work experience. Harry suggests calling technically focused people “informaticists” and those specializing in clinical applications and user experience “informaticians.” Kelley says a challenge in public health is separating informatics from IT.

New poll to your right or here: What is the primary reason hospitals don’t exchange patient information freely?

This Week in Health IT History

One year ago:

• CMS offers providers four “pick your pace” Quality Payment Program options for 2017.
• St. Jude Medical sues a medical security services vendor, claiming its pacemaker vulnerability testing was not only improperly performed, but also part of stock short-selling scheme.
• Apple announces the iPhone 7.
• In England, NHS announces a digital exemplar grant program for trusts.

Five years ago:

• Merge Healthcare hires an investment bank to review strategic alternatives.
• Vocera announces its public offering.
• Harris Corporation investigates potential US bribery law violations by its Carefx China division, whose employees were found to have provided gifts and payments to prospects.
• A computer hacker in Italy shares his brain cancer-related medical records on the Internet in seeking help in a project he calls “My Open Source Cure.”

Ten years ago:

• Ingenix acquires Healthia Consulting.
• Athenahealth prices its IPO.
• Allscripts announces its largest EHR sale in its history to Columbia University Medical Center.
• A UK hospital blocks employee access to Facebook after heavy use degrades its network performance.
• Health Evolution Partners, started by former National Coordinator David Brailer, MD, PhD, begins its search for investments.

Last Week’s Most Interesting News

• FDA announces a voluntary recall of St. Jude Medical pacemakers to install a firmware update to fix cybersecurity vulnerabilities.
• CHIME and DirectTrust announce plans to promote universal deployment of the Direct network.
• Advisory Board announces plans to sell its healthcare business to UnitedHealth Group.
• Texas hospitals struggled with flooding from Hurricane Harvey.

Webinars

September 13 (Wednesday) 1:30 ET. “How Data Democratization Drives Enterprise-wide Clinical Process Improvement.” Sponsored by: LogicStream Health. Presenter: Katy Jones, program director of clinical support, Providence Health & Services. Providence is demonstrating positive measurable results in quality, outcomes, and efficiency by implementing clinical process improvement solutions in arming operational and clinical stakeholders with unlocked EHR data. Providence’s army of process engineers use their self-service access to answer questions immediately and gain an understanding of how their clinical care delivery is impacting outcomes. The presenter will describe practical applications that include antibiotic stewardship, hospital-acquired infections, and comprehensive knowledge management.

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

Decisions

• Mercy Medical Center (MD) will replace Meditech with Epic.
• Southeast Health Center Of Stoddard County (MO) changed from Medhost to Evident in June 2017.
• Integris Canadian Valley Hospital (OK) replaced Cerner with Epic in May 2017.

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

People

Orion Health hires Terry Macaleer (Anthelio Healthcare Solutions) as president of its US operations.

Henry Mayo Newall Hospital (CA) hires Ray Moss (Cedars-Sinai) as VP/CIO.

Announcements and Implementations

A new Reaction report finds that only one in four cardiology facilities use speech recognition, with far less enthusiasm and effort than their counterparts in radiology, but cardiology use is increasing quickly. Nuance and MModal hold 89 percent of that market.

Cerner and its customer HealthSouth will work together to develop tools to manage post-acute care patients.

Privacy and Security

A university in Canada loses $12 million to scammers who impersonated an employee of its construction company vendor in requesting that checks be sent to their new address that was actually that of the scammers.

Other

Artificial intelligence researcher Oren Etzioni proposes in a New York Times op-ed piece that AI be regulated in three ways, based on Isaac Asimov’s 1942 “three laws of robotics”:

• Companies that deploy AI systems must be held accountable for any illegal behavior that results.
• The AI system, such as a chatbot, must disclose that it is not a human in any conversations with humans.
• AI systems must not retain or disclose confidential information they receive, such as background audio recorded by Amazon Echo.

Google’s Verily life sciences company develops a way to predict cardiovascular risk factors by analyzing a person’s retinal image with a machine learning algorithm instead of performing blood tests. The model showed high accuracy in using only the retinal image to predict age, blood pressure, body mass index, gender, and smoking status.

A federal judge certifies as class action a lawsuit covering all Medicare recipients who were hospitalized but categorized by the hospital as observation patients, which means that as outpatients without necessarily knowing it, they pay more for drugs, co-insurance, and nursing home care.

Sponsor Updates

Blog Posts

• Assessing Your Population Health Plan: Start with a Simple Framework (Medecision)

Contacts

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

News 9/1/17

Top News

A Health IT Now stakeholder group made up of several member associations (including AMIA) and health IT vendors ask ONC and HHS OIG to provide guidance around information blocking:

• What are examples of behaviors that the federal government will interpret as being information blocking?
• How is “should have known” defined?
• How will patient access be measured?
• How does the law interact with HIPAA and medical malpractice laws?
• What reasonable business practices and contract terms are exempt from information blocking requirements?
• How will the $1 million per violation vendor penalty be defined?
• What mitigation opportunities will be offered before incidents are turned over to HHS OIG for investigation and penalties?

Reader Comments

From Harvey Headbanger: “Re: HIPAA. The HHS secretary has waived HIPAA Privacy Rule provisions for hospitals in Texas and Louisiana for 72 hours after their disaster protocol has been activated. So you’ve got a hospital in a disaster area with problems including, but not limited to, rolling power outages, floating fire ants, looting, a looming public health crisis, and of course all the flooding compounded with strained emergency and utility services. The Secretary graciously expects that after three days, I have to create a semi-manual process for distributing and capturing NPPs and managing requests for privacy restrictions in an environment where communication is already very difficult, workforce shortages are common, and I’m trying to determine how to triage the unusual influx of patients. Not seeing it. Thoughts and prayers to the people of SE Texas and Louisiana.”

From Geaux Texans: “Re: your Houston donations. Why not the Red Cross?” I’m not a fan of that organization since they don’t earmark donations for specific causes, multiple reports exist over years indicating that they are dismissive of local volunteers, and my unscientific observation is that they seem to take advantage of global natural disasters to promote themselves and their fundraising. They also get a score of 83 on Charity Navigator, which isn’t so great. I know that their fundraising machine will allow them to do mass-scale work, leaving me to support more local efforts without feeling guilty. I donated to the Salvation Army of Houston because Salvation Army is my favorite charity overall and I trust their mission and stewardship even though as a religious-based organization they aren’t rated by Charity Navigator. Houston Food Bank earns a Charity Navigator score of 100 and the Houston SPCA gets a 97, both of those being local organizations that I’m pretty sure will quickly do the right thing without much bureaucratic overhead. Please donate, but be careful – scammers abound during high-profile disasters when donors are anxious to help quickly. Donate directly from the verified home pages of charities you’ve first checked on Charity Navigator. This isn’t the time to click shady Facebook “donate here” links or to send money to GoFundMe projects.

HIStalk Announcements and Requests

The inaccessibility and loss of paper medical records during Hurricane Katrina kicked off the uptake of EHRs (and led New Orleans health commissioner Karen DeSalvo, MD, MPH, MSc to the National Coordinator role). I’m wondering if Hurricane Harvey will provide the impetus for adoption of other technologies, perhaps telemedicine or even drone delivery of drugs and medical supplies.

I passed on a modestly interesting news item today because the company has so much high-falutin’ gibberish on its website that I couldn’t figure after several minutes exactly what it is they do. Marketing people convince company executives that their painfully wrought, committee-driven aspirational BS prose is what users want, but I say it’s a big fail if their site doesn’t quickly tell me what they’re selling and why I should care.I envisioned the result of that company’s marketing brain trust being cut loose on some kid’s lemonade stand, with the resulting tagline being, “Refreshment, realized” and a mission statement of:

Katy’s Lemonade Stand is a regionally recognized, trusted partner for implementing a diverse portfolio of innovative products, strategies, and frameworks that enhance synergistic hydrationary outcomes and provide an exemplary customer experience that inspires human achievement.

I’m also annoyed by companies that add a customer service chat box to their websites, which is intrusive but not super annoying, but then double down by including a loud “look down here at our cool automated chat agent” sound effect that makes me jump a foot off my chair. Websites should not automatically play any sound or auto-start a video that includes audio. Sites are killing off traffic in jamming poorly performing video, overlay ads, pop-ups, and slow-loading third-party content on their sites (CNN and other news sites along with the usual clickbait sites – was that redundant? — are prime examples).

This week on HIStalk Practice: Texas officials fast-track licensing permits for out-of-state physicians looking to help after Harvey. Indica MD launches medical marijuana telemedicine services. Florida law enforcement implements new heroin overdose tracking software. Harvey relief efforts tap into Medicare data to identify at-risk patients. Marathon Health adds behavioral health services. PeakMed Direct Primary Care raises $5.5M. Oklahoma officials call for more funding, better MD use of statewide PDMP. AI-generated facial emojis could be coming to a telemedicine visit near you. West’s Allison Hart discusses the importance of technology in ambulatory care for chronic disease management. The MAVEN Project looks to connect community health centers with telemedicine services.

Webinars

September 13 (Wednesday) 1:30 ET. “How Data Democratization Drives Enterprise-wide Clinical Process Improvement.” Sponsored by: LogicStream Health. Presenter: Katy Jones, program director of clinical support, Providence Health & Services. Providence is demonstrating positive measurable results in quality, outcomes, and efficiency by implementing clinical process improvement solutions in arming operational and clinical stakeholders with unlocked EHR data. Providence’s army of process engineers use their self-service access to answer questions immediately and gain an understanding of how their clinical care delivery is impacting outcomes. The presenter will describe practical applications that include antibiotic stewardship, hospital-acquired infections, and comprehensive knowledge management.

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

Acquisitions, Funding, Business, and Stock

Kevin Mullin, chair of the Green Mountain Care Board that oversees Vermont’s medical industry, demands that Vermont Information Technology Leaders improve its operations to justify its public funding. VITL gets the money generated from a health insurance claims assessment that ends this year, as lawmakers will decide whether to end the tax or send its proceeds elsewhere. Mullin, who was a state senator when the tax was approved, says, “VITL was oversold to legislators. I regret ever selling the claims tax.” 

Drug pricing analytics vendor Truveris raises $35 million in a Series D funding round. 

Madison-based ImageMoverMD, which offers a secure image-sharing app for doctors, raises $1.2 million.

Sales

Penn Medicine (PA) chooses the LiveProcess emergency management system for universal employee notification and response during disasters, cyberattacks, and everyday coordination, bringing it into compliance with CMS’s emergency preparedness rule.

My Health My Resources of Tarrant County (TX) selects Netsmart’s EHR.

Announcements and Implementations

Experian Health announces its Pandora data quality platform that can ingest, index, and cleanse data from one or many data sources.

Non-profits CHIME and DirectTrust will jointly promote the universal deployment of the Direct network for secure information exchange.

Canada’s PrescribeIT national e-prescribing service will begin its rollout in Ontario “in the coming weeks” in eventually covering six provinces, 2,600 drug stores, and an unstated number of EHR vendors using technology from Telus Health.

Government and Politics

A bi-partisan group of eight state governors makes recommendations to Congress for stabilizing the individual insurance market, including:

• Committing to continuing paying cost-sharing reduction payments.
• Creating a temporary stability fund for states to create reinsurance programs.
• Exempting insurers from federal health insurance taxes from exchange plans sold in counties designated as underserved.
• Keeping the individual mandate until a credible replacement can be devised.
• Continuing the funding of outreach and enrollment efforts that encourage younger, healthier people to sign up.
• Shortening grace periods and verify special enrollment to make sure people aren’t waiting to sign up for insurance until they are about to incur expenses.
• Addressing unsustainable increases in the cost of healthcare services by paying providers based on quality rather than quantity of care, including a committing to support value-based healthcare purchasing.

Meanwhile, the White House on Thursday violated the fifth point above in announcing that President Trump will cut ACA signup advertising spending by 90 percent and in-person assistance funding by 39 percent, saying that Americans already know about the ACA. Critics say insurance risk and thus pricing will increase in a “let it fail” strategy” with fewer healthier, younger people being reminded to sign up to balance the risk pool. Former CMS Acting Administrator Andy Slavitt said in a tweet that the change won’t save taxpayers money because the costs are paid by insurance company user fees. An HHS press secretary (she was previously Congressman Tom Price’s press secretary and before that executive assistant at The Beer Institute) said ACA is a “bad deal” and isn’t working because premiums have doubled and half of US counties have only one coverage option.

Privacy and Security

FDA issues a voluntary recall of 465,000 St. Jude Medical pacemakers, recommending that patients return to their doctor or hospital to have their device’s firmware updated to address cybersecurity vulnerabilities.

Security firm Barracuda says it has logged 20 million ransomware attack attempts in the past 24 hours that uses a spoofed “from” address and the attachment’s name in the subject line, attempting to lure the recipient into clicking the attachment, which then begins encrypting the device.

Innovation and Research

Inova Personalized Health Accelerator offers a free educational program for first-time health technology entrepreneurs. The topics are interesting but the program is limited to folks who can attend seven, 90-minute on-site sessions in Fairfax, VA.

Other

Health system consolidation continues as UNC Health Care and Carolinas HealthCare announce plans to form a jointly operated system that will have 52 hospitals, nearly 100,000 employees, and $13.4 billion in annual revenue. The health systems insist that the proposed transaction is a partnership rather than a merger since they will not combine their assets to create a new entity.

An article in the Joint Commission’s journal describes the newly revised, ONC-published SAFER (Safety Assurance Factors for EHR Resilience) Guides and offers implementation advice for provider organizations, written by Dean Sittig, PhD and Hardeep Singh, MD, MPH.

A California Healthline article explains why it made sense for Santa Barbara County to send an employee who needed surgery to a hospital 250 miles away near San Diego. Answer: Scripps Hospital charged $62,000 for a surgery that would have cost more than double that amount at the two local hospitals. Scripps priced its services via bundled pricing as contracted through startup Carrum Health. The county waives employee co-pays and deductibles and pays travel costs for a luxury resort. The program is at risk since CMS is proposing eliminating bundled payments under the Trump administration in accusing Medicare –as have anxious hospital trade groups — of overstepping federal authority and interfering in the doctor-patient relationship. Insurance premiums in Santa Barbara County are 27 percent higher than those of Los Angeles, with a county HR executive saying, “The only difference between our two hospitals is one is expensive and the other is exorbitant.”

A Cleveland Clinic neurologist says the movie “Moneyball” showed that baseball uses more decision-making analytics than his own field, but that a wealth of EHR data and availability of disease-modifying therapies for multiple sclerosis will allow better treatment choices than the previous tools of physical examination and patient self-assessment. He notes the use of an iPad-powered performance test, new MRI and blood tests, and EHR-enabled doctor-patient collaboration.

In England, Royal Devon and Exeter NHS Foundation Trust sues ATOS for $10 million for selling it an EHR scanning and document management system that is slow and buggy, problems the vendor attributes to the trust’s network and hardware.

University of Michigan researchers develop Verdict, a database tool that learns from each user-submitted query to deliver answers 200 times faster with 99 percent accuracy. The software stores each query as a query synopsis and breaks it up into snippets that are used to create a mathematical model of questions and answers, allowing it to then target newly needed data efficiently or even to deliver results directly from its own stored information. Medical research and business decision-making are likely use cases.

FDA approves the first gene-altering drug for treating leukemia, with manufacturer Novartis declaring Kymriah a bargain at $475,000, especially since it will charge only if the drug works. The company claims it cost $1 billion to bring Kymriah to market.

The Wall Street Journal reports that 27 Gulf Coast hospitals have closed or evacuated patients since Hurricane Harvey made landfall and another 25 have reported storm-related problems that may prevent them from seeing new patients. Those that are open are expecting to be overwhelmed as roadways clear.

Some employers in the Louisville, KY area have stopped performing pre-employment drug tests because the high number of failures leaves too few candidates to fill their open positions. Other companies report that half of job candidates drop out of the hiring process once they realize they’ll be tested for drug use.

In India, an OB-GYN and anesthesiologist are suspended after an employee-recorded video goes viral that shows them engaging in a heated, insult-filled argument while standing over their C-section patient.

Sponsor Updates

• Logicworks opens a new office in Denver.
• Navicure will exhibit at Greenway Health Engage17 September 7-10 in Orlando.
• IDC names Nuance as the market share leader among global device and print management vendors.
• NTT Data Services publishes a new case study, “Two health systems in Qatar partner on a nationwide EHR to enhance quality of care.”
• Healthwise adds enhanced visual design to its Patient Instructions.
• Experian Health will present at the HFMA/AAHAM Western PA conference September 7 in Farmington.
• Vocera announces that 15,000 care team members of Franciscan Alliance are using its secure text messaging and hands-free communication system.
• The SSI Group and ZirMed will exhibit at the CASA 2017 Annual Conference September 6-8 in Indian Wells, CA.
• Nuance Communications wins the 2017 Star Performer and Implementation Awards at Speech Technology Magazine’s annual awards event.
• Solutionreach publishes a new case study, “Dr. York Yates Plastic Surgery Triples Their Response to Review Requests.”
• Verscend Technologies publishes a new infographic, “Analyzing 2017’s risk adjustment valuation to improve 2018’s processes.”
• McLaren Flint (MI) avoids a $1 million capital expense for new IV pumps by tracking its pump inventory using Versus Advantages Asset Management.
• Visage Imaging will exhibit at SIIM/NYMIIS 2017 September 7 in New York City.
• Huron partners with the Red Cross to support relief efforts for victims of Hurricane Harvey.

Blog Posts

• CIO Chat – Lori Johnston, ProMedica (Huntzinger Management Group)
• How to optimize your patient portal for Meaningful Use Stage 3 (Meditech)
• The Master Training Environment’s (MST) Role in Go-Live Readiness (Optimum Healthcare IT)
• CMS Emergency Preparedness for Healthcare Coalitions (LiveProcess)
• Why you should prioritize a service area merge for your healthcare organization (Nordic)
• Who Wants to Be a Millionaire? (Navicure)
• Whole-Person Care: Value-based Care for the Justice-Involved (Netsmart)
• Appropriate Use Criteria Requirements – Imaging Claims (Parallon Technology Solutions)
• Want both a healthy bottom line and happy patients? (Experian Health)
• Seniors Need, and Want, Better Care Coordination (PatientPing)
• Autonomous Auto-Adjudication 101: Blockchains Are Revolutionizing How Providers Get Paid (PokitDok)
• Improving Clinical Communication Across the Care Continuum (PerfectServe)
• What to Expect When You’re Expecting … to Integrate with a Health System (Redox)
• Turn Your Culture Into a Competitive Advantage (Salesforce)
• The Future of Population Health Management Strategies and Solutions (The SSI Group)
• Work Smarter, Not Harder: Four Simple Ways to Add Revenue, Not Work (Solutionreach)
• Avoiding risky business. (Voalte)
• 10 New Rules of the Inbound Contact Center (West)

Contacts

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

News 8/30/17

Top News

The Advisory Board Company will sell its healthcare business to UnitedHealth Group’s Optum. The education part of its business will be acquired by Vista Equity Partners. The breakup and acquisitions were accurately rumored in early July.

The healthcare business drew $1.3 billion of the $2.58 billion total deal value.

Advisory Board said in February that it would explore strategic options after an ownership stake was taken by activist investor Elliott Management, which is now exerting similar pressure on Athenahealth.

Reader Comments

From Athenahealth Spokesperson: “Re: Givenchy’s comment from the 8/23/17 HIStalk regarding financial success metrics for community hospitals. Thank you for bringing this to our attention. The metrics listed were a carryover from the previous iteration of the page and speak to our results on the ambulatory side. We have removed the numbers to avoid any confusion.” I speculated in my original response that the metrics probably weren’t related to hospitals, especially since they were footnoted to suggest all Athenahealth customers excluding hospitals since the company wasn’t in the inpatient business during that pre-RazorInsights benchmark period.

From Whassup: “Re: MDeverywhere breach. The newly listed breach affects E-MDs since it merged with MDeverywhere. Looks like they are trying to keep it hush hush, along with the fact that E-MDs is up for sale.” HHS is investigating an unauthorized access / disclosure incident of MDeverywhere that was reported August 10, 2017. Marlin Equity Partners acquired E-MDs in March 2015 and merged it with its existing portfolio company MDeverywhere, which offers revenue cycle management and credentialing services. I found a breach notice sent by an MDeverywhere customer that says that the company and its customers use a messaging board to exchange patient information and worksheets, but the customer found on June 6, 2017 that any Internet user could log into the message board without entering a name and password. The non-clinical information of just 1,396 people was involved, so it’s pretty unexciting as healthcare breaches go.

From Josh: “Re: potential changes to E/M visit codes. It’s buried in a large article, but CMS has opened a public comment window until September 11, 2017 saying they have heard from stakeholders that E/M visit codes are outdated and a source of audit vulnerability and administrative burden. CMS wants public input.” A snip of the proposed Medicare rule – which is rather startlingly insightful and technologically current — says:

We continue to agree with stakeholders that the E/M documentation guidelines should be substantially revised. We believe that a comprehensive reform of E/M documentation guidelines would require a multi-year, collaborative effort among stakeholders. We believe that revised guidelines could both reduce clinical burden and improve documentation in a way that would be more effective in clinical workflows and care coordination. We also think updated E/M guidelines coupled with technological advancements in voice recognition, natural language processing and user-centered design of EHRs could improve documentation for patient care while also meeting requirements for billing and population health management. We recognize that achieving the goal of reduced clinician burden and improved, meaningful documentation for patient care will require both updated E/M guidelines, as well as changes in technology, clinician documentation practices and workflow …We are specifically seeking comment on how we might focus on initial changes to the guidelines for the history and physical exam because we believe documentation for these elements may be more significantly outdated, and that differences in MDM are likely the most important factors in distinctions between visits of different levels. We are also specifically seeking comment on whether it would be appropriate to remove our documentation requirements for the history and physical exam for all E/M visits at all levels. We believe medical decision-making and time are the more significant factors in distinguishing visit levels, and that the need for extended histories and exams is being replaced by population-based screening and intervention, at least for some specialties. In addition, an increase in the utilization of EHRs, and to some extent, shared health information via EHRs, may have changed the character of extended patient histories since the guidelines were established. As long as a history and physical exam are documented and generally consistent with complexity of MDM, there may no longer be a need for us to maintain such detailed specifications for what must be performed and documented for the history and physical exam (for example, which and how many body systems are involved). We are seeking comment on whether clinicians and other stakeholders believe removing the documentation requirements for the history and physical exam would be a good approach.

HIStalk Announcements and Requests

Texans need our help, so I invite you to do as I did in making generous donations to The Salvation Army of Houston, the Houston Food Bank, and the Houston SPCA. The best thing you can do is to send money to reputable local organizations – it’s just too hard to deploy well-intentioned contributions of physical items and those organizations need the flexibility to use their buying power to provide the most benefit. Houston has a marketing problem – it’s the nation’s fourth-largest city, yet few of us visit there on vacation or attend a conference there, so we don’t really have much of a connection to it. As was the case with Hurricane Katrina, the extent of the death and destruction there won’t become evident until days after the floodwaters recede and public health issues – such as food and housing shortages – take over the shrinking headlines and outlast by years the nation’s short attention span.

Meanwhile, in a discussion that mimics our country’s healthcare debate, a Politico report blames the federal government’s subsidized flood insurance program for encouraging people and developers to build and re-build homes in known floodplains and to pave over drainage areas. More than half of the country’s “repetitive loss properties” are located in Houston, second only to New Orleans, as the federal flood insurance program is running $25 billion in the red. One federally insured home in Mississippi has flooded 34 times in 32 years, with federal taxpayers paying $663,000 for claims involving the $69,000 home, while members of Congress have voted to delay charging homeowners actuarially sound premiums following complaints about inevitably higher prices from coastal communities. Only 15 percent of Houston homes are insured against flooding since such insurance isn’t required for most mortgages and people either can’t afford the premiums or play the odds that they won’t experience a loss.

Webinars

September 13 (Wednesday) 1:30 ET. “How Data Democratization Drives Enterprise-wide Clinical Process Improvement.” Sponsored by: LogicStream Health. Presenter: Katy Jones, program director of clinical support, Providence Health & Services. Providence is demonstrating positive measurable results in quality, outcomes, and efficiency by implementing clinical process improvement solutions in arming operational and clinical stakeholders with unlocked EHR data. Providence’s army of process engineers use their self-service access to answer questions immediately and gain an understanding of how their clinical care delivery is impacting outcomes. The presenter will describe practical applications that include antibiotic stewardship, hospital-acquired infections, and comprehensive knowledge management.

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

Acquisitions, Funding, Business, and Stock

Surgery management system vendor ExplORer Surgical raises $3 million.

India-based technology vendor Tech Mahindra names Jacksonville, FL as its global healthcare headquarters following its $110 million acquisition earlier this year of Jacksonville-based The HCI Group. 

A Stanford drop-out distances his startup from Theranos in describing its own in-home finger-prick blood analyzer. The co-founders of Athelas are 20 and 22 years old. Their Amazon Echo-like technology, which has yet to earn FDA approval, uses machine learning to analyze blood cell images that pathologists have interpreted and then applies that knowledge to new high-resolution images of a patient’s home blood sample. Their target market is oncology patients who require frequent blood tests.

Columbus, OH-based PriorAuthNow increases its funding to $3.6 million to expand its hospital procedure prior authorization system.

Sales

Yale New Haven Health System (CT) will add pharmacogenomic decision support from ActX to its Epic EHR.

People

Marc Milstein (University of Texas System) joins University of Texas Southwestern Medical Center (TX) as VP of information resources.

Announcements and Implementations

Allscripts will integrate Vidyo’s video visit technology into its FollowMyHealth patient portal.

Cedars-Sinai launches a 20-month, $25,000 executive master’s degree program in health delivery science that emphasizes analytics, health IT implementation, quality and safety, and cost-effective service delivery.

MDLive offers free non-emergency telephone or video visits to people impacted by Hurricane Harvey from August 25 to September 8.

T-System offers its T Sheets disaster relief documentation templates at no charge to hospitals and freestanding EDs in areas affected by Hurricane Harvey.

Government and Politics

The Senate’s HELP committee will hold hearings early next month in hopes of creating legislation to stabilize and then improve the Affordable Care Act individual insurance marketplace. Leaders Senator Lamar Alexander (R-TN) and Senator Patty Murray (D-WA) have successfully collaborated previously on the 21st Century Cures Act. The committee will take the unfortunately refreshing approach of holding actual committee hearings and seeking input from lawmakers on both sides of the political wall. Alexander wants to quickly get legislation on the books to guarantee the federal government’s payment of legally challenged insurance premium subsidies, hoping to reduce the number of insurers pulling out of the individual market or raising premiums due to uncertainty.

Privacy and Security

System downtime at Scotland’s NHS Lanarkshire is being blamed on a new variant of Bit Paymer ransomware, which demands payment of an unusually high ransom of $218,000 for the return of “private sensitive data.” Mass media articles say the malware is spread by phishing emails, but technical sites say it is manually installed following brute force password attacks on insecure Remote Desktop Protocol connections, after which the size of the ransom is set by the hacker’s perception of the victim’s ability to pay.

A former ED employee sues Northwell Health for firing her for looking up Justin Bieber’s medical records, claiming she didn’t do it and instead was fired just because she’s female. Somehow I suspect Northwell’s audit logs contain information that implicates her beyond her gender.

Innovation and Research

Non-profit digital health lab Pulse@MassChallenge — which is backed by the Commonwealth of Massachusetts and industry partners (Microsoft, AARP, BIDMC, Cerner, etc.) — seeks startups for its next class. Early bird applications are due September 15 and the application fee is discounted 100 percent using code “2018HISTalk100.”

Other

A Salesforce research paper covers the potential of translating natural language questions into database SQL queries, which could allow users to ask database questions without knowing SQL syntax.

A Department of Defense video shows how Walter Reed National Medical Center (MD) makes prostheses.

Bloomberg Businessweek covers predatory journal publisher Omics International, an India-based open access journal publisher that charges “publish or perish” academics to run their often poorly prepared research papers as well as those of drug companies that want to disseminate favorable but sloppily researched studies. The founder of Omics calls the FTC’s investigation into his company – which took in $11.6 million in publishing and conference revenue in 2016 – as “fake news.” The article questions whether the company’s journals that feature papers that are “rife with grammar glitches and low-resolution headshots” are confusing drug companies that publish research in them or whether they really don’t care. Omics has 2,000 employees who occupy 250,000 square feet of office space in Hyderabad. Academic and business speakers pay more than attendees to participate in its conferences, which says a lot, while all attendees get 50 percent of the publishing fee for their next research masterpiece. I bet quite a few healthcare organizations are unwittingly underwriting this ego-boosting crap in sending people off to fun destinations under the guise of academic achievement. The company repeatedly accepts hilariously fake article and conference presentation abstracts, one that was submitted as a test being “Evolution of flight characteristics in avian-porcine physiology” that purports to explain how pigs fly. Another author submitted a journal article consisting of 10 pages of the repeated phrase, “Take me off your $&%#! list,” which was happily accepted pending payment of a $150 publishing fee by The International Journal of Advanced Computer Technology.

Sponsor Updates

• AssessURHealth and Intelligent Medical Objects will exhibit at Greenway Engage17 September 7-10 in Orlando.
• Besler Consulting releases a new podcast, “Key takeaways from the FY 2018 IPPS Final Rule.”
• FormFast publishes a new case study featuring Duncan Regional Hospital (OK).
• Healthgrades and Gartner publish “Beyond Healthcare CRM: Changing the Paradigm of Patient Communication.”
• Healthwise will exhibit at the 2017 HCEA Conference September 6-8 in Salt Lake City.

Blog Posts

• The Do’s and Don’ts of Legacy Due Diligence (Leidos Health)
• MIPS/MACRA Impact Simplified: the “Competition Curve” (Impact Advisors)
• 7 Must-Have Components for a Mobile Strategy (Spok)
• Helping Patients Understand the Value-Based Care Definition (CareSync)
• What are the Chances for Success for Physicians Under MACRA? (ECG Management Consultants)
• Is Biometric Identification the Answer to Patient Data Integrity Issues? (Hayes Management Consulting)
• MIPS/MACRA Impact Simplified: the “Competition Curve” (Impact Advisors)
• Helpful everyday uses for SSO (Imprivata)
• Do You Need a Healthcare Website Redesign? (Influence Health)
• The Business Value of Global Summit (InterSystems)

Contacts

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

Curbside Consult with Dr. Jayne 8/28/17

My heart goes out to the people of Houston along with the many other areas impacted by Hurricane and Tropical Storm Harvey. In addition to residents who weren’t able to leave the area before the flooding, there are scores of out-of-town patients stranded after traveling to Houston for care at facilities such as MD Anderson Cancer Center.

Working in the ED and urgent care space, I’m connected to my community’s emergency preparedness efforts. Natural disasters can strike anywhere at any time and I would encourage everyone to take this opportunity to make sure your family has a preparedness plan. Keeping a small stock of non-perishable food and bottled water is a good idea for everyone. Even if you don’t live in a flood plain, tornado alley, fault zone, or wildfire hazard area, there’s always a chance of losing power or other essential services.

Healthcare organizations large and small should also have preparedness plans, including resources to support staff who might become stranded at work. My area is prone to ice storms, and although I always keep bottled water and energy bars on hand when I have to go out in bad weather, I can’t assume that my staff is likewise prepared. The leftover pizza and freezer-burned Hot Pockets aren’t going to go very far if we ever encounter a catastrophic weather event. I’m not advocating that everyone needs to constantly live in Doomsday Prepper mode, but our society has embraced the just-in-time and convenience culture so thoroughly that many people and organizations haven’t given much thought to basic preparedness in the face of a calamity.

The schools in my state now require education in CPR as a high school graduation requirement. I’d love to see a little coverage given to basic emergency preparedness. We do have a teen CERT (Community Emergency Response Team) program along with an adult program and there is always a waiting list for people to attend. If you can’t get into a community offering or your area doesn’t have one, there are some great educational resources available through the Ready.gov website.

I had two client-facing trips cancel due to the weather, so I’ve been using the opportunity to play catch-up and try to get ahead for the busy times that are surely coming. Although there has been a relaxation in the requirements to have 2015 Edition Certified EHR Technology in place before January 1, I’m not seeing my clients take the foot off the gas as far as preparing for upgrades and workflow changes. I think they’ve already done so much work to get ready they just want to see things through and get the decks cleared for the next thing that gets thrown at them. I’ve also got several clients moving forward aggressively with Patient-Centered Medical Home initiatives, and since I haven’t been to formal training yet for the 2017 NCQA standards, I’m trying to become more familiar with the requirements.

Although there are a lot of details to learn, many of the principles are straightforward. Sometimes those are the hardest to bring into daily clinical practice, not only because they require people to change, but because they require attention to efficiency and detail. Take for example the daily huddle. In its simplest form, it’s the opportunity for the care team to look at the daily schedule and anticipate specific needs related to each patient appointment. It could be basic things like ensuring there is an extra chair in the exam room for an interpreter or family member, or it could range to issues like tracking down lab results or reviewing needed clinical preventive services and counseling.

I’ve seen a lot of daily huddles derailed by the lack of an effective meeting strategy. The team needs to show up on time, someone needs to be the leader, someone needs to be the timekeeper, and someone needs to document and manage the follow-up. The reality in many medical offices across the country is that these skills are lacking, and if the practice wants to be successful, the skills need to be taught and reinforced. If staff members are habitually late, it needs to be addressed. If huddle attendees aren’t paying attention and things need to be repeated, it needs to be addressed. Staff discussion needs to stay on topic and sidebar conversations should be stopped.

I see practice leaders sometimes struggle to address these issues, which is why bringing in an outsider to help with change leadership activities is tempting. It’s also easier to let someone else be the lightning rod, which sometimes happens. One group I’m working with in preparation for an aggressive PCMH rollout has a provider and a nurse manager who are very difficult. The provider often makes changes to his schedule without telling anyone (I’d revoke his access to the scheduling system in a heartbeat) and the nurse manager enables the bad behavior by making everyone else dance around trying to accommodate the last-minute changes. The provider frequently overloads his schedule by double- and triple-booking appointment slots, which makes the entire day run badly and frustrates the staff. The practice doesn’t have a good understanding of their true capacity to see patients, and I suspect some of their panels need to be adjusted by shifting patients from busier PCPs to more accessible PCPs on a given care team. The provider in question is resistant to this change, and although I understand his wanting to maintain patient relationships, it shows that he is not embracing the concept of PCMH and that the practice will continue to suffer until this is addressed.

I’m planning a series of leadership discussions where try to solidify provider buy-in and discuss the benefits that being a patient-centered practice can provide. If we can’t get everyone to arrive at a place where they can at least agree not to obstruct efforts, however, I’m going to recommend that they seriously consider placing the initiative on hold until we can figure out how to get people on the same page. Simply saying “this is what our practice is going to do” hasn’t been enough for them to be successful thus far. Change is hard, but it’s the reality for medical practice in the years to come. I’ll be on site with them in a couple of weeks, so we’ll see how things go.

What’s your strategy for keeping staff sane during times of change? Email me.

Email Dr. Jayne.

Monday Morning Update 8/28/17

Top News

Southeast Texas continues to be hammered by the stalled remnants of Hurricane Harvey, which has already dropped 25 inches of rain on Houston and continues to linger over the state in what could be the most expensive natural disaster in US history. Rivers exceeded their historic high-water levels by as much as 10 feet. At least five people are known dead, but the toll will certainly rise when conditions allow the storm’s damage to be assessed.

• Several hospitals evacuated patients or closed.
• Driscoll Children’s Hospital in Corpus Christi air transported 10 NICU babies to a hospital in Fort Worth, fearing that a power outage would disable their ventilators.
• Five of 11 Memorial Hermann hospitals in Houston reported spikes in newborn deliveries, with barometric pressure changes doubling the usual number of births in some hospitals.
• Several Houston-area hospitals closed the flood doors they had installed after Tropical Storm Allison in 2001, hoping to protect their basements and ground floors.
• MD Anderson closed its campus and advised employees and patients to stay home Sunday morning due to impassable roads, with on-site staff assigned to remain at work until conditions improve.
• Clinicians at DeTar Hospital Navarro volunteered to stay at the hospital instead of at home with their families.
• 911 lines were jammed as families in danger took to Twitter seeking rescue from anyone nearby.

Behrouz Zand, MD posted this picture of MD Anderson’s lobby on Twitter.

This Twitter-posted photo is of Aransas Pass Care Regional Medical Center, which was heavily damaged when its roof blew off, after which it was burglarized.

A Twitter user reported that these guys walked five miles in the water to respond to a Twitter plea for a help from a family with a sick baby.

The mother of a baby delivered as the storm approached land at Corpus Christi Medical Center Doctors Regional decided to name the boy Harvey.

Reader Comments

From Gladiolus: “Re: The Advisory Board. After information leaked out in July about the company’s split and UnitedHealth Group purchasing the consulting side, no further public information has been provided.” The company said in its August 8 earnings call that it would not comment on the board’s strategic review process. ABCO shares dropped sharply after the earnings miss, but they’ve still kept pace with the Nasdaq index over the past year.

HIStalk Announcements and Requests

The results of last week’s poll are interesting, although IP address analysis doesn’t inspire much confidence in their validity.

New poll to your right or here: which backgrounds entitle someone to call themselves an “informaticist?” I ran a similar poll in 2010 and it stirred up quite a bit of discussion, such as whether a nurse doing EHR implementation and support work is an informaticist.

HIStalk readers funded the DonorsChoose teacher grant request of Nevada middle school PE teacher Mr. H, who asked for shot puts and relay batons so the track and field team can practice for meets.

Thanks to these companies for their recent support of HIStalk. Click a logo for more information.

This Week in Health IT History

One year ago:

• The systems of two West Virginia hospitals go down in a malware attack.
• The Department of Defense pushes back its first scheduled go-lives of MHS Genesis.
• Apple tightens App Store requirements for health-related apps.

Five years ago:

• SAIC announces that it will split itself into two publicly traded companies.
• ONC says it will not allow EHR vendors to drag their feet in supporting data exchange with competing EHRs.
• HL7 announces that it will make its standards available at no charge to increase their use.
• Technology investor Vinod Khosla says computers will eventually replace 80 percent of doctors.

Ten years ago:

• Acer buys Gateway Computers.
• MedAssets files for its IPO.
• A lawsuit brought against McKesson for its involvement in setting inflated drug cost benchmarks is certified as class action.
• The builder of Epic’s $100 million, 5,300-seat learning center posts photos of the project online.
• HIMSS offers its second Virtual Conference.

Weekly Anonymous Reader Question

Responses to last week’s question:

• Misys gave away a car a couple of times. Created buzz, not sure if it created sales.
• The most memorable I’ve seen is when Medicomp launched Quipstar – I think at HIMSS 2011. There was a tremendous amount of buzz. Of course it also helped that they helped sponsor HIStalkapalooza that year.
• HIMSS Orlando 2017 Watson. Simple, bright booth with actual physicians and researchers demonstrating their work throughout the day. The individuals around the booth were knowledge, including marketing representatives, not just hourly booth babes. Admittedly, they can’t all be like this as the distraction of infotainment, gadgets, and snacks is occasionally welcome throughout the day.
• Epic’s cartoon books and tights-wearing WebMan.
• Iatric had a magician at a trade show who was quite memorable for his tricks and demeanor.
• Richard Simmons at the booth for a “Thin Client” promo for either IDX or Cerner. Way back in the late 90s.
• The urinal screens with advertising by ???? Guess it wasn’t that effective over the really long term. What, four years ago?
• Cold-emailed me to offer me shots at the bar!
• A Vermont-based vendor offering cans of Heady Topper, which is one of the top IPAs in the world and accessible only within a 25-mile radius of Waterbury, VT.
• Can’t beat the OnBase Bar in the middle of the vendor floor.
• Ivo Nelson’s Pub Night. Long after the show floor is closed, the dinners and parties are over, most in the know head to Ivo’s pub night. An informal gathering to see old friends and build new relationships. Much work gets done.
• Years ago Arthur Andersen distributed jazz CDs at HIMSS in New Orleans. I still play the CD today and it’s loaded on my mobile devices.
• HIMSS itself, conducting the annual Interoperability Showcase.

This week’s question: who is the most inspirational health IT or healthcare person you interact with regularly?

Last Week’s Most Interesting News

• Google offers a link to a depression questionnaire to mobile users who search on “clinical depression.”
• CliniComp files a bid protest with the VA for choosing Cerner in a no-bid contract.
• A reader calls attention to Care Otter, which is apparently an Allscripts project to develop a new EHR, after which Care Otter’s web page, Twitter account, and YouTube channel are taken down.
• Investment research firm Hedgeye speculates that the new, unnamed six-hospital Allscripts Sunrise customer is Verity Health, owned by Allscripts investor Patrick Soon-Shiong.
• HIMSS Analytics provides detailed information on inpatient EHR market share by hospital count, total beds, and the number of physician users.

Webinars

September 13 (Wednesday) 1:30 ET. “How Data Democratization Drives Enterprise-wide Clinical Process Improvement.” Sponsored by: LogicStream Health. Presenter: Katy Jones, program director of clinical support, Providence Health & Services. Providence is demonstrating positive measurable results in quality, outcomes, and efficiency by implementing clinical process improvement solutions in arming operational and clinical stakeholders with unlocked EHR data. Providence’s army of process engineers use their self-service access to answer questions immediately instead of waiting for reports to be written and double checked for possibly inaccurate information. The presenter will describe practical applications that include antibiotic stewardship, hospital-acquired infections, and comprehensive knowledge management.

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

Acquisitions, Funding, Business, and Stock

Philips will create a Nashville health technology center that will add 800 jobs.

Decisions

• Roane Medical Center (TN) will switch from McKesson to Cerner in 2018.

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

Announcements and Implementations

Sunquest announces GA of Mitogen, a laboratory information management system and genetic software suite for molecular diagnostics and precision medicine.

Privacy and Security

In Scotland, NHS Lanarkshire urges people with non-emergent conditions to avoid its ED due to a malware incident that has taken its systems down. The same trust was hit hard by the WannaCry ransomware this past May. 

Salina Family Healthcare Center (KS) notifies 70,000 patients that its computer systems were infected with ransomware in June. Afterwards, a patient who hadn’t been seen there for 13 years complained that his records should have been purged and that outdated addresses on file means the breach notices will be sent to the wrong people.

Innovation and Research

A new Reaction report covers the Allscripts acquisition of McKesson’s EIS business. The report finds that McKesson already had a high rate of users interested in replacing its systems, a process that may speed up with the acquisition.

Other

Epic CEO Judy Faulkner makes the “Forbes Richest People in Tech” list, coming in at #73 with an estimated net worth of $3.4 billion. Rishi Shah, the 31-year-old CEO of waiting room advertising company Outcome Health, was #69 at $3.6 billion.

Lloyd Minor, MD,  dean of Stanford’s medical school, blames EHRs for physician burnout and says that they (along with shorter office visits) “turn medical practice into a regimented, one-size-fits-all endeavor.” He says EHRs should add diagnostic support functions and use speech recognition, while doctors should use scribes to free up their time. 

The Las Vegas paper covers the fire department’s deployment of RNs to staff its emergency call line for less-urgent medical calls, where the nurses follow software-driven to decide whether to roll an ambulance or to call Lyft to take the caller to a hospital or urgent care center. The pilot project’s return on investment might be questionable – nurses work from 9 a.m. to 6. p.m. and take just six calls per day, costing $300,000 per year.

In Australia, a cancer survivor blames the lack of interoperability between the EHRs of two hospitals for her missing follow-up visits. A member of parliament says he has received several complaints that Sunshine Coast University Hospital cannot access patient histories since it does not use the state-wide, Cerner-powered IEMR system and instead uses a scanning-based system while it plans its transition to IEMR.

Weird News Andy can’t visualize why some clueless eclipse-watchers who weren’t able to get protective glasses decided that their next-best option was to put sunscreen on their eyeballs.

Sponsor Updates

• Medicity publishes a new white paper, “Interoperability 2.0: Solving Health Care’s Data Aggregation Problem.”
• ZeOmega’s Jiva population health management platform earns NCQA certification.
• Experian Health will exhibit at AAHAM California August 27-30 in Rancho Palos Verdes, CA.
• Patientco recognizes Houston Healthcare (GA) as its Client of the Quarter.

Blog Posts

• Defining Your Healthcare and Life Sciences Vision Through Digital Transformation: Peace of Mind (Liaison Technologies)
• Your Guide to the MACRA 2018 Proposed Ruling (Meditech)
• 12 things your office staff automate (Navicure)
• Achieving Care Coordination in Home Health and Beyond (Netsmart)
• Five Reasons Behavioral Health Clinicians Need to Use Voice Recognition Software (NVoq)
• New Medicare Cards On the Way – Are You Ready? (Parallon Technology Solutions)
• PCPs at the Helm of Care (PatientPing)
• Autonomous Auto-Adjudication 101: Blockchains Are Revolutionizing How Providers Get Paid (PokitDok)
• Nontraditional Team Outings to Build Stronger Bonds and Have Fun (Salesforce)
• What You Need to Know About Healthcare Bundled Payments (The SSI Group)
• 10 Truly Awesome Ways to Reduce No-Shows (Solutionreach)
• The Migration of Middleware (Sphere3 Consulting)
• Web Service Integration – Another Approach to Breaking Down Integration Barriers to Healthcare (Summit Healthcare)

Contacts

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

News 8/25/17

Top News

Google offers users who search for “clinical depression” on a mobile device an option to take a PHQ-9 online depression test, offered in partnership with the National Alliance on Mental Illness in hopes of increasing the percentage of depressed people who seek and receive treatment.

Reader Comments

From CinderFella: “Re: Verity Health. HIStalk had the edge on Hedgeye’s analysis over a month ago, with a reader commenting on the NantHealth purchase of Verity saying that it would buy ‘his Nant-whatever stuff’ and Allscripts products. The real story is that Verity scrapped a year’s worth of evaluations as it was looking to implement a new EMR. The selection process was still finalizing and a go forward choice was TBD, but it wouldn’t have been Allscripts.” I’m a Wall Street lightweight, but I would be uncomfortable as a shareholder of either company with the Allscripts investment in NantHealth, Patrick Soon-Shiong’s personal investment in Allscripts, and now NantHealth’s rumored pushing of the products of both companies on non-profit Verity, especially given that NantHealth seems to have made quite a few “sales” of its own products that looked more like mutual back-scratching than objective purchasing decisions that suggest market momentum. I suppose Verity being forced to choose a product it didn’t want is a legitimate sale, if indeed they have lost that choice, but it smacks of desperation from both companies. Maybe Allscripts also worries about that perception, too, since it hasn’t named Verity as the mysterious new client it signed.

From HIE Watcher: “Re: Informatics Corporation of America. Hearing it is being acquired by the SSI Group.” Unverified. I’ve sent an inquiry to ICA with no response so far.

From Orange Vest: “Re: LinkedIn. How do you choose which connection requests to accept?” I pretty much accept all invitations, declining only those that are obvious scams (like someone who works for a Chinese air conditioner manufacturer who has no overlapping connections), although sometimes that opens me up to annoying messages from recruiters or overzealous salespeople who I squelch quickly. I really don’t do anything with LinkedIn except (a) look up people who have changed jobs, and (b) sometimes check to see if somebody’s connected with me or is in the reader-started HIStalk Fan Club to decide if I’m willing to reply to their email.

From Dreydel: “Re: Devoted Health. I don’t have access to the full story, but Todd Park’s LinkedIn says he’s the founder. I bet other ex-Athena execs are involved.” I don’t pay for WSJ either, but Athenahealth co-founder Todd Park’s LinkedIn says he’s the co-founder and executive chairman of insurance startup Devoted Health.

From Publius Tullius: “Re: Epic in Denmark’s Capital Region. The projects are going so poorly that Epic was cut in the first round of the bid process to support the Southern Region. Stories go back to February related to project under-scoping, missing functionality, and budget overruns.” PT provided a ton of links to Danish sites describing Epic project problems, with some Google-translated headlines above.

HIStalk Announcements and Requests

Blain Newton of HIMSS Analytics sent over another interesting analysis, this one from its Logic database that shows the EHR user count of physicians who are employed by, leased, or managed by health systems. Epic has a four-to-one lead over Cerner and Allscripts in doctor count, nearly equal to all other vendors combined since its customer base is mostly huge health systems. That also means that Epic has displaced a lot of EHR/PM vendors in practices as hospitals acquired them and put Epic in. It also makes InterSystems very happy since they license Cache by concurrent user.

Blain also provided this graph showing those organizations, both for-profit and non-profit, that have made the most hospital acquisitions in the past 10 years. Such acquisitions drive a good bit of the EHR market as acquired hospitals are moved to the corporate EHR standard.

This, as they say, resonates with me.

So does this, since I am always baffled that more people play the lottery when the prize goes up. Are these folks who couldn’t be bothered for only $100 million?

This week on HIStalk Practice: Alaskan providers share challenges, triumphs with HHS Secretary Price. Allscripts makes it easier for physicians to participate in clinical trials. The Institute for Women’s Health succumbs to keylogger virus. Wellpepper CEO Anne Weiler shares why virtual assistants and interactive mobile treatment plans are poised to meet consumer healthcare expectations in a big way. LifeWorks NW VP of Clinical Services Mark Lewinsohn expects new population health management technology to boost its participation in the national demonstration project for Certified Community Behavioral Health Clinics. Behavioral healthcare stakeholders lament telemedicine’s slow progress in MA. Petaluma Health Center becomes data-driven FQHC. DoD honors ChartLogic. Dispatch Health expandsto Arizona. In a new monthly series, PRM Pro Jim Higgins outlines the ways in which physicians can use patient relationship management technology while still maintaining the human touch.

I’m disappointed that nobody bothered to make an Eclipsys-related eclipse pun.

Listening: new from 29-year-old Minneapolis-based hip hopper Lizzo, whose Missy Elliott-style brash confidence includes more explicit lyrics than I like, but I overlook that because her music is a joyous, soulful bridge between the late 1960s Motowners and today’s rappers. I’m also listening with nostalgia to the unparalleled R.E.M., which ceased to exist in its original configuration as a foursome and one of America’s greatest bands 20 years ago, their unexpected high harmonies still giving me chills last night when the family chain restaurant I was in surprisingly played “Fall On Me” on its canned music system.

Webinars

September 13 (Wednesday) 1:30 ET. “How Data Democratization Drives Enterprise-wide Clinical Process Improvement.” Sponsored by: LogicStream Health. Presenter: Katy Jones, program director of clinical support, Providence Health & Services. Providence is demonstrating positive measurable results in quality, outcomes, and efficiency by implementing clinical process improvement solutions in arming operational and clinical stakeholders with unlocked EHR data. Providence’s army of process engineers use their self-service access to answer questions immediately instead of waiting for reports to be written and double checked for possibly inaccurate information. The presenter will describe practical applications that include antibiotic stewardship, hospital-acquired infections, and comprehensive knowledge management.

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

Acquisitions, Funding, Business, and Stock

Agfa-Gevaert is considering spinning off its health IT business that includes vendor-neutral archive, PACS, image sharing, data aggregation, patient engagement, and digital radiography.

Startup Doc.ai comes out of stealth mode in describing its AI-powered “silicon doctors” medical dialog system. Its CEO is the co-founder and former CEO of Scanadu, which seems to have fizzled out following the retirement of its Tricorder-like vital signs device that earned tons more press than it deserved as technical limitations kept dumbing it down.

Sales

Pomona Valley Hospital Medical Center (CA) chooses Imprivata’s biometric positive patient identification solution.

The VA and DoD sign a 10-year contract with Fujifilm Medical Systems USA to make the company’s Synapse enterprise imaging portfolio available to government healthcare providers. The maximum contract value is $768 million.

People

Grattan Smith (RelayHealth) joins Loyal Healthcare as VP of business development.

Announcements and Implementations

An Athenahealth survey finds that patients of small physician practices are heavier patient portal users than those of regional and national health systems, with respondents offering these suggestions to improve use:

• Let patients know that the portal is the primary way the practice will communicate with them.
• Help patients sign up while they are in the office, creating an email account for them if necessary.
• Review their labs and chart entries from the portal on a large monitor during their visit.
• Remind new patients to register on the portal before their first visit.
• Commit to responding to patient questions within 24 hours.
• Use services like Solutionreach that text patients when their lab results are ready to view on the portal.

Government and Politics

The President’s political appointees have turned HHS into a remarkably shrill and partisan White House lapdog, loudly criticizing the laws they swore to uphold. The latest example is this statement from HHS Principal Deputy Assistant Secretary for Public Affairs (and former Koch Brothers employee and aide to former Governor and now VP Mike Pence) Matt Lloyd, who instead of encouraging healthy people to sign up to create better ACA risk pools, dutifully does his part to perpetuate the “let it fail” agenda with campaign slogans instead of responsible statements:

Obamacare failed to create a thriving, competitive market that offers the kind of coverage people want to buy at prices they can afford. On Obamacare’s exchanges premiums continue to surge, insurers continue to abandon wide swaths of the country and choices continue to vanish – an unfortunate reality for the American people who are required to buy Washington-approved health insurance or pay a fine.

The Supreme Court is reviewing a lawsuit that argues that Google’s trademark of its own name should be nullified because “Google” has become a synonym for “searching the Internet.” The term “genericide” refers to former trademarks that became plain old words because of their non-specific usage, among them “thermos,” aspirin,” and “videotape.”

Privacy and Security

Aetna exposes the HIV status of 12,000 patients in several states by mailing HIV medication prescription information in envelopes that contain an overly large window.

Other

MD Anderson Cancer Center (TX) credits its cost management efforts – which include laying off 800 employees – for several straight months of profitability that have swung it into the black for the fiscal year, digging itself out of a $169 million hole.

Fast Company magazine covers the drug and blood delivery drones being used in Rwanda, where startup Zipline has in its first 10 months’ of service made 1,400 deliveries of 2,600 units of blood using its 15 drones, 25 percent of those involving life-saving emergencies. The service will go live in much-larger Tanzania next year, hoping to make it “the first country in the world to achieve 100 percent in-stock rates at all health facilities and hospitals” for anti-malarial drugs, HIV medication, vaccines, and insulin.

A nursing home owner pays $13 to acquire a Missouri hospital that BJC HealthCare bought and then closed nine months later, probably hoping that BJC is being overly cautious in warning of potential asbestos problems and high maintenance costs.

Pharma bro Martin Shkreli, who was famously banned from Twitter for his creepy harassment of reporters, is buying Internet domains that are associated with the names of journalists who have criticized him, then putting up web pages that mock those people. He then offers to sell them back the domains for several thousand dollars, an extortion-like scheme not unlike his Turing Pharmaceuticals pricing strategy in being simultaneously despicable yet legal. Shkreli says, “I wouldn’t call these people journalists. They are the unwitting recipients of liberalism subsidy from large media and telecom companies … only a few notches above the white supremacists we hear so much about these days.”

Colorado and Maine have enacted laws that require veterinarians to check pet owners in doctor-shopping databases in hopes of detecting drug users who obtain addictive drugs through their pets. Some states require vets to perform such a check, while two-thirds of states explicitly prohibit it, with the president of the California Veterinary Medical Association explaining, “I’m a veterinarian, not a physician. I shouldn’t have access to a human’s medical history.” 

Weird News Andy follows up on my mention of CuddleCot, observing that people took photos of their deceased children back in Victorian times because they were unsure of the then-new technology’s role in memorializing their dead loved ones. I recall a movie that led off with a series of photos like these, where it brilliantly added no explanation until it became obvious about halfway through what I was looking at. Memento mori.

In England, a hospital CEO is criticized for refusing to accept $3,200 donation for ECG equipment, saying that the fundraising team of men who’ve run an annual hospital bed-pushing contest for 25 years are demeaning nurses by dressing in their female uniforms.

Sponsor Updates

• Nuance announces that 600 healthcare organizations chose Dragon Medical One in the past year, also adding 25,000 users in the past 90 days.
• EClinicalWorks will exhibit at the NACHC Community Health Institute & Expo August 27-29 in San Diego.
• Hayes Management Consulting will exhibit at the AHIA Annual Conference August 27-30 in Boston.
• People: Laura Kanov joins HBI Solutions as SVP of product strategy.
• Impact Advisors donates more than 5,000 personal care products to active troops overseas.
• Ingenious Med will exhibit at the SHM-VA Chapter Meeting August 30 in Virginia Beach, VA.
• InterSystems will exhibit at the annual SHIEC Conference August 27-30 in Indianapolis.
• ConnectiveRx is a finalist for the 2017 PM360 Trailblazer awards.

Blog Posts

• While Not Perfect, Bundles May Still Be Our Best Bet (ECG Management Consultants)
• How technology empowers healthcare providers to achieve accessibility, affordability and availability (Elsevier Clinical Solutions)
• Brown Clinic: Superusers Building Value (EClinicalWorks)
• How to Boost Physician Engagement with Claims Data Insight (Evariant)
• Rethinking Customer Relationships (Access)
• Will I be able to advance in my career as a consultant? (Nordic)
• Reimbursement Analysis – A Critical Component to the Implementation of New Services (Hayes Management Consulting)
• Healthcare Digital Transformation: What, Why & How? (Part 3) (The HCI Group)
• Changing the Paradigm of Patient Communication (Healthgrades)
• Your guide to the MACRA 2018 proposed ruling (Meditech)
• One Moment That Mattered – A Physician’s Perspective on Patient Education (Healthwise)
• Change is Constant, How Do You Manage It? (Iatric Systems)
• Considering Telemedicine? Don’t Be Afraid. Funding is Out There. (Impact Advisors)
• Top 5 Tips When Using a Clinical Service Desk (Leidos Health)
• Protecting medical devices to build cyber resilience (Imprivata)
• Best Practices for Maximizing Your Healthcare Marketing Effectiveness (Influence Health)
• Final Countdown: Annual Thought Leadership on Access Symposium 2017! (Kyruus)

Contacts

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

News 8/23/17

Top News

CliniComp files a bid protest lawsuit against the VA, saying that it improperly issued Cerner a no-bid contract for an EHR that will replace VistA. CliniComp’s systems are used in several VA hospitals.

CliniComp prevailed in a similar 2014 lawsuit in which it protested that the VA’s selection process was flawed when it awarded a $4.5 million bid to Picis instead of low bidder CliniComp.

The White House took credit for the VA’s surprise selection of Cerner, apparently believing that interoperability with the Department of Defense will be easier if the organizations use the same vendor’s system. 

Reader Comments

From Givenchy: “Re: Athenahealth. Their community hospital webpage is misleading customers by claiming financial success for a time period in which it had no hospital customers.” I’m not clear from Athenahealth’s community hospitals web page if the claimed improvement in financial and quality measures is specific to hospitals, but I’m thinking not since, as you observed, the footnote cites customer data “based on a weighted average for Athenahealth clients with valid pre-Athenahealth benchmark data that had their 15 month anniversary with Athenahealth between January 1, 2010, and October 31, 2013.”  Athena didn’t acquire RazorInsights and its small-hospital system until early 2015. They also could be referring to hospital customers that use its other systems in their ambulatory operations.

From Lab Animal: “Re: best-of-breed LIS vendors. I left one of those companies to work on Epic’s clinical solutions in a major medical center. Beaker is now competitive enough to convince enterprise customers to convert. I have seen the advantages of integrated solutions. It’s not a new trend, though – my peers and I are contacted several times each week by recruiters looking for people experienced on the LIS I previously worked on to keep the lights on while the LIS team goes to Epic training and builds Beaker. The best-of-breed writing has been on the wall for years.” Sunquest and SCC (but not so much Orchard from what I can tell) are trying to find runway in the genetics information system business to offset their significant customer losses due to LIS domination by Epic and Cerner. Sunquest has also smartly branched out into lab instrument interface software, specialty pathology applications, and clinician collaboration, although I haven’t seen numbers of how much profit those products contribute or whether revenue is growing significantly. You don’t want to be a best-of-breed vendor these days unless Cerner and Epic don’t offer your particular product (yet, anyway, since Epic’s selling the industry-leading LIS also seemed unlikely a few years ago).

From Boomer: “Re: Medhost. Heard a rumor they are being considered for acquisition by a physician systems vendor that might be interested in entering the hospital market. They are strong with chains like Community Health Systems, which is selling off a bunch of its hospitals.” Unverified.

From Leftcoaster: “Re: Portland Adventist’s partnership with OHSU and scheduled conversion to Epic. It’s at risk due to a high-profile infant death lawsuit that could place OHSU at risk if the partnership occurs.” 

From Failed Merger: “Re: Presence Health merging into Ascension Amita. That should be interesting as Ascension is on Cerner, the Resurrection portion of Presence is on Epic, and the Provena part is on Meditech. At one point, Adventist Midwest was McKesson.” Thanks to Turnaround Failure, who tipped me off over the weekend of the merger rumor that I ran in the Monday Morning Update. Ascension proposes to acquire the struggling, 11-hospital Presence Health and operate it within its Amita Health joint venture that includes Adventist Midwest Health, pending regulatory approval.

Lloyd McKenzie, who is a co-chair of HL7’s FHIR Management Group, provided some background on the FHIR specifications that a reader asked about last week.

There are two mechanisms for sharing FHIR specs. The first is a computable format that uses FHIR itself. It allows sharing system capabilities and expectations; rules around data elements, such as what elements are required, optional, or conditional; what codes are allowed for use for which elements; etc. That format is intended to support automated testing, comparison of system capabilities, software configuration, etc. It can also be rendered for human review. The computable “resource” format is formally defined as part of the FHIR specification. HL7 strongly encourages implementers to expose their capabilities using this format.

The second mechanism is the human-readable rendering of FHIR implementation guides. Typically this is an HTML representation with hyperlinks back to the FHIR specification. HL7 produces tooling to support generating such human-readable rendered views, but does not mandate it. The tooling is also quite flexible, allowing content to be organized in a variety of ways, so it’s certainly possible to find interface documentation of varying quality and expressiveness that is generated using the same tooling. As well, the HL7-maintained IG publisher is not the only set of tooling available. HL7 developed and maintains it because it also needs a way to publish implementation guides and we’re happy for other organizations and implementers to make use of it. Best practices for producing human-readable FHIR interface documentation are far from settled, so expect the tooling to continue to evolve based on implementer feedback.

HIStalk Announcements and Requests

I questioned as a card-carrying cynic why so many people – many of them ignorant or even dismissive of science and math – would rearrange their lives to watch the moon block the sun for a short period, much like sticking your thumb into the air and obscuring the celestial fireball yourself for 10 seconds of child-like fun. I’ve heard that airlines weren’t able to meet the demand for flying in and out of certain (and hopefully cloud-free) parts of the country and hotels there were charging extortionate room rates for out-of-towners. I’m pretty sure that quite a few fad-following science haters who don’t vaccinate their kids, who don’t think climate change is real, or who argue passionately that the earth is actually flat still confidently uttered “totality” at every opportunity. I took a hooky break and went to the golf course — I’ve never played an actual round of golf, but I like to blast balls unskillfully on the driving range, putt on the practice green while quietly imploring others nearby to “miss it, Noonan,” and then have a burger and beer afterward, which seem to be the best parts of the game anyway – and nobody was paying the slightest attention to the sky or fishing in their golf bag for a flashlight. At least it got folks looking up from their phones long enough to share a rare in-person experience and it gave long-faded singer Bonnie Tyler a chance to sing her 34-year-old hit that has nothing at all to do with an actual eclipse (the writer, who isn’t Bonnie,  says it’s about vampire love).

Webinars

September 13 (Wednesday) 1:30 ET. “How Data Democratization Drives Enterprise-wide Clinical Process Improvement.” Sponsored by: LogicStream Health. Presenter: Katy Jones, program director of clinical support, Providence Health & Services. Providence is demonstrating positive measurable results in quality, outcomes, and efficiency by implementing clinical process improvement solutions in arming operational and clinical stakeholders with unlocked EHR data. Providence’s army of process engineers use their self-service access to answer questions immediately instead of waiting for reports to be written and double checked for possibly inaccurate information. The presenter will describe practical applications that include antibiotic stewardship, hospital-acquired infections, and comprehensive knowledge management.

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

Acquisitions, Funding, Business, and Stock

Vestar Capital Partners acquires health plan network management software vendor Quest Analytics.

Discharge software vendor SilverVue acquires Ergo Sum Health, which offers preventive care software that supports MACRA payments to providers.

A jury orders Johnson & Johnson to pay $417 million to a woman who blames her use of the company’s baby powder for her ovarian cancer, extending a string of verdicts against the company of $110 million, $55 million, and $72 million despite a lack of evidence that the product is unsafe. That’s a lot to pay out from revenue of a product that sells for $3 at Walgreens.

Sales

University of Utah non-profit reference lab ARUP Laboratories will offer physician users Illumicare’s Smart Ribbon to display cost and risk of patient harm on EHR screens.

People

Andy Page (23andMe) joins Livongo as president and CFO.

Announcements and Implementations

Rush University Medical System (IL) sues Draeger for fraud, claiming the $18 million patient monitoring system it bought issued unreliable alarms, erased log data, and lacked the promised capability of automatically switching from wired to wireless monitoring during patient transport. Rush replaced the system for $30 million last year.

Datica posts a “Rethinking Health Technology” ebook that includes contributions from several industry luminaries, including St. Luke’s Health System VP/CIO Marc Chasin, MD and University of Wisconsin Health Center SVP/CIO Jocelyn DeWitt, PhD.

In the UAE, Al Jalila Children’s Specialty Hospital goes live on Vocera’s secure text messaging and hands-free voice communication platform.

A Department of Justice-funded project at Penn State’s nursing school will use telehealth technology to support rural sexual assault nurse examiners, offering them live physical exam mentoring, peer review, and education.

Government and Politics

The DoD proposes spending $250 million to build a five-bed hospital at Guantanamo Bay that would serve 5,500 residents and 41 prisoners. The Senate Armed Services Committee has asked for an analysis of why a tiny remote hospital would cost $50 million per bed.  

Privacy and Security

Patient rights groups complain to insurer Wellmark that one of its executives described at a local Rotary Club meeting how a 17-year-old’s hemophilia cost the company $1 million per month to treat in trying to explain that health insurance doesn’t work actuarially if only people who are already sick sign up. The group claims that the remarks constitute a HIPAA violation, which might be the case since she cited the patient’s specific age even though she didn’t step over the HIPAA line in providing geographic information that is more granular than state level.

Other

A DC magazine profiles Meghan Buck, a former political consultant who formed Veda Data to apply machine learning to keeping physician directories updated.

This is either heart-wrenching, morbid, or both. A St. Louis hospital buys Cuddle Cots, a refrigerated bassinet that allows parents of stillborn or deceased babies to “put time on hold” in allowing them take photos and dress the body instead of moving it directly to the morgue. An article from earlier this year profiles families who spent up to two weeks with their deceased child’s body, taking it home and going for stroller walks as part of their grieving process.

The Miami paper runs a Q&A with CareCloud, whose CEO Ken Comee says the company will go public because, “My competitors are 20- and 30-year-old technologies and I have the best damned platform in the space.”

In India, the dean of a medical school’s hospital is placed on leave for trying to sabotage the parent company’s enterprise patient record and imaging project in favor of the hospital’s preferred vendor.

A Forbes Africa report finds that trained doctors are forced to work as restaurant servers and call center operators due to restrictive government policies and lack of coordination between the Department of Health and individual provinces, even as hospitals struggle with a shortage of practitioners.

In India, the government denies that a reported drop in oxygen levels killed three hospitalized babies. This follows an incident in which 60 babies died when another hospital’s oxygen supply ran out due to non-payment of bills. This time, a NICU doctor noticed low levels in the oxygen storage unit and called the hospital operator, who didn’t answer and was later arrested for being drunk and asleep on the job. The hospital says parallel systems kept the oxygen flowing to the wards while the problem was resolved, blaming the deaths on natural causes and therefore declining to perform autopsies, triggering the predictable complaints of a cover-up.  

Weird News Andy isn’t elevated by this news. In Spain, a 25-year-old woman who had just delivered a daughter by C-section is crushed to death when a hospital elevator malfunctions on the way to the maternity ward. Her daughter was on the same gurney, but was unharmed.

Sponsor Updates

• Attendees at Aprima’s annual user conference make and donate 150 blankets to the Children’s Medical Center in Dallas.
• Datica announces self-service onboarding and free trials of its updated platform.
• Besler Consulting releases a new podcast, “Utilizing data and technology to manage your EPM programs.”
• Nine healthcare organizations select Nuance solutions to replace legacy radiology systems.
• ClinicalArchitecture and Diameter Health will exhibit at the SHIEC Conference August 27-30 in Indianapolis.

• The CoverMyMeds hockey team wins the league championship.
• CTG will exhibit at the AI Summit August 24-25 in Cincinnati.
• Cumberland Consulting Group raises over $2,000 for the Center for Family Services Project Backpack initiative.
• Ohio Business Magazine includes Direct Consulting Associates in its list of Best Places to Work in 2016.

Blog Posts

• Do Your Patient Access and Front-End Revenue Cycle Processes Need a Health Check? (Optimum Healthcare IT)
• Medicaid Incentive Program & MACRA Medicare QPP Differences (AdvancedMD)
• #RSNA17: The countdown has started (Agfa Healthcare)
• Investing in Care Management (Arcadia Healthcare Solutions)
• Spear Phishing: Hackers Aiming for Healthcare (Datica)
• Solutions for Improving Medication Nonadherence Costs (CareSync)
• Examining the Implications of the Human Cloud (CTG)

Contacts

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

Monday Morning Update 8/21/17

Top News

The New York Times reviews patients recording their doctor visit for their later review.

The article notes that one family practitioner records patient visits himself, then uploads the annotated recordings to a secure web platform that patients and family members can review at any time. He says the de-identified recordings could help researchers find ways to improve medical communication.

University of Texas Medical Branch at Galveston buys recorders and batteries in bulk and offers them to cancer patients, with 300 of them accepting the devices each year. The program will be expanded to internal medicine and geriatrics.

The article describes how a neurosurgeon records his visits on an iPad and posts them to a platform he created called Medical Memory. He says half of the patients watched their videos more than once and its use has cut the practice’s malpractice insurance costs in half. 

A recently published research proposal describes a Dartmouth project to develop a platform that would store visit recordings and use machine learning to tag their specific elements, such as the treatment plan.

Reader Comments

From Nutmeg Grater: “Re: Allscripts. This is their new, top-secret EHR. Two years of work and just recently deemed not ready to demo at ACE. I wonder if they forgot about this website?” The Care Otter website doesn’t mention Allscripts specifically, but (a) some of the folks whose bios are listed hail from there, and (b) I found a cached copy of a since-removed API documentation page whose FHIR API license agreement lists Allscripts as the licensor. The company touts its “bleeding edge technology” and data science. The group’s address is, per Google Maps, a defunct steakhouse in Litchfield, IL. Their job postings list technologies such as Azure, Power BI, Apple’s Swift 3, the Xamarin moble app development platform, and reactive programming. Care Otter’s LinkedIn lists 56 employees, including former Allscripts engineering SVP Jeff Franks as president. Here’s a YouTube video highlighting Silicon Valley aspirations with dogs running around the office, free snacks at the bar, impromptu kite-flying, and collaborative slouch-ready furniture in what they call the “SiloCorn Valley.” I like the strategy of putting a creative group in a freewheeling setting far from corporate overseers, although the ultimate success measure is whether Care Otter earns market share.

From ACD_Fan: “Re: Epic. Our local hospital seems to be moving to it under the Community Connect program of Parkview Health Systems in Fort Wayne, IN. Another Paragon client jumps ship.” DeKalb Health’s web page says it is moving to Epic.

From Turnaround Failure: “Re: Presence Health. Word on the street is that Presence Health will announce Monday its merger with Ascension. Bet that Advocate, North Shore, and Northwestern will have something to say about that.” Unverified. The struggling 11-hospital Presence, created by the 2011 merger of Provena Health and Resurrection Health Care, announced plans earlier this month to sell two downstate hospitals to OSF HealthCare. I think Presence uses Epic, while Ascension is mostly Cerner.

HIStalk Announcements and Requests

I ran a reader’s query last week about the status of Cerner PowerInsight. The company provided this response, although the referenced HealtheEDW does not appear anywhere I could find on Cerner’s website:

PowerInsight Explorer is still available and widely used across Cerner’s US and global client base as a real-time reporting tool for Cerner Millennium. Cerner’s go-forward enterprise data warehouse, HealtheEDW, was released in 2011 and built on the source-agnostic cloud platform HealtheIntent. PowerInsight EDW will be supported in the US and sold globally as Cerner transitions legacy clients to HealtheEDW and stands up the cloud platform in global markets.

I received these responses to the reader’s question about FHIR specs:

• Much better than HL7’s old-style PDF bundles. Faster to navigate, easier to reference in our own documentation.
• I’m confused by what Sweet Ride is asking. I’ve done next to nothing with FHIR, having spent most of my career working with 2.x and V3/CDA, so maybe I’m looking at the wrong specs but the FHIR specs I’m looking at on hl7.org (starting with http://hl7.org/fhir/) are HTML and seem to me to be well-organized and easy to use. It’s definitely different than the PDFS HL7 used to use but I find it easier to navigate than previous specs – particularly V3/CDA.
• Anything is better than the current format.

It’s probably a lost cause trying to take the term “cloud-based” back to its original technical meaning as companies have turned it into a loosely-defined marketing slogan. Clustered says that while it really just means “in our basement instead of yours” and marketing departments have abused the term, it’s still accurate although incomplete, requiring prospects to perform due diligence.

New poll to your right or here: which of these inpatient EHR vendor companies do you admire most? I’ve hidden the interim results this time to hopefully decrease desperate ballot box stuffing. Feel free to add a comment explaining your choice.

Welcome to new HIStalk Platinum Sponsor Image Stream Medical. The Littleton, MA-based company’s technology connects providers with visual information and collaborative insight that allows them to make better decisions and to spend more time caring for patients. Solutions include procedure space integration, procedure recording, medical virtual presence for teaching, live video streaming, real-time room status, clinical video and image content management, video editing, and integrating procedure and video images with EHR, PACS, VNA, and other repositories to create a unified patient record. Healthcare systems benefit from increased clinical efficiency, reduced risk, improved patient safety by automating tasks, and reduced infection risk in allowing observers to participate outside the procedure room. The company, acquired by Olympus Corporation of the Americas in May 2017, just announced MedPresence, a virtual presence solution that allows surgical and interventional clinicians to connect and collaborate virtually. Thanks to Image Stream Medical for supporting HIStalk.

This Week in Health IT History

One year ago:

• Gartner predicts via its Hype Cycle that the technologies that will most quickly find mainstream adoption are machine learning, software-defined anything, and natural language question answering.
• Promedica (OH) attributes its swing to a big first-half loss on the cost of implementing Epic, while MD Anderson Cancer Center (TX) also blames Epic-caused higher expenses and lower patient revenue for its 77 percent drop in net income.
• A Medscape physician EHR survey finds that Epic is the most-used by far, Allscripts falls from #2 to far down in the list in user scoring, the VA’s VistA is the top-rated EHR overall, and VistA and Epic lead the pack in connectivity.

Five years ago:

• NextGen President Scott Decker resigns following the addition of dissident shareholder representatives to the board of parent company Quality Systems.
• Walgreens announces plans to deploy an customized version of Greenway PrimeSuite as its pharmacy EHR.
• University of Michigan Health System names Sue Schade as its new CIO.

Ten years ago:

• Congress gives the VA $1.9 billion for EMR and DoD integration, with the Appropriations Committee calling for blocking any EMR expenditures for software that won’t work with DoD systems and for the VA to work with private software companies to improve interoperability and mobile apps.
• West Penn goes live on Eclipsys.
• Misys licenses iMedica’s PM/EHR to get a small-practice system to market quickly.

Weekly Anonymous Reader Question

I got a ton of responses to “best musical group or performer seen live,” so I will excerpt (the asterisked ones were named more than once):

• Prince*
• Depeche Mode*
• Bruce Springsteen*
• Rolling Stones*
• Led Zeppelin*
• Moody Blues*
• Garth Brooks*
• U2*
• Pink Floyd*
• Billy Joel and Elton John*
• Paul McCartney*
• Adele*
• Santana*
• Radiohead
• Nine-Inch Nails
• AC/DC
• Journey
• Tedeschi Trucks Band
• My Morning Jacket
• LCD Soundsystem
• The Who
• Living Colour
• Nektar
• Grateful Dead
• Genesis
• Annie Lennox
• Jason Mraz
• Dead Kennedys
• Earl Scruggs Review
• Train
• Chicago
• The Wiggles
• Soundgarden
• Bryan Ferry
• Lindsey Buckingham
• Ray Charles
• Paco de Lucia
• John Prine
• Arcade Fire
• Ed Sheeran
• Mark Knopfler
• Tragically Hip
• Meatloaf
• The White Stripes
• Kid Rock
• Styx
• Beyonce
• James Taylor
• Steve Wonder
• Godspeed You! Black Emperor
• Kendrick Lamar
• The Clash
• Sarah Brightman
• John Mayer
• Phish
• Great Big Sea
• Shinedown
• Alanis Morrisette
• Red Hot Chili Peppers
• Jethro Tull
• John Hiatt
• Steve Winwood and Traffic
• Savages
• Jimi Hendrix
• Neil Young with Booker T and the MGs
• Uncle Tupelo
• The Old 97s
• Gladys Knight and the Pips
• Big Head Todd and the Monsters
• Coldplay
• Brian Wilson
• J. Geils
• Air Supply
• Guns N Roses
• Clarence Clemons
• The Rippingtons
• Metallica
• Lynyrd Skynyrd
• Bee Gees
• Iron Maiden
• Frank Zappa
• Melissa Etheridge
• The Eagles
• Jimmy Buffett
• Aretha Franklin
• Van Cliburn
• Dixie Chicks
• Gil Shaham

This week’s question:  what is the most memorable, creative, or effective thing you’ve seen a HIMSS conference exhibitor do to drive business, establish relationships, or create buzz?

Last Week’s Most Interesting News

• HIMSS Analytics data shows Cerner holding a slight edge over Epic in overall US hospital count, but Epic handily leading in large-hospital customers, total beds served, and doctors that use its ambulatory EHR.
• Google buys Senosis Health, which is developing smartphone sensors and apps for diagnosis jaundice, reduced lung function, and low hemoglobin.
• NIH awards Children’s Hospital of Philadelphia an NIH grant to mine databases to look for causes of pediatric cancer and birth defects.

Webinars

September 13 (Wednesday) 1:30 ET. “How Data Democratization Drives Enterprise-wide Clinical Process Improvement.” Sponsored by: LogicStream Health. Presenter: Katy Jones, program director of clinical support, Providence Health & Services. Providence is demonstrating positive measurable results in quality, outcomes, and efficiency by implementing clinical process improvement solutions in arming operational and clinical stakeholders with unlocked EHR data. Providence’s army of process engineers use their self-service access to answer questions immediately instead of waiting for reports to be written and double checked for possibly inaccurate information. The presenter will describe practical applications that include antibiotic stewardship, hospital-acquired infections, and comprehensive knowledge management.

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

Acquisitions, Funding, Business, and Stock

Investment research firm Hedgeye picked up the rumor I ran last week from reader At Last an Alias that Baylor Scott & White will replace Allscripts with Epic starting in the next few weeks, saying another research company confirmed the rumor with Allscripts. The firm’s tweets say that Allscripts has lost two of its top five Sunrise customers in the last six months (New York-Presbyterian and now BSW, assuming they have confirmed the rumor), with those two health systems representing 12.5 percent of all US Sunrise business with their 19 hospitals and 7,000 licensed beds. They tweeted out the graphic above (click to enlarge) that shows the top 25 Sunrise customers and indicating which are at risk. The elephant in the room is obviously Northwell Health (the former North Shore-LIJ) which along with University Hospitals are the only two of the top six Sunrise customers that haven’t already announced plans to replace it with Epic or Cerner. The former Baylor Health System is the only part of BSW that still runs Allscripts following its 2013 merger with Epic-using Scott & White.

Meanwhile, Hedgeye speculates on the identity of the puzzlingly unnamed six-hospital system that Allscripts announced as a new Sunrise customer in its August 3 earnings announcement. NantHealth’s Patrick Soon-Shiong bought struggling six-hospital Verity Health in July. The company later worked out a deal that allowed Allscripts to trade back its devalued $200 million investment in NantHealth for the FusionFx software suite and NantHealth’s promise to buy Allscripts products. The Allscripts 10-Q form says its Q1 bookings growth was almost entirely driven by “a large new multi-year relationship with a commercial partner that was executed during the second quarter of 2017.”

Decisions

• Enloe Medical Center (CA) will switch from Meditech to Epic in 2018.
• Erlanger Bledsoe Hospital (TN) will go live on Epic in October 2017.
• Erlanger East Hospital (TN) will go live on Epic in 2017, replacing McKesson.
• Virtua Memorial Hospital (NJ) will go live on Epic in the spring of 2018.

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

Announcements and Implementations

A new Reaction report from a survey of 119 people (most of them lab managers and directors) covers trends in laboratory information systems, concluding that best-of-breed LIS vendors such as Sunquest, SCC, and Orchard are at significant risk as a shocking 60 percent of LIS customers overall say they are considering replacing systems, with many of those likely to move to their EHR vendor’s offering in enterprise decisions made by executives instead of lab managers. Sunquest is listed as having the highest risk of contract replacement and the lowest net promoter score among the best-of-breed vendors as well as the lowest mindshare among all vendors that offer LISs, while the report notes that Epic has massive mindshare despite its KLAS-leading LIS offering that is just five years old. Orchard leads the NPS scores of all vendors by far, but it’s a tiny sample size. The report concludes, “It’s also not unreasonable to expect continued (although modest) consolidation, as the writing may be on the wall for some best-of-breed LIS vendors, causing them to seriously consider finding suitors among the EHR vendors.” Allscripts is now in the LIS business with its acquisition of McKesson EIS that includes a lab system as well as a blood bank module that Epic says it will never develop. Allscripts has previously offered Orchard LIS to its Sunrise customers. 

Technology

Amazon releases a developer toolkit for Alexa that provides programming interfaces for adding hands-free voice control to software products.

Other

An Atlanta-area business paper profiles the use by several area WellStar hospitals of Epic’s MyChart Bedside, in which the hospitals give patients a tablet that contains care team bios, meds, lab results, vital signs, and treatment schedules.

MaineGeneral Medical Center (I detest that spelling) blames a technical error for its sending of nearly 10,000 bills of under $25 to a collection agency.

US tourists are apparently being served tainted or drugged alcohol at upscale, all-inclusive resorts in Mexico’s Riviera Maya, sometimes resulting in crimes being committed against them. The story says nobody in Mexico really seems to care, including the resorts themselves, as visitors are assaulted, extorted by police, fall victim to drowning, or are regaining consciousness only to find unexplained broken bones or other injuries and no memory of the preceding hours, all after minimal alcohol consumption and often with simultaneous symptoms among group members. The US State Department has issued a Mexico travel warning about tainted alcohol and the Mexican government confirms that up to half the alcohol consumed there is produced illegally. Tourists report frustration at the indifference of the resorts when they report problems, the upfront cash required to obtain medical treatment at hospitals, and the fact that nobody ever gets arrested even though the tourists file reports in person with the local police departments.

When injured tourists turned to police, an instinctive step for many Americans, they were often stonewalled again. For starters, resorts in Mexico don’t typically call law enforcement to the scene. Vacationers have to take complaints to the police station. The few who did encountered further indifference: Nothing to investigate. It was an accident. You were drunk. In one case, a woman who was sexually assaulted by a hotel security guard … said the police chief overseeing her case seemed genuinely concerned and determined to help her … The chief tried to get the Iberostar Paraiso Maya resort to cooperate with the investigation and to provide photos of security staff. Frias was shot dead in his squad car months later. Local news reports said it was likely a killing meant to intimidate law enforcement.

The money-losing visiting health service of Mid-Columbia Medical Center (OR) says its use of a non-Epic EHR while the hospital uses Epic is hard since physician care plans don’t move electronically, but the service is still not willing to spend $750,000 to implement Epic.

I’m surprised that the names and logos of these healthcare services companies haven’t earned the attention of Epic’s legal team.

Potential jurors being interviewed by attorneys involved in the securities fraud case against pharma bro Martin Shkreli had some interesting comments recorded, although perhaps some of them were just grandstanding to get out of  jury service:

• I’m aware of the defendant and I hate him.
• He’s the most hated man in America. In my opinion, he equates with Bernie Madoff with the drugs for pregnant women going from $15 to $750.
• I just walked in and looked right at him and that’s a snake.
• I believe the defendant is the face of corporate greed in America.
• I don’t think I can [judge him impartially] because he kind of looks like a dick.
• The only thing I’d be impartial about is what prison this guy goes to.
• I just can’t understand why he would be so stupid as to take an antibiotic which HIV people need and jack it up 5,000 percent. I would honestly, like, seriously like to go over there …
• It’s my attitude toward his entire demeanor, what he has done to people. And, he disrespected the Wu-Tang Clan.

A hospital visitor in China is detained by police after posting online criticism of the price of the cafeteria’s meals, saying he “wanted to faint” when he saw the small portion of his $2 bowl of noodles, adding, “Poor quality, expensive prices, little food – is this still a hospital for the people?” After the man’s arrest, local police reminded Internet users that it is illegal to post false information online although they didn’t actually say he was lying. The article reminds me of how weird hospital cafeterias are: (a) they are just about the only place other than grocery store food bars to sell some foods by weight; (b) they don’t allow free refills on their overpriced drinks; (c) they are often outsourced to companies accustomed to serving low-bidder meals to prisoners and high school students, outfitting their unsmiling employees in jaunty, chef-like attire to suggest culinary artistry instead of the heating of frozen institutional entrees; and (d) they are passionate about portion control but indifferent to taste, customer experience, and wiping down tables and chairs between occupants, some of them wearing scrubs bearing materials you would not want near you while eating. There’s a challenge for you – send me photos of whatever you find weird about your hospital’s cafeteria.

Sponsor Updates

• Redox will exhibit at Health:Further August 23-24 in Nashville.
• Impact Advisors employees donate 385 pounds of personal care products to troops deployed overseas.
• The SSI Group will exhibit at the NC HFMA Summer Institute August 23 in Myrtle Beach, SC.
• Sunquest Information Systems will host its users group meeting August 21-24 in Tucson, AZ.
• Visage Imaging publishes a new whitepaper, “Can you? Visage can. Volume 1: Speed.”
• Medecision is named to the 2017 IDC Health Insights HealthTech Rankings Top 50.

Blog Posts

• What the new changes to MU and IQR mean for you (Advisory Board)
• 70 Healthcare Books for People Who Want to Understand the Industry (Redox)
• 5 Methods to Prevent Colleagues from Being Backseat Drivers (Salesforce)
• MACRA Challenges for Hospitals in 2018 (The SSI Group)
• Your Online Reputation: Learn How to Own It, Work It, and Reap the Rewards (Solutionreach)
• NACDS Total Store Expo: Pharmacies are increasingly playing a critical role in driving interoperability in healthcare (Surescripts)
• Jumping the hurdles to value-based care (Verscend Technologies)
• Close collaboration creates solid solutions. (Voalte)
• The Evolution of 911 and PSAP Data (West Corp.)
• Opioid Overdose: Looking for the signs (Conduent Health)
• Tips and Tools to Monitor Charge Correction at Go-Live (Sagacious Consultants)

Contacts

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

Morning Headlines 8/18/17

A Start-Up Suggests a Fix to the Health Care Morass

The New York Times profiles Aledade, a startup founded by former National Coordinator for health IT Farzad Mostashari, MD.

Strategic partnership enables physicians to conduct clinical research and offer new clinical therapies to their patients

Allscripts announces a partnership with Elligo Health Research that will allow users to enroll patients in clinical trials managed by clinical research organizations.

Mylan Agrees to Pay $465 Million to Resolve False Claims Act Liability for Underpaying EpiPen Rebates

EpiPen manufacturer Mylan will pay a $465 million fine to settle a false claim act for intentionally misclassifying EpiPen as a generic drug to avoid paying rebates to Medicaid.

Cerner selected as Medical Center’s new electronic health record provider

St. John’s Medical Center (WV) choses Cerner Millennium CommunityWorks as its next EHR.

News 8/18/17

Top News

The New York Times profiles Aledade, started by former National Coordinator Farzad Mostashari, MD, ScM.

The piece calls Aledade a tech startup (it has raised $75 million in investor funding), which seems incorrect since technology is just a tiny part of its ACO program to improve healthcare quality and reduced cost via its primary care doctor participants. The profile was run in the Technology section of the paper.

Aledade gets paid only if it saves Medicare money, which didn’t happen in 2016. Second-year results are due in October and Mostashari says he expects the company to generate revenue then.

Reader Comments

From At Last an Alias: “Re: Baylor Scott & White. Replacing Allscripts with Epic starting in October, estimated to take 18 months. I think this just refers to the 10 owned facilities. The North Texas ambulatory practices (aka Health Texas Provider Network) converted from Centricity to Epic in October 2016.” Unverified.

From Sweet Ride: “Re: FHIR. Older health standards are published as PDF or text documents, but FHIR has developed a new format for sharing specs that has the same look, feel, and functionality as the FHIR Standard for Trial Use, which they believe will be preferable to their developer audience. Our organization is trying to decide if we should move fast or slow to this format for our FHIR specs given that most hospitals and vendors aren’t used to FHIR yet and may prefer PDFs. Any chance you could run a survey to get input from your readership?” I set up a survey for those willing to help Sweet Ride out. I don’t know anything about it, so maybe we could all stand some enlightening from those who do.

From BI Watcher: “Re: Cerner PowerInsight. Did they quietly discontinue it? I’m looking at the latest KLAS analytics report and there’s no mention of it. It was listed last year, albeit with dismal scores.” I don’t know, but I bet someone who does will respond.

HIStalk Announcements and Requests

Blain Newton of HIMSS Analytics is providing great information on EHR vendor footprints, which I appreciate. Here’s his latest, responding to an HIStalk reader who wondered about total inpatient beds served by vendor (click to enlarge). The dominance of Epic and Cerner is obvious.

Here’s a view comparing 2012 market share by bed count vs. that of 2016. Meditech and Allscripts each lost 15 percent of their bed coverage over those years as hospital EHR uptake was booming, while McKesson customers stampeded for the door (and into the arms of Cerner and Epic) as the company lost nearly half of the beds it was covering in 2012. Both Cerner and Epic gained a lot of business, but Epic jumped most significantly (120 percent) to lead the pack. 

This last graph shows the utter dominance of Epic in terms of physicians using its ambulatory EHR and the dismal failure of Cerner to make a respectable showing.

I’ve also asked Blain if he can identify the fastest-growing large health systems/chains and which system they use corporately (which would foretell vendor footprint gains for doing nothing but watching their customers grow). It would also be really interesting to add up the total revenue of each vendor’s customer base as an even better indicator of customer footprint, but that sounds like a daunting project. Fascinating stuff. It’s pretty cool that Blain is willing to share this information given that HIMSS Analytics is in the business of selling rather than gifting it. I certainly appreciate it.

An anonymous HIStalk reader donated to my DonorsChoose campaign. Her money plus matching fully funded the first project below and provided the remaining funds needed to complete the other three:

• Beginner robotics and STEM activities for Ms. M’s first grade class in Knoxville, TN
• Tolerance and individuality books and study desks for Mrs. P’s first grade class in Williamsburg, VA
• Educational materials for teaching tolerance through STEM exploration for Ms. P’s first grade class in Orlando, FL
• Frederick Douglass autobiography books for the tolerance project of Ms. O’s high school class in San Antonio, TX

I’m growing increasingly impatient at articles – most of them written by inexperienced industry newbies, some of them submitted to me as Readers Write articles aimed at a C-level audience – whose authors think they are insightful in reciting dull, plainly obvious facts, often to pad out questionably valuable articles. I’m a harsh self-editor perpetually in “just the facts” mode and such journalistic flab drives me nuts. Here’s a sampling from some of those sites that elicit an instant “duh” when I read them:

• Get everyone on the same page.
• Now is the time to start steering toward actionable information for the sake of clinicians and, even more important, the patients that IT, administrators, executives and caregivers all serve.
• The barriers to EHR implementation and interoperability are slowly coming down and once they do, vendors will start looking to add more functionalities to the systems.
• Improved healthcare interoperability is a top priority for providers, policymakers, and patients in 2017.
• Getting a footing in the health IT industry is more challenging than it looks.
• Care coordination between healthcare settings can have a significant impact on patient care.

This week on HIStalk Practice: Amazing Charts decides to sunset InLight. AdvancedMD develops physician reputation management tool. HHS celebrates National Health Center Week with grants to centers across the country. Aledade partners with local PCPs to launch New Jersey ACO. DuPage Medical Group welcomes $1.45 billion investment. UnitedHealthcare helps fund telemedicine services at Kansas FQHC. Prescription management and delivery service company Phil raises $10 million. New Jersey Academy of Family Physicians President believesphysicians are shouldering too much of the opioid epidemic blame. AMA President David Barbe, MD shares his frustration with home state of Missouri’s PDMP efforts.

Listening: Ayreon, progressive metal rock opera from a Netherlands-based virtuoso who “casts” singers to portray “characters” that perform only in studio since the “band” never appears on stage. With one exception: they’re playing their first-ever actual concerts September 15-17 in the Netherlands featuring 16 singers, including the incomparable Floor Jansen of After Forever and Nightwish. 

Webinars

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

Vince and Frank put their usual expert and brutally honest spin on “Allscripts’ ‘Repeal and Replace’ of McKesson’s EIS” in Thursday’s webinar. We had a bunch of people watching live and the boys answered their questions at the end, guaranteeing that your one hour of watching the YouTube video will be well spent. I tuned in for a quick look and ended up hooked into watching the entire presentations.

Acquisitions, Funding, Business, and Stock

Israel-based Medaware, whose technology warns a physician when their drug order appears to deviate from the normal prescribing patterns of similar patients, raises $8 million in Series A funding, increasing its total to $12 million. 

Revenue cycle technology vendor ESolutions acquires RemitData, which offers comparative analytics.

Forbes names Salesforce as the world’s most innovative company for 2017.

EpiPen maker Mylan will pay $465 million to resolve False Claims Act charges that the company intentionally misclassified the drug product as a generic drug to avoid paying rebates to Medicaid.

Sales

St. John’s Medical Center (WY) chooses Cerner Millennium CommunityWorks, explaining that it “began seeking an alternative EHR vendor when industry events called into question the hospital’s ability to ensure that support from the vendor would continue to be available.” I believe they are (soon to be were) a McKesson (soon to be Allscripts) Paragon user.

Gwinnett Medical Center (GA) chooses ROI Healthcare Solutions to provide around-the-clock support for its legacy systems during its new EHR implementation.

People

The Strategic Health Information Exchange Collaborative names Kelly Thompson (Pennsylvania Department of Health) as CEO.

Verisys hires Joe Montler (McKesson) as SVP of sales.

Announcements and Implementations

Glytec earns its fourth FDA clearance for components to Glucommander, the core of its patented EGlycemic Management System: a titration module for enteral nutrition patients, an insulin-to-carb ration titration for outpatients, a more streamlined transition of inpatients from intravenous to subcutaneous insulin therapy, and general enhancements to the user interface, workflow capabilities, and messaging.

Allscripts will offer its EHR users access to clinical trials via integration with the trials recruitment system of Elligo Health Research.

Sunquest Information Systems will resell automated laboratory testing software from Software Testing Solutions.

Other

A St. Louis podiatrist who owns a company that services nursing homes is sentenced to 90 months in prison and ordered to repay $7 million for creating an EHR that automatically logged diseases and symptoms the patients didn’t have and for pressuring his employed podiatrists to provide unneeded services. His attorney wife is already in prison for the same conspiracy and the company’s CEO and four of its podiatrists are awaiting sentencing.

A 31-year-old restaurant owner is charged with assault after a cardiology clinic’s front desk employee told him his test wasn’t covered by insurance, after which he grabbed her computer monitor (luckily, it was a flat panel) and threw it at her.

I was amused by this newswire photo, which suggests that VA Secretary David Shulkin, MD rushed right over from hospital rounds to appear in a White House photo op, stethoscope poking conspicuously from his pocket. I have to laugh when doctors who clearly have no use for a stethoscope – such as administrators, psychiatrists, and dermatologists – still drape one over their shoulders or hang it prominently from their pocket to make sure everybody reflexively genuflects. At least Shulkin is an internist and still sees patients, according to some reports. My early experience in rural community hospitals was that the biggest quacks we had on staff – mostly foreign medical graduates back then when standards were low and they didn’t even have to take US boards – were likely to strut around in stiffly starched, name-embroidered lab coats adorned with stethoscopes, perhaps for convenience in pronouncing dead the patients they were mismanaging with a stunning mix of incompetence and arrogance.

A Jackson Memorial Hospital (FL) respiratory therapist is arrested for attempting to view child pornography on a hospital computer that a co-worker had left logged on. There was no happy ending to the story — he couldn’t even see the material he was arrested for seeking because the hospital’s web monitoring software blocked him (doh!)

Sponsor Updates

• Medecision Chief Marketing Officer Ellen Dalton will speak at a Technology Association of Georgia Marketing roundtable September 6 in Atlanta.
• Meditech and Parallon Technology Solutions will exhibit at the HIMSS Summit of the Southeast August 23-24 in Nashville.
• Navicure will exhibit at the Azalea Health annual user conference August
• Optimum Healthcare IT interviews Jon Morris, former SVP/CIO of WellStar Health System.
• Imprivata joins the CommonWell Health Alliance.
• NTT Data begins accepting applications for its global Open Innovation Contest.
• Nvoq will exhibit at Aprima’s annual users conference August 18-20 in Dallas.
• Clinical Computer System, developer of the Obix Perinatal Data System, will exhibit at the Indiana AWHONN State Conference August 25 in Plainfield.
• Uniphy Health appoints Ken Fishbain (Cardiothoracic & Vascular Surgical Associates) to its health advisory board.

Blog Posts

• As Excitement Builds, What Does Data Tell Us About the Upcoming Eclipse? (Liaison Technologies)
• Breaking Down the Top 5 Healthcare Revenue Cycle KPIs (MedData)
• 5 vital EHR features to help reduce sepsis (Meditech)
• Establishing the Leadership to Optimize your IT Strategy (Leidos Health)
• Health Insurance Companies are Evil, and Other Things People Believe (Redox)
• Improving Care Through Adopting Technology: What’s Next? (Netsmart)
• The Value of Online Reviews in Healthcare (HealthLoop)
• Increasing Family Engagement Needs a Proactive Approach (PatientPing)
• A Guide to Mobile Computing: Healthcare Going Mobile (PatientSafe Solutions)
• Forget the Rearview: Look Ahead to More Patient Payments (Patientco)
• What Bears Can Teach Us About Risk (PatientKeeper)

Contacts

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

News 8/16/17

Top News

The Congressional Budget Office scores the expected impact of the White House’s threat to stop paying Affordable Care Act-mandated cost-sharing reductions:

• Insurers would pull out, leaving 5 percent of the country with no access to exchange insurance.
• Premiums would increase 20 percent in the first year.
• The federal deficit would increase by $194 billion through 2026.
• The number of uninsured people would increase slightly in 2018 but then start moving slightly lower in 2020.

CBO qualifies its prediction based on how and when the White House stops making the payments, which the President has incorrectly described as “insurance company bailouts.”

The big takeaway is the deficit estimate. Paying premium subsidies based on income actually saves the country money.

CBO adds that President Trump’s CSR threats alone have already driven premiums up since insurers are required to request approval for their 2018 prices now.

The House of Representatives sued over the ACA’s cost-sharing reductions in 2014, arguing that the payments are illegal since Congress never appropriated the money to fund them. That case remains open.

Reader Comments

From Keelhauler: “Re: cloud computing. Thought you would enjoy this.” I did, thanks.

From Surprise!: “Re: Allscripts. Layoffs today of around 60 worldwide. Some senior people had their positions eliminated. Pretty eventful couple of weeks with the Paragon and NantHealth stuff.” Unverified, but reported by several readers. I reached out to the company’s media contact, who responded, “Allscripts does not discuss rumors or speculation,” which leaves the rest of us to do so without its participation.

From Life’s Changing the Ocean Floor: “Re: [health IT site name omitted]. Seems to be dead.” Sure does. Googling turns up no user outrage or fond reminiscing, which suggests that its demise was not untimely.

From Pacifico: “Re: Caradigm. LinkedIn shows that several top execs, salespeople, and security team members have left. GE is taking over, cutting headcount and leveraging shared services.” Unverified. I compared the company’s September 2016 leadership page to the current version – the 13 executives are now down to seven, of whom two are new.

From Gaslighter: “Re: market share by hospital size. Were those numbers for US hospitals only? Wondering since Meditech has a significant presence in Canada.” Blain Newton of HIMSS Analytics, who provided the count, says the numbers cover only domestic hospitals.

From Supine on the Sand: “Re: market share by hospital size. The most meaningful stat is the 500+ bed hospitals since they often take smaller hospitals with them when they choose a vendor, which is why Meditech and Siemens (Cerner) have lost hospitals. Number of beds is most important since it equates better to the number of people – particularly doctors – who use the systems. Meditech is in big trouble because it has no ambulatory presence and Cerner, too takes a hit with ambulatory. Epic is much stronger than Cerner because of its 500+bed dominance and its ambulatory market share. I would love to see market size by beds and by ambulatory doctor count.” I mentioned your interest to Blain and he’s going to analyze EHR vendors by total beds and total physicians, so watch for that. I think Meditech can maintain its relevance for those hospitals that can’t manage the complexity or afford the cost of Epic or Cerner, but I agree that Meditech waited too long to conclude that the offering of partner LSS – which Meditech later bought – wasn’t the integrated ambulatory answer many of its clients and prospects were looking for. All three companies have common traits: they offer single-platform products for nearly every hospital service, they rarely acquire companies (“never” in the case of Epic), and they run on a single database. Those characteristics seem obviously desirable with 20-20 hindsight, but were lost on now-lagging competitors who were busily milking their cash cows, buying and nameplate-integrating anything that moved, and waltzing with Wall Street.

From EclipsysGal: “Re: Chad Eckes. Glad to see an IT leader move into the CEO role.” Chad takes the CEO role at Pinnacle Dermatology, a private equity-backed dermatology practice in the Midwest that hopes to expand to 100 locations. He has served time as CIO of Cancer Treatment Centers of America and EVP/CFO of Wake Forest Baptist Medical Center (NC).

From Vaporware?: “Re: MHS Genesis pilot sites. I found this testimony from March that says interoperability at Fairchild is through the legacy JLV portal via logging into AHLTA. Future plans include moving the legacy portal into Genesis. Fair to take that as a ‘no’ on CommonWell?” I’ll invite knowledgeable readers to chime in since I don’t know much about the DoD and the planned interoperability with the VA once they’re both on Cerner. It may be that workarounds are necessary until Genesis is live at all DoD facilities.

From Eco Chambers: “Re: nonsensical terminology. I submit ‘ecosystem’ or ‘hyper-convergence.’ Where does this stuff come from?” I suspect someone (probably folks aspiring for cleverness in their books or articles) spends a lot of time coming up with words they hope will spread virally. Unfortunately, that sometimes happens, replacing perfectly serviceable and accepted words with cute new ones that only a marketer could love. 

HIStalk Announcements and Requests

I thought my old Plantronics USB headset was failing since my new laptop wouldn’t recognize it (it wasn’t failing, as it turned out – I fixed the problem by deleting and reinstalling the latest version of the motherboard’s audio driver). I wanted a more comfortable headset since I often listen to music for hours while writing HIStalk and remembered that the best one I’ve owned was a gamer version. My solution: the fantastic EasySMX PS4 for $18.99 (for some reason, it’s gone up to $28.99 since last week). The driver-free headset’s deep ear cushions eliminate room noise while pumping out impressive bass from its 40mm driver with a cool option to vibrate as well, which I like. I’m rocking out to the much richer sound.

Listening: new from former Oasis singer-songwriter Liam Gallagher, whose Lennon-like brilliance is tempered by bizarre behavior that should make him a top pick in the rock dead pool. I’m also enjoying the immensely talented Sia, who is suddenly a global superstar at 41 (you’ve surely heard her stunning tropical house hit “Cheap Thrills” or “Chandelier”) after writing songs for other stars and battling personal demons.

The healthcare relevance of the folks HIMSS chooses for keynote speakers often puzzles me and Magic Johnson is no exception. His accomplishments, as far as I can tell, were (a) surviving HIV when most other patients didn’t, and (b) getting rich off basketball and the business deals he struck after he retired (I’ll skip his awful 1998 TV talk show, whose low quality and alarmingly short tenure was eclipsed only by the pitiful late-night efforts of Chevy Chase and Pat Sajak). At least he has directed some of his attention toward social causes and that alone will probably make his speech interesting. He’s on the agenda for Friday of HIMSS week, with the absence of most of us dearly departed attendees providing an intimate setting for those stalwarts can never get too much time at conferences or in my least-favorite city.

Thanks to HIStalk sponsors EClinicalWorks and ZappRX for upgrading their Gold sponsorship to Platinum.

Thanks to Nuance, which apparently dropped their long-held HIStalk Founder sponsorship by mistake and have reconnected as Platinum since their original spot had already been snapped up by the time they realized it.

Webinars

August 17 (Thursday) 2:00 ET. “Repeal and Replace McKesson’s EIS.” Sponsored by HIStalk. Presenters: Frank Poggio, CEO, The Kelzon Group; Vince Ciotti, principal, HIS Professionals. The brutally honest and cynically funny Frank and Vince will analyze the Allscripts acquisition of McKesson’s EIS business. They will predict what it means for EIS’s 500+ customers, review what other vendors those customers might consider, describe lessons learned from previous industry acquisitions, and predict how the acquisition will affect the overall health IT market. Their 2014 webinar on Cerner’s acquisition of Siemens Health Services has generated over 8,000 YouTube views.

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

Acquisitions, Funding, Business, and Stock

Credentialing technology vendor Silversheet raises $5 million in Series A funding, increasing its total to $10 million. I interviewed CEO Miles Beckett, MD just over a year ago since I was fascinated that he created the “lonelygirl15” web series that ruled YouTube in 2006-2008.

A Goldman Sachs report says Amazon’s initial healthcare ambitions may involve partnering with a pharmacy benefits manager to optimize prescription ordering and delivery. The report also speculates that Amazon could provide patient monitoring and telemedicine visits via its Echo that would then allow patients to order the drugs prescribed. It also says Amazon could be interested in using the patient data it collects to cross-sell products, which wouldn’t be the day’s best privacy news.

Google buys Seattle-based Senosis Health, which was developing apps that use smartphone sensors for diagnosing newborn jaundice, reduced lung function, and low hemoglobin levels. Those apps have yet to earn FDA’s marketing clearance.

Medication management technology vendor Swisslog Healthcare makes an unspecified investment in managed telepharmacy solutions vendor PipelineRx. 

Personalized health behavior change technology vendor Happify Health raises $9 million in funding.

Dublin, Ireland-based Clanwilliam Group makes its 13th medical technology acquisition in three years in buying digital dictation vendor Medisec Software, which is a supplier to NHS.

CHOP spinoff Haystack Informatics closes an additional funding round to expand the rollout of its privacy solution, which analyzes EHR activity logs to identity potentially inappropriate user activity.

Clinical research organization PRA Health Sciences will pay $520 million to acquire Symphony Health Solutions, which resells prescription data of 280 million US citizens to drug companies who use the information to market their products to doctors.

Sales

St. Luke’s University Hospital (PA) will implement MModal’s Fluency Direct EHR-integrated clinical documentation as it moves to Epic in 2018. St. Luke’s CMIO James Balshi, MD calls MModal’s platform “cloud-based but not cloud-dependent.” 

Children’s Hospital New Orleans (LA) selects Vocera’s smartphone app for secure text messaging and hands-free communication.

Saint Luke’s Health System (MO) will expand its FormFast implementation in rolling out the company’s electronic signature product.

In England, Bolton NHS Foundation Trust chooses Allscripts Sunrise.

MIT’s student and faculty ambulatory care center chooses Cerner Millennium and HealtheIntent.

People

Libby Curtis Webb (Copatient) joins ZappRX as SVP of product.

Announcements and Implementations

Children’s Hospital of Philadelphia (PA) will run an NIH-funded project to mine big data to look for causes of pediatric cancer and birth defects, with partner organizations running several data portal, genomics standards, and analytics sub-projects that will combine clinical and genetic sequence data from several cohorts into a centralized database.

PatientPop – which offers practice-building tools – adds the ability for Google searchers to schedule an appointment directly from the practice’s Google My Business listing that shows up to the right of the search results.

Navient subsidiary Xtend Healthcare buys HIM and revenue cycle consulting firm Elipse.

A technology paper profiles Phynd, with founder and CEO Tom White explaining its provider data management solution. The company’s Phynd a Doc consumer search function is used on Duke Health’s website (above).

The Tennessee Hospital Association and Audacious Inquiry launch ConnecTN, which will share real-time ED visits and hospital admissions among THA’s hospital members and TennCare.

Apple is reportedly talking to Aetna about making the Apple Watch available for free or at a discount to the insurer’s customers, which would extend the program beyond Aetna’s wellness program that covers its 50,000 employees.

Optimum Healthcare IT opens a managed services office in Duluth, MN and is profiled in the local paper.

OpenEMR enhances its open source EMR to operate as an out-of-the-box cloud services solution using Amazon Web Services, providing benefits that include automatic scaling of computational resources for cost effectiveness, cutting edge network security, zero hardware maintenance, easy software deployment, and robust backup and recovery solutions.

Privacy and Security

The Department of Justice demands that web hosting company DreamHost turn over the personal information of 1.3 million visitors to an anti-Trump website, ordering the company to provide IP address, contact information, photos, and emails.

Technology

Microsoft defensively downplayed a Consumer Reports estimate from last week that 25 percent of its Surface tablets and laptops experienced problems – which caused CR to withdraw its “recommended” rating – but internal Microsoft documents suggest that Microsoft was fully aware that the Surface Pro 4 and Surface Book have high customer return rates. Here’s some easily-remembered advice: never buy hardware from Microsoft other than keyboards, mice, joysticks, and Xbox components. The rest of their lineup is stuff other companies sell better and cheaper (unless you still believe the Zune was a great digital media player and subscription music service).

Other

The HR SVP and an interim hospital CEO of Broward Health (FL) quit following the resignation of an SVP who had been accused of overpaying a politically connected marketing company by $1.7 million in a secret side agreement. The health system’s then-CEO committed suicide 18 months ago, after which the board ignored the candidates presented by its search firm and instead gave a fellow board member the $650,000 job. That CEO is a nurse whose only graduate degree was issued by a notorious diploma mill that has since closed.

I hadn’t seen this: Physicians Healthsource sues Allscripts under the Telephone Consumer Protection Act for sending junk advertising faxes without opt-out instructions. The plaintiff claims it received 36 faxes from 2008 through 2011 and seeks class action status. The judge labeled Physicians Healthsource as a “professional class-action plaintiff” that has filed several similar “junk fax” class action lawsuits using he same law firm and notes that fax machines have mostly been replaced by computer software, meaning that recipients expend little money or time in discarding unwanted faxes even though federal law still allows filing such lawsuits. The judge also noted that Allscripts had previously been sued by a physician’s office for the same issue and paid $600,000 in legal fees plus whatever settlement they agreed to, concluding that Allscripts “should adjust its marketing strategy a bit, or at the very least, stop sending faxes to what might be one of the more litigious businesses, in terms of junk fax litigation, in the country.” The court also notes that the maximum penalty for junk faxing is $500, but such class action lawsuits can create a windfall for the law firm as both sides pay expensive attorneys to argue over the small sum. The judge’s comments are entertaining and cynical, showing obvious disdain in the ruling above for a Congress-created law that he clearly thinks is ridiculous.

Sponsor Updates

• UnityPoint Health (IA) is optimizing its EHR build by using LogicStream Health’s Clinical Process Improvement solutions to review sepsis screenings and to compare protocol usage to evidence-based best practices in real time.
• EClinicalWorks supports National Health Center Week and the 700 Community Health Centers that use its systems. The company was also named as a Frost & Sullivan customer value leadership award winner for its RCM services.
• Kyruus will integrate its ProviderMatch for Consumers with Binary Fountain’s online patient reviews to enhance its online search directory pages.
• Besler Consulting will present at the HFS Provider User Meeting August 18 in New Orleans.
• Gartner includes Dimensional Insight and its analytics applications in three healthcare research reports in July 2017.
• IDC Health Insights includes Medecision in its HealthTech Rankings Top 50.
• Glytec CMO Andrew Rhinehart, MD discusses Glytec’s contributions to value-based reform.
• Ingenious Med will exhibit at the HFMA NC Summer Institute August 23-26 in Myrtle Beach, SC.
• InterSystems will exhibit at the Sunquest User Group meeting August 21-24 in Tucson, AZ.

Blog Posts

• Are Your Healthcare Communications Ready for the Total Solar Eclipse? (Spok)
• Embracing Differences and Maximizing Strengths (Access)
• Aprima’s Adaptive Learning Technology and the AI/Machine Learning Buzz (Aprima)
• Why There is No Up Front Pricing (Datica)
• Help with Physician Burnout and Other Challenges Physicians Face (CareSync)
• Lessons Learned from an Internship (Direct Consulting Associates)
• 2017 National Health Center Week: Celebrating the Care All Americans Deserve (EClinicalWorks)
• Are You Ready for Value-Based Care? 7 Things to Consider (Hayes Management Consulting)
• Healthcare Digital Transformation: What, Why & How? (Part 2) (The HCI Group)
• The Tension Between Healthcare Pricing and Consumerism (Healthcare Growth Partners)
• Change is Constant, How Do You Manage It? (Iatric Systems)
• Bipartisan legislation in US Congress requires e-prescribing to combat opioid abuse (Imprivata)
• 5 Ways to Grow Your Healthcare Brand with Consumer Reviews (Influence Health)
• Back to School: 5 Lessons Learned in Healthcare Payments (InstaMed)

Contacts

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

Monday Morning Update 8/14/17

Top News

NantHealth shares dropped 14 percent on Friday after Thursday’s announcement of poor financial results, a 300-employee layoff, and re-acquisition of heavily devalued NH shares previously purchased by Allscripts. NH shares closed Friday at $3.49, valuing the company at $424 million.

Above is the one-year share price chart of NH (blue, down 71 percent) vs. the Nasdaq (green, up 19 percent).

CEO Patrick Soon-Shiong said in the earnings call that acquisitions had swelled NantHealth’s payroll to 1,000 employees. He says synergies, a refocusing on artificial intelligence and decision support products, and transferring some employees to Allscripts as part of its purchase of NantHealth’s patient-provider portal product will enable the 30 percent headcount reduction.

Soon-Shiong says the FusionFx product that Allscripts is buying is non-core business because the company can exchange clinical documents without its interoperability component and that “this middleware that actually talks to EMRs was merely a tool and not really core and was better in the hands of an organization with hundreds of salespeople calling on customers during EMR implementations.”

NantHealth’s FusionFx was part of its July 2015 acquisition of Harris Healthcare Solutions, which had previously acquired the former CareFx in early 2011 for $155 million in cash. That offering included HIE, patient and provider messaging, and single sign-on. 

Reader Comments

From Ciro Cumulus: “Re: the question of whether Epic is a cloud-based system. Based on your criteria, I would say yes.” CC provided this review of Epic’s offering:

• It connects via the Internet.
• The user organization doesn’t pay capital expense, just a cost per concurrent user with license fees to InterSystems.
• The standard term is five years with renewals.
• Epic uses software-defined networks and state-of-the-art virtualization across compute, storage, and network.
• Customers can scale up or down on the fly.
• Epic manages the infrastructure and applies upgrades, although with more coordination than the typical cloud provider since application software requires more testing, training, and integration review.
• Epic provides service-level agreements for performance and uptime.

HIStalk Announcements and Requests

Poll respondents are not really sure who will benefit most from Allscripts acquiring Mckesson’s EIS business, but the customers of both companies top the list. New poll to your right or here: what kind of term is “cloud-based?”

Blain Newton, EVP of HIMSS Analytics, was kind to answer my question about hospital count by bed size in providing the worksheet above. The information should dispel the notion that the inpatient EHR market is a wide-open race with many participants. My takeaways:

• Cerner, Epic, and Meditech are far ahead of the pack in terms of overall hospital count.
• Epic has nearly double the number of 500+ bed hospitals as Cerner.
• The good news for Allscripts (sort of, anyway) is that McKesson had twice as many hospitals as Allscripts pre-acquisition, but most of those are under 150 beds.
• I consider 250 beds to be the minimum size hospital to provide significant revenue opportunity and that race is all Epic (38 percent), Cerner (31 percent), and Meditech (14 percent).
• Allscripts, which was touted by a reader as being a major, competitive player that generated my original question, is not – they have just 6 percent of the 250+ bed hospital market and only 3 percent of hospitals overall vs. Cerner’s 24 percent, Epic’s 23 percent, and Meditech’s 19 percent.
• The unstated factors involve the “which modules” question — running a full suite of available products vs. just a few key systems from a particular vendor – as well as the overall trend in switching from one vendor to another. Hospitals are often all in with Cerner, Epic, and Meditech, but I suspect much less so with Allscripts given its more limited product line (although Allscripts has a strong ambulatory presence). There’s also the issue of which hospitals are running a system vs. who is paying for it and how much, which then gets into how health systems buy software corporately.
• Regardless of the slicing and dicing applied, I’ll stand by my long-held conclusion that it’s all Epic and Cerner with Meditech as the dark horse when it comes to inpatient EHRs. Everybody else is eating their dust and likely to lose business due to hospital consolidation and a shift toward the most successful vendors as much as all of us who – for our own reasons – wish that weren’t the case. We need more and better competition.

It’s a slow news time every year from early August through Labor Day. After that, everybody puts their nose back to the grindstone, conferences gear back up, and a flurry of work kicks in that lasts until Thanksgiving. Until then, the news is mostly an occasional big announcement (like acquisitions and quarterly earnings reports) and a product sale every now and then.

This Week in Health IT History

One year ago:

• Karen DeSalvo, MD, MPH resigns as National Coordinator, replaced by Vindell Washington, MD but continuing in her full-time role as Assistant Secretary for Health.
• Bon Secours Health System (VA) notifies 665,000 patients that a revenue cycle optimization vendor’s mistake left their information freely discoverable on the Internet.
• Patient advocate Jess Jacobs dies.
• The FTC resolves its patient privacy complaint against Practice Fusion, which it accused of soliciting patient reviews about their doctor and posting them to its website without adequate warning.

Five years ago:

• SAIC completes its acquisition of MaxIT Healthcare.
• The Surgeons of Lake County (IL) reports that its system was attacked by ransomware.
• Arkansas Heart Hospital signs a $10 million deal to implement Siemens Soarian.
• CMS publishes requirements for Meaningful Use Stage 2.

Ten years ago:

• The first screenshots of Google Health are leaked.
• Healthcare billing company Verus shuts down following a string of system breaches.
• CompuGroup wins the bidding for taking over iSoft.
• Epic opens its $100 million, barn-red learning center as Campus 2 construction begins and the company’s revenue hits $422 million.
• Walmart announces plans to open 400 in-store medical clinics.

Weekly Anonymous Reader Question

Responses to last week’s question:

• I would love to live in Maui — mild weather, beautiful landscape, and friendly people.
• The Tuscany countryside.
• Boulder, CO.
• Fiji has the most wonderful people I have ever encountered, and it’s beautiful. New Zealand is also beautiful, has wonderful people, and is progressive. I’m buying a house in both places.
• Near my family and my (hopefully) eventual grandchildren.
• Madison, WI.
• San Francisco.
• A restored Vanderbilt mansion in Newport, RI in the summer and a hut on Little Palm Island near Key West in the winter.
• A beach house in Playa del Carmen.
• Notre Dame du Pre, France.
• London.
• Scandinavia or Holland.
• Paris.
• La Jolla, CA.
• New Zealand! Tropical beaches, rainforests, mountains, glaciers, and volcanoes all within driving distance (long ferry ride potentially required).
• Jacksonville, FL.
• Captiva Island, FL, the Caribbean island in the US.
• Denver.
• Oahu, Hawaii — slower pace of life, great weather, great people, great natural world, but still has modern world amenities.
• US Virgin Islands.
• Right where I already am – on the North Shore of Lake Superior.
• Moorea, FP.
• Curacao or the Bahamas.
• Jekyll Island, as close to Driftwood Beach as I can get.
• Alaska.
• Fairhope, AL on the bay.
• In a giant fifth-wheel, exploring the country (and probably spending a lot of time in New England and California)
• Byron Bay, Australia.
• Western Montana.
• London on the Northern or Western ends so I can still have trees around me, and since money isn’t a factor I’m going to have a little cottage on the lower Cape, maybe Eastham or Orleans. Water, but set way back so my house won’t fall into the ocean for at least 20 years.
• Coastal Southern California.
• Lauterbrunnen, Switzerland or some other spectacular Alpine town. Clean water, clean air, solar power and living life in person instead of through an electronic device.
• Florence, Italy.
• Carmel, CA.
• St. John, USVI.
• Destin, FL.
• San Diego, CA.
• Goodyear, AZ.
• Chicago downtown.
• Chapel Hill, NC.
• Paris.
• Vegas, with summer trips to the rest of the world.
• Encinitas, CA.
• Auckland.
• SoCal rocks.
• Carlsbad, CA.
• Jackson, WY.
• Boston.
• Munich, Paris, NYC.
• Redmond, OR.
• Coronado Island Calfornia. The best climate in the country year round and a beautiful beach! Can’t beat it.
• St. Maarten.
• Mobile Bay, AL.
• San Diego. Best of all worlds n the US. Vancouver for Canada.
• Hands down – Ireland (just got back – amazing), also Wyoming, Ft. Myers, FL.
• London.
• Florence, Italy near the Ponte Vecchio.
• I would live a nomadic life in a class B motor home. Then I would really more deeply experience places I’ve visited that caught my eye. Durango, CO, Travelers Rest SC, Venice FL, Seattle, WA, Saranac Lake, NY.
• With George Clooney. Before he was married and had kids.
• San Francisco or Seattle.
• The house I grew up in. There I knew happiness and love.
• San Diego.
• Big Island, Hawaii.
• Costa Rica. It’s an amazing place with amazing people. Have been there five times and am overdue for a trip back!
• Hawaii.
• Santa Fe.
• London.
• The Alaskan Bush.

This week’s question, which isn’t really work related but interesting to me personally since all work and no play makes Mr. H a dull boy:  which musical group or performer is the best you have ever seen in a live, in-person performance?

Last Week’s Most Interesting News

• Allscripts swaps its mostly devalued NantHealth shares for NantHealth’s provider and patient engagement solutions.
• NantHealth announces poor quarterly results and a restructuring that involves laying off 300 employees.
• UC San Diego Health migrates from its self-hosted Epic implementation to an Epic-hosted version.

Webinars

August 17 (Thursday) 2:00 ET. “Repeal and Replace McKesson’s EIS.” Sponsored by HIStalk. Presenters: Frank Poggio, CEO, The Kelzon Group; Vince Ciotti, principal, HIS Professionals. The brutally honest and cynically funny Frank and Vince will analyze the Allscripts acquisition of McKesson’s EIS business. They will predict what it means for EIS’s 500+ customers, review what other vendors those customers might consider, describe lessons learned from previous industry acquisitions, and predict how the acquisition will affect the overall health IT market. Their 2014 webinar on Cerner’s acquisition of Siemens Health Services has generated over 8,000 YouTube views.

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

Acquisitions, Funding, Business, and Stock

Nordic expands its Madison, WI office, adding space for another 60 employees. The company says the new space won’t last long as it rapidly expands beyond its 800 employees and 2016 revenue of $180 million.

Technology company The Bitfury Group and Baltimore-based AI startup Insilico Medicine will work together to develop blockchain applications for healthcare.

Decisions

• Dukes Memorial Hospital (IN) will replace McKesson with Cerner in 2018.
• Dupont Hospital (IN) will go live with Cerner in 2018.
• Carroll Hospital (MD) will replace McKesson with Cerner in 2018.
• UMass Memorial – HealthAlliance Hospital (MA) will implement Epic in October 2017, replacing Siemens.
• Bryan Medical Center – East (NE) will go live on Epic in March 2018.

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

People

Santa Rosa Consulting hires Mike Ragan (NTT Data) as chief revenue officer.

Announcements and Implementations

HIMSS Analytics expands its Logic health IT market intelligence platform with international data, increasing its coverage to 380,000 facilities in 47 countries, including 100 percent of US hospitals. 

Other

In India, the head of a state-run medical college is suspended after the deaths of 60 children in the past week – at least 30 of them on Thursday and Friday alone — that local newspapers claim were due to the hospital’s oxygen vendor cutting off the hospital’s supply after it accumulated $90,000 worth of unpaid bills. The administrator says he repeatedly warned the state that the hospital didn’t have the money to pay the overdue oxygen bills but was ignored. Witnesses say doctors handed out manual resuscitator bags to family members asked them to pump it themselves as many of them watched their children die needlessly.

In Ireland, Mater Hospital’s storage-area network fails, forcing the hospital – which is among the country’s busiest – to divert ambulances and cancel appointments.

Here’s Vince’s final HIS-tory installment on Cerner, closing out a nice look back on the company’s history.

Sponsor Updates

• Forrester Research names Salesforce Service Cloud a leader in its latest report on customer service solutions for enterprise organizations.
• Surescripts will present at ONC’s 2017 Technical Interoperability Forum August 15-16 in Washington, DC.
• T-System joins Athenahealth’s More Disruption Please program.
• Wake Forest Baptist Medical Center joins the TriNetX Global Health Research Network.
• ROI Healthcare Solutions hires Jeff Powell as director of business development.

Blog Posts

• The United States of Digital Health: Therapeutic Devices (Redox)
• Boost Your Google Ranking: 10 Tips to Get You on Your Way (Salesforce)
• MIPS Quality Payment Program Criticized (The SSI Group)
• 4 Practice Marketing Lessons Gleaned From Star Wars (Solutionreach)
• Staying Healthy While Working From Home (Summit Healthcare)
• Building on Direct: Improving interoperability and patient data exchange (Surescripts)
• Thinking inside the box with a provider decision quadrant: identifying FWA and taking action on low-risk providers (Verscend Technologies)
• Cake and Best Practices for Enterprise Imaging (Visage Imaging)
• Nurse satisfaction is at the top of every nursing leader’s agenda. (Voalte)
• Top Seven Reasons Ambulatory Practices Leak Revenue (ZirMed)

Contacts

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

News 8/11/17

Top News

Allscripts will trade its significantly devalued 15 million shares in NantHealth for most of NantHealth’s provider and patient engagement solutions. That includes NantHealth’s FusionFx business, unstated “components of the NantOS software connectivity solutions,” and a guarantee that NantHealth will book an unstated minimum value of Allscripts product sales over a 10-year period.

The NH shares for which Allscripts paid $200 million two years ago are worth around $50 million. The company announced in last week’s quarterly earnings report that it will write down $145 million of its investment.

NantHealth’s FusionFx was part of its July 2015 acquisition of Harris Healthcare Solutions, which had previously acquired the former CareFx in early 2011 for $155 million in cash. That offering included HIE, patient and provider messaging, and single sign-on. 

NantHealth’s Patrick Soon-Shiong personally invested $100 million in Allscripts shares in the mid-2015 deal. He is down around $8 million as MDRX shares have fallen almost 10 percent since.

Meanwhile, NantHealth announces Q2 results: revenue up 17 percent, EPS –$0.58 vs. -$0.54. The company’s quarterly losses increased from $87 million to $111 million. NantHealth said in the earnings announcement that it will reduce headcount by 300 in a restructuring that will focus on cancer machine learning systems.

Soon-Shiong’s other publicly traded company, NantKwest, IPO’ed in July 2015, with a first-day closing share price of $34.64. NK shares now trade at $5.67.

Reader Comments

From Captain Beefheart: “Re: the term cloud-based. Several publications used this term for UCSD’s move to an Epic-hosted system. Epic isn’t really a cloud-based system just because they run the same product from their data center.” Health IT has long blurred the definition once it devolved from a technical term to a marketing one, simply renaming “hosted” systems (which also include the various forms of “just a longer cord” such as Saas, ASP, etc.) as being “cloud-based,” the same way “software” became “solutions” without changing anything. Googling didn’t turn up a firm definition of cloud-based systems, but here’s my best summary that begs for more technically astute readers to weigh in, with my interpretation being that calling Epic a “cloud-based system” is incorrect even though I’m guilty of having done so in UCSD’s case without really thinking about it:

• Connection to the remote system is via the Internet.
• The user organization doesn’t pay capital expenses but rather is billed at regular intervals based on a fixed monthly expense or for metered services.
• The hosting data center uses a shared pool of infrastructure (multi-tenancy) that can be managed virtually and provisioned on the fly. It is not simply moving the customer’s servers to a more distant data center owned by someone else.
• Customers can add or decrease system capabilities (bandwidth, server processing power, storage) on their own in flexing their metered capacity to their needs.
• The host manages the infrastructure and applies updates without using the customer’s resources.
• The host guarantees service levels for response time and downtime.

From Gene Gene: “Re: HIStalkapalooza. Wondering if you had reconsidered since we’re planning our own event and don’t want to compete.” I haven’t reconsidered. It’s a ton of work and a great financial risk for me personally without any benefit. I thought about it again a few months ago when: (a) we devised a new invitation/admission idea that would have eliminated much of the work, and (b) a company expressed interest in underwriting much of the cost in reducing my risk, but it didn’t work out. I have just one FTE (Lorre) for non-writing tasks and she spends ridiculous hours starting in early January trying to get event sponsors so I don’t go broke and arguing over who gets invited, not to mention that while we’re trying to set up and run our own little HIMSS booth, people are messaging both her and me nearly non-stop asking silly event questions or making unreasonable demands that reek of self-entitlement. RIP HIStalkapalooza, whose life reached its timely end at 10 years of age. HIMSS might actually be fun for us without all those headaches.

From Bilge Pump: “Re: Paragon. Why don’t you think Allscripts can sell it?” McKesson wasn’t having much luck selling it, so the question then becomes whether Allscripts has the sales force and channel to outperform McKesson in getting 150-bed hospitals to sign up for Paragon instead of Meditech, CPSI, Athenahealth, or even hosted Epic or Cerner systems that are admittedly overly complex for their needs. And while I admire the company’s upfront demarcation line of saying that Paragon will be pushed only for hospitals with fewer than 250 beds that offer no specialty services (of which there are quite a few), my cheap-seats experience is that vendors with overlapping products struggle with sales team infighting and confused prospects. Maybe Allscripts can move some of the Series and Star users to Paragon or the larger Paragon customers to Sunrise, but that won’t be a slam dunk – a project of that cost and magnitude requires a look at the other vendors who often win those deals and McKesson failed to accomplish that as well. They had better act quickly since the number of independent under-250 bed hospitals seems to be decreasing fast as they are acquired by health systems that mostly use Cerner and Epic. I would be interested in the customer count by bed range for all the inpatient EHR vendors if anyone has access to that information, although Cerner and Epic are playing the Electoral College-type strategy in focusing on enterprise size rather than a simple count of hospitals. 

From Denizen: “Re: Carequality. Our organization of long-term acute care hospitals was quoted $400,000 per year to onboard to Carequality as an implementer so we can get patient information from short-term acute care facilities, more than half of which run Epic. We don’t receive Meaningful Use incentives to help pay for this technology and we feel the costs are excessive given that the data belongs to the patient and it would allow us to provide them with better quality and safer care.” I contacted the non-profit Sequoia Project, which runs the eHealth Exchange, Carequality, and RSNA Image Share Validation. Their spokesperson explained:

Carequality is designed to connect networks and is not intended to be a network that providers directly join. As a result, the Carequality fees that you saw apply to the networks themselves, not to provider organizations who participate in a data sharing network. The assumption is that providers like this are already connected to a health data sharing network of some kind. If their “home network” is a Carequality implementer, then the provider should be readily able to connect to other Carequality connections. There are a number of health data sharing networks available in the market that this hospital may already be leveraging. Some of these networks are geographic-centric, such as regional and statewide HIEs. Others have a more nationwide focus, such as eHealth Exchange, Surescripts, and CommonWell Health Alliance. While still others are facilitated by the health IT vendor that the provider uses. Providers that would like to share health data via Carequality need to contact their participating network. If their network is not an implementer, they can encourage their network to implement the Carequality Interoperability Framework to dramatically expand their connectivity options.

From Non-Annoying Vendor: “Re: Stanford Health Care CIO position. Accepted by [name omitted].” I’ve emailed the person whose name I omitted for confirmation since it’s not cool to run unverified job changes. UPDATE: Verified. Eric Yablonka, VP/CIO of University of Chicago Medicine, emailed me to confirm that he will start at Stanford at the end of September. He replaces Pravene Nath, MD, who is now an executive in residence at Summation Health Ventures.

From Roman Hands: “Re: CHIME. It’s paying President and CEO Russell Branzell $500K per year, which seems like a lot for a non-profit whose revenue is less than $7 million.” Basically all of the $529K in member dues CHIME took in for FY2015 went toward Russ’s paycheck. It collected $1.6 million from conference registration and vendor advertising and $4.27 million from the CHIME Foundation. I’m not interested in doing compensation research, but one study I saw said that non-profit CEOs of organizations with budgets of $5 million to $10 million are paid an average of $100K. I remember doing some legwork years ago on Steve Lieber’s HIMSS compensation vs. similarly-sized member associations and he was certainly at the top of the chart (the current median is about one-fourth of what Steve makes). Whether either is worth the lofty salary is up to members to decide, not just in the amount of their dues, but how comfortable they are being pimped out to high-paying vendors that contribute most of the revenue.

HIStalk Announcements and Requests

This week on HIStalk Practice: The American Telemedicine Association looks for new leadership. A Chance to Change invests in telemedicine for behavioral health patients. Delaware physicians hope blockchain will speed up the prior authorization process. WellAve expands mobile dermatology clinic business. Colorado physicians up in arms over delinquent Medicaid reimbursements. ApolloMed takes a minority equity stake in LifeMD. Cow Creek Health & Wellness Center Clinic Director Dennis Eberhardt details the ways in which a new commercial EHR will better serve patients. Independent MDs express extreme dissatisfaction with MACRA. Buoy Health raises funding for symptom checker software.

Webinars

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

Acquisitions, Funding, Business, and Stock

The New York Times profiles Eko Devices, started by three UC Berkeley undergrads. The company has sold 6,000 digital stethoscopes and will this fall introduce the FDA-cleared Duo, a prescription-only version for home use that collects EKG readings and heart sounds to send to doctors. One of Eko’s founders says the product should work like “Shazam for the heartbeat” in being able to recognize unusual heartbeat patterns just like the Shazam app can “listen” to a song being played and then display its title and artist. The Duo is intended only for heart patients and will cost $350 plus $45 per month. The Duo’s main competitor will be AliveCor’s Kardia, a $99 smart phone add-on that records EKGs.

People

Justin Diehl (Healthware Partners) joins Parallon Technology Solutions as VP of Epic services.

NHS England’s first chief clinical information officer, Keith McNeil, MBBS resigns after 13 months, returning to Australia to become CMIO of Queensland Health.

Announcements and Implementations

AdvancedMD launches AdvancedReputation, which automatically emails or texts patients a one-question satisfaction poll following their office or telemedicine visit and invites those who score positively to post their feedback on the practice’s Google business profile. Those who score negatively are asked to describe their experience to be posted privately to the provider’s dashboard.

Christus Health reports its results from implementing Epion Health’s iPad appointment check-in system: collections per encounter increased 3.5 percent, patient portal sign-ups increased 300 percent, and 21,000 patients opted in for text messages. Epion CEO Joe Blewitt graduated from the United States Air Force Academy, was on active duty in the Air Force for 10 years, then spent 17 years as an Air Force Reserve pilot at McGuire Air Force Base.

Change Healthcare adds the capability of adding attachments to dental claims submissions.

Government and Politics

The Austin, TX paper reviews the state’s lawsuit against Xerox, which the state says did shoddy pre-authorization reviews for Medicaid dental services. The company hired high school dropouts and gave them just a one-hour training session. One of them responded to a deposition question about the definition of severe handicapping malocclusion, “Not a clue. Their teeth are messed up.” Records show Xerox ran the process like a high-pressure boiler room where supervisors ordered employees – many of whom worked from home and thus couldn’t even see the records that had been submitted by dentists – to “push those keys as fast as you can.” Xerox hired just one dentist to review hundreds of requests each day, with one such review being clocked at exactly six seconds. HHS OIG ordered the state to repay it $133 million for services it had paid that didn’t pass pre-authorization rules. Records show the state knew about the rubber-stamped authorizations but did nothing for several years, eventually culminating in the firing of Xerox and the lawsuit brought against the company in hopes of covering the HHS repayment.

President Trump declares the opioid crisis a national emergency, contradicting a statement made two days ago by HHS Secretary Tom Price, who said such a declaration is unnecessary. 

Australia’s government approves automatic sign-up of citizens for its My Health Record provider and patient e-health system, formerly known as PCEHR. People will have to opt out if they don’t want their information shared. The government hopes to approve interoperability standards in 2022 and to make secure provider-patient and provider-provider communication universally available the same year. The government published its national digital health strategy this week. Reports suggest that the government has spent at least $1 billion on My Health Record, which has struggled with poor patient and provider participation.

Oregon’s governor demands and receives the resignation of the head of its health authority following leaking of a document describing her planned smear campaign against a Medicaid provider who sued the state claiming that the agency’s rate-setting process is not fair.

Privacy and Security

Princeton Community Hospital (WV) is still down from its June 27 malware attack, saying it is dealing with a transcription backlog and interfaces that aren’t working yet following its complete rebuilding of systems.

Technology

CNBC covers the potential use of the Amazon Echo for helping homecare patients with medication reminders, instructions, and staying connected with family. It mentions voice startup Orbita, which offers an Amazon Alexa skill and a graphical development tool for Amazon Echo, Google Home, and other voice platforms.

Other

This should help dispel those negative perceptions of Alabama.

In South Australia, 20 percent of surveyed doctors say the government’s EPAS electronic health record is causing medication errors, critical delays, and pathology mistakes, with one-third of respondents saying the Allscripts system has caused near-misses. 

State auditors accidentally find that a struggling 15-bed Missouri hospital was apparently used as a shell company to bill $90 million worth of lab tests that were performed by other hospitals run by the same management company that installed its president as the hospital’s CEO. The auditors also found that the CEO and his company were paid nearly $1 million in the first 10 months of the agreement, the hospital paid $10.6 million to the hospital company’s lab division in just three months, and the hospital was covering the salaries of 33 phlebotomists of other company-run hospitals. The state, which is considering a corruption investigation, says decisions made by the hospital’s management and board were “astounding in their irresponsibility.” The CEO has charges pending against him in Louisiana related to a another managed hospital’s claims that he forged checks made out to another management company he owned. The state auditor says the hospital did no background checks and minimal due diligence before turning its operations over to the management company and CEO.

A Texas Public Radio report covers the dispute between Nuance and its remote workers following its extended malware-caused downtime, during which the company’s transcriptionists say they were promised overtime and incentive pay that was later rescinded. The report reviewed the recording of a management conference call for transcriptionists in which Nuance clarified that the incentives it had offered (and that its managers had promised) were not intended for all transcriptionists, but said its message was misunderstood because its communications systems were also down due to the malware. One employee who worked more than 12 hours per day saw that her expected $3,000 extra payment ended up being just $21. The recorded call also captures a Nuance manager who explained that the error was widespread, adding, “We blew it. We completely blew it.” The article concludes that it’s tough for remote workers to react to employment conditions since they can’t band together to protest in person. They may still get their chance – several lawyers added their contact information to the article’s comments.

Sponsor Updates

• CSI Healthcare IT completes its at-the-elbow support for the Epic ambulatory go-live at Atlantic Health System (NJ).
• Meditech will exhibit at the Mid-South Critical Access Hospital Conference August 16-18 in Nashville.
• Spok announces that all 20 of the hospitals on US News & World Report’s list of best hospitals as well as all 10 of the best children’s hospitals use its solutions for enterprise healthcare communications.
• Netsmart will exhibit at the FADAA/FCCMH Annual Conference August 16 in Orlando.
• Experian Health will exhibit at the HFMA Arkansas Summer Conference August 16-18 in Hot Springs.
• PatientPing names former Medicare deputy administrator and director Sean Cavanaugh as an advisor.

Blog Posts

• Meditech’s Fetal Monitor Interface Improves Nursing Workflow at Beaufort Memorial (Meditech)
• A Constant in a Sea of Change (Spok)
• Malware got you down? Get 3 no-regrets strategies to protect your IT contracts (Advisory Board)
• Getting the “Ops” in DevOps Right (LogicWorks)
• 3 Considerations when Planning Epic Upgrades (Optimum Healthcare IT)
• As You Wish … Best Practices for Gaining Physician Buy-in for Your Revenue Cycle Wish List (Navicure)
• Home Health Rule Will Bring Big Changes in 2018 and 2019 (Netsmart)
• How to Maximize Value from Healthcare’s Digital Transformation (PatientKeeper)

Contacts

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