Counting the Costs of a Data Breach

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

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

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

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

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

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

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

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

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

Providers Get Proactive With Identity Theft Protection Services

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

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

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

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

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

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

Shopping Around

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

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

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

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

Don’t Forget to Use It

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

Be Proactive to Keep the Doors Open

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

Monday Morning Update 10/24/16

Top News

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

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

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

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

HIStalk Announcements and Requests

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

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

Last Week’s Most Interesting News

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

Webinars

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

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

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

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

Acquisitions, Funding, Business, and Stock

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

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

Decisions

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

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

Announcements and Implementations

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

Privacy and Security

From DataBreaches.net:

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

Other

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

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

Sponsor Updates

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

Blog Posts

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

Contacts

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

News 10/21/16

Top News

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

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

Reader Comments

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

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

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

HIStalk Announcements and Requests

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

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

Webinars

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

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

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

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

Acquisitions, Funding, Business, and Stock

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

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

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

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

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

Sales

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

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

People

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

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

Announcements and Implementations

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

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

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

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

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

Privacy and Security

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

From DataBreaches.net:

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

Innovation and Research

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

Technology

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

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

Other

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

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

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

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

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

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

Sponsor Updates

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

Blog Posts

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

Contacts

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

News 10/19/16

Top News

St. Joseph Health (CA) will pay $2.14 million to settle OCR charges that it exposed the information of 32,000 patients for a full year in 2012-2013 when it brought a server online using default security settings that allowed its contents to be viewed via Internet searches. The exposed files had ironically been created to document the health system’s Meaningful Use participation, so some of the MU money it presumably earned from HHS because of those files will go right back to HHS as punishment for exposing them.

OCR found that the contractors that SJH hired to assess its PHI security did their work “in a patchwork fashion” that failed to meet the requirement of performing an enterprise-wide risk analysis.

The health system paid $7.5 million earlier this year to settle a class action lawsuit filed by patients whose information was exposed.

SJH had previously reported the theft of unencrypted PHI-containing devices in 2010, 2012, 2013, and 2014 as well as a 2014 incident in which an employee failed to delete a PHI-containing Excel worksheet tab before sending it to an investment firm.

Reader Comments

From Greek Goddess: “Re: Epic. The same publication that ran the R&D nonsense with Judy’s ‘trust me’ as verification seems to publish whatever Judy says. The latest contains the usual sound bites about industry misinformation about Epic and the tired narrative that it doesn’t have a marketing department.” They were obviously typing with velvet gloves. This 1998 article quotes Judy as saying that she was increasing Epic’s sales and marketing budget by 70 percent because “we want to be very big,” also mentioning the hiring of an advertising department and marketing director. In 2015 I reported a reader’s observation that at least eight former Epic employees identify themselves on LinkedIn as having done Epic marketing and one of them says she reported directly to Judy (“leading in-house marketing team,” she says). Epic hired a high-powered lobbying firm awhile back as well. I think the people who write for the HIMSS-produced publication (which lives in a picture-perfect fairytale HIT land in which seldom is heard a discouraging word about HIMSS-paying vendors) are so pleased with themselves at earning Judy’s rare attention that they simply uncritically regurgitate whatever she tells them, which makes that publication an Epic favorite for planting “news” that is really just Epic disputing any negative industry impressions about the company. Make no mistake: Epic is not naive about marketing and sales even though they might do it differently – all those gazillion-dollar contracts didn’t just happen because a health system CEO cold-called 608.271.9000 and asked to speak to any available 23-year-old programmer.

From The Truth Hearst: “Re: Zynx Health. Laid off 50 percent of the company last week, including all of finance and marketing, perhaps to either fold the company or roll it into one of the other Hearst entities.” The company provided this response to my inquiry:

Zynx has taken the necessary steps to better position itself in a changing healthcare market. We are aligning our solutions, clinical expertise, and content capabilities to meet the needs of the shifting marketplace and new requirements with emerging value-based payment models. With the changes in the marketplace, the difficult decision to eliminate positions was necessary. However, new opportunities have opened as we deploy an interdisciplinary team of professionals to provide more comprehensive support for our products and services to each client. We believe Zynx will be better equipped to innovate as the healthcare market requires and that these changes will not only make Zynx stronger in this new marketplace, but also, and more importantly, provide better service and support to our valued clients. We are definitely not folding and look forward to another 20 years of market leading innovation and solutions.

From Nasty Parts: “Re: Extension Healthcare. An executive tells me the company has been sold with an announcement forthcoming.” Unverified. Nasty Parts has a pretty good rumor-sniffing track record.

From Big ‘Un: “Re: HIStalk links. I notice some refer to a click counter rather than a direct link. What does that do?” It’s interesting to me how many times readers click on links to new sponsor web pages or webinar sign-up pages, which tells me what kind of information readers want (and how well or how poorly I present it). That’s all I use it for. A recent webinar announcement got more than 1,300 clicks to the sign-up page, for instance, and the ratio of how many of those actually registered to attend tells me whether the abstract and learning objectives were on point. Mentioning a new sponsor usually gets 200-400 readers to click over to the company’s webpage to learn more, which tells me the kinds of technologies that pique the curiosity of readers. Beyond my self-improvement efforts, the invisible click counter, which is run from a free PHP script I found on the Internet, does absolutely nothing.

From Jock O’ Lantern: “Re: fitness trackers. Do you think their lack of success in improving health will hurt sales?” No, since companies will continue to market them smartly (which is to say slightly deceptively). Fitness trackers and apps make few people healthier, but they play to the vanity of buyers who fancy themselves as possessing the willpower to change their lives and their mental outlook once they just buy more jock gear so they can look like the sweaty-yet-sexy models in the fitness tracker ads. Accurate ads would show several of the devices stashed in the underwear drawer along with unworn yet stylish exercise clothes while the owner — who moans about having too little time for exercise — spends the entire evening eating Cheetos, watching TV, and interacting with pretend Facebook friends. We’re going to muster one mushy militia if it ever comes to that.

HIStalk Announcements and Requests

I’ve corrected my Monday mistake in listing Southwest General Hospital (OH) as moving from McKesson to Cerner next year. They’re already a Cerner shop – it’s Southwest General Hospital (TX) that’s changing systems. Sometimes Google magnifies rather than resolves my confusion over multiple hospitals that share a name.

Welcome to new HIStalk Platinum Sponsor Protenus. The Baltimore company’s privacy monitoring system detects inappropriate EHR user behavior (with 97 percent accuracy and thus few false alarms) to proactively identify potential HIPAA violations in helping hospitals avoid huge OCR settlements and jury awards. Examples: EHR users who inappropriately access a VIP’s records; employees who snoop through the files of friends or estranged family members; employees who use patient information to file fraudulent tax returns; hackers who obtain user credentials by phishing and then move freely through patient records; contractors who use their access for unauthorized purposes; and laptop thieves who gain EHR access. Protenus learns how each user normally works instead of trying to apply simple rules to detect their unusual behavior, then provides alerting and collaboration tools that enable quick resolution instead of waiting the average 200 days it otherwise takes providers to detect and fix inappropriate access. IT folks benefit from the elimination of expensive managed services, lightweight data integration of any number of systems, and the option to run it in-house or hosted. The company was founded by Robert Lord, a former Hopkins medical student, medical researcher, and hedge fund analyst; and Nick Culbertson, MD, who earned two bronze stars during his eight-year service as a Green Beret sergeant with the 20th Special Forces Group (Airborne) and helps run an East Baltimore veteran support group. Read the Johns Hopkins case study or Robert’s Readers Write article. Thanks to Protenus for supporting HIStalk.

Here’s a look at the privacy monitoring and incident tracking system of Protenus.

Listening: new from Avenged Sevenfold, polished, literate heavy metal in their first album since 2013. They sound great for a band that’s gone through more drummers than Spinal Tap. Pretty cool lyrics.

Webinars

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

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

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

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

Acquisitions, Funding, Business, and Stock

Adobe sues MedAssets (via its new owner nThrive) for copyright infringement, claiming that MedAssets distributed Adobe’s ColdFusion web development tool in its CodeCorrect product despite having a license for internal use only.

Home-centered clinical trials management vendor Science 37 raises $31 million in a Series B funding round, increasing its total to $38 million. The founders are dermatologist Belinda Tan, MD, PhD and Noah Craft, MD, PhD, who was chief medical officer of VisualDX.

UnitedHealth Group, which is pulling out many insurance exchanges because too many expensively sick people signed up, books Q3 revenue of $46.3 billion and a profit of $3.6 billion, with the CEO (whose shares are worth $356 million) saying the company will in 2017 “deliver more value to the health system overall.” 

Three post-acute care software vendors – Casamba, HealthWyse, and TherapySource – announce their merger under the Casamba nameplate.

The SEC declines to prosecute Harris Corp. after its auditors reported to the SEC that they found evidence that the fired CEO of its Carefx China subsidiary had in 2011-2012 bribed Chinese government officials with as much as $1 million to earn nearly $10 million in business. Harris acquired Carefx for $155 million in cash in 2011. The SEC fined the executive $46,000 and Harris sold its healthcare business to NantHealth in mid-2015. The executive, Ping Zhang, PhD, is now SVP of product innovation and CTO of MedeAnalytics.

Sales

The Dubai Health Authority signs a collaboration agreement with GE Healthcare for hospital predictive analysis, efficiency, and training.

People

Nancy Ham (Healthagen Population Health Solutions, an Aetna Company and Medicity) joins physical therapy EHR  vendor WebPT as CEO.

Congratulations to interoperability expert Keith “Motorcycle Guy” Boone of GE Healthcare for completing his master’s in biomedical informatics from OHSU.

Announcements and Implementations

Nuance announces GA of a new version of its Dragon Medical Advisor real-time computer-assisted physician documentation system.

HCS integrates document exchange interoperability technology from Kno2 into its Interactant system to support care transition and care coordination with referring hospital partners.

Long-term care EHR vendor PointClickCare releases an integrated smartphone app for skin and wound assessment and documentation.

AHIMA will offer a health informatics certification credential in early 2017 to candidates with (a) a bachelor’s degree and two years of informatics experience; (b) a master’s degree with one year of experience; or (c) a master’s in health informatics. Like certification programs offered by HIMSS and other industry groups, the credential’s value is clear to the organization being paid to issue it (and the alphabet soup of other certificates AHIMA sells) but much less obvious to those who might receive it. Someone who has earned a master’s in health informatics doesn’t need to pass an AHIMA test to prove their knowledge for an employer who is probably more interested in experience and capabilities anyway. If I were interviewing a candidate for a non-technical position, I would place zero value on trade group certification. Actually, I would probably place negative value on them since I would question the motivation of a possibly insecure and under-qualified candidate who is proud of a credential that was earned by completing a single multiple choice test that has a high pass rate. CHIME’s certified healthcare CIO is the silliest one I can imagine – what health system CEO would value that credential when hiring a CIO? (perhaps only a certified healthcare CEO if there is such a thing, which I sincerely hope there isn’t). Organizations make a lot of money preying on the personal insecurities and educational shortcomings of ambitious people with generous disposable income or employer educational expense reimbursement programs.

Healthgrades releases its annual hospital evaluation report. The company also announces Risk IQ, a questionnaire-based tool that allows consumers to evaluate their personal risk for six common surgical procedures.

MModal launches a risk adjustment solution suite that helps optimize chart documentation to improve HCC charge capture.

LifeImage releases version 5.0 of its image-sharing platform, which adds real-time collaboration, FHIR support, and more extensive integration of information from PACS, VNA, and clinical systems.

Agfa HealthCare announces a new version of its Enterprise Imaging platform that includes new migration tools, image management and workflow rules, live streaming and virtual conferences, and multi-specialty imaging.

Government and Politics

An investigation by the Minneapolis paper finds that FDA has allowed drug device manufacturers to hide reports of patient harm, either by rolling individual reports up into a generic summary or accepting years-overdue reports. A former FDA official who created a search engine called Device Events to track medical device performance says doctors might behave differently if they knew how many incidents were reported.

Wisconsin state inspectors cite a veterans home for dozens of medical errors, some of them related to incorrect transcription and employees confused by new software. An LPN who administered 100 units of insulin instead of the ordered 12 units said she attended training but then went on vacation, with her supervisor advising upon her return that she should just “wing it.” Nurses interviewed by the inspectors said the rollout was poorly handled.

Privacy and Security

St. Jude Medical forms a cybersecurity advisory board following published claims that its medical devices are vulnerable to hacking.

From DataBreaches.net:

• Rainbow Children’s Clinic (TX) reports to HHS that it was attacked by ransomware on August 3, exposing the information of 33,000 patients to an unknown hacker and resulting in the permanent loss of some patient records.
• Medi-Cal plan provider CalOptima reports its second breach in two months after discovering that a “departing” employee downloaded patient information to an unencrypted USB drive that was later returned.

Technology

Philips earns FDA approval for an ultrasound sensor for Android-powered mobile devices, enhancing its Lumify ultrasound diagnostic solution to allow clinicians to perform heart, lung, and OB/GYN ultrasound without an ultrasound cart. It costs $200 per month.

Other

Weird News Andy wonders whether this story really happened. An Oregon hospital quarantines its ED after treating a woman with hallucinations, after which the two deputies who brought her in as well as her caregiver and a hospital employee also began hallucinating for reasons unknown. They’re thinking her medication patch might have been spewing active ingredients all over the place.

Sponsor Updates

• Attendees of Experian Health’s annual Financial Performance Summit put together 1,000 hygiene kits and collected 200 pairs of socks for Nashville charity.
• GE Healthcare will work with India-based Tata Trusts to train 10,000 students for healthcare technology careers.
• Aprima earns high ratings for its RCM services in a KLAS specialty report highlighting ambulatory billing services.
• Bernoulli CEO Janet Dillione is included in the 17 female health IT company CEOs to know.
• Besler Consulting releases a new podcast, “Strategies for navigating bundled payments.”
• Carevive Systems will host a half-day symposium on non-small cell lung cancer October 26 in Philadelphia.
• CoverMyMeds will sponsor the CBI Electronic Benefit Verification & Prior Authorization Summit October 25-26 in San Francisco.
• Consulting Magazine includes Cumberland Consulting Group and Divurgent on its list of fastest-growing firms.
• EClinicalWorks will exhibit at AAP 2016 October 22-25 in San Francisco.
• Iasis Healthcare streamlines documentation processes with FormFast technology during its EHR transition.
• FormFast will exhibit at CHIMA October 24-25 in Edmonton, Alberta.
• Healthwise will exhibit at the EClinicalWorks National Conference October 21-24 in Orlando, FL.

Blog Posts

• 5 Strategies to Reduce Financial Risk (AdvancedMD)
• 5 Ways to Break the Glass for Women in Tech (AirWatch)
• If Ada Were an Arcadia … (Arcadia Healthcare Solutions)
• Announcing Customer Spotlights (Catalyze)
• 10 Things End Users Need to Know About Secure Text Messaging Right Out of the Gate (Spok)
• MACRA Final Rule: Empowering Physicians and Health IT (Caradigm)
• Breathe Easy … CCM has Your Patients Covered (CareSync)
• Translating EHR Training into Improved Revenue Cycle Metrics (Culbert Healthcare Solutions)
• Collaboration is Key in Oncology Care (ECG Management Consultants)
• EHRA Reiterates Key Recommendations for Program Alignment and Practicality in Comments on HOPPS (E-MDs)
• A Guide to Managing Physician Relationships (Evariant)
• The Direct Link Between a Security Breach and Patient Safety (Extension Healthcare)
• What a top 10 college football matchup has to do with healthcare IT consulting (Nordic)
• PCMH 2nd Annual Congress Recap (Galen Healthcare Solutions)
• DSRIP: A Major Step Toward Reinventing Medicaid (Hayes Management Consulting)
• McKesson Horizon Legacy Support: The Case for Third Party Assistance (HCI Group)
• What’s So Scary About Automation? (Healthfinch)

Contacts

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

Morning Headlines 10/18/16

Biden outlines five-year plan for ‘cancer moonshot’

Vice President Biden delivered his final status report on the administration’s cancer moonshot, laying out a five-year plan and reiterating the need for continued funding from Congress and private organizations.

A laboratory in your pocket

In The Lancet, Eric Topol, MD discusses the value that digitally connected point-of-care diagnostic tests would have locally and in resource-poor remote regions of the world.

Obese soldiers get £100 Fitbits in battle of bulge: Servicemen failing Army fitness tests are handed high-tech calorie-counting bracelets to help them lose weight 

In England, overweight soldiers facing discharge for failing the Army fitness test are being issued Fitbits to help them get back in shape.

Medical College spins out startup

A local paper covers RPRD Diagnostics, a spinoff from the Medical College of Wisconsin developing DNA tests to match patients with the pharmaceuticals that will work best for them.

Monday Morning Update 10/17/16

Top News

HHS publishes the final MACRA rule (2,204 pages, although much of it is draft comments with responses) with a 24-page executive summary (provided the executive in question understands a lot of jargon in sentences such as, “We are finalizing the method to calculate and disburse the lump-sum APM Incentive Payments to QPs, and we are finalizing a specific approach for calculating the APM Incentive Payment when a QP also receives non-fee-for-service payments or has received payment adjustments through the Medicare EHR Incentive Program, PQRS, VM, or MIPS during the prior period used for determining the APM Incentive Payment”) and a website explaining it.

CMS Acting Administrator Andy Slavitt summarizes the rule:

Other than a 0.5 percent fee schedule update in 2017 and 2018, there are very few changes when the program first begins in 2017. If you already participate in an Advanced APM, your participation stays the same. If you aren’t in an Advanced APM, but are interested, more options are becoming available. If you participate in the standard Medicare quality reporting and Electronic Health Records (EHR) incentive programs, you will find MIPS simpler. And, if you see Medicare patients, but have never participated in a Medicare quality program, there are paths to choose from to get started. The first couple of years are aimed at getting physicians gradually more experienced with the program and vendors more capable of supporting physicians. We have finalized this policy with a comment period so that we can continue to improve the program based on your feedback.

Like every other notable EHR-related legislation, the final rule came out on a Friday. Industry groups seemed mostly happy with it.

Reader Comments

From The Hurricane: “Re: [vendor name omitted]. Laying off half its employees and being folded into of the parent corporation’s entities.” Unverified. I’ll keep my eye out.

HIStalk Announcements and Requests

Nearly 60 percent of poll respondents spend little to no time in their workday talking about patients and their needs. New poll to your right or here: How much work is your organization doing to prepare for Medicare’s 2019 issuance of new ID numbers to replace SSN?

Last Week’s Most Interesting News

• The Department of Defense moves back its first Project Genesis Cerner go-live from December 2016 to February 2017 and says it will involve only one Washington hospital rather than the originally planned two, although the project’s 2022 completion date remains unchanged.
• A hedge fund operator and $100 million Theranos investor sues the company for securities fraud.
• A court orders Parkview Hospital (IN) to release its chargemaster prices and insurance company discounts after an uninsured patient says his bill, which the hospital sent off to collections, is unreasonable because insurers don’t pay the full price he’s being sued over.

Webinars

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

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

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

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

Decisions

• Southwest General Hospital (TX) will switch from McKesson to Cerner in July 2017.
• Central Peninsula General Hospital (AK) went live with an Infor Lawson human resources system in October 2016 and will follow with time and attendance and payroll go-lives in November.
• Fisherman’s Hospital (FL) will go live with a Paycom Human Resources System in October 2016.

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

Government and Politics

A military-focused reporter’s article on the delay in the initial rollout of MHS Project Genesis at Fairchild Air Force Base (WA) says the DoD’s new Cerner system will be interfaced to legacy systems that include AHLTA, the ancillary department systems of CHCS, and CliniComp’s Essentris. It doesn’t indicate how or when those systems will be phased out by Cerner.

Intuit and CMS release Benefit Assist, open source software that determines eligibility for income-based government benefits.

Privacy and Security

From DataBreaches.net:

• The Russians that hacked into the Democratic National Convention servers used a phony Gmail security update message that lured users to reset their passwords, then sent them to a phony log-on page that stole their credentials.
• The Vermont Health Connect insurance marketplace exposes the information of 700 users due to a payment contractor’s mistake.
• Vermont’s attorney general reaches a settlement with software vendor Entrinsik to provide more explicit instructions for its business intelligence tool, which when users run reports from their browsers, sometimes creates temporary files that are not automatically erased and fails to warn users of their existence.

Innovation and Research

CB Insights publishes a list of digital hospital technology vendors.

A UK psychiatric hospital pilots Oxehealth, which analyzes streaming video to monitor vital signs with no attached sensors and alerts staff if a patient appears to be at risk.

Other

Surgeons at St. Vincent Hospital (MA) remove the healthy rather than the cancerous kidney of a patient after a mix-up with another patient’s CT results. Investigators also found several problems with patient ID bracelets, with a patient’s son receiving his father’s bracelet and another observed being taken to X-ray without any bracelet at all. They also noted that one patient had been registered with another patient’s name and was assigned two medical record numbers.

Texas authorities free the convicted murderer of a four-year-old boy because the county can’t afford to pay his medical bills. The inmate spent 967 days in incarceration in running up $19,000 in medical expenses, nearly 20 percent of the prison’s total annual medical budget. A local resident weighs in with the opinion that he should be just allowed to die untreated in jail as a cost for committing a crime.

Sponsor Updates

• T-System, Vital Images, and VitalWare will exhibit at AHIMA through October 19 in Baltimore
• .TierPoint presents “Hackers, Superstorms, and Other Disruptions” October 19 in New York City.
• Valence Health, Verscend, and ZeOmega will exhibit at AHIP’s National Conference on Medicare, Medicaid & Duals October 23-27 in Washington, DC.
• Visage Imaging will exhibit at Health Connect Partners October 19-21 in Chicago.
• Wellsoft will exhibit at the ACEP Scientific Assembly through October 19 in Las Vegas.
• ZirMed earns Frost & Sullivan’s 2016 Technology Innovation Award for revenue cycle management.
• Zynx Health will exhibit at the 2016 Meditech Physician and CIO Forum October 20-21 in Foxborough, MA.

Blog Posts

• AHIMA 2016: Prepared for Takeoff? (VitalWare)
• Matthew vs. Magnet. (Voalte)
• Four Tips for Encouraging Fitness in Employees with Chronic Conditions (West Corp.)

Contacts

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

News 10/14/16

Top News

The Department of Defense announces that the first go-live of its MHS Genesis implementation of Cerner is scheduled for February 2017 at Fairchild Air Force Base (WA), moved back from the originally planned December 2016 date that involved two test sites. Three other Washington military hospitals will follow no earlier than June 2017.

The DoD says it pushed the schedule back to give it more time to develop interfaces to legacy systems and for system testing, as well as to allow implementing speech recognition and transfusion management. The project’s budget and planned completion date of 2022 have not changed.

Reader Comments

From Redacted: “Re: Epic certification. Users are now required to complete proctored exams every five years for each application they’re certified in. As a consultant, it’s not the worst thing in the world for them to remove other certified people from the pond, but I have 10 certs and their time estimate is 6-8 hours for each (doubled between the assessment and booster training). Seems like a huge pain.” Unverified, although the forwarded document above appears genuine.

From Boy Blunder: “Re: Epic‘s 2016 release. My TS contact says there was a two-month period in early 2016 where the entire development division pivoted to fixing issues with the 2015 release, delaying 2016 projects. She tells me we should not upgrade to 2016 for a while because the key features won’t be added until months after the initial release, delaying the discovery and fixing of the kinks we usually find.” Unverified.

From Booster: “Re: Epic’s Boost program. It’s an attempt by Epic to provide consulting services to customers deploying new functionality or optimizing their systems. The concept has been around for years, but was only recently formalized. Boosters tend to be less available and are rarely around for more than a short engagement, with most of them on their way out of the company and working somewhere other than Madison (less than one year). It’s good in theory, but cannot get off the ground because Epic employees have such short half-lives and aren’t compensated competitively to retain them.” Unverified.

From Little David: “Re: Hillary Clinton’s HIMSS14 speech. Did we get $225K of value?” It appears that the Secretary’s rack rate was $225K per speech, so HIMSS paid the same as everybody else. On the question of value, I’ll side with readers who observe that while we claim we want to hear selfless keynotes from patients, the size of the HIMSS crowd is always directly proportional to the fame of the presenter and Hillary (and Bill the year before) packed the house. I didn’t attend her presentation since I was tired of being at the conference before her Wednesday keynote slot, but I summarized it back then as:

I didn’t hear much about Hillary’s Wednesday keynote other than (a) it was extremely short; (b) like any skilled politician, she didn’t really say anything other than predictably lauding the work of the crowd that brought her there and kissing up to HIMSS. I would have been mad about waiting an hour or two to squeeze into the huge room for her talk given its lack of substance. Hillary’s rumored minimum speaking fee is $200K plus expenses, so she took home a big paycheck in addition to potentially impressing would-be Presidential voters who were apparently happy just to bask in her celebrity.

HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor Healthlink Advisors. The St. Petersburg, FL-based consulting firm was founded by industry long-timer and former SVP/CIO Lindsey Jarrell, who hand-picks the people he (and the company’s client base) wants to work with based on their experience, passion, integrity, accountability, and commitment to social responsibility. Areas of practice include IT operations performance acceleration (leadership coaching, interim management, contract negotiation, application and technology rationalization, roadmaps); engagement (IT governance, system selection, program management, product and sales strategy development); and transformation (future state definition, consumer and digital engagement). I’m fascinated that one of the company’s core values that employees make healthy choices, which it supports by offering healthy foods at meetings, holding meetings while walking, requiring mandatory vacation time away from work, and insisting that no emails being sent after 10 p.m. or while the employee is on vacation. I also liked this insightful nugget in its “have fun” core value – “people leave managers, they don’t leave companies.” Thanks to Healthlink Advisors for supporting HIStalk.

This week on HIStalk Practice: Chinese Community Health Care Association moves forward with enterprise master patient index tech. Telemedicine companies offer free consults to victims of Hurricane Matthew. NextGen’s Cherie Holmes-Henry and Charles Kaplan offer advice on “Readying the Revenue Cycle for MACRA.” GMed develops patient check-in software for gastroenterologists. AmeriGroup partners with LiveHealth Online for telemedicine services in New Jersey. Health Fidelity co-founder Anand Shroff helps physicians understand the implications of risk adjustment. Zoom+ launches chat-based telemedicine app. Encompass Medical Partners gets into the IT maintenance and security game.

This week on HIStalk Connect: Pager raises $5.2 million. Proposal deadlines loom for the Stanford Medicine X | Withings Precision Research Challenge. Eccrine Systems closes $5.5 million in Series A financing. Bill Evans joins Rock Health. Charlie Rose focuses on artificial intelligence.

Webinars

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

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

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

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

Acquisitions, Funding, Business, and Stock

Axial Healthcare, which mines a database of 100 million patient cases to give insurers insight into risky pain care practices, raises $16.5 million in a Series B funding round, increasing its total to $26 million.

Nordic completes a minority recapitalization and announces plans to offer equity participation to all employees starting in 2017.

Sales

Providence Health & Services chooses LogicStream Health’s Clinical Process Measurement.

Meditech customer Hays Medical Center (KS) will implement the company’s Web EHR.

Cerner customer Olathe Health System (KS) will add Millennium Revenue Cycle and the RxStation automated drug dispensing system.

Insurer Highmark will implement Welltok’s CafeWell Rewards program for its Medicare Advantage policyholders.

People

Family medicine practitioner Doug Spotts, MD takes a full-time role as chief health information officer at Evangelical Community Hospital (PA).

Ascension SVP Mike Schatzlein, MD will resign effective December 31, 2016 to focus on his role as chair for the Nashville-based Center for Medical Interoperability. The non-profit was formed in 2015 with a $10 million grant from the Gary and Mary West Foundation, with membership focused on hospitals.

Population health management technology vendor Altruista Health hires Munish Khaneja, MD, MPH (EmblemHealth) as chief medical officer.

Zillion hires Cheryl Morrison Deutsch (Kronos) as chief experience officer.

Announcements and Implementations

T-System announces EVolvED, a low-cost, quickly implemented ED documentation system that combines T-Sheets paper documentation with a best-of-breed technology solution.

Adventist Health System goes live on Imprivata’s PatientSecure palm vein biometric identification system.

InstaMed achieves PCI SSC Point-to-Point Encryption Standard version 2.0 validation for protecting credit card payment data, the first company in healthcare to earn that recognition.

Portland, OR-based clinic model insurer Zoom+ launches a free medical chat service for its members that provides advice, diagnosis, treatment, prescriptions, and visit scheduling, with the chat transcript being added automatically to the EHR. I’m not sure if the apparently missing “with” in the “chat our doctors for free” page above is a mistake or intentional hipster wit.

National Decision Support Company will debut its CareSelect Imaging decision support solution at RSNA, offering expanded Appropriate Use Criteria.

Government and Politics

ONC and HHS OCR update their HIPAA Security Risk Assessment tool.

CMS will review MACRA-required documentation and hold regional meetings with practices in trying to reduce the clinician administrative burdens involved.

Privacy and Security

Canada-based online medical advice startup Ask The Doctor becomes the first healthcare company to accept Bitcoin, providing users with extra privacy over charging services on their credit card. I can’t find any mention of how much the company charges to answer questions.

Innovation and Research

Women who avoid having sex on the days a physicist’s temperature tracking app says they are fertile avoid pregnancy 99.5 percent of the time, offering the same reliability rate as oral contraceptives and condoms and much better than the 75 percent success rate of the rhythm method alone. The company is in Sweden, which is probably a good thing since its claims might otherwise interest the FDA and the lawyers of unexpectedly pregnant women.

Other

A study of mobile health apps finds a crowded market in which downloads are limited and  declining, users aren’t willing to pay, newcomers have saturated the market, and 78 percent of publishers make less than $100,000 per year from their entire healthcare app business. Most app-related revenue comes from sales of sensors or other required hardware. Features seen as easiest to implement that have the highest user impact are personalized messages, dashboards, and the delivery of educational content. Publishers see their best hope of success as addressing users with chronic illnesses, but insurance companies haven’t shown much interest in getting them involved. Still, it’s a growing market even if it’s more competitive and selective.

In England, St. George’s University Hospitals NHS Foundation Trust freezes all software rollouts following a June 6 infrastructure failure in which its Cerner-provided downtime system didn’t work. The trust is out of storage capacity, can’t perform backups, runs Windows XP on 2,000 PCs, and has network stability problems.

An American Hospital Association report finds that hospitals spent nearly 40 percent more on drugs for each inpatient inpatient in 2015 than they did in 2013 due to higher drug prices rather than increased volume, saying that the price jumps “appear to be random, inconsistent, and unpredictable.” Prices increased from 52 percent to 3,263 percent for the 10 drugs on which hospitals spent the most money, with even the journeyman drug acetaminophen recording a 135 percent price increase from 2013 to 2015. It’s interesting to me that a couple of decades ago, the field of pharmacoeconomics was created to make sure drugs delivered outcomes commensurate with their cost, which turned on a light bulb over the heads of drug companies that realized they could price based on those same outcomes rather than simply defend a markup based on their research and manufacturing costs. These top 10 drugs are all old, work inarguably well for mostly specific uses, and have little competition. The pharmacoeconomics model then supports high prices and thus high drug company profits.

The local paper covers the November 1 Epic go-live at Vernon Memorial Healthcare (WI), which is working with Gundersen Health System (just writing that even with a different spelling makes me think of the police chief in “Fargo” or The Swede in “Hell on Wheels,” yah).

I ran across an article that mentioned Twine Health, which I’ve written about a couple of times. The company’s team-based coaching and primary care app offers shared action planning among patients, coaches, and clinicians; secure messaging; real-time population monitoring; and analytics. Practices can use its system for $1 per patient per month for up to 1,000 patients. The company has raised $6.75 million in a single December 2015 funding round. The founders are serial entrepreneur and former MIT professor Frank Moss, PhD  and John Moore, MD, PhD.

A UCSF hospital medicine professor makes his case for “clinician data scientists” to analyze complex and sometimes inconsistently entered EHR patient information. He suggests training in clinical systems, data extraction, report writing, and statistical methods.

Cerner can honestly say that the company sits at the intersection of “Health Care” and “Information Technology” as it names the streets of its new campus. Other avenues are named after medical scientists and computing pioneers.

Eighty volunteers from HCA’s IT division participated in a 36-hour “Hack the Community” hackathon in Nashville this week, supporting local non-profits with limited technology resources.

Sponsor Updates

• Florida State University recognizes Vyne CEO Lindy Benton with its 2016 Distinguished Alumni Award.
• Forward Health Group COO Subbu Ravi will serve on panel discussing Wisconsin state health IT initiatives at a Wisconsin Technology Council innovation lunch in Madison on October 18.
• Iatric Systems will exhibit at the Hospital & Healthcare IT Fall Reverse Expo October 19-21 in Chicago.
• Momentum Partners includes ID Experts in its list of top 10 private cybersecurity companies to watch in Q3 2016.
• Impact Advisors will exhibit at the Scottsdale Institute CIO Summit October 13-14 in Scottsdale, AZ.
• Optimum Healthcare IT posts a white paper titled “The Problem (and Solution) With Data Governance.”
• InterSystems, Intelligent Medical Objects, NVoq, PatientKeeper, Streamline Health will exhibit at AHIMA October 15-19 in Baltimore.
• Kyruus will exhibit at the HMA Fall Forums October 19-22 in Laguna Beach, CA.
• MedData will exhibit at the ACEP Scientific Assembly 2016 October 16-19 in Las Vegas.
• Meditech Senior Manager Corinne Proctor Boudreau will speak at the Western Pennsylvania Healthcare Summit October 14 in Pittsburgh.
• Nordic will sponsor Piedmont Healthcare’s Southeast User Group Meeting October 18 in Atlanta.
• NTT Data announces its return to Chip Ganassi Racing Teams.
• Obix Perinatal Data System will exhibit at the ACOG Annual District II Meeting October 21 in New York City.
• Recondo Technology will present at the Michigan HFMA Fall Conference October 17 in Plymouth.
• Experian Health will present at NEHAM October 17-18 in Providence, RI.
• Red Hat accepts speaking proposals for Red Hat Summit 2017 through December 2.
• The SSI Group will exhibit at the AHCA/NCAL Annual Convention & Expo October 16-19 in Nashville.
• Sunquest Information Systems will exhibit at ASHG 2016 October 18-22 in Vancouver.
• Sutherland Healthcare Solutions VP and Global Health of RCMS Healthcare Tina Eller will speak at the Region 2 HFMA Fall Institute Conference October 20 in Verona, NY.

Blog Posts

• Healthcare Leaders Convene at 2016 Annual General Meeting and Fall Summit to Discuss Strategies for Expanding CommonWell (Meditech
• )Is Your Organization Trustworthy? 5 Essential Cybersecurity Promises to Keep (ID Experts)
• Digital Quality Management – Find Your Broken Link Before Your CEO Does (Influence Health)
• What Does it Mean to Offer a PCI-Validated P2PE Solution? (InstaMed)
• A Cable Care Named Interoperability: New KLAS Study Takes the Clinician View (InterSystems)
• ELearning = Painless EMR Adoption (Learn on Demand Systems)
• Radiology and MACRA: Using a Cloud-based Image Sharing Service to Address MIPS Quality Measures (LifeImage)
• Emergency Department Throughput: A Conundrum (Live Process)
• LogicStream Health Taste & Toast Recap (LogicStream Health)
• People are the Key to True Care Coordination (Netsmart)

Contacts

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

Morning Headlines 10/12/16

Unintended Consequences of CPOE

An emergency physician describes an event in which an intern using a CPOE system they were unfamiliar with ordered a CT scan of the abdomen and pelvis with contrast, and then separately ordered oral contrast, the combination of which resulted in contrast nephropathy.

Epic Fact Check

Epic responds to a recent Jonathan Bush interview during which he suggests that achieving interoperability with Epic sites was difficult until recently.

Google DeepMind has doubled the size of its healthcare team

Google’s UK-based AI team DeepMind has doubled its healthcare division from 20 to 40, including some of the biggest names in the AI industry.

Siemens Healthineers and IBM Watson Health Forge Global Alliance for Population Health Management

Siemens Healthineers announces an agreement to start reselling IBM Watson as part of a new population health management solution.

News 10/12/16

Top News

Hedge fund operator Partner Fund Management sues Theranos for securities fraud, saying Theranos and CEO Elizabeth Holmes told “a series of lies” about its lab testing capabilities and prospects in soliciting a $100 million investment.

Above is Holmes holding the company’s remaining credibility.

Reader Comments

From Ken Bone: “Re: Athenahealth. JB got Trumped.” Epic posts a fact check for a recent interview with Athenahealth’s Jonathan Bush. Thankfully, JB’s brother Billy was not available to facilitate an uncomfortable Judy-JB hug.

From Looming Presence: “Re: HIStalkapalooza. Here’s video of Jonathan Bush doing his Donald Trump imitation at HIStalkapalooza earlier this year.” I had forgotten about that. JB, the most politically connected person in health IT, has said that he can’t support his Republican party’s nominee in calling him “a clinical narcissist” and “a wack job,” but says he’ll vote Libertarian instead of Democratic, explaining, “Why going for the nut on the right or the nut on the left when you can have the Johnson?” Bush downplayed his own political aspirations a few weeks ago by saying, “We need another Bush like I need a hole in my head,” although technically speaking, all of us need a hole in our head, just not another one that isn’t a mouth, nose, eyes, or ears (or in cases of emergency, a surgical trepanation). 

From PitViper: “Re: blockchain conference in Nashville last week. Humana’s CIO gave the keynote and his team participated in many of the breakout sessions. Nothing is production-ready and vendors themselves admit the technology is immature, but the ideas are interesting and if there’s truly a common trusted data layer in our future, it will address a lot of the issues we face.”

HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor Agfa HealthCare. The company, which provides eHealth and digital imaging solutions to half the world’s hospitals, offers Care You Can See, an enterprise-wide approach to medical imaging that provides a single patient record within a single EHR view. Its product line includes enterprise imaging (VNA, universal viewer, ECM, image exchange, patient portal, scheduling, business intelligence and clinical apps); integrated care (data aggregation for multiple sites, patient engagement); and digital radiography. The company focuses its radiology commitment to maximize the value of medical images within an interoperable ecosystem to support collaboration and the availability of image to all caregivers under value-based care. Its Engage suite provides a first step toward an integrated care model, offering patient-centric views and actions, native mobile functionality, support for clinical networks, and integration with third-party systems. The company is the #1-recommended image sharing vendor in a recent Peer60 report. Thanks to Agfa HealthCare for supporting HIStalk.

Here’s an Agfa HealthCare intro video I found on YouTube.

Webinars

October 13 (Thursday) 2:00 ET. “Glycemic Control During Therapeutic Hypothermia.” Sponsored by Monarch Medical Technologies. Presenter: Tracey Melhuish, RN, MSN, clinical practice specialist, Holy Cross Hospital (FL). Using therapeutic hypothermia (TH) as a method of care can present risks of hyperglycemia, hypoglycemia, and blood glucose variability. Maintaining safe glucose levels during the cooling and rewarming phases of TH reduces the risks of adverse events. Tracey Melhuish, author of “Linking Hypothermia and Hyperglycemia,” will share best practices for optimal glucose control during TH and the success Holy Cross Hospital sees while using a computerized glucose management software.

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

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

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

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

Acquisitions, Funding, Business, and Stock

Siemens Healthineers will resell  IBM Watson Health’s population health management solutions. The companies will also work together to create new solutions in a five-year strategic alliance.

3M Health Information Systems and Verily Life Sciences will work together to analyze population-level datasets into usable quality measures for complications, readmissions and mortality, and cost.

Pharmacy software vendors Rx30 and Computer-Rx announce their merger.

People

AMN Healthcare-owned contingent workforce management systems vendor ShiftWise names Steven Rodriguez (Asure Software) as president.

Outpatient rehabilitation therapy technology vendor Clinicient hires T. Kent Rowe (ZirMed) as CEO.

CTG promotes Rick Sullivan to VP of strategic staffing services.

Announcements and Implementations

HIMSS Europe is conducting a “Women in Health IT” survey whose results it will use to tailor future female-focused offerings. 

Privacy and Security

In India, Chennai city police have filed 43 cases against people they say have spread rumors about the health of the chief minister of Tamil Nadu, who has been hospitalized since September 22. The latest two arrests are of a website manager who published audio claiming to be from an Apollo Hospitals employee and an IT engineer who they said posted false information on Facebook. They’re charged under a law prohibiting statements intended to cause public panic.

The incarcerated human rights activist who coordinated an Anonymous-led denial-of-service attack against Boston Children’s Hospital in April 2014 to protest the involuntary commitment of a teenager stages a hunger strike to protest behavior modification programs for non-adults.

Technology

China-based search engine Baidu launches Melody, a smartphone chatbot app that asks consumers AI-generated questions in performing basic triage before sending the information to a doctor to take over. The company says it’s talking to US healthcare companies as a potential market.

London-based, Google-owned DeepMind has doubled its team to 40 employees since its February 2016 launch, hiring experts in artificial intelligence and from the NHS to help develop its products.

Other

The Wall Street Journal says apps that help migraine sufferers predict their attacks or identify their triggering factors hold promise, but they struggle to distinguish triggers (causation) from warning signs (correlation).

CMS Acting Administrator Andy Slavitt is one of my favorite tweeters, with refreshing recent examples above.

Family physician, CMIO, and AAFP board member Carl Olden, MD says that EHRs provide important benefits despite the extra work they require of doctors. He suggests that documentation responsibilities be spread to non-physician care team members and that payment reform “get us off the E/M treadmill.”

An emergency medicine professor blames CPOE for an error in which an intern ordered “CT Abdomen and Pelvis with contrast” and somehow thought she would need to order oral contrast separately, which she did in sending the patient into contrast nephropathy when both agents were administered. I disagree with blaming CPOE for these reasons:

• The intern ordered an item without understanding it.
• The same error would likely have occurred with paper-based ordering, especially if the hospital was equally sloppy in how it phrased the orderable’s description on paper.
• All the other doctors appeared to have understood and used this orderable without problems. 
• Receiving a non-paper, non-verbal order does not eliminate the responsibility of the employees acting on it to review it for mistakes, electronic or otherwise.
• It’s hard to understand how an undertrained intern’s one-off mistake – without the author’s seeing even basic evidence, such as how the hospital built the pick list in question — provides sufficient rationale to throw CPOE under the bus.
• I agree with only one point of the article – system administrators should monitor cancelled or replaced orders to help them understand where there system setup might be confusing users.

Kaiser Permanente CEO Bernard Tyson says in a conference presentation that 52 percent of KP’s 2015 physician-member interactions were conducted via technology rather than face-to-face visits. The article’s author calls those encounters “virtual visits,” but I would bet that the huge number is mostly portal text messages, refill requests, and lab test communication. KP has turned in those big numbers going back to at least 2014, so this is really not news.

Canada-based drugmaker Valeant, known for acquiring old drugs and then jacking up their price, does it again with a drug for lead poisoning it bought in 2013, raising its price from $950 to $27,000. The company’s excuses (short shelf life, low sales volume) don’t hold much water since they haven’t changed since the previous owner was presumably making a nice profit at $950.

An expert criticizes vendor-operated company wellness programs, saying that data from the program that was recently chosen as the industry’s best suggests that employees were actually harmed rather than helped. He also cites the 2015 winner McKesson, who claimed savings despite no change in employee biometric risk factors.

In India, illegible doctor handwriting forces medical examiners to switch to computer-completed autopsy forms that police and juries can more easily read.

The Atlantic profiles Tristan Harris, a former Google employee who created an advocacy group called Time Well Spent that is trying to convince app developers to take a Hippocratic Oath that they won’t turn their users into slot machine-like tech addicts by exploiting their psychological vulnerabilities. He says app developers are like junk food vendors in introducing the digital version of sugar, salt, and fat into their apps to profitably satisfy user craving in earning “likes” and impressive LinkedIn connections via pointless yet hypnotic auto-play videos and clickbait stories. He’s thinking about developing an app to measure app usage vs. user-reported benefit in calling out apps that create addiction without satisfaction. Harris responds to the magazine’s reporter who expresses anxiety at trying not to check his cell phone during their interview:

Our generation relies on our phones for our moment-to-moment choices about who we’re hanging out with, what we should be thinking about, who we owe a response to, and what’s important in our lives. If that’s the thing that you’ll outsource your thoughts to, forget the brain implant. That is the brain implant. You refer to it all the time.

Sponsor Updates

• AHIMA will add Meditech’s EHR to its Virtual Lab for HIM student training.
• Haystack Informatics publishes a white paper on insider data breaches.
• Aprima will exhibit at the Texas Association of Community Health Centers meeting October 17-18 in Dallas.
• Arcadia Healthcare Solutions CMO Rich Park, MD will present at the inaugural meeting of the American Association of Strategic Regional Organizations October 17 in Philadelphia.
• Bernoulli will exhibit at AARC16 October 15-18 in San Antonio.
• Besler Consulting, Clinical Architecture, Direct Consulting Associates, and FormFast will exhibit at AHIMA October 15-19 in Baltimore.
• The Chartis Group adds three principals: Mary Jo Morrison, Mark Pasquale, and Robert Schwartz, MD, MPH. 
• Besler Consulting releases a new podcast, “Five keys to mitigating risks associated with hospital-physician contracting.”
• Dimensional Insight and Hayes Management Consultants will exhibit at the Centricity Healthcare User Group October 13-15 in Austin.
• MedScape includes E-MDs as a leading vendor for usability and customer satisfaction in its latest EHR report.
• Elsevier Clinical Solutions features predictions from Geeta Nayyar, MD in its celebration of 100 years of medical clinics.
• EClinicalWorks will exhibit at the AOAO Annual Meeting October 13-15 in Washington, DC.
• HCS will exhibit at the NASL annual meeting October 16-18 in Nashville.Healthgrades will exhibit at the Built in Colorado Fall Startup Showcase October 13 in Denver.

Blog Posts

• A Peaceful Co-Existence: Physicians and Screens (Spok)
• 5 Connect Atlanta Attendees Share Their Big Takeaways (AirWatch)
• The Purpose of HITRUST’s Business Associate Council (Catalyze)
• How mHealth can Enhance a Physician’s Brand (CareSync)
• Steps to NPI Verification with CoverMyMeds (CoverMyMeds)
• Optimization – A Strategic Imperative, Not a Buzzword (CTG)
• Managing Costs for CJR – Where to Start (ECG Management Consultants)
• Let’s Talk About PRM and Market Intelligence Data … And Its Complexity (Evariant)
• So Many Call Bells, So Little Time (Extension Healthcare)
• Four Years of Being the Best Place to Work! (Galen Healthcare Solutions)
• Amidst the Angst, Value-Based Care is Working (Hayes Management Consulting)
• Healthcare Improvement Moving Both Fast & Slow: IHT2 NYC Reflections (HBI Solutions)
• EMR Data Migration: 3 Planning Considerations (HCI Group)
• Building the Nest, Culture at Healthfinch Part 3 (Healthfinch)
• Dense Breasts? Patient Education can Help Women Feel More Empowered and Informed (Healthwise)

Contacts

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

Morning Headlines 10/10/16

Court won’t take Parkview rate suit

Parkview Hospital (IN) has been ordered to release its chargemaster prices and insurance discounts after an uninsured patient that was charged $625,000 for his care sues the hospital, arguing that the bill is inflated and unreasonable since insured patients receive the same care at a significant discount.

Physicians’ Take on EHRs

A Peer60 survey of physician EHR satisfaction finds that usability and missing functionality still top the lists of physician frustrations.

Millions of Australians caught in health records breach

In Australia, Health Minister Sussan Ley apologizes at the annual conference of the Royal Australian College of General Physicians after the health department inadvertently published confidential data from three million patients.

How body-worn cameras improve EMS documentation

A pilot study finds that EMS documentation improves significantly if body-worn cameras are used so that EMS staff can review events after care is delivered.

Monday Morning Update 10/10/16

Top News

The legal effort by Parkview Hospital (IN) to keep its chargemaster prices and insurance discounts secret fails, forcing it to provide the information demanded by an uninsured patient who sued the hospital after receiving a bill for $625,000 for a three-month stay after a car accident. The patient says the bill isn’t reasonable since the hospital discounts its services to insurance companies while charging uninsured patients list price. The state’s Hospital Lien Act allows patients to negotiate bills when a hospital files a collection lien against them.

The hospital’s attorney argues that insurers are given discounts because of the patient volume they provide and that the patient’s guardian signed a an admission agreement that included a 35-word “agreement to pay” paragraph. “We don’t think a person who is not a member of the club should get the benefits of the club,” he said. Other healthcare lawyers say hospitals don’t have a choice in offering discounts because insurers won’t sign a contract with them otherwise.

Legal experts say that if their debt collection practices are questioned by a ruling for the plaintiff in this case, hospitals will probably switch tactics to instead use breach of contract lawsuits, which have favorable legal precedents in Indiana.

A billing expert hired by the patient concludes that the reasonable value of the services he received was $247,000, which would represent a 60 percent discount to billed amount.

Reader Comments

From Stick and Rudder Man: “Re: Epic. Does its Boost program even exist? Our experience from making requests is that no one is ever available. Recent networking with other clients suggests that our experience is not unique.” I’m not familiar with that program and found no references to it on Epic’s site, so I’ll ask knowledgeable readers to comment.

From Golan Heights: “Re: MedCPU. Looks like leadership change.” I didn’t see an announcement, but comparing old vs. new versions of the company’s executive page calls out the removal of the company’s two co-founders, promotion of the CFO to the CEO position, and the departure of two other executives. MedCPU has raised $51 million, $35 million of it in May 2016.

From Block and Tackle: “Re: HIStalk. It’s being blocked in the Middle East countries, which I experienced when traveling to Bahrain and Dubai over the past two weeks. Not sure if you care much about getting traffic from there, although given the level of IT activities and the global nature of your sponsorship base, it could be an expansion opportunity. Not getting our weekly dose of HIStalk news causes a lot of anguish!” I’ve heard that before, although reports were inconsistent.

HIStalk Announcements and Requests

Attention speakers and Webinar presenters: people hate it when you: (a) read from your slides; (b) place your pitch ahead of the educational needs of your attendees; (c) cram too much material on your slides; and (d) talk too much about yourself and your employer. I’ll side with the majority: PowerPoint, when used by unskilled presenters as a Teleprompter instead of as a visual aid to complement their enthusiastic and not overly rehearsed verbal narrative, is pure evil.

New poll to your right or here: how much of your work day involves talking about patients and their needs?

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

Thanks to the IT department of Centura Health (CO), which raised $1,500 for my DonorsChoose project, doubling last year’s total. I applied matching funds in fulfilling these STEM-related grant requests Friday and have already received grateful emails from all of the teachers. Classroom photos will follow once the students begin using their new materials.

• Genetics kits (plant lights and seeds) for Ms. T’s high school class in Juneau, WI
• A document camera and wireless keyboard for Ms. N’s third grade class in Lugoff, SC
• Math games for Ms. L’s kindergarten class in Chicago, IL
• A math gaming system for Mrs. S’s second grade class in Virginia Beach, VA
• A media studio for producing a daily school news show for Ms. C’s middle school class in Citrus Heights, CA
• Multimedia teaching technology for Ms. C’s high school class in Philadelphia, PA
• Math manipulatives for Ms. R’s elementary school class in New York, NY
• Six tablets for Mrs. P’s kindergarten class in Dry Ridge, KY

I also received a donation from Mark and Tammy, which provided programmable robots for Mrs. E’s elementary school class in Greenwood, SC.

Welcome to new HIStalk Platinum Sponsor Black Book. The Tampa, FL-based company offers unbiased, transparently collected, survey-powered research services such as Black Book Rankings, vendor comparisons, customer satisfaction, and market and competitive intelligence. It measures image, attitudes, opinions, awareness, and market share. Users are invited to participate in its user satisfaction and loyalty surveys via its app, with their responses validated using sophisticated data quality tools to ensure accurate, authentic results. Kudos to the company for recently fine-tuning its methodology after noticing and fixing questionable results caused by hospitals completing surveys on behalf of their EHR affiliates, which it likened to a salesperson rating their own merchandise. Here’s the best part: nobody at Black Book has a financial interest in a vendor; the company doesn’t allow companies to pay to participate; and vendors don’t get to review the results until they’re published for the whole world to see. Thanks to Black Book for supporting HIStalk.

I’ve worked in hospitals affected by hurricanes. I would be interested in hearing about your experience with Hurricane Matthew. People might forget that while they’re being urged to evacuate or stay home, hospitals are being staffed by people who are protecting someone else’s family instead of their own.

Last Week’s Most Interesting News

• Theranos exits the laboratory business, laying off 40 percent of its staff to focus on commercializing its MiniLab testing machine.
• A single Brigham and Women’s researcher gets a $75 million, five-year grant to analyze study participant data, including that generated by wearables, hoping to find early predictors of heart disease.
• Warburg Pincus Private Equity files FTC documents indicating that it will acquire Intelligent Medical Objects.
• Evolent Health completes its acquisition of Valence Health for $219 million.
• Cerner tells the local newspaper that it will aggressively expand its revenue cycle business.

Webinars

October 13 (Thursday) 2:00 ET. “Glycemic Control During Therapeutic Hypothermia.” Sponsored by Monarch Medical Technologies. Presenter: Tracey Melhuish, RN, MSN, clinical practice specialist, Holy Cross Hospital (FL). Using therapeutic hypothermia (TH) as a method of care can present risks of hyperglycemia, hypoglycemia, and blood glucose variability. Maintaining safe glucose levels during the cooling and rewarming phases of TH reduces the risks of adverse events. Tracey Melhuish, author of “Linking Hypothermia and Hyperglycemia,” will share best practices for optimal glucose control during TH and the success Holy Cross Hospital sees while using a computerized glucose management software.

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

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

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

Decisions

• Logan County Hospital (KS) will go live on Athenahealth’s RCM system in January 2017.
• Bayhealth (DE) switched from McKesson Horizon to Epic in August 2016.
• Franciscan Missionaries of Our Lady Health System (LA) will replace Cerner with Epic.

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

People

Kyruus hires John Downey (McKesson Health Solutions) as SVP of sales.

Announcements and Implementations

Peer60 publishes “The Physician’s Take on EHR Suppliers 2016,” which surveyed around 1,000 doctors (75 percent of them in ambulatory practice) about EHRs. Adoption was 85 percent, with the most common systems being those from Epic, Cerner, and Allscripts. Most respondents say they aren’t planning to replace their current systems. Top-ranked Epic joined its competitors in scoring low in Net Promoter Score, but few of Epic’s users reported specific problems or plans to replace it. Usability topped the list of user concerns for all systems, while first-time adopters say cost is what’s holding them back. As Peer60 points out, the market seems to violate Economics 101 in that users are nearly universally unsatisfied with their systems, but don’t see more attractive alternatives.

Privacy and Security

The health minister of Australia apologizes to doctors for publishing a file of de-identified claims data covering 10 percent of the country’s population that was quickly re-identified by researchers who matched the records with other publicly available datasets. 

Technology

A small study finds that paramedic documentation improves significantly when they are equipped with body-work video cameras that allow them to review their work afterward.

Other

The Green Beret brother of Maggie Stack, who played the lead role in the Epic UGM production of “Alice in Wonderland” two weeks ago, was killed by an IED while on patrol in Afghanistan last week. Staff Sgt. Adam S. Thomas of the 10th Special Forces Group (Airborne), 31, had earned several Army medals in deployments to Iraq and Afghanistan. ISIS has claimed responsibility for his death.

Vince and Elise close out their “Rating the Ratings” series with ideas on a “do it yourself” rating.

Sponsor Updates

• Nordic is recognized in “Best Places to Work in Healthcare” for the third straight year.
• T-System and Wellsoft will exhibit at ACEP16 Scientific Assembly October 15-18 in Las Vegas.
• TierPoint completes a $12 million TekPark data center expansion.
• Valence Health will exhibit at TAHP Annual Conference October 14-16 in Dallas.
• Huron offices across the country donate over 4,000 backpacks to local nonprofit organizations.
• ZeOmega will exhibit at Washington State Hospital Association’s annual meeting October 12-14 in Seattle.
• Zynx Health will exhibit at the 2016 Meditech Physician and CIO Forum October 20-21 in Foxborough, MA.

Blog Posts

• Are Your Improper Payments Hiding in Plain Sight? (Verscend Technologies)
• Dawn Story’s: VitalWare’s Lesson in Hope (VitalWare)
• Learning Curve? What Learning Curve? (Voalte)
• OCR to Expand Compliance Reviews of Small Healthcare Breaches (Iatric)
• The IMAX of Patient Care (West Corp.)
• How we helped Montana expand Medicaid to nearly 50,000 (Xerox)
• Put lost revenue from claim denials in the rearview mirror (ZirMed)

Contacts

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

News 10/7/16

Top News

Theranos CEO Elizabeth Holmes announces that the company will close all its clinical labs and wellness centers and lay off nearly half of its employees to focus exclusively on trying to commercialize its MiniLab testing platform.

Theranos investors continue their high level of cluelessness by inexplicably keeping Holmes as CEO, although at this point her train wreck behavior is about all that remains interesting about the former high flyer.

My bet: Theranos will bleed out all its remaining investor cash before it can get its machine through the FDA to market, and even if the company is successful, nobody’s going to buy a MiniLab given the company’s historical lack of transparency and shady business practices (would you really want to buy diagnostic equipment from someone who is federally banned from all lab involvement?)

Reader Comments

From Tripp the Lite Fantastic: “Re: Drummond Group. A shakeup after it was sold – President Kyle Meadors has left.” Unverified. He’s still showing on the certification company’s executive page (which lists only two people), but his LinkedIn profile shows that he left the company in July. He took the job in November 2015 after the two co-founders stepped aside. I don’t recall that I knew (or cared) that the company was acquired. Drummond and CCHIT were named by ONC as the first authorized testing bodies for EHRs in 2010.

From Nasty Parts: “Re: NextGen. There’s a sales book on the street, according to contact there. The only insiders who will benefit are the Cardinal hires brought over by CEO Rusty Frantz, such as the new CFO whose package included 75,000 restricted stock units.” Unverified.

HIStalk Announcements and Requests

Sixteen companies have joined my little HIStalk sponsor family in the past handful of weeks, motivated in part by the fall new sponsor special offer that throws in the rest of 2016 free for a full-year 2017 sponsorship. Contact Lorre to join them.

Welcome to new HIStalk Platinum Sponsor Learn on Demand Systems. The company’s OneLearn training management system allows organizations of all sizes to deliver experience-based training, software demos, and performance-based assessments in managing programs, instructors, classrooms, schedules, and metrics. Its OneLearn lab-on-demand platform automates the delivery of hands-on labs and product demonstrations, using the hospital’s custom EMR instance (a mirror image, not a simulation) to deliver an Interactive Digital Lab with testing to identify those departments that are (or aren’t) ready for an implementation or upgrade go-live. Everybody gets a sandbox to play in whenever their schedule allows – no more marathon classroom sessions. You can try a live preview of a training lab – I did and it’s very cool (scroll down on the page to launch a sample environment with no sign-up required).  The company has reached users in 145 countries, launched 10 million labs, and trained 5 million students for customers that include Google, Microsoft, Citrix, and Caradigm. Thanks to Learn on Demand Systems for supporting HIStalk.

Here’s a screenshot of my playing around with a live preview of Learn on Demand Systems. It presented an exam on the right with links to resources such as a network diagram while in the middle of the screen was a virtual live session of Windows NT (browser based, no setup required), allowing the student to work on a live server while completing a test on how to configure user e-mail accounts.

We provided math games for the third-grade class of Ms. Burkett in Missouri in funding her DonorsChoose grant request. She says her students get excited about math every day because the activities are fun and allow them to work together to solve problems.

The industry’s most talked-about HIMSS party is on. Would your company like to help me pay for it since I’m otherwise personally on the hook for the rather shocking price tag in entertaining 800 or so industry notables? Contact Lorre for sponsorship options that can range from small to blow-out.

This week on HIStalk Practice: Central Virginia Coalition of Healthcare Providers selects CCM software from Smartlink. CityMD partners with Par80 for referral management. Survey shows patients want pricing up front, but providers aren’t prepared to comply. Internet icon advocates for an "NIH for Cybersecurity." AMA unveils new MACRA tools for physician prep. MTBC acquires MediGain and Millenium Practice Management. NHHIO ED Jeff Loughlin helps New Hampshire providers set up a centralized data repository now that they’ve gotten over the EHR implementation hump.

Webinars

October 13 (Thursday) 2:00 ET. “Glycemic Control During Therapeutic Hypothermia.” Sponsored by Monarch Medical Technologies. Presenter: Tracey Melhuish, RN, MSN, clinical practice specialist, Holy Cross Hospital (FL). Using therapeutic hypothermia (TH) as a method of care can present risks of hyperglycemia, hypoglycemia, and blood glucose variability. Maintaining safe glucose levels during the cooling and rewarming phases of TH reduces the risks of adverse events. Tracey Melhuish, author of “Linking Hypothermia and Hyperglycemia,” will share best practices for optimal glucose control during TH and the success Holy Cross Hospital sees while using a computerized glucose management software.

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

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

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

Acquisitions, Funding, Business, and Stock

ICU surveillance monitoring technology vendor Sotera Wireless, which offers the ViSi Mobile wireless sensor, files for Chapter 11 bankruptcy. The company had raised $84 million in nine funding rounds, but none since early 2014.

Consumer wellness software vendor Welltok raises $33.7 million in a Series E funding round, increasing its total to $164 million.

In an unpleasant health IT flashback special, Vista Equity Partners will take England-based Misys public again on the London Stock Exchange, valuing the company at $7 billion in England’s largest IPO of 2016. Vista bought the company for $1.6 billion in 2012, five years after the banking software company sold off its Sunquest and CPR product lines as well as its majority stake in Allscripts in its hasty exit from the healthcare market (they’ve since added “financial software” to their logo to remind themselves of their unsuccessful sector unfaithfulness). I remain amused even now that two British banking software vendors – Misys and Sage – nearly simultaneously made a major mess in their pathetic and fortunately short-lived attempts to milk a US healthcare IT market that they clearly didn’t understand.

Evolent Health completes its acquisition of Valence Health, paying $219 million rather than the originally announced $145 million since the sale price was tied to Evolent’s share price. Evolent says Valence will generate revenue of around $85 million this year.

UPMC Enterprises makes an unspecified investment in RxAnte, a UPMC vendor that uses analytics to predict medication adherence. The company reports $4.6 million in fundraising, all of it in 2012.

Xerox, preparing to split itself into two publicly traded companies, names its business process services segment (which includes healthcare) Conduent. You’ll either be inspired or appalled by the lengthy, marketing-heavy explanation of what every aspect of the made-up word and logo signifies other than that they let creative types run expensively amok (“A bold typeface conveys stability and complements the symbol while acknowledging a 30-year history supporting the critical operations of businesses and governments. A connection between the ‘N’ and the ‘T’ in the typeface of ‘Conduent’ reinforces that the constituent is at the core of the company’s business model. The connected letters also draw the reader’s eye to this unique pronunciation of the coined name.”) Apparently the most important factor in the new company’s eventual success is allowing those last two letters to touch.

Sales

Harrison Memorial Hospital (KY) chooses Santa Rosa Consulting’s InfoPartners subsidiary as its Meditech 6.1 Ready implementation partner.

Island Hospital (WA) chooses Meditech.

In England, Chelsea and Westminster Hospital NHS Foundation Trust selects Cerner, sharing its implementation with Imperial College Healthcare NHS Trust. 

In Canada, William Osler Health System will implement Extension Engage for unified clinical communications and collaboration.

Choosing Wellsoft’s EDIS are Angleton ER (TX) and the third freestanding emergency center of Cypress Creek ER (TX).

People

Harry Greenspun, MD (Deloitte) joins Korn Ferry as chief medical officer and managing director of its KF Health Solutions business.

PM/EHR vendor InSync Healthcare Solutions promotes Roland Therriault to president, replacing Tom Wilson.

Gregg Waldon (RedBrick Health) joins Kareo as CFO.

Government and Politics

CMS discloses that it (meaning we taxpayers) paid over $1 billion per year for the past five years buying Mylan’s EpiPens for Medicare and Medicaid patients. The government also claims that Mylan misclassified the allergy injection as a generic drug –which earns CMS only a 13 percent rebate– instead of a brand name product for which CMS would have received at least a 23 percent discount. CMS indignantly tells the press that it has repeatedly warned Mylan that they were mischaracterizing the drug, but doesn’t explain why it kept paying the inflated price anyway.

CMS Acting Administrator Andy Slavitt describes the state of healthcare insurance marketplaces in a Wednesday speech:

We’ve chosen to address the need to transform in most traditional American way possible– through the private sector. Which means we’re relying on innovation and competition to serve consumers best … If anyone’s premise was that by passing one law, we would fix the affordability of health care all at once, that’s just not how it works. We’re here because the law sets a path in motion … Particularly if you see churn in your book– as people move in and out of jobs and struggle with affordability, how do you build loyalty? Are you building on-boarding processes, monthly touch points, and other initiatives that create “stickiness?” Remember, consumers don’t like churning any more than you do … do you have your first tier hospitals contracted to manage aggressive ER utilization so people can get care in the right setting? Have you set up telemedicine, nurse lines, and other convenient forms of both coaching and steerage? Is there free primary care and other incentives to detect health concerns early?

CMS opens a search for a replacement for former CIO David Nelson, who was brought on to save Healthcare.gov before moving to the Nuclear Regulatory Commission in August.

CMS adds hospice payment information to its publicly available datasets.

Privacy and Security

In England, an NHS security official provides a specific example of how far hackers will go to penetrate a hospital. They targeted an employee, looked up his background on LinkedIn to find that he played college rugby, spoofed an email account using the name of the team captain he played with, and included an attachment claiming to be an old team photo of the two of them together. The victim clicked on the attachment, clicked OK to allow it to open, and in doing so permitted the installation of Trojan spyware that probed the network for two weeks until it was discovered. NHS’s particular problem is that 15 percent of its PCs still run the insecure Windows XP either because old apps and devices require it or that money is too tight to upgrade everything.

Innovation and Research

The American Heart Association, Verily Life Sciences (Google), and drugmaker AstraZeneca award a $75 million, five-year grant to Calum MacRae, MD, PhD, chief of cardiovascular medicine at Brigham and Women’s Hospital (MA), for a big data-powered study in which he will apply engineering, computing, and genomics expertise to the data of heart study participants to look for early markers for heart disease. His team will use data from wearables and patient-reported information in attempting to answer the question of why so many patients get heart disease despite having none of the currently known risk factors.

Technology

The RWJF-funded project The Mood Challenge names the finalists of its competition to use Apple’s ResearchKit to assess mood and its relationship to PTSD. BiAffect tracks and predicts mood episodes by the speed and accuracy of the user’s typing, while Aware Study administers weekly surveys and two daily tasks.

Other

In Australia, doctors at Cairns Hospital request an independent review of its Cerner rollout after learning that 48 mislabeled blood specimens have been identified this year vs. nine in all of 2013. Employees say the specimen collection workflow is convoluted and that printing tube labels for multiple patients on a single printer has caused mixed-ups.

The AMA publishes new MACRA tools for doctors: a calculator to predict the impact of payment changes on a given practice, new MACRA tools for its STEPS Forward practice redesign program, and a podcast series.

Internet pioneer and venture capitalist Marc Andreessen says in an interview that rising-cost sectors (mostly healthcare and education) are dragging down the economy in canceling out the benefits and lower prices created by technology, leading to stagnant incomes, loss of jobs, and a bigger chunk of personal income spent on those sectors:

You have the sectors in which prices are rapidly rising: healthcare, education, construction, prescription drugs, elder care, and child care. Here there’s very little technological innovation. Those are sectors with insufficient productivity growth, innovation, and disruption. You’ve got monopolies, oligopolies, cartels, government-run markets, price-fixing — all the dysfunctional behaviors that lead to rapid increase in prices. The government injects more subsidies into those markets, but because those are inelastic markets, the subsidies just cause prices to go up further … The problem is insufficient technological adoption, innovation, and disruption in these high-escalating price sectors of the economy. My thesis is that we’re not in a tech bubble — we’re in a tech bust. Our problem isn’t too much technology or people being too excited about technology. The problem is we don’t have nearly enough technology. These cartel-like legacy industries are way too hard to disrupt.

Odd: a closed Ohio bridal shop sues a Texas Health Resources hospital for $1 million, saying it lost hundreds of thousands of dollars after one of the two THR nurses who contracted Ebola in 2014 tried on dresses there before she knew she was infected, after which the stigma of being known as “the Ebola store” caused the store’s failure.

I would say drug pricing and profits are way too complicated when I can’t even understand a dumbed-down graphic of where prescription money goes. I do understand, however, that despite the title that suggests middlemen are raking it in, the last line shows that the brand-name manufacturer still keeps 75 percent of whatever made-up price they choose (thus encouraging them to price accordingly).

A writer whose 34-year-old wife died in CHA Cambridge Hospital (MA) pens a moving letter to the ICU employees who cared for her:

When I needed to use a computer for an emergency email, you made it happen. When I smuggled in a very special visitor, our tuxedo cat, Cola, for one final lick of Laura’s face, you “didn’t see a thing.” And one special evening you gave me full control to usher into the ICU more than 50 people in Laura’s life, from friends to co-workers to college alums to family members. It was an outpouring of love that included guitar playing and opera singing and dancing and new revelations to me about just how deeply my wife touched people. It was the last great night of our marriage together, for both of us, and it wouldn’t have happened without your support.

Sponsor Updates

• VMware shares its vision for intelligent analytics from VMware AirWatch.
• Impact Advisors volunteers with SCARCE DuPage as part of its annual Operations Team meeting.
• Catalyst’s HITRUST CSF certification is extended to customers using Microsoft Azure.
• InstaMed recaps its event at Epic’s UGM.
• HCI Group will exhibit at the Ministry of Health & HIMSS Middle East conference in Riyadh, Saudi Arabia next week.
• Glytec is named an innovation award finalist for its diabetes management solution.
• John Yurkschatt of Direct Conulting Associates is named to “2016 Millennials in Staffing.”
• MedData will exhibit at the ACEP Scientific Assembly October 16-19 in Las Vegas.
• A Spok survey finds that most hospitals are formalizing their mobile strategy, often with the help of outside experts, but are challenged by deficiencies in Wi-Fi and cellular coverage.
• Meditech celebrates October’s health literacy heroes.
• Wellsoft will exhibit at ACEP October 16-18 in Las Vegas.
• Medicity President of HDMS Analytics Patrice Wolfe will keynote the New Jersey & Metro Philly HFMA Annual Institute taking place this week in Atlantic City.
• Obix Perinatal Data System will exhibit at the Tennessee State AWHONN Conference October 7-8 in Memphis. 
• Experian Health will exhibit at the HFMA SoCal/Imperial Chapters Fall Conference October 9-11 in Newport Beach.
• Red Hat will host its North America Partner Technical Exchange October 10 in Chicago.

Blog Posts

• Medicity Client Summit 2016 – Collaborating to generate transformative ideas (Medicity)
• Promoting Healthcare IT Cybersecurity Awareness on Capitol Hill (Imprivata)
• Doctor! Doctor! (Iatric)
• Would your hospital pass a workforce compliance audit? (Infor)
• Doctor! Doctor! (Iatric Systems)
• Will Your Organization Suffer the Next Big Email Scandal? (ID Experts)
• Convince Your Executives and Physicians That Online Scheduling is a Win/Win (Influence Health)
• What Do Health Systems, Hotels and Airlines Have in Common? (Kyruus)
• Who Uses Image Sharing? (LifeImage)
• Getting Ready for the End of the Hurricane – It’s the End of CMS’ Grace Period: How to Make Sure You’re Prepared (Navicure)
• Bringing Home the Value of Health IT (Netsmart)
• Respondents Wary of Value-Based Care: Population Health Management May Ease Fears (Orion Health)
• Impact Advisors “Hearts” Healthcare IT (Impact Advisors)
• Future-Proof Your Clinical Communications Strategy (PatientSafe Solutions)
• Happy 1st Birthday ICD-10 (PatientKeeper)
• Connect content to succeed in a value-based care environment (Lexmark Healthcare)
• Don’t Even Think About Using the EMR for Provider Data Management! (Phynd Technologies)
• Let’s Get Specific: What the End of the ICD-10 Grace Period Means for Your Practice (PMD)
• Can Your Change Control Processes Support Affiliates? (Sagacious Consultants)
• Technology’s Role in the Future of Healthcare (Surescripts)

Contacts

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

News 10/5/16

Top News

Private equity firm Warburg Pincus will acquire Intelligent Medical Objects, according to an FTC pre-merger filing.

Reader Comments

From The Truth: “Re: lying on contracts. I know a major EMR vendor who does it.” Only one? However, allow me to take the other side of the argument: a client who rightly insists on a properly detailed set of terms and conditions with appropriate non-performance penalties makes vendor lying pointless. My experience is that while salespeople might on occasion embellish the truth, skate to where the puck is going in describing offerings that technically might not actually exist, and sometimes speak in soothing but non-binding generalities, wise customers include everything they expect in their contracts. Hospital people are often so exhausted by their product selection process and so loath to restart it that they subconsciously align themselves with their vendor in treating the contract as a relief-inducing ceremonial formality than what it really is – the only tangible manifestation of all that prep work and the sole protection against an undesirable future state. Don’t be that football player who spikes the ball and commences a showily choreographed celebratory dance before the ball has actually crossed the plane of the goal line. 

From In the Know: “Re: eClinical Works. Has lost two huge customers in their own back yard that are switching to Epic – the physician networks of Boston Children’s Hospital and Mount Auburn Hospital.” Unverified.

From Twice Bitten: “Re: Streamline Health. Laid off half its financial management and scheduling team (the 13 year in a row KLAS winner).” Unverified. Streamline Health acquired patient scheduling system vendor Unibased Systems Architecture in early 2014. USA’s product has always ranked high in KLAS but is pretty low profile, both in terms of existing customers and in STRM’s promotional material.

From Freddie Kroger: “Re: [publication name omitted]. They just gave a big splash to their EHR satisfaction results. Note the small print: they received only 340 responses.” That didn’t stop them from running a bunch of brashly written articles that tried to sound authoritative but were embarrassing given the complete lack of statistically defensible methodology. They got even fewer responses than the 400 last year that fueled a ridiculous salvo of pointless articles and overly cute graphics. The survey also seems to confuse inpatient and ambulatory EHRs and fails to distinguish among multiple EHRs offered by a single vendor. It’s a worthless survey other than for fueling clickbait. I ended my critique of last year’s version by listing factors to ponder in deciding whether to trust a survey’s results:

1. How did you choose your pool of potential survey respondents? Was random sampling of a known population used?
2. How did you invite participation?
3. What was your survey’s sample size and response rate?
4. What were the characteristics of your survey’s non-respondents?
5. What is the motivation of those who responded? (unsatisfied people are more likely to respond in most cases).
6. What were the demographics of your respondents?
7. How did you prevent ballot box stuffing?
8. What did your survey instrument look like? Were your questions clear, unbiased, and appropriate for those surveyed? Did the sponsoring organization create bias (unintentional or otherwise) in the choice and wording of questions?
9. Does your survey report include raw data that prove its conclusions? What type of statistical methods did you apply in analyzing the responses?
10. Do your conclusions overreach the underlying data in trying to gain publicity with catchy headlines and graphics that aren’t supported? Do your published results state the limitations of the survey?

HIStalk Announcements and Requests

Thanks to Jenn for covering for me as I took a few days off. I’m happy nobody missed me so I could enjoy my little vacation without feeling too guilty. I love traveling with my Chromebook for instant-on connections with a fantastic keyboard instead of an on-screen one. It has fully replaced my tablet and laptop for traveling, other than using the tablet as a Kindle reader on planes.

I was unfortunately imprecise in last week’s poll question, where I was interested in learning how providers view the resumes of salespeople, but my poor wording suggested I was also cultivating the opinions of those in a sales hiring role. Nonetheless, I’ll go with the most important salesperson attributes as voted: (a) a lifetime career in health IT; (b) a healthcare professional degree; and (c) consulting experience. Since earning a non-healthcare graduate degree ranked low, nothing important on my list is easily undertaken by someone already in sales who wants to make a better LinkedIn first impression, which means that professionalism, honesty, and interpersonal skills rule the day. I’m an outlier in that military service ranks #1 on my list, especially if the person either graduated from one of the service academies, served as an officer, or deployed overseas.

New poll to your right or here: what speaker tendency annoys you the most when attending a conference session or webinar? Early returns suggest the same problems that we vigorously coach against when we help people make their planned webinar better.

Welcome to new HIStalk Platinum Sponsor Dimensional Insight. The Burlington, MA-based data analytics and business intelligence solutions vendor offers the award-winning (Best in KLAS in BI/Analytics for five years) Diver Platform, an end-to-end enterprise reporting and analytics system that provides actionable, role-based business intelligence. Capabilities include diabetes management, MU compliance, quality reporting, population health, payroll analysis, product line analysis, reimbursement management, asset utilization, EHR reporting, staffing requirements forecasting, and strategic planning. Specific solutions include Physician Performance Advisor, which brings all KPIs into a single application; Surgery Advisor for OR management; Meaningful Use Advisor that allows measuring, analyzing, and attesting from a single app; and GL Advisor for allowing finance departments to answer their own questions using data integrated from multiple systems such as accounting, payroll, and time and attendance. See the case studies. Thanks to Dimensional Insight for supporting HIStalk.

I found this just-published Dimensional Insight customer testimonial from Henry Mayo Hospital (CA) on YouTube.

Welcome to new HIStalk Gold Sponsor Kyruus. I like the company’s description of what it does as “precise demand-supply matching,” which advocates that as an alternative to standardizing medical practices into a one-size-fits-all model, we should instead “understand, measure, and embrace the heterogeneity” in identifying patient outliers and matching them with doctors who are best at managing their condition. I had marginally fond, acetone-fumed memories of organic chemistry classes in reading the origins of the company’s name, which is derived from the word “chiral” and features two U’s to represent using big data to unleash physician potential. The company’s ProviderMatch helps access centers and networks (and even patients themselves) connect patients with the right doctor, taking into account doctor expertise, insurance acceptance, locations, availability, demographics, and business rules to enable real-time provider search, scheduling, and referral instead of the creaky and nearly worthless “doctor finder” webpages offered by most hospitals. The company’s executive roster boasts folks with impressive backgrounds. Customers include Beaumont, Keck Medicine of USC, MedStar Health, MercyHealth, Partners HealthCare, Providence and Swedish. Thanks to Kyruus for not only supporting HIStalk, but for putting up an interesting and passionate website. 

I found this Kyruus video called “The Patient Access Journey” on YouTube.

Listening: new from Metallica, which sounds just like Metallica. They aren’t the most musically amazing group and aren’t likely to extend their loyal fan base with this offering, but they stick to their Flying-V knitting nicely and remain intense on stage.

Webinars

October 13 (Thursday) 2:00 ET. “Glycemic Control During Therapeutic Hypothermia.” Sponsored by Monarch Medical Technologies. Presenter: Tracey Melhuish, RN, MSN, clinical practice specialist, Holy Cross Hospital (FL). Using therapeutic hypothermia (TH) as a method of care can present risks of hyperglycemia, hypoglycemia, and blood glucose variability. Maintaining safe glucose levels during the cooling and rewarming phases of TH reduces the risks of adverse events. Tracey Melhuish, author of “Linking Hypothermia and Hyperglycemia,” will share best practices for optimal glucose control during TH and the success Holy Cross Hospital sees while using a computerized glucose management software.

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

October 26 (Wednesday) 1:00 ET. “How to Create Healthcare Apps That Get Used and Maybe Even Loved.” Sponsored by MedData. Presenter: Jeff Harper, Founder and CEO, Duet Health. Patients, clinicians, and hospital employees are also consumers who manage many aspects of their non-medical lives on their mobile devices. Don’t crush their high technology expectations with poorly designed, seldom used apps that tarnish your carefully protected image. Your app represents your brand and carries high expectations on both sides. This webinar will describe how to build a mobile healthcare app that puts the user first, meets their needs (which are often different from their wants), creates "stickiness," and delivers the expected benefits to everyone involved.

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

Acquisitions, Funding, Business, and Stock

Infor systems integrator Avaap acquires Falcon Consulting, which offers Epic consulting services that are ranked #1 in KLAS.

Consumer health site Sharecare, founded by TV huckster Dr. Oz, acquires BioLucid, which offers the You 3D human body simulator. The product might even accurately depict that portion of Dr. Oz’s anatomy from which his medical claims originate (it’s conveniently located right next to his wallet).

Wolters Kluwer will acquire patient engagement systems vendor Emmi Solutions for $170 million.

The innovations group of the ProMedica health system (OH) partners with app development technology vendor Kaonsoft to form Kapios health, which will apparently commercialize apps developed by ProMedica.

Cerner tells the Kansas City business paper that it will expand its revenue cycle management business “aggressively.”

Decisions

• Cooperstown Medical Center (ND) will go live on Epic on November 2016 under the Community Connect program of Altru Health System.
• Keefe Memorial Hospital (CO) went live on CPSI’s EHR and revenue cycle systems in June 2016, replacing systems from CPSI-acquired Healthland.
• University Medical Center of Southern Nevada will replace McKesson Horizon with Epic in 2017.

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

People

Keith Hagen (IHM Services) joins Aviacode as CEO.

Spok hires Andrew Mellin, MD, MBA (RedBrick Health) as chief medical officer.

Announcements and Implementations

In Africa, the World Health Organization is completing development of a phone-based app that will help non-specialists manage pregnancies, hoping to reduce child and maternal death by applying the knowledge gleaned from the hospital records of 10,000 pregnant women in a “patients like me” model.

Varian Medical Systems releases its 360 Oncology care management platform that supports virtual tumor board meetings, care coordination, trials management, and patient engagement.

Providence Hospital North Houston (TX) goes live on Wellsoft’s EHR. It’s a micro-hospital, a small facility that offers full services but with only a handful of inpatient beds intended for short stay, often built by a large health system that can’t justify developing a full-sized hospital in an otherwise attractive geographic area. Advisory Board has a nice overview of the concept, which is pretty fascinating. That handful of beds might be enough even for larger areas if hospitals can ever be financially convinced to manage the health of the populations they claim to serve instead of feeding their never-ending edifice complex.

FormFast launches Connect, which guides patients through their healthcare experience by making sure they read and complete forms and checklists before and after each care event, such as for pre-admissions or post care follow up.

VMware adds smart glasses management features to AirWatch, the first unified endpoint management solution to extend into wearables.

Carevive Systems will offer a CME/CNE-accredited symposium on applying the IOM care management plan to patients with non-small cell lung cancer on October 26 in Philadelphia.

Government and Politics

Non-profit Maryland insurer Evergreen Health switches to a for-profit company as it brings in private equity investors to avoid its imminent shutdown, leaving intact only five of the 23 non-profit insurance co-ops funded by the Affordable Care Act. The insurer blames ACA’s risk adjustment program, which resulted in the company’s receiving a $23 million bill for not having as many expensive patients as other insurance companies. Its website (and perhaps its mission) might need an update since it continues to declare that, “for far too long, health insurance carriers have put profits ahead of people.”

Former President and would-be First Gentleman Bill Clinton, stumping on behalf of his wife, calls the Affordable Care Act “the craziest thing in the world” that has provided insurance for 25 million more people, but with premiums doubled and coverage halved because those individuals have no leverage with insurers since they aren’t part of a big risk pool. He advocates Hillary Clinton’s proposal to allow middle-class consumers who aren’t eligible for federal insurance subsidies to buy into Medicare and Medicaid.

Meanwhile, UnitedHealth Group’s startup Harken Health, which offered relationship-based, lower-cost ACA insurance plans and healthcare services, pulls all of its offerings from the marketplace and fires its founding CEO, citing huge losses due to – like even the less-hip insurance companies — unexpectedly older and sicker enrollees.  

The DEA will require opiate drug manufacturers to decrease production by 25 percent next year, with the federal government trying yet again to impose a war on drugs by limiting the supply instead of the demand. The main result will be to drive up the street price and shift more addicts to impure street products that will in many cases kill them.

Privacy and Security

From DataBreaches.net:

• The US Surgeon General warns the 6,600 medical professionals of the Public Health Service that their information has been accessed by hackers.
• An illegally operating medical marijuana dispensary in Canada exposes the identities of 500 of its customers when a now-fired employee uses CC: instead of BCC: in sending them a mass email.

Johnson & Johnson warns users of its Animas OneTouch Ping insulin pump, which the user controls via a Wi-Fi remote control, is susceptible to hacking, assuming the would-be hacker can get within 25 feet of it.

Innovation and Research

A UK-based project is studying 100,000 people in matching their brain imaging results to their demographic and medical history to identify early markers of age-related brain problems

Other

A fifth Texas man pleads guilty for his involvement in a scam in which the co-conspirators created a company called Cerner LLC and sold Summit Medical Center (OK) a new MRI machine. You might wonder how a surgery center’s due diligence could be insufficient to the point of not being aware that Cerner doesn’t sell MRI machines.

The mainstream press is amused that a hospital charged a father $39.95 to hold his newborn. They should be outraged that if he was a cash-paying customer, he would have been stuck with a $13,000 bill since he wouldn’t get the $5,600 discount extended to his insurance company.

In case you didn’t know, non-profit healthcare is a pretty big business.

Here’s some nicely dry wit from Acting CMS Administrator Andy Slavitt.

Here’s the new video from ZDoggMD.

Sponsor Updates

• Medicomp Systems is hosting a sold-out training program in Bangkok, Thailand this week in which customers will learn how to integrate the company’s Quippe documentation tools into their EHRs.
• Healthegy names Health Catalyst as its Digital Healthcare Innovator of the Year.
• Optimum Healthcare IT launches a new website and branding.
• Aprima will exhibit at the Patient-Centered Medical Home Congress October 7 in Chicago.
• Audacious Inquiry releases a new video on “How to Reduce Hospital Readmissions.”
• CompuGroup Medical releases a newly rewritten version of its Labdaq Teleios laboratory information system that includes best practices rules, an interactive performance dashboard, and an interface monitoring tool.
• Bernoulli will exhibit at the American Association for Respiratory Care Congress 2016 October 15-18 in San Antonio.
• Catalyze publishes daily recaps of Health 2.0.
• Besler Consulting releases a new podcast, “Revenue recovery opportunities from class action settlements.”
• CapsuleTech will exhibit at HIMSS Middle East October 12-13 in Riyadh, Saudi Arabia.
• CTG’s Angela Rivera is featured in the San Diego Business Journal.
• Cumberland Consulting Group Principal Taylor Ramsey speaks at the South Carolina HFMA Women’s Leadership Conference.
• EClinicalWorks will exhibit at IPHCA’s 2016 Leadership Conference October 5-7 in St. Louis.
• The Connecticut Technology Council and Marcum name Evariant to the Marcum Tech Top 40 list.
• Two locations of Sutherland Healthcare Solutions earn URAC Credentials Verification Organization Accreditation, recognizing the company’s commitment to quality and best practices in the areas of credentialing, provider data management, claims administration, and population health solutions.
• GE Healthcare creates a Centricity Partner Program.
• A Journal of Diabetes Science and Technology study demonstrates Glytec’s superiority in meeting ADA guidelines.
• HCS will exhibit at the NJ HFMA Annual Institute October 5-7 in Atlantic City.
• Healthwise will exhibit at AdvancedMD Evo16 October 11-12 in Salt Lake City.

Blog Posts

• The Path to Health IT Project Success (Spok)
• A Pathway to Alternative Payment Models (APMs) (AdvancedMD)
• How to Manage Pharmacy Costs in an ACO (Arcadia Healthcare Solutions)
• Can MACRA and MIPS Move the Needle for Healthcare Analytics? (Caradigm)
• 3 Major Benefits of Leveraging Mobile Health Tools (CareSync)
• 10 Ingenious Things You Can Do With Your CoverMyMeds Account (CoverMyMeds)
• Benefits of Giving Back as an Organization (Direct Consulting Associates)
• Improving Provider Efficiency and Satisfaction through EHR Optimization (Culbert Healthcare Solutions)
• Choosing the Right Care Transformation Model (ECG Management Consultants)
• Serving Clients Before and After the Sale with Extension Engage Health Checks (Extension Healthcare)
• Why #IHeartHIT with a Passion (Galen Healthcare Solutions)
• 3 Ways Technology Must Show Up in the Consumerization of Healthcare (Hayes Management Consulting)
• 3 Unexpected Issues to Look Out for During an EMR Go-Live (The HCI Group)
• The Right Amount of Disruption (Healthfinch)
• Writing Content That Connects: This Time It’s Personal (Healthwise)

Contacts

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

Monday Morning Update 10/3/16

Top News

Former and current National Coordinators Karen DeSalvo, MD and Vindell Washington, MD take to Health Affairs to detail the “health IT transformation” seen across the country since the HITECH Act was passed in 2009. A few stats:

• 96 percent of hospitals and 78 percent of physicians use certified EHRs.
• 84 percent of academic literature review studies showed that certified EHRs had a positive or mixed-positive effect on care quality, safety, and efficiency.
• 80 percent of hospitals electronically exchanged lab results, radiology reports, clinical care summaries, or medication lists with providers outside their organization in 2015.
• 84 percent of providers reported in 2015 that their EHR met or exceeded their expectations.
• 90 percent of hospitals had digital health data they needed from outside sources or providers available at the point of care – double the national average.

The duo, who both have fond memories of caring for patients in Louisiana, emphasize that continued transformation will require federally recognized standards, combating data blocking, and creating an ROI around interoperability.

Last Week’s Most Interesting News

• Aetna announces plans to offer an Apple Watch subsidy through large employers and select individual customers to ramp up its wellness and care management programs.
• InstaMed announces a $50 million investment from Carrick Capital Partners.
• Former Tuomey Healthcare (SC) CEO Ralph Cox will personally pay a $1 million fine to settle Stark Law allegations that he illegally compensated doctors in exchange for unnecessary patient referrals to the hospital.
• The FDA approves Medtronic’s artificial pancreas that automatically monitors a patient’s blood sugar levels and then administers the appropriate insulin dose.
• Hilary Clinton outlines in NEJM her plans for improving healthcare, which includes improving ACA, working to “integrate our fragmented healthcare delivery systems,” and helping to increase research and innovation.

Webinars

October 13 (Thursday) 2:00 ET. “Glycemic Control During Therapeutic Hypothermia.” Sponsored by Monarch Medical Technologies. Presenter: Tracey Melhuish, RN, MSN, clinical practice specialist, Holy Cross Hospital (FL). Using therapeutic hypothermia (TH) as a method of care can present risks of hyperglycemia, hypoglycemia, and blood glucose variability. Maintaining safe glucose levels during the cooling and rewarming phases of TH reduces the risks of adverse events. Tracey Melhuish, author of “Linking Hypothermia and Hyperglycemia,” will share best practices for optimal glucose control during TH and the success Holy Cross Hospital sees while using a computerized glucose management software.

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

Acquisitions, Funding, Business, and Stock

Safety Net Connect and private equity firm Gary Comer Inc. acquire Chicago-based patient engagement and care coordination technology company VCareConnect for an undisclosed sum.

Senior care services provider US CareNet forms a new company, HC360 Technologies, after purchasing the chronic care and transitional care management technology used in its NavCare care management division.

Announcements and Implementations

Miami Children’s Health System adds ambulatory business office services including RCM to its existing Millenium EHR partnership with Cerner.

Cohen Veterans Network (CT) selects Netsmart’s MyEvolv CareRecord to help it provide free mental healthcare to veterans and their families. The network, which launched in April, have opened five Steven A. Cohen Military Family Clinics across the country and plans to open 20 more over the next five years.

Community Health Partnership (CO) will implement ClientTrack case management software from Eccovia Solutions to better assist its membership of 25 organizations coordinate medical and behavioral healthcare.

Technology

Drchrono develops a “native” iPad and iPhone app for e-prescribing of controlled substances.

Government and Politics

The Dallas Morning News spotlights the refusal of the Texas Department of State Health Services to release data related to pregnancy and maternal death rates to reporters and other organizations looking to gain a better understanding of why the state’s death rates doubled between 2011 and 2012. The department has even refused – without explanation – to release a data record layout, akin to a table of contents that shows what data it collected and how it’s stored. “It’s ridiculous,” says Texas-based lawyer and open records expert Joe Larsen. “We have a clear public health problem, and the people really need to know what in the world is going on here, and they’re stymied by this," he said. "A record layout is not software. It’s not code. It’s not source code. Period. I liken it to the key of a map. It’s actually public information itself.”

Privacy and Security

From DataBreaches.net:

• Marin Medical Practices Concepts notifies 5,000 patients that their medical records were lost during a recovery process stemming from a ransomware attack in July. After patient files were held for 10 days, the California-based billing and EHR company decided to pay an undisclosed ransom amount, which successfully unlocked the files. MMPC attributes the lost files to a faulty backup, adding that the recovery was done during a system upgrade.
• Urgent Care Clinic of Oxford (MS) notifies patients seen before August 2 of a likely ransomware attack initiated in early July, noting in their letter that, “The hackers held the server for ransom before turning control back over to the Urgent Care staff.” The clinic shut down their server’s remote access shortly thereafter, implying that the hackers (thought to be of the Russian variety) snuck in via remote desktop access.
• Martin Army Community Hospital (GA) alerts patients of a possible HIPAA breach that took place at Fort Benning between January 2011 and December 2013. The breach stems from “criminal activity involving identity theft by an employee in the laboratory shipping section.” The employee, who was tried for the crime and is now serving time, apparently used information from discarded lab specimen labels to file fraudulent tax returns.

Other

Ochsner Health System (LA) SVP David Carmouche highlights EHRs, registries, and new compensation models as integral to its population health activities and overall move away from fee-for-service:

“We’re leveraging electronic health records, which connect all of our systems. We have created some 20 registries identifying groups of patients with certain diseases and conditions, and we’re reaching out to them proactively, to make sure they’re getting the care they need, when they need it. We’re realigning physician compensation for Ochsner-employed physicians, moving away from fee-for-service payment to higher payment for high-value, high-quality care. We’re looking at physician preference items, trying to consolidate down to one or two knee implants, or one or two cardiovascular implants, so that we can get better pricing from manufacturers. The best way to keep costs down will be to provide high quality care, so patients can go home quickly and recover fully.”

The system went live on Epic in 2011, and three years later became the first provider to integrate Epic with Apple’s HealthKit.

Scientific American takes a long-form look at the ways in which the FDA (and, increasingly, other federal agencies) manipulates the media, denying access and offering not-so-true findings to some news organizations, while enforcing restrictive rules like the “close-hold embargo” on others. “By using close-hold embargoes and other methods, the FDA, like other sources of scientific information, are gaining control of journalists who are supposed to keep an eye on those institutions,” writes Charles Seife. “The watchdogs are being turned into lapdogs.”

Sponsor Updates

• Forward Health Group CEO Michael Barbouche is featured in a Wisconsin State Journal article on Wisconsin healthcare technology.
• The HCI Group launches a new “Monday Morning Podcast” series.

Blog Posts

• Need help meeting your 2016 goals? Finish the year strong! (Nordic)
• Nordic’s 5th annual Open House Recap (Nordic)

Contacts

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

EPtalk by Dr. Jayne 9/29/16

There has been a lot of chatter in the physician lounge recently about the “Pick your Pace” options for Medicare-related quality reporting next year. Of course, most of the chatter has been either from hospital administrators or from physician leaders of larger groups, since many smaller and independent physician groups may not even be aware of what is about to happen. I was part of a lively exchange this week around the fact that the program has to be budget neutral. To recap, the four options are: 1) Test the quality payment program (no penalty); 2) Report for part of the calendar year (small incentive); 3) Participate for the full year (modest incentive); and 4) Participate in an Advanced Alternative Payment Model (5-percent incentive). The devil may be in the details since it’s unclear how no penalty and small incentives can balance out to be budget neutral. Where is the incentive money going to come from?

It’s also not clear what the actual “test” process in option 1 is going to entail. Unless you’re just starting on your EHR journey, most organizations should be able to report for at least part of the year without significant difficulty. The data may not be of great quality, depending on how well you’re using your EHR, but you can still report it out. We’ll have to wait for the final rule, however, to see what the reporting requirements end up looking like. The partial-year option is going to be attractive to a great number of providers whose EHRs may not be ready for full-year reporting, so I expect to see the most questions on that option.

For providers that are in the thick of trying to comply with all the federal requirements, the 2015 Annual Quality Resource and Utilization Reports (QRURs) were released this week. The QRURs show what a provider’s payment adjustment will be for 2017 based on analysis of quality and cost domains. I attended the Medicare Learning Network call on the topic today. If I didn’t already know a considerable amount about the Value Modifier payment adjustment and the PQRS payment adjustment, I might be more confused after attending the call. The call began with a presenter essentially reading slides to the audience. There were constant references to the appendix, and fortunately the slides were available for download at the beginning of the call so that attendees could follow along.

I’m still mystified by the fact that it takes 21 months to analyze and release the data. We’re talking about using data from 2015 to determine how providers are paid in 2017. Although there was a Mid-Year QRUR that was released in the summer, it didn’t fully illustrate how payment adjustments might be applied. Regardless, the Mid-Year QRUR has little utility to encourage providers to modify their behavior in order to avoid adjustments, since it’s a look-back document. When trying to modify behavior, it’s most useful to provide real-time or at least fairly immediate feedback. Under the CMS construct, the feedback loop is delayed. Does it really take 21 months to aggregate and interpret the data? Or maybe the delay is intentional, as providers move deeper and deeper into a state of learned helplessness.

After about 15 minutes on the call, I felt my brain going numb as the presenter reviewed all the steps needed to access the QRUR. Providers or their designees have to go through the process of requesting an Enterprise Identity Management (EIDM) account which has multiple steps and sub-steps. The acronym soup became less savory as we learned about Provider Transaction Access Numbers (PTAN), which have to be obtained from the Medicare Administrative Contractor (MAC). Once you go through all the related steps and click your heels a couple of times, you can either view or download the presentation.

The presenter tagged-out to a second presenter who went through a table explaining the different sections of a “hypothetical” QRUR. Again, it was basically someone reading a slide to the audience – actually showing the various exhibits and sections while talking about them would have been useful. They did eventually go through some of the specifics, but I wonder how many attendees were following especially if this was the first time they were seeing this material. As the talk moved into discussion of the various quality and cost composite scores, and the need for a statistically significant deviation from the mean to be categorized as more (or less) than average, I wondered how many people attending the webinar understood those statistical terms.

Having spent my final two years at Big Medical Center working on a provider attribution project, I was eagerly awaiting the discussion of how Medicare beneficiaries were assigned to their respective Taxpayer Identification Numbers (TIN). This attribution drives the cost composite score found in the QRUR. Not only is CMS looking at spending per beneficiary, they are also looking at per capita costs for beneficiaries with various chronic conditions including diabetes, chronic obstructive pulmonary disease, coronary artery disease, and heart failure. They didn’t go into anywhere near the detail I expected for a provider to actually understand how the attribution was done. There are detailed elements involving whether a given TIN provided the majority of primary care services during the year, whether primary care services were received from subspecialists in the TIN, and more. None of that was covered.

Heading into the discussion of the “Informal Review Process” that providers can use to disagree with Value Modifier calculated for their TIN, the presenter became flustered due to a missing slide and rather than vamping her way through it, actually paused the presentation while they tried to sort it out. When she restarted, she actually re-read some scripted comments. I felt bad for her – we’ve all been on the downside of presentations that don’t go as planned. She then went into a discussion of various tables in the appendix, which again weren’t on the screen. Apparently, providers can download them in Excel and use them to analyze their own data, even de-identifying it by removing specific columns. It would have been good to see a screenshot of the data format to go along with the discussion.

Once she finally made it to the discussion of the review process, things were back on track. The review period began September 26 and is open for 60 days. The review has to be requested using the EIDM system and the process includes a Multi-Factor Authentication (MFA) step. Users have to remember to use the same MFA device type that they selected to use when they first created their accounts. Depending on how long ago one’s account was created, this may be a challenge. Users can then request the review, which leads to an additional three steps that weren’t shown in the webinar. Users can download a quick reference guide from the CMS website for more information on the reviews, although the link wasn’t shown in the webinar. As a side note, there were a couple of times at the beginning of the webinar where the speaker gave Web addresses verbally but with no link or text shown. Especially with a webinar platform, is there any reason why a link shouldn’t be shown on the screen and provided in the deck that was given to attendees? Another unusual statement (given by two different speakers) was that users should disable their popup blockers and should not connect wirelessly or via VPN but should connect via a wired connection. In this day of mobility and multi-platform device use, it felt like CMS is out of touch with how people use devices to receive information.

They opened the call to Questions and Answers and the first one seemed to challenge them, about whether the adjustment would be provided on a claim-by-claim basis or at the end of the year. Eventually they arrived at the per-claim answer. They answered the second question (about beneficiary attribution) by referring users to yet another website. I finally figured out why they wanted popup blockers disabled when a poll popped up asking how many people were viewing the session with me. There were also polling questions on whether I had difficulty accessing the webinar and whether I was satisfied with the webinar platform used. The questions continued, including one from a group who had discrepancies in the data from their QRUR. She was instructed to submit informal review for both QRUR and PQRS, and the latter has to be done through a different process that the group had difficulty explaining. They had to pause while they conferred, agreeing to look it up and provide it later.

That only served to underscore how complicated these programs are and how challenging it will be for provider groups of all sizes to try to keep up. Staying current with software and enforcing end-user behavior is hard enough, but this adds an entirely different layer of challenges for practice operations and management teams. I had to duck out for another call but am looking forward to seeing the rest of the Q&A in the transcript.

How is your organization coping with the QRUR? Email me.

Email Dr. Jayne.

News 9/30/16

Top News

Aetna announces plans to offer an Apple Watch subsidy through large employers and select individual customers to ramp up its wellness and care management programs, and will provide its own 50,000 employees Apple Watches free of charge.

HIStalk Announcements and Requests

This week on HIStalk Practice: Dr. Gregg pontificates on the proper way for vendors to apologize for unexpected downtime. Enjoin VP James Fee, MD describes how physician engagement efforts can improve clinical documentation. Malvern Family Medical Clinic Owner Shawn Purifoy, MD offers insight into the benefits of joining an ACO and the struggle to remain independent. Medecision William Gillespie, MD lists three population health must-haves for primary care. Midwest Nephrology Associates Owner Gary Singer, MD digs into the benefits of Carequality’s Interoperability Framework.

This week on HIStalk Connect: Sirono Chief Revenue Officer Peter Longo discusses the problem with hospital billing and keys to successful patient payments.

Webinars

October 13 (Thursday) 2:00 ET. “Glycemic Control During Therapeutic Hypothermia.” Sponsored by Monarch Medical Technologies. Presenter: Tracey Melhuish, RN, MSN, clinical practice specialist, Holy Cross Hospital (FL). Using therapeutic hypothermia (TH) as a method of care can present risks of hyperglycemia, hypoglycemia, and blood glucose variability. Maintaining safe glucose levels during the cooling and rewarming phases of TH reduces the risks of adverse events. Tracey Melhuish, author of “Linking Hypothermia and Hyperglycemia,” will share best practices for optimal glucose control during TH and the success Holy Cross Hospital sees while using a computerized glucose management software.

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

Announcements and Implementations

Vidyo launches a clinical design service to help providers integrate telemedicine into their workflows.

PatientPing and Vermont Information Technology Leaders deem their care coordination technology collaboration a success at the six-month mark. Since going live, 400 provider locations in New England have been “pinged,” letting them know that their patients have been seen at local hospitals. PatientPing has recorded 62,000 notifications on 12,000 Vermont citizens.

UAB Medicine will replace its connectivity software with Orion Health’s Rhapsody Integration Engine – a project that will include rewriting 300 interfaces.

Cypress Creek ER (TX) selects Wellsoft’s EDIS for its third freestanding ER, set to open mid-October. Angleton ER (TX) will go live with Wellsoft technology when it opens in December.

NewCrop adds specialty medication prescribing software from AssistRx to its e-prescribing software.

Acquisitions, Funding, Business, and Stock

Former Tuomey Healthcare (SC) CEO Ralph Cox will personally pay a $1 million fine to settle Stark Law allegations that he illegally compensated doctors in exchange for unnecessary patient referrals to the hospital.

MedWand Digital Health secures a “major investment” from sensor technology-focused Maxim Ventures, which the Las Vegas-based startup will use to work towards anticipated 2017 FDA approval of its diagnostic device for virtual consults.

People

Wendy Deibert (The VirtualEngine) joins Vidyo as VP of clinical services.

Teladoc adds the new role of COO to CFO Mark Hirschhorn’s responsibilities.

Greg Alexander (Evolent Health) joins Lumeris as national VP of market operations.

The Chartis Group promotes Michael Topchik to head of the new Chartis Center for Rural Health.

Michael Bain, MD (Qualified Emergency Specialists) will head Cincinnati-based TriHealth’s new clinical informatics department as CMIO.

Technology

Dr. Oz lends his gravitas to San Francisco-based wearables startup IBeat, becoming an investor, partner, and advisor to the company as it launches its heart-monitoring smartwatch via an Indiegogo campaign. For a mere $5,000, buyers can purchase the “Meet Dr. Oz Special,” which includes VIP access to this show, a two-night hotel stay in New York City, two watches and monitoring services, plus a signed book and scrubs. Oz was not involved in last month’s seed funding round of $1.5 million.

Government and Politics

HHS and AARP announce the winners of their “A Bill You Can Understand” contest. Designs from Los Angeles-based RadNet, which won in the easiest-to-understand category, and San Francisco-based Sequence, which won in the overall approach category, will be tested or implemented in six healthcare facilities – including Cambia Health Solutions – across the country. (Jenn talked with CHS President and CEO Mark Ganz about the challenge as part of “The Hypocrisy of a Simpler Patient Bill.”)

Hillary Clinton takes to the New England Journal of Medicine to outline her vision for universal, quality, affordable healthcare. Her short op-ed hints at healthcare IT among her four goals: “I am also committed to expanding access to high-quality data on cost, care quality, and health delivery system performance to help patients and doctors make informed choices, and entrepreneurs build new products and services.” Donald Trump has thus far declined the same editorial opportunity.

ONC awards seven organizations $1.5 million to improve the flow of health data for patients and providers, particularly data related to medication management, laboratory data, and care coordination. The funding comes via the office’s High Impact Pilot and Standards Exploration Award programs.

HIMSS presents Acting Assistant Secretary for Health and former national coordinator Karen DeSalvo, MD with the Federal Health IT Leadership Award during its National Health IT Week festivities.

Privacy and Security

HITRUST connects and begins bi-directional sharing of cyber threat indicators with the Department of Homeland Security’s Automated Indicator Sharing Program. The information exchange corresponds with HITRUST’s new CyberAid program, which helps smaller organizations select security solutions and contribute to the exchange.

From DataBreaches.net:

• The New Jersey Spine Center notifies patients of a July 27 ransomware attack that resulted in the provider paying an unspecified dollar amount to unlock all of its digital patient records. Files were reinstated on August 1.
• Royal Cornwall Hospitals Trust in England suffers multiple ransomware attacks over the past year.
• Australia Health Minister Sussan Ley apologizes to physicians for the accidental leaking of Medicare data, discovered after University of Melbourne researchers attempted to decrypt some of the data, thus inadvertently revealing sensitive information.

Research and Innovation

The FDA approves Medtronic’s artificial pancreas that automatically monitors a patient’s blood sugar levels and then administers the appropriate insulin dose.

An American Telemedicine Association/Wego Health survey of 429 patients finds that just 22 percent have taken advantage of video visits in the last year, with the average patient engaging in between one and four virtual consults. Of that percentage, as many patients requested telemedicine services as their providers initially offered it. I’m not sure that “strong demand,” as tweeted above, is warranted with these results.

Other

Seems like #HIMSSanity has already begun.

British researchers have created a 3D-printed replica of the human body to help train surgeons, particularly when it comes to making that initial slice.

Sponsor Updates

• Fortified Health Solutions will exhibit at the HIMSS Southern California Annual Privacy & Security Forum September 30 in Newport Beach.
• Frost & Sullivan recognizes Orion Health with the 2016 European Frost & Sullivan Award for Product Leadership.

Blog Posts

• Ensuring a healthy, safe and environmentally conscious workplace—not only for patients, but your employees. (Infor Healthcare)
• The Dawn of Artificial Clinical Awareness (ClinicalArchitecture)

Contacts

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

Safeguarding Smartphones in an Era of Escalating Vulnerabilities

HIPAA-related security concerns mount as smartphones become more ubiquitous across enterprise healthcare environments.
By @JennHIStalk

Ransomware headlines seem to reign supreme in healthcare news, and yet industry insiders know that the greater potential for cyberattack and financial loss resides in just about every person’s pocket (or pocketbook). Catholic Health Care Services of the Archdiocese of Philadelphia’s $650,000 settlement with OCR for HIPAA violations this summer is a prime example of the vulnerability of mobile smart devices. The settlement stemmed from the theft of a smartphone containing the PHI of 412 nursing home residents. Acting as a business associate, CHCS provided IT and management services to six SNFs, and was thus responsible for protecting resident PHI under HIPAA. OCR found that, in addition to a lack of encryption and password protection, CHCS also neglected to develop a risk analysis and accompanying plan for risk management.

While the organization’s lack of cyber safeguards and subsequent fine made headlines, it’s probably a safe bet to assume that other similar entities are operating without the appropriate security safety nets.

Getting on the MDM Hamster Wheel

Smartphone security “is a moving target,” says Alex Brown, director of strategy at healthcare communications company Voalte. “Today, there seems to be two layers of what people are looking into when it comes to smartphone security – applications on the device and the content of those applications. If your application has PHI sitting in it all the time, than you have a much higher risk than with an app that has PHI on it only when it’s connected to a server.

“Not every healthcare organization has the expertise to deploy security,” he adds, “which is why providers rely so much on vendors to make sure that they’re really keeping up to date with best practices around mobile device management.”

Brown finds that in today’s world of escalating cybersecurity concerns, constant dialogue with hospital customers about the importance of up-to-date MDM is a must. Hospitals are now faced with managing almost daily updates from Apple and Google, he explains, which, for many, has taken some getting used to.

“It’s an important piece that not a lot of sites think about,” Brown says. “It’s constantly moving. I like to refer to the smartphone space as a hamster wheel of updates. It can be a little daunting to get on it, and once you’re on it, you really have to keep up. If you don’t, that’s where you can introduce risk. The CHCS settlement was a gut check for other providers in the sense that they hopefully are now asking themselves, ‘Are we checking all the boxes constantly? Are there new boxes that we can now check?’”

Great Vendor Expectations

Parkview Medical Center (CO) CIO and Vice President of IT Steve Shirley has seen his fair share of cybersecurity practices, having spent 30 years in banking IT and nearly eight in healthcare. “In banking, we were mandated and audited on our vendor management programs. I routinely went onsite at vendor locations to audit their data centers, review their SaaS70 reports, and determine the overall security posture of the firm. We looked at their financials and did a significant amount of work to ensure the vendor was not only financially strong and stable, but secure, and that our data was safe.”

Shirley adds that security in the financial industry is at a higher level of maturation than in healthcare for obvious reasons. “They have to protect identities and money,” he explains. “Now that health data is under attack, we need to raise security to a higher standard. At Parkview, we’re heavy users of smartphones. The challenge is that in the BYOD world, other than our MDM strategy and provisioning, we don’t have a lot of control over what devices come in the door. And so we expect the highest level of security from our vendors. We include vendor management in our RFPs and require BA agreements for any vendor dialing into our system in any way. This is in addition to the standard requirement when the vendor has access to our data for things like analytical activity.

“When we implement new solutions,” he adds, “we collaborate with them to plan and design for security, whether at the mobile device level or system level. When we partnered with PatientSafe Solutions to roll out PatientTouch on the iPhone for services ranging from bedside medication verification to care team texting and communications, we brought in all of the vendors involved to develop a system that was not only reliable and functional, but also secure across all connections and access points. Six companies were involved: PatientSafe, their wireless vendor, our IT team and wireless vendor, Cisco, and Apple all participated in ensuring the system worked seamlessly and securely.”

Sticks Will Get the Cybersecurity Job Done

With regard to the CHCS breach, Shirley isn’t shy about sharing his opinion. “In the banking industry, I learned that we all mean to do good, but the movement of the day is so fast and furious that things tend to fall by the wayside,” he says. “And so the government stepped in with punitive measures for not meeting security or other standards. Y2K was a great example. The FDIC threatened to close banks if they didn’t have an appropriate Y2K strategy. I pray every day my hospital doesn’t get attacked and a breach occurs. As regretful and tough as the fine is, it’s a necessity because it creates an industry wakeup call for those who haven’t realized healthcare is under attack.

“It seems that while people understand that systems like servers, desktops, laptops, etc. are highly susceptible to attack if not properly protected, there’s a perception that smartphones are different,” he explains. “We, both industry and our consumers, need to get serious about understanding that a smartphone is a device that has access through the Internet and is thus vulnerable.”

Grace Hua, director of product management, clinical communications at PatientSafe, is of a like mind in her belief that hospitals should demand that vendors provide technology support and safeguards for clinician end users. “This should be a wakeup call not only for BAs, but for the industry as a whole,” she says in reference to the CHCS news. “BAs need to fully understand the importance of the data they are potentially putting at risk, and the implications of theft or security breach, as that data now has a dollar value tied to it. Hacking is now just as profitable in healthcare as other industries.”

Increasing Staff Awareness

When it comes to safeguarding smartphones and patient PHI, Shirley and his team are taking proactive measures to keep CHCS-type incidents at bay. Higher-level efforts include membership in security organizations like the SANS Institute and making sure that new technology deployments include a project milestone for evaluating and understanding potential security risks, and then developing a plan to mitigate them.

“This seems so intuitive,” he says, “but I think it is sometimes not the highest priority in the deployment of healthcare systems. Examples of this include installation of modalities for radiology that have communications facilities onboard, or even simple things like network printers.”

Shirley is especially excited about boots-on-the-ground efforts at Parkview. “We have a network security engineer who, in addition to his technical role, is responsible for security education. He regularly visits units during their daily huddles to give security tips like how to create strong passwords or how to validate that the person on the phone is authorized to receive information. Throughout the hospital, we use our digital wallboards to deliver security messages to everyone onsite. Our employee and physician newsletters have standing articles about safety. We’re also putting together a security video that will be required viewing for all employees. The effort has been huge in the last year to increase staff awareness.”

A Rising Tide Lifts All Cybersecurity Practices

Shirley is happy to report that his colleagues at neighboring institutions are paying just as much attention to securing mobile devices. “Two years ago, I would have said healthcare organizations are not paying enough attention to cybersecurity protection,” he says. “Now, I’m seeing new and extreme efforts every single day. Recently, a competitor healthcare system went to two-factor authentication for external access, and I think that’s awesome. At Parkview, we’ve implemented MDM for all of our devices. We don’t store data on laptops or mobile devices, and we don’t deploy any mobile hardware that hasn’t been encrypted. I think the industry understands healthcare is under threat and there are many points of potential vulnerability we need to address. It’s absolutely becoming more of a focus.”