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Acquisition Announcements 2/11/19

February 11, 2019 News No Comments

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Francisco Partners acquires Qualcomm Life from Qualcomm and will restore the name of Capsule Technologies, the medical device connectivity business that Qualcomm acquired in 2015. The business also includes the 2Net medical grade mobile connectivity platform. Qualcomm announced in June 2018 that it was seeking a buyer for the Life division.

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Patient communications and nurse call vendor Critical Alert Systems will acquire nurse call analytics vendor Sphere3 Consulting. 

From HIMSS 2/10/19

February 10, 2019 News 4 Comments

From Degree Checker: “Re: Hal Wolf. WTF on his undergrad degrees and no advanced ones?” I’m not quite sure how Hal’s undergrad-only degrees in business and textile management became the perfect qualification for running the sprawling HIMSS (although I bet he wears really nice suits), but quite a few people in the industry show little evidence of academic achievement or curiosity. However, my dichotomy is this: while I sometimes share the urge to belittle those whose educational accomplishments seem inferior to my own, I appreciate those who lacked the resources or connections to attend big-name schools (or to graduate college at all) yet made their mark purely on their ability and/or ambition. My classroom knowledge has often proved laughably simplistic as I mounted a feeble argument with someone who toils in the trenches every day. I remember that despite my freshly minted MBA, I struggled with the practical impact of depreciation and PTO balances on our health system IT budget until someone who didn’t have a degree provided stories that helped me keep it straight. Therefore, I will save my wrath for those who lack both education and work achievement, holding firm that Twitter-professed enthusiasm offsets neither.

From Overhead Opener: “Re: this article pitching a specific EHR vendor’s app. Looks like pure shill work.” I agree. I won’t mention specifics since what I’m about to say is unkind. The author is a notoriously self-promoting gasbag (I edited out the other kind of bag that I originally wrote) and the site isn’t exactly known for the purity of its journalistic endeavors. The author’s LinkedIn lists no degrees and no work experience outside of marketing, which is exactly what this crap piece smacks of despite being labeled as some sort of thought leadership. All of the author’s recent articles for that site pitch the products of specific companies under the guise of identifying big-picture trends.

From Green Around the Gills: “Re: Greenway’s DoJ settlement. There are a lot of extremely vindicated former (and current) Greenway / Vitera employees out there this week. Too bad Tee Green just got himself named chairman by Streamline Health. There really isn’t a lot of justice in the world.” I’ve learned from experience that those people at the top tend to stay there. My takeaway: when the captain of the ship sprints for the lifeboats, the rowers had best be considering their escape route, which probably doesn’t include the typical C-level exits of moving to another executive role, taking an investment firm job, or sitting profitably on company boards. Those aren’t rower benefits, but perhaps provide incentive to seek situations that are less dependent on the whimsy of those who are, like everybody else, mostly interested in their own outcomes.

Since I’m complaining about misleading clickbait posing as journalism, here’s my full disclosure: despite my headline, I am “from HIMSS” only mentally, not yet physically (that happens Monday at the last possible minute). This is just my pre-HIMSS19 warm-up stretch before the real exercise begins.

I criticize HIMSS a lot (because they give me ample reason), but let me be clear – they are unbelievably good at running conferences. Their slips won’t be showing this week. Everything will seem to unfold effortlessly, every microscopic detail will form one pixel of the big picture, and you will leave at the end of the week having seen a polished show in which the props, backstage workers, and a year of planning stayed out of the spotlight. Groups are often lured into starting their own conferences because HIMSS and others make it look deceptively easy to draw a satisfied crowd in the absence of a large staff or budget, but it doesn’t work like that.

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This week’s Orlando weather is looking good, other than prediction of a slightly bleaker Wednesday that exhibitors will love because it will keep attendees inside.

Many attendees – including Dr. Jayne – aren’t so lucky with their weather at home, as folks are having their flights to Orlando delayed or cancelled. 

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Text me interesting news, rumors, and photos during the conference. It’s a burner, so I’ll likely ignore voice calls and block the inevitable PR spammers. I’ll just be cruising the exhibit hall and convention center hallways looking for examples to share of both good and bad behavior.

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Thanks to Dimensional Insight, which celebrated its “Best in KLAS 2019” for business intelligence and analytics by increasing its level of HIStalk sponsorship.

Speaking of that, Lorre is offering a deal to companies that want to sign up as sponsors or upgrade their sponsorship, a reward you get only for having the perseverance and ingenuity to find our tiny, poorly positioned booth buried in the exhibit hall alleys (hint: it’s near the place where guys come out checking their zippers – no outside jokes allowed, please).

Buffalo-based Catholic Health will implement Epic. I think they’ve been on Cerner Soarian for many years.

Also choosing Epic – Saudi Arabia’s King Fahad Medical City. Cerner is usually stronger in that part of the world, but Epic’s go-live at Johns Hopkins Aramco Healthcare a year ago may have established a figurative beachhead.

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I’m not too bothered by non-experts running underfoot throughout the exhibit hall snapping selfies and acting important, but charging vendors for in-booth appearances while riding the HIMSS social media ambassador coattails seems inappropriate. However, HIMSS itself rakes in a lot of vendor cash for providing exposure and access in blurring the ethical line, so at least it isn’t being hypocritical in insisting that pay-for-play be ended or even clearly noted. I should run a poll of how many readers have been “influenced” by each “influencer,” although I expect they would implore their Twitter followers to stuff the ballot box to validate their self-imagined importance.

Buzz suggests that ONC may announce its long-delayed information blocking rules this week.

Decisions, brought to you by Definitive Healthcare:

  • Kenosha Medical Center (WI) will replace teleradiology from REAL Radiology To Envision Physician Services in 2019.
  • Central Peninsula General Hospital (AK) moved from NightShift Radiology to REAL Radiology on February 1.
  • Island Hospital (WA) replaced Nightshift Radiology with REAL Radiology on February 1.

Business Insider ponders the $1.8 billion paper valuation of Medicare Advantage insurer Devoted Health, started up by Ed and Todd Park (formerly of Athenahealth) even with zero customers or revenue so far. That must be one fantastic slide deck.

More birth tourism news: a couple from China who paid a company to get them into the US for their baby’s delivery hightails afterward back to China, leaving their hospital bill unpaid and leaving their baby still in NICU because it was born with birth defects. China’s one-baby policy was recently expanded to two and may be eliminated entirely as the country faces economic stagnation, which should reduce some of the barbaric health practices that the law caused.

News 2/8/19

February 7, 2019 News 3 Comments

Top News

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Greenway Health will pay $57 million to settle Department of Justice allegations that the company falsified the certification process for Prime Suite EHR and paid kickbacks to customers who recommended its product.

DoJ accused Greenway of falsely obtaining 2014 Edition certification by modifying its software to look as though it used standardized clinical terminology. DoJ also says Greenway failed to correct an error in its calculation of the percentage of patients who were given clinical summaries, allowing Prime Suite users to inappropriately earn EHR incentive payments.

Greenway also entered a five-year HHS OIG Corporate Integrity Agreement, pledging to:

  • Hire a third party to review its software quality control
  • Notify customers promptly of known software bugs that place patient safety at risk
  • Offer free upgrades to the latest version of Prime Suite or provide free data conversion to another EHR upon customer request

HIStalk readers have been reporting red flag rumors for several weeks. Greenway recently recommended that customers file a MIPS hardship exemption because Prime Suite was calculating their measures incorrectly


Reader Comments

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From CICIO: “Re: CHIME. In between extended breakfasts with consultants, strategic vendor partnerships lunches, and evening bashes to unwind from the long day, CHIME members can earn up to $2,400 by participating in focus groups while at HIMSS. To acquire that windfall you do need to spend almost 20 hours sequestered in hotel meeting rooms with vendors, so value will be in the eye of the beholder. There should be time to get to the booth of the vendor showcasing the AI powered blockchain bots for patient engagement.” I really dislike the idea of encouraging vendors to buy time with prospects, not to mention the HIMSS practice of segregating CIOs off on their own private conference tracks far from the unwashed so they can charge vendors more for access to them. Any time someone says it’s not the money, it’s the money, even if they do call it honoraria to make it sound less greedy. On the other hand, CIOs are paid plenty well enough that earning just $100 for fidgeting through a 90-minute vendor pitch shouldn’t be attractive. I should get someone to take names of the vendors and CIOs who play this rather seedy game. Imagine a CIO having to explain their attendance to patients of their hospitals who can’t pay their inflated bills.

From Imran of Imuran: “Re: sports spread. Explain again how it isn’t what people think.” Most sports betting in this country involves bookmakers setting a spread as a risk management strategy. It’s not the consensus opinion of sports experts of who will actually win or lose the game and by what margin, but rather the dynamically recalculated number that will attract an equal number of bettors on both sides. The bookmaker doesn’t care about the game, just having enough losing gamblers to cancel out the winners so they can pocket a predictable percentage as vig without risking wild gains or losses. The spread, therefore, reflects the belief of armchair quarterbacks rather than experts, rather like company share prices.

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From Groundhog Day: “Re: HIMSS TV. Believe they got the year wrong.” Quite a few readers chuckled at last year’s email that was accidentally and obviously repurposed Thursday by HIMSS Media (you know, the journalism people). Still, I’ll forgive sending the wrong email a lot quicker than the fact that last year’s email called Las Vegas “Vegas,” which I detest since surely even we verbally challenged Americans can spit out three full syllables instead of two.


HIStalk Announcements and Requests

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Welcome to new HIStalk Gold Sponsor Oneview Healthcare. The company’s inpatient solution helps patients (education, meal ordering, entertainment, and video chat) and caregivers (rounding, telehealth consultations, screencasting, and service requests) in improving patient experience, clinical outcomes, and caregiver productivity and satisfaction. It offers the Connect mobile app for outpatients, Pathways for managing clinical pathways, and a senior living solution. See them in #450 at HIMSS19. Thanks to Oneview Healthcare for supporting HIStalk.

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It seems like only yesterday that I was turning down whiny hospital users who were demanding that part of our underpowered IT budget be used to replace their CRT monitors with the state-of-the-art, $1,500 15” flat panel versions that we approved only for HIM employees (as IT’ers know, employees are always asking for technology they don’t really need for their jobs in seeking a tangible love token of their value, a practice that will send a lot of people to HIMSS19 next week). I noticed a monitor deal I couldn’t pass up this week – a massive 32” Dell for $160. It dwarfs the desk, but it’s pretty great if you regularly open several windows on a single monitor (or if you just like to see really big text).

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It’s been too long since I’ve run outdoors and my previous training app hasn’t been updated for years (even though it’s still listed in the app stores of Apple and Android), so I tried to find a “couch to 5K” type program that includes music to get back into shape without hurting myself. I came up blank except for an app developed by NHS England that unfortunately can’t be downloaded outside that country, as enforced by the app stores. However, NHS offers a great solution – a series of podcasts featuring a trainer’s instruction over music that can be downloaded and played on any podcast player. NHS continues to impress me. Can they open a branch here?

I see from a HIMSS email that pre-registered HIMSS19 attendees can pick up badges staring Saturday afternoon at the airport, outside the luggage “carrousels” (interesting spelling).

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Speaking of HIMSS19, its speakers are dropping like flies as HHS Secretary Alex Azar finds that he can’t unite with all his fellow champions of health after all.

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Here’s my HIMSS guide, which will help you find my sponsors in the exhibit hall’s vast ocean of commercial excess and check out their HIMSS19 activities. Lorre will be in #4085, hoping that you wash up as you leave the adjacent bathroom on the way to shake her hand. No offense to our fellow tiny-boothers, but other than National Decision Support, I’ve never heard of any of them. I might have to reconsider spending the money next year since the return is zero and I have to decide based on how much fun it provides.

I just realized today that I can post the HISsies winners at any time since there’s no HIStalkapalooza that requires fake drama, so here they are.

I won’t run a Weekender on Friday, so we’ll pick it back up here with a Saturday or Sunday post if I have anything interesting, then we begin the snarky booth commentary and skeptical review of mostly pointless announcements that vendors save up for the conference for some reason. Safe travels to everyone going to HIMSS19. 


Webinars

March 6 (Wednesday) 1:00 ET. “Pairing a High-Tech Clinical Logistics Center with a Communication Platform for Quick Patient Response.” Sponsored by Voalte. Presenters: James Schnatterer, MBA, clinical applications manager, Nemours Children’s Health; Mark Chamberlain, clinical applications analyst, Nemours Children’s Health. Medics at Nemours Children’s Health track vital signs of patients in Florida and Delaware from one central hub, acting as eyes and ears when a nurse is away from the bedside. Close monitoring 24 hours a day integrates data from the electronic health record, such as critical lab results, and routes physiological monitor and nurse call alerts directly to the appropriate caregiver’s smartphone. This session explores how the Clinical Logistics Center and more than 1,600 Zebra TC51-HC Touch Computers running Voalte Platform connect care teams at two geographically dispersed sites for better patient safety and the best possible outcomes.

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


Acquisitions, Funding, Business, and Stock

Trinity Health will centralize patient billing in a move that will force 1,650 employees to change jobs or relocate. The 22-state health system will also transfer 450 IT employees who support legacy applications to Leidos as it moves to Epic.

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Orion Health Group founder Ian McCrae plans to take the company private once again after four years on the New Zealand and Australian stock exchanges. He and several other colleagues will form a holding company to buy up the necessary shares to take controlling interest. The company’s stock has fallen since selling off its Rhapsody and population health units to private equity firm Hg last year.

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Health Catalyst secures up to $100 million in a Series F round led by OrbiMed, increasing its total to $392 million. The new funding gives the company a paper valuation of $1 billion.

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From the Cerner earnings call:

  • The company will announce a “refined operating model” at HIMSS19.
  • As usual, it was lower-than-expected low-margin technology resale that caused the revenue miss. I don’t really understand why the company can’t fix this since it bites them every quarter. Maybe they should create a separate company just for technology resale, or perhaps get out of that business entirely if it’s as low-margin as they always say.
  • The company expects that “less than three percent” of its employees will leave under its voluntary separation program.
  • The company added just one ITWorks client in the quarter, increasing its total to 32.
  • ITWorks and RevWorks are single-digit margin contracts.
  • The company formed a separate group to go after big health systems that are buying hospitals and practices and thus want to thin their EHR herd.
  • Cerner will run “kind of an incubator concept” to get ideas to market faster.
  • The EHR replacement market is declining.
  • The company announced that it will start paying a dividend for the first time, saying that 80 percent of comparable S&P companies do it and more investors will buy shares if they earn dividends.
  • Executive bonuses will be changed from just hitting EPS targets to also include revenue and free cash flow.
  • The company expects the VA business to ramp up linearly from $250 million in annual revenue this year to $1 billion in four years.
  • Cerner will look at acquisitions to round out its HealtheIntent platform.

People

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Cambridge Health Alliance (MA) promotes Brian Herrick, MD to CIO.

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MedAptus appoints Susan Sliski, DNP, RN (Harvard Pilgrim Health Care) as CNO.

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Jay Colfer (Acorn Credentialing Solutions) returns to The SSI Group as COO.

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Kevin Weinstein (Analyte Health) joins Apervita as chief growth officer.


Sales

  • HIE NY Care Information Gateway selects the InterSystems HealthShare Patient Index.
  • Children’s of Alabama selects medication safety and stewardship technology from Children’s Hospital of Philadelphia spinoff Bainbridge Health.
  • Billings Clinic (MT) will roll out Health Catalyst’s Data Operating System as part of its population health initiatives.
  • Franciscan Missionaries of Our Lady Health System (LA) contracts with Nordic for managed services for its 18 Epic applications.
  • California-based health data network Manifest MedEx will implement HealthShare patient care record software from InterSystems, and de-duplication medical records software from Verato
  • Atrium Health (NC) will use Koan Health’s population health analytics and consulting services.
  • Reliance eHealth Collaborative, an HIE with members in Oregon and Washington, selects Zen Healthcare IT’s Gemini integration software.

Announcements and Implementations

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MDLive announces GA of MDLive Go, chatbot-managed virtual visit capability that the company guarantees will return a physician-reviewed diagnosis and electronic prescription to the patient within two hours.

Mayo Clinic and Leidos will build an accelerator at the health system’s campus in Jacksonville, FL that will foster research, development, and commercialization of technologies and therapeutics.

Manifest MedEx rolls out Audacious Inquiry’s real-time Encounter Notification Service.

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A new KLAS report on home health EHRs finds that while Homecare Homebase and Epic lead in mindshare, Thornberry (for small agencies) and Meditech (for agencies affiliated with Meditech-using health systems) top the satisfaction list.


Government and Politics

After learning that the VA’s EHR project could balloon beyond its estimated $16 billion budget, lawmakers call for an interagency leader to oversee the EHR overhaul and integration efforts of the VA and DoD. The Interagency Program Office has assembled a task force to determine how to move forward with accountability for both projects and will release its findings by the end of the month.


Other

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Facebook will launch a tool that will allow hospitals, blood banks, and the Red Cross to ask for blood donations. Users who opt in will receive notifications of blood shortages in their areas. The company launched a similar feature in Brazil, Bangladesh, Pakistan, and India, where users are allowed to approach one another with donation requests – a capability that has led to several shady black market blood deals.

An NHS report determines that aging IT systems have become detrimental to the health service’s 11 screening programs, which are maintained by a legacy database that depends upon a variety of IT systems that are between 10 and 30 years old. NHS came under fire last year for an IT oversight in its breast screening program that resulted in a failure to encourage 122,000 women to obtain screenings over a nine-year period, likely contributing to the early deaths of 270 women.


Sponsor Updates

  • Formativ Health’s enterprise-wide scheduling solution, DASH, is now available on the Salesforce Appexchange.
  • With the help of Meditech’s integrated supply chain functionality, East Tennessee Children’s Hospital will save $1.3 million in costs this year.
  • Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the Society for Maternal *Fetal Medicine February 11-16 in Las Vegas.
  • PatientBond identifies five psychographic segments through analysis of its fifth national market research study of healthcare consumers.
  • VentureFizz profiles PatientPing and its new Boston headquarters.
  • CB Insights names Qventus as one of 2019’s 100 most innovative AI startups.
  • Sansoro Health’s 4×4 Health Podcast convenes experts to discuss health IT predictions for 2019.
  • DrFirst and Meditech partner to give EHR users the ability to access California’s Cures 2.0 PDMP.
  • SymphonyRM will sponsor and present at the Healthcare Marketing & Physician Strategies Summit May 21-23 in Chicago.
  • TriNetX benefits from Snowflake’s data warehouse built for the cloud.
  • Spectralink certifies Imprivata’s Mobile Device Access for its Versity enterprise smartphone.
  • HGP publishes its January health IT insights.
  • Nuance rolls out its virtual assistant technology to Dragon Medical One users.
  • Holy Redeemer Health System expands its partnership with Prepared Health’s post-acute management EnTouch Network.
  • Meditech adds an Opioid Stewardship Toolkit to its Expanse EHR.
  • PCare integrates Mobile Heartbeat’s MH-CURE clinical communications and collaboration technology with its interactive bedside patient system.
  • Collective Medical names Allison Barlow (Allison Barlow HR Consulting) head of people.
  • Lightbeam Health Solutions releases Version 3.0 of its population health management software.

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HISsies 2019

February 6, 2019 News 1 Comment

News 2/6/19

February 5, 2019 News 8 Comments

Top News

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Cerner reports Q4 results: revenue up 4 percent, adjusted EPS $0.63 vs., $0.58, meeting earnings expectations but falling short on revenue.

The company announced plans to start paying a quarterly dividend of $0.15 in Q3 2019.

Also in Cerner news, the company will lay off 129 employees at its Augusta, GA office on March 31, according to WARN Act filings. I assume that’s at Augusta University Health, which I believe outsourced IT to Cerner a few years back but seems to be using at least some Epic now.


Reader Comments

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From Slack MF: “Re: Slack. Looks like it’s getting into healthcare.” The CNBC story suggesting that Slack will target the provider market for information sharing is is a stretch, based on the collaboration technology vendor’s security page being updated to say that its product is HIPAA compliant. It’s good practice for general tech vendors, especially those like Slack who are about to IPO, to make sure they meet HIPAA business associate requirements, but that doesn’t mean they will go after that (or any) end user market specifically. Slack is like Salesforce in offering the core technology and leaving most of the industry-specific content to third-party app developers, so I would expect its new HIPAA status to create interest among vendors to use its API to develop new healthcare tools, such as patient messaging and engagement. I wouldn’t expect Slack to suddenly delve into a specific healthcare product and sell it directly, especially as it tries to optimize its first few quarterly reports. A lot of time and energy is being wasted speculating on whether or how Amazon, Google, or other tech giants will invade healthcare instead of just waiting to see what they announce. Meanwhile, if you’re a health IT vendor dealing with PHI and are looking for a pivot or expansion area while riding some big coattails, give Slack’s API specs a look.

From Amish Avenger: “Re: ICD-10. It’s interesting that people can submit ideas for new terms.” An expert says CDC is overwhelmed and thus way behind in reviewing code requests for newly discovered rare diseases, with the ICD-10 codes being important for quantifying each condition’s prevalence and for performing research. The article also notes that ICD-11 is scheduled to take effect on January 1, 2022.

From Talking Dead: “Re: broadcasting from HIMSS19. Who is consuming all of those podcasts, fake TV shows, and audio and video interviews that clog up the exhibit hall aisles?” No one. It’s just a vanity project for the people who produce them. Just because someone lugs video gear around the exhibit hall or perches in front of the lights answering questions doesn’t mean anyone else cares. I recall few times that I’ve even glanced at those videos and no times that I missed anything when I didn’t. I notice that some questionable sites are taking vendor payoffs to do their interviews and gabfests directly in their booths, which should immediately evaporate whatever credibility they had in the first place (think Fyre Festival, and I’m resisting hard saying FHIR Festival).


HIStalk Announcements and Requests

Expectations were appropriately low for Super Bowl halftime performer Maroon 5 — which has racked up a puzzlingly long yet entirely undistinguished career peddling corporately-crafted drivel like “Moves Like Jagger” — but the bland – er, band – managed to underwhelm anyway. The dull show, which bisected a dull game, sent America to console itself in guacamole and wings. Here’s my too-late, Georgia-focused alternative of some real music: get REM to reunite, maybe with the B52s backing (as long as they don’t play “Shiny Happy People”). My set list: (1) “Texarkana;” (2) “What’s The Frequency, Kenneth?;” (3) “Losing My Religion;” (4) “Man On the Moon;” and (5) the obvious and appropriate closing number, “It’s The End Of The World As We Know It (And I Feel Fine).”

Dann, who started the HIStalk Fan Club on LinkedIn forever ago, tells me it has over 3,700 members. I don’t look at it unless someone’s asking me for a favor, in which case seeing that logo on their profile makes me a lot more likely to help.


Webinars

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


Acquisitions, Funding, Business, and Stock

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Premier Inc. announces Q2 results: revenue up 3 percent, adjusted EPS $0.66 vs. $0.50, beating expectations for both. COO Mike Alkire said in the earnings call that the November acquisition of Stanson Health was highly strategic and its decision support product is selling well, although that business’s revenue is only in the $3-5 million range.


Sales

  • Four hospitals in Europe choose Hyland Healthcare for enterprise imaging.

People

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Healthwise hires Daniel Meltzer, MD, MPH (Blue Cross of Idaho) as chief medical officer.


Announcements and Implementations

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A new KLAS report on EHR/PM systems for practices of 10 or fewer doctors finds that they’re looking for products based on functionality, usability, and support – they don’t care much about about outcomes or technology. NextGen Healthcare, CureMD, and Aprima were the vendors most aligned with those product attributes, while the lower user satisfaction with CareCloud, Cerner, and EMDs may be due to their technology focus.

MedStar Health’s National Center for Human Factors in Healthcare and the American Medical Association launch “See What We Mean,” a campaign for EHR safety and usability. It asks people to sign a letter asking Congress to push ONC to implement the EHR Reporting Program that was mandated in 2016 by the 21st Century Cures Act.

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Baylor Scott & White Health and Memorial Hermann end their merger discussions.

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In England, NHS Digital publishes its front-end code in GitHub to help third parties build mockups, prototypes, and working applications that connect to NHS’s websites and services.

CommonWell announces a Connector program in which health IT vendors can connect to its services through a CommonWell integration member without joining CommonWell themselves.

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“A Machine Intelligence Primer for Clinicians” by Alexander Scarlat, MD is now available on Amazon. He wrote the 12-part series on HIStalk and he clearly knows his stuff from both a machine learning and MD perspective.


Other

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The US Patent Office publishes a 2017 Google patent application for AI-powered software that would use aggregated EHR information collected via FHIR to predict and summarize medical events, sending its findings to individual providers as a patient timeline. The focus seems to be on mining valuable information that would otherwise be lost in the EHR clutter, including a quote, “A wealth information creates a poverty of attention.” I can’t figure out how some sites concluded from the patent application that Google is developing an EHR.

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A study published in Health Affairs finds that hospital prices – not those of physicians who bill for services they provide in hospitals – are responsible for driving up healthcare costs, according to the first research to distinguish between the two. Hospital inpatient prices increased 42 percent over eight years. The data came from the Health Care Cost Institute, which made headlines recently when UnitedHealthcare said that it will no longer share its claims information with the organization.

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We’ll need a new ICD-10 code for the time doctors spend debunking the dopey and sometimes dangerous health ideas of Gwyneth Paltrow’s Goop, which has bagged a docuseries deal with Netflix from which GP will dispense the “more strategic, bigger stories we want to tell,” presumably to gullible women who trust that Gwyneth’s “lifestyle brand” products (vitamins, sex toys, cookbooks) will help them lead the full lives that have otherwise escaped them. We’re in the public health danger zone when people trust obviously underqualified “experts” or their own “feelings” to decide which parts of proven science they choose to ignore.

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Doh! The Super Bowl featured a male Nipplegate, so now we have a HIPPAgate.

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A former nurse of Vanderbilt University Medical Center is indicted for making a medical error in which she injected an elderly patient with the paralyzing agent vecuronium (Norcuron) instead of the ordered sedative midazolam (Versed) that was intended to to overcome the patient’s claustrophobia before having a PET scan. The nurse withdrew the wrong medication from the automated dispensing cabinet after typing in the letters VE for versed, then after not finding the drug’s name, overriding the system to gain access to the vecuronium. The patient was left alone in the scanner for up to 30 minutes where she experienced cardiac arrest and brain death, then died the next day after life support was turned off. The Tennessee Bureau of Investigation charged the nurse with reckless homicide and impaired adult abuse after Vanderbilt fired her. So much for a non-punitive culture that encourages a review of errors to help prevent more instead of coming down hard on a professional who makes a mistake (which is all of them). Having reviewed thousands of medical error reports in hospitals over the years, I guarantee that the “Swiss cheese effect” was in place, where the nurse’s carelessness wasn’t the only procedural irregularity that day. For example, the CMS investigation contains these big red flags that go beyond an incompetent nurse going rogue:

  • Pharmacy had not approved the nurse’s dispensing cabinet override.
  • The nurse didn’t document the administration in the EHR after asking the charge nurse how to do it, being told that “the new system would capture it on the MAR.”
  • I assume barcode verification was not used since it should have prevented the error, perhaps because the medication was administered in radiology rather than in the usual patient care areas.
  • The nurse was assigned as a “help-all,” for which no specific job description exists.
  • She was talking to an orientee who was assigned to her while she was working hard to obtain the wrong drug.
  • The nurse was asked to administer the drug in the radiology department, but she wasn’t assigned to work in radiology, so she left the patient immediately after injecting her.
  • The radiology control room had cameras, but they don’t show sufficient detail to detect whether a patient is breathing. The techs assumed that the patient’s eyes were closed because of the bright lights.
  • The nurse gave the patient’s primary care nurse the bag containing the medication vial immediately after the injection, but that nurse didn’t look at it for 15 minutes because he was charting.
  • The event occurred on December 26, 2017. I would have looked into whether VUMC’s Epic go-live on November 2, 2017 might have contributed to the error because of the related changes (ADC interfaces, labels, documentation, etc.)
  • That date might have had its own impact – the radiology department told CMS they were swamped that first day after Christmas. Staffing levels may also have been affected in that vacation-popular week between Christmas and New Year’s Day.

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A Canada-based cryptocurrency exchange says its clients will lose their $190 million in holdings after the only person who knew the password to its storage system – the company’s 30-year-old founder – has died. Questions are understandably being raised about whether perhaps his death was faked and he’s off somewhere having fun with the money given that currency-moving transactions have occurred after the account was locked. Not that cryptocurrency attracts scammers or anything.

Super Bowl viewers seemed mostly unimpressed with the all-important commercials, but this one from Microsoft is not only touching and relevant to the company’s business, but it’s also an ode to diversity, inclusiveness, and resilience that the country can certainly use.


Sponsor Updates

  • Mobile Heartbeat’s 2018 monthly active user count for its MH-CURE communications and collaboration platform doubled year over year, with hospitals averaging 1,150 regular users.
  • Providence St. Joseph Health expands its use of provider data management and patient access solutions from Kyruus.
  • AssessURHealth will participate in the Startup Grind Global Conference February 11-12 in Silicon Valley.
  • Culbert Healthcare Solutions will exhibit at the WRUG Winter Conference February 14-15 in Las Vegas.
  • UConn Technology Innovation Program’s first growth award goes to Diameter Health.

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Monday Morning Update 2/4/19

February 3, 2019 News 11 Comments

Top News

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Dignity Health and Catholic Health Initiatives complete their merger to form the 142-hospital, $29 billion CommonSpirit Health.

The new health system said in the announcement, “We didn’t combine our ministries to get bigger, we came together to provide better care for more people.” I’ll be interested to see the post-merger metrics that prove success beyond the “bigger” part.

CommonSpirit Health will be run by co-CEOs (a horrible idea) from its ritzy headquarters in Chicago. The system does not otherwise operate in Illinois.

Interim co-CIOs Laura Young-Shehata and Denis Zerr are running IT until a replacement for Deanna Wise is hired.


Reader Comments

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From Significant Brother: “Re: HIMSS health IT trends forecast. What did you think of it?” I didn’t see anything in it that was particularly insightful or interesting, to be honest, so I didn’t even mention it (plus they called it the “first annual” report, which is a journalistic no-no – you describe something as “annual” only after it has been around for two years). The full-body photo and boilerplate quote from CEO Hal Wolf did little to dispel the perception that it’s just a vanity piece intended to remind everybody how influential HIMSS thinks it is. It also focuses entirely on care providers rather than public health (the former has only a tiny impact on the latter). We have the cliche reference to “the perfect storm” and the yet-again maturing of digital health. The report was obligingly parroted as news by the HIMSS marketing – err, media – division. That group just did a conference tips video that was absolutely painful, ranging from the obvious (wear comfortable shoes, make a schedule, allow enough time between events) to the self-serving (watch HIMSS TV, track down the social media ambassadors as the “celebrities of HIMSS,” and read the vendor-friendly HIMSS publications).

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Here’s my scorecard from two years ago on rating self-proclaimed industry thought leaders, which might work well in scoring the LinkedIn profiles of those “celebrities of HIMSS” in the form of social media ambassadors. I hadn’t heard of a particular one, so I checked that person’s LinkedIn and calculated a score of exactly zero — no healthcare experience, no degree, no membership in HIMSS, few health-related tweets, few health-related followers, and a ton of Twitter followers that mostly seem to be the phony ones you buy online to look influential.

From Crafty Ploy: “Re: HIMSS. Are you interviewing CEOs there?” No. I attend anonymously with a phony name, job title, and employer name on my badge. I meet with no one, attend no parties, and don’t even utter the word HIStalk. I just trudge the exhibit hall and then go back to my VRBO place to write up what I saw and heard. You can’t be objective while hanging out with executives or sucking up trying to bag ego-flattering speaking engagements or advisory board positions. Remaining anonymous keeps me objective and transparent since it’s all right here on the page.

From Truant: “Re: Best in KLAS. I didn’t see some department systems in there, like pharmacy.” Best-of-breed ancillary systems have mostly died off. First to go were pharmacy and medication administration systems (due to the need to integrate with ordering), then radiology, and finally lab systems. Those departments liked their standalone systems better, but were outvoted in favor of enterprise integration. About the only survivors in hospitals – and it’s a short-term position as Cerner, Epic, and Meditech eat the world – are LISs from Orchard, SCC, and Sunquest. You do not want to be a standalone hospital system vendor whose company future depends on your customer not ousting you in favor of their EHR’s integrated module. The appeal is obvious — integration becomes a single vendor’s problem and you’re down to one throat to choke.

From Ignoble End: “Re: doctors getting lap dances to prescribe opiates. What’s the world coming to?” The world has already arrived at this destination. Regardless of their expressed noble intentions, everybody (doctors, corporations, patients, software vendors, social media platforms, and politicians) will do whatever rewards them the most. Your only hope is that their most-sought reward is something more altruistic than cash, but you’ll be wrong in most cases. It’s also true that doing something slimy that involves only a relatively small punishment is still a net win. It’s nice but unreasonable to think that doctors are more virtuous than the rest of us.


HIStalk Announcements and Requests

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Three-fourths of poll respondents say they’ll be working harder next week, with identical percentages for attendees as well as those left behind. Let’s agree not to think about how much productivity is lost from attending the annual spring boat show.

New poll to your right or here: Did the VA make the right decision in abandoning its Epic schedule pilot and implementing Cerner instead?

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My once-yearly reader survey has drawn the usual mix of positive and negative, but I appreciate every response equally because someone cared enough to fill it out — indifference kills more sites than anything. One randomly chosen respondent will be reimbursed (aka “paid,” but we coyly don’t call it that in healthcare) with a $50 Amazon gift card, so fill it out and nobody will be the wiser whether you’re being nice or just looking for Amazon giftage. I try not to peek before all responses are in, but I’m touched by how many folks have kept reading even after they retired or moved to other industries, as well as by those who apparently worry daily that HIStalk will have gone dark because I’ve lost interest or died (I’m hoping for the former if forced to choose). I can also say that while my audience is self-selecting, I’m sitting on a treasure trove of their feedback that tells me why they keep reading year after year and everybody knows that rewarded behavior is likely to recur.

Here’s the digital technology that could revive Apple and maybe some people besides – create a real-time sensor for measuring blood levels of alcohol and recreational drugs, or use existing ones to detect overdose symptoms and call a pre-defined friend for help.

I got wrapped up in the music that was cranking in a small store I was in the other day, picking up on some deep tracks from Pink Floyd and a few other prog bands. The kid working said it was a Pandora Pink Floyd playlist customized via extensive use of the thumbs up/down option, which I always forget about. It had a few missteps, such as Credence and the Rolling Stones because older people listen to older music and fool the algorithms, especially Spotify’s, into thinking the bands are similar. My search for early Pink Floyd jams led me to new music from Rodrigo y Gabriela, a Mexico-based acoustic guitar duo whose all-guitar cover of Pink Floyd’s “Echoes” (from 1971’s “Meddle”) is perfect. I then understandably needed to revisit the stunning original, as recorded by the visionary Floyd live (using their regular touring gear) in the ruins of Pompeii in 1972 with no audience present in a brilliant exploration of a new art form by impossibly god-like band members who were all in their 20s. The contributions of the underappreciated Nick Mason (drums) and Richard Wright (keyboards and vocals) are evident, even more so on “A Saucerful of Secrets.” No crowd noise, no idiots waving cell phones, just the band getting deep into the zone in broad daylight (for some of the tracks) while ignoring the film crew. Just because it’s not loud or flashy doesn’t make it for stoners only. Music as contemplative art for the ages  – what a refreshing idea.

If Pink Floyd isn’t your thing (how is that even possible?) then there’s new music from one of my favorite hard-rocking bands, Norway’s The Dogs.

Dear industry people who aren’t technologists: please stop using the phrase “full stack” immediately. Thank you.

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Orlando’s weather for HIMSS19 is looking about as good as it did in 2017 in my photos from then above, with highs predicted to be around 80 and lows in the mid-60s. You’ll be sunning yourself while sprawling in the convention center’s questionably hygienic grass under that HIMSS sign before you know it.

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Welcome to new HIStalk Platinum Sponsor Avaya. The Santa Clara, CA-based company offers unified communications and contact center products and services. For healthcare, that means collaboration solutions (mobile communications, multimedia, automated workflows); patient services (resource matching, omnichannel solutions, automated administration), and virtual care solutions and outreach. Seamless care team member communication improves outcomes, provides patient support, and keeps EHR information updated; patient services such as digital scheduling, referrals, reminders, and revenue cycle inquiries create a better patient experience; and telehealth video and outreach provide remote access to specialists and care teams and support care plan coordination. See Avaya at #6451 at HIMSS19 for communications solutions demos. Thanks to Avaya for supporting HIStalk.

Thanks to these companies for recently supporting HIStalk. Click a link for more information.

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Webinars

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


Acquisitions, Funding, Business, and Stock


People

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Waystar hires Steve Levin (Connance) as chief strategy officer and Bill Barrett (Connance) as general counsel.

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The SSI Group promotes Mark Blossom to chief data operations officer and Will Israel to VP of enterprise analytics solutions.


Other

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The editorial board of the New York Times warns that 23andMe’s consumer DNA testing performs poorly in predicting the risk of developing chronic diseases because it only recognizes a few relevant genetic mutations and thus isn’t a substitute for medical office testing, calling it “more parlor trick than medicine.” The authors describe the company’s BRCA breast cancer test as “like proofreading a document by looking at only a handful of letters” since 23andMe tests only two rare BRCA mutations while ignoring 1,000 others. The tests also offer predictions for diseases that aren’t most often cause by genetics. The article notes that FDA reversed its decision to allow the company to perform health-related tests only because the company posts a host of disclaimers.

In Australia, a law professor questions why any doctor at Queensland Health can change the medical record of any patient in the nine hospitals where IEMR is live.

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It’s not just this country that spends ridiculous sums erecting ornate hospital buildings that do little to improve patient care or access – the estimated cost of Ireland’s National Children’s Hospital has swollen to $2.3 billion, or $4.7 million per bed. That price doesn’t include IT systems, the research center, and integrating the three existing hospitals that will be combined. The wildly over-budget project is so expensive that only four beds will be added beyond the total of 473 that were already available.

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Here’s a good example of something that clinicians do better than EHRs, at least for now – compare the rise in abnormal liver lab results with courses of drug therapy to see what caused the damage (or false positives, you could also interpret). This might be something that a well-trained machine learning algorithm could have kicked out as suspicious.

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Thanks to ethnographic researcher Sam Ladner, PhD (she’s a female, by the way) for tweeting out the link to this Microsoft paper titled “Guidelines for Human-AI Interaction.” The 18 AI design guidelines it lists include some that are particularly relevant to healthcare:

  • Time services based on the user’s current task
  • Make it easy to invoke and dismiss the system’s service and to correct it when it’s wrong
  • Clarify the user’s intent or “gracefully degrade” the system if the user’s goals are not clear
  • Remember recent interactions to provide user context
  • Personalize the user’s experience by learning from their behavior
  • Notify users when capabilities are changed or added

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This is a fresh take. IT systems often provide value in catching physician mistakes, but sometimes are over-programmed as an enforcement tool by hospital executives and ancillary departments who are convinced that doctors will harm patients without their wise oversight. That’s a dynamic that needs to be better understood – just how clinically autonomous should physicians be? What organizational structures and policies best protect the patient’s interests? Are we expecting too much or too little from the decision-making of doctors? Should we trust them to turn off EHR oversight (like certain warnings or informational pop-ups) that they find more intrusive than helpful? If medical practice is to be standardized and corporatized, what is the best use of physician expertise?


Sponsor Updates

  • Liaison Technologies releases a new executive perspective video, “Digital Transformation Starts With Data.”
  • LiveProcess publishes a hospital emergency preparedness self-assessment quiz.
  • Health systems realize significant financial benefits from AI-driven revenue cycle solutions from Recondo Technology.
  • Pivot Point Consulting will exhibit at the AHA Rural Healthcare Conference 2019 February 3-6 in Phoenix, AZ.
  • Zen Healthcare IT partners with Aigilx Health to deliver healthcare data exchange and interoperability services.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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News 2/1/19

January 31, 2019 News No Comments

Top News

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EHR and practice management company EMDs acquires competitor Aprima.


Reader Comments

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From On the Hunt: “Re: Health Catalyst. Completed its second RIF in six months, with all affected employees working in the HCI division (the former Medicity).” I reached out to Health Catalyst, whose statement I’ll summarize as follows:

  • The company identified an unspecified number of positions that were not financially sustainable as it integrated the former Medicity.
  • The affected employees will be invited to apply for the company’s 40 open positions, where they will automatically be considered finalists.
  • Those who aren’t offered or don’t accept a new position will receive a minimum severance of three months and the company’s help in finding a new job.
  • The company increased headcount from 500 to over 700 in 2018 and expects to add 100 more in 2019.

From Vaporware?: “Re: DoD. I was wrong when I accused Cerner of not being able to share data.” A Bloomberg Law article – of which I can read only the first couple of paragraphs that aren’t paywalled – says that hackers found that the MHS Genesis Cerner system was “not survivable” when military hackers tested its cybersecurity. That sounds like the report from October 2018, but perhaps the formation of a new DoD cybersecurity working group is the new development.

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From Robert Lafsky, MD: “Re: NEJM article. I know you’re not a sports guy, but I’m sending this because of its privacy implications and potential qualification as a Weird News Andy item if you read to the end.” A NEJM case study recaps the abdominal issues of an unnamed 18-year-old professional athlete. It wouldn’t take much to identify him from the article – he plays professional sports in the Boston area; he weighs just 72 kg (so that rules out football and probably basketball); he’s just 18, making baseball a strong possibility, probably on a farm team at that age. I scanned past rosters and found one pitcher from the Lowell, MA minor league affiliate that was the only match, although perhaps the patient has been traded in / out since the medical incident whose date was not indicated. The WNA connection is that the patient’s problems and hospital encounters were caused by a toothpick he had swallowed. I’ve poked my nose (and nearly my eye) with a restaurant sandwich’s well-hidden toothpick more than once, so I’m all for stopping the practice of overstuffing sandwiches to the point that inedible hardware is required to hold them together.


Webinars

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


Acquisitions, Funding, Business, and Stock

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Nordic acquires Canada-based Healthtech Consultants, increasing its headcount to over 1,000.

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RTI Institute becomes a minority equity investor in analytics and population health management vendor SPH Analytics. The nonprofit healthcare research organization plans to help SPH broaden the scope of its research and consulting services.

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Livongo acquires MyStrength, adding the startup’s app-based mental health therapy software to its digital diabetes management program.

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Iatric Systems acquires Haystack Informatics, a patient privacy monitoring startup spun out of Children’s Hospital of Philadelphia in 2014. Terms were not disclosed, though the deal went through Iatric parent company Harris Healthcare. I interviewed co-founder Bimal Desai, MD, MBI in August 2017.

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CNBC reports that GE Healthcare will sell off half of its healthcare business in an effort to pay down debt, a move that, combined with its other planned business dealings, could generate $50 billion. GE plans to take its healthcare unit public later this year.

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Meditech files its annual report: revenue up 2 percent, EPS $1.51 vs. $2.08. Revenue rose to $488 million, the highest since 2014’s $517 million. Last year’s net income of $56 million is by far the lowest since 2014 and less than half of the $124 million that was booked in 2014 specifically. Product revenue has jumped 30 percent in the past two years. The report indicates that the company commendably pays its executives extraordinarily modestly, gives them tiny bonuses, and does not offer them stock options.

McKesson announces Q3 results: revenue up 5 percent, adjusted EPS $3.40 vs. $3.41, beating Wall Street expectations for both. That excludes the huge boost in last year’s earnings from the White House’s generous corporate tax cuts.


People

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Paul Grundy, MD (HealthTeamWorks) joins Innovaccer as chief transformation officer.

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Solutionreach hires Nagi Prabhu (Icertis) as chief product officer.

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Provider management and credentialing company Symplr promotes Amie Teske to VP/GM of provider management operations and Randy Bahr to VP of product development.

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Livongo hires Anmol Madan (Ginger.io) as chief data officer and Julia Hoffman (VA) as VP of behavioral health strategy.

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HealthStream names Scott McQuigg (GoNoodle) as SVP of HStream Solutions.

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Former National Coordinator Karen DeSalvo, MD, MPH joins venture platform LRVHealth as executive advisor.


Sales

  • Total Life Healthcare, part of the St. Bernards Healthcare system in Arkansas, selects medication risk mitigation, e-prescribing, and EHR software from Tabula Rasa Healthcare.
  • The VA will implement UpToDate Advanced decision-making software from Wolters Kluwer Health.
  • Northwell Health (NY) will integrate Jvion’s predictive analytics with its Allscripts EHR to reduce readmissions at 15 hospitals.
  • Sanitas will offer CirrusMD’s white-label chatbot app to patients at its medical centers in Florida.

Announcements and Implementations

Meditech adds Nuance’s Dragon Medical Virtual Assistant to its Expanse EHR and enhances its population health capabilities using data and analytical insights from Arcadia.

New York HIEs HealthlinkNY and HealtheConnections will merge to create the state’s largest HIE, covering 26 counties.

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KLAS issues its “Best in KLAS 2019” report, with overall software suite rankings above and these winners being the most interesting to me:

  • Large hospital EHR: Epic
  • Large hospital patient accounting and management: Epic
  • Community HIS: Athenahealth
  • Ambulatory EMR >75 physicians: Epic
  • Ambulatory EMR 11-75 physicians: Epic
  • Practice management >75 physicians: Epic
  • Practice management 11-75 physicians: NextGen Healthcare
  • Practice management < 10 physicians: Aprima, an EMDs Company
  • HIE: Epic
  • Laboratory: Epic
  • Claims and clearinghouse > 20 physicians: Waystar
  • Home health: Thornberry
  • Long-term care: MatrixCare
  • ERP: Workday
  • Patient access: DCS
  • Front-end EMR speech recognition: MModal
  • Patient portal: Epic
  • Population health: HealthEC
  • Application hosting: Epic
  • Management consulting: Premier
  • Health IT advisory: Optimum Healthcare IT
  • Enterprise implementation: Impact Advisors
  • Implementation support and staffing: Galen Healthcare
  • Partial IT outsourcing: ROI Healthcare Solutions
  • Revenue cycle outsourcing: Navigant
  • Strategy, growth, and consolidation consulting: Premier
  • Value-based care managed services: Arcadia
  • Cardiology imaging: IBM Watson Health
  • Large hospital PACS: Sectra
  • VNA: Carestream
  • Care management: Casenet

KLAS’s Category Leaders include:

  • Community hospital EMR: Athenahealth
  • Community hospital patient accounting and patient management: Athenahealth
  • Care plans and order sets: Elsevier
  • Clinical decision support point-of-care clinical reference: Wolters Kluwer
  • Emergency department: Wellsoft
  • Retail pharmacy: Epic
  • Ambulatory RCM: Greenway Health
  • Ambulatory specialty EMR: PCC
  • Ambulatory therapy / rehab: WebPT
  • Behavioral health: Credible
  • Urgent care: Practice Velocity
  • Business decision support: Strata Decision
  • Clinical documentation improvement: MModal
  • Computer-assisted coding: Dolbey
  • Credentialing: Verge Health
  • Document management and imaging: Hyland
  • Patient flow: Epic
  • RTLS: CenTrak
  • Staff scheduling: Schedule360
  • Physician scheduling: Shift Admin
  • Talent management: Workday
  • Time and attendance: Kronos
  • CRM: Salesforce
  • Secure communications: Telmediq
  • Single sign-on: Imprivata
  • Business solutions implementation: ROI Healthcare Solutions
  • CDI services: Claro Healthcare
  • Clinical optimization: Impact Advisors
  • Revenue cycle optimization: Navigant
  • Transcription services: MModal
  • Price transparency: Change Healthcare

KLAS also released its “Global Best in KLAS 2019,” with the leading EHRs by region being:

  • Asia / Oceania: Cerner
  • Canada: Meditech
  • Europe: Epic
  • Latin America: MV
  • Middle East / Africa: Cerner

Government and Politics

The VA will scrap its sucessful MASS pilot of Epic scheduling and instead use Cerner at all of its facilities. Epic went live on time and on budget after nine months in Columbus, OH and delivered significant improvement in patient access metrics. Epic also offers FHIR-powered Book Anywhere, which allows VA schedulers to book appointments at any site whether they use Epic or not.

Document Storage Systems will integrate the MyCare iMedicware EHR from Eye Care Leaders with VistA at all VA eye care clinics.

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VA Secretary Robert Wilkie downplays the notion that the agency is moving towards privatization in his remarks announcing proposed standards that will allow veterans to seek care outside of the VA system. As vets seek care further afield, the pressure (and media scrutiny) for interoperability between VA facilities and outside providers will likely mount.


Privacy and Security

In Canada, Health Sciences North CEO Dominic Giroux commends hospital staff for the way they handled downtime procedures after a virus took down its IT systems – and those of nearly two dozen area facilities — for several days earlier this month. He says:

  • The IT staff’s quick decision to shut the system down prevented loss of data: “What we’ve learned from cybersecurity experts is that other hospitals who go through similar situations, 80 per cent of the time, decide not to shut down the systems. It ends up being the equivalent of trying to change the engine while the plane is still flying.”
  • The HIS team had to manually re-enter data for hundreds of patients during the digital freeze.
  • A pharmacy robot named Pixie was disabled “with 50,000 unit doses trapped inside it.”
  • Emergency management training that was conducted a few days prior helped hospital leaders keep staff calm and focused so that clinical care was not affected.
  • The hospital used runners to deliver lab results.

Other

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In Australia, Queensland’s Department of Health puts a stop to the procurement process for a new patient administration system after discovering that EHealth Queensland CEO Richard Ashby had an inappropriate relationship with a staff member who was involved with the $210 million project. Ashby, who has been under investigation by the state’s Crime and Corruption Commission since last year, has resigned. As CEO, he was also the front man for the state’s struggling ieMR EHR roll out. DXC and Cerner had been contenders for the new PAS system, which some department employees said was too short of a list, and Cerner got the contract in 2015.

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Interesting: a witness in the federal racketeering case brought against Insys Therapeutics says the drug company hired as a regional sales director a former stripper, who the witness observed at a company-sponsored dinner giving a lap dance to a pill mill doctor (to whom the company also paid consulting fees) in hopes of increasing his inappropriate prescribing of its addictive fentanyl spray.


Sponsor Updates

  • Sansoro Health names Micky Tripathi (Massachusetts eHealth Collaborative) to its board.
  • CarePort Health releases a new video, “Unlock Real-Time Data to Better Manage Care.”
  • CTG appoints Romulo Juarez (Slalom Consulting) managing director, delivery, of its health solutions and life sciences business in North America.
  • Surescripts joins the Elite Partners Program of the National Council for Prescription Drug Programs.
  • QuadraMed partners with LexisNexis Risk Solutions to improve patient matching within its Enterprise Patient-Matching Index.

Blog Posts


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Contacts

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

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News 1/30/19

January 29, 2019 News 2 Comments

Top News

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FDA Commissioner Scott Gottlieb, MD says in an address to the Bipartisan Policy Center that “digital technologies are one of the most promising tools we have for making healthcare more efficient and more patient focused.”

He added that streams of real-world data from EHRs, devices, and medical claims can provide important safety and effectiveness information beyond randomized controlled trials.

Gottlieb says that adding real-world data into regulatory quality programs is a “key strategic priority for the FDA.”

FDA will:

  • Convene stakeholders to develop a framework for incorporating digital systems into clinical trials oversight
  • Bring clinical trials to the patient using data from EHRs and wearables
  • Use software-based learning to analyze real-world data to suggest drug labeling changes
  • Work with universities to develop an FDA curriculum on machine learning and artificial intelligence and to offer a post-doctoral fellowship on AI tools

HIStalk Announcements and Requests

Filling in your HIMSS19 dance card? Check out what HIStalk’s sponsors will be doing there in “HIStalk’s Guide to HIMSS19” (online) or downloadable as a PDF file here. Spoiler: they will be doing presentations (with customers in many cases), cocktailing, donating to worthy causes for each booth attendee, and giving stuff away.

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Also for your HIMSS19 list, please drop by our unbelievably tiny and sparsely furnished booth (#4085), perhaps multi-tasking by swinging by on your way to the adjacent restroom. No swag, no BS, just Lorre (who’s stuck solo in there all week) saying hello and the usual cadre of really cool industry people who seek us out. We have nothing to sell and little to give away, although I expect that our friends at Arcadia will again provide the ever-popular conference first aid kits.

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Perhaps you’ve basked in the verdant Wisconsin summer moments between sessions of Epic training or UGM, fantasizing about drowsing away an afternoon in the company treehouse or spending a lazy day baring souls with Judy over Chardonnay (a milkshake in her case) in a swing chair as the Epic herd grazes contentedly below in the fragrantly rolling fields. Visitors this week will instead be dashing dangerously from bus to building, appreciating only the geothermal heating and the countless fireplaces that adjoin training rooms. Many of us aren’t thrilled about going to HIMSS19, but Orlando’s blue sky and green grass with highs in the mid-70s are probably sounding pretty good right now to Epic employees as they watch their exhaled breath shatter.

Speaking of weather, the AP Stylebook reminds me of yet another pet peeve, this one involving immaculately coiffed TV weather celebrities. It’s the weather that gets warmer, not the temperature (temperatures, or “temps” as they sometimes say, merely increase). I watch zero broadcast TV except when I’m stuck somewhere, but I’m always amazed at (a) the near-ubiquity of “scare weather” intended to keep people panicked in tracking the steady march of certain Armageddon in the form of a few minor impending flurries or sprinkles; and (b) milking what should be a 10-second update (temperatures now and for the next couple of days, chance of rain or snow) into a grinning, gesticulating, graphics-heavy spiel that lasts several minutes as advertisers wet themselves from excitement. I’m also puzzled (not quite annoyed since I haven’t figured it out) by the suddenly rampant use of the word “inform” in odd ways , such as “to inform product strategy.”


Webinars

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


Acquisitions, Funding, Business, and Stock

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Zebra Technologies will acquire healthcare temperature monitoring solutions vendor Temptime.

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Philips will try to dodge trade war tariffs by swapping production to and from the US and China in the first half of 2019. An analyst likes the company’s recently reported numbers, but says that “Connected Care & Healthcare Informatics was, like previous quarters, well below expectations.”

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Interesting: the merging Catholic Health Initiatives and Dignity Health (set to become CommonSpirit Health this week) operate hospitals in 21 states, but none of them are in Illinois even though the combined organization will have its headquarters in a fancy office building on Chicago’s West Loop. A CHI spokesperson says the Chicago office “will house the office of the CEO” even though the 150,000 widgets of production will stay in their non-Illinois trenches. That’s not the stupidest part of the new organization’s plan – the CEOs of both merged organizations will become co-CEOs of the new one, a democratic mess that always results from mergers that one side won’t approve if the other side gets the big chair or more board seats. Co-CEO Kevin Lofton (paid $6.8 million by CHI in the most recent tax year) sits on the board of a drug company and Rite Aid, while Co-CEO Lloyd Dean (his side of the “ministry” paid him over $10 million last year) serves on the board of McDonald’s, so they can do their business stuff far from paying patients. The non-profit, merged ministry’s 140 hospitals will crank out an unholy annual revenue of $28 billion. While I was poring over tax records, I noticed that former Dignity CIO Deanna Wise outearned some of the hospital presidents at an eye-popping $2.3 million for the most recent tax year, eclipsing her CHI counterpart Michael O’Rourke’s $1.3 million. Deanna’s new employer Banner Health paid her CIO predecessor Ryan Smith around $900K.  

Patient scheduling website Zocdoc will start charging physician subscribers for each new patient who books an appointment, abandoning the flat-priced subscription model that has been in place since 2012. One dermatologist says that a new patient appointment will cost him an unsustainable $35. The CEO of the Jeff Bezos-backed Zocdoc helpfully advised that half of New York subscribers would pay less (meaning that .. well, it’s pretty obvious) and adds this insultingly dumbed-down excuse as to why the fee structure the company itself developed now makes no sense since it leaves money on the table: “Providers who receive a greater volume of bookings from our Marketplace have benefited the most from this flat fee structure. However, it has been a less sensible economic decision for the many providers who received fewer bookings via our Marketplace.” Punishing your best customers isn’t usually the soundest business strategy.

Apple reports Q1 results: revenue down 5 percent, EPS $4.18 vs. $3.89, beating expectations for both. The company has stopped reporting individual product unit sales that would likely be embarrassing in the case of the IPhone, whose sales revenue dropped 15 percent year over year, a situation Apple blames on China’s economic uncertainty instead of offering a premium-priced product in a commoditized market. Services revenue was flat at $10.9 billion, representing  13 percent of total revenue.


Sales

  • Summit Healthcare (AZ), an 89-bed specialty provider, chooses Allscripts 2bPrecise for precision medicine. The hospital is also replacing Allscripts Paragon with Sunrise.
  • West Calcasieu Cameron Hospital (LA) will implement Wellsoft EDIS.
  • Northeastern Health System (OK) selects the IntelliGuide financial advocacy and patient eligibility system from PatientMatters.
  • Orlando Health is implementing Collective Medical’s EDie help its ED clinicians identify and support patients at risk of opioid use disorder and those exhibiting opioid-seeking behavior. 

Announcements and Implementations

A former IBM VP says the company fired her after she warned her bosses that their layoff plans would expose the company to age bias lawsuits. She also says she ordered to ignore the federal government’s request to provide the names of those employees over 50 who were laid off from her Nevada business unit as the company attempted to “correct seniority mix.” Catherine Rodgers offers a simple way to resolve the issue: “IBM is a data company, Release the data.” 

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Health Catalyst releases Rapid Response Analytics Solution, which reduces the time required to develop analytic insights by 90 percent by allowing less-technical people to answer their own questions.

Clinical Architecture releases Symedical 2.1 for clinical content management.


Government and Politics

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The VA’s Office of Electronic Health Modernization is recruiting deputy chief medical officers holding the MD/DO degree and state medical license to share EHR best practices, oversee EHR change management, and coordinate with their DoD counterparts. The four-year term positions pay $145,000 to $245,000 per year and require relocation to Washington, DC, Seattle, or Kansas City.

Walgreens will pay $209 million to settle federal charges that it defrauded Medicare and Medicaid by dispensing more insulin pens to patients than their prescriptions called for, falsified claims information, and programmed its pharmacy computer system to prevent its pharmacists from dispensing less than a five-pen box regardless of the quantity actually ordered.


Privacy and Security

Facebook blocks crowdsourced tools that allowed journalists and the public to see how its advertisers – especially those running political ads — target users. Facebook says the change was necessary to protect user privacy under its terms of service.

Singapore’s Health Ministry says the medical records of 14,200 people with HIV were posted online by a previously jailed and deported American who had lied to officials about his own HIV status. Authorities think the information was obtained by the man’s lover, a doctor who formerly headed up a public health unit until he was fired for submitting his own blood samples so that his partner wouldn’t be fired.


Other

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China’s Ping An Health Medical Technology Company installs one of its unstaffed “One-minute clinics” (they don’t really pay attention to US trademarks like MinuteClinic over there) in a highway rest stop, offering drivers and passengers medical advice and prescription drugs that have been “cryogenically refrigerated to ensure their quality.” It’s basically a drug vending machine attached to a Porta Potty-like telemedicine booth. “Cryogenic” actually means using temperatures lower than –238 degrees Fahrenheit, which if the announcement were true would be great for those who enjoy watching liquids explode.

Stanford researchers, including iconoclast John P. A. Ioannidis, warn that healthcare “unicorns” like Theranos often have not published peer-reviewed studies to prove their claims, reiterating a previous definition of “stealth research” in which seemingly brilliant ideas are packaged within aggressive corporate announcements and mass media hype rather than any forms of transparency, accountability, and credibility that might help identify investment thesis holes that range from irrational exuberance to outright fraud.

In Australia, a newspaper’s investigation finds that Queensland Health’s Cerner ieEMR EHR project continues to struggle with mislabeled specimens, missing data, medication errors, and vanished test results. Clinicians in critical areas such as ICU and anesthesia are struggling most after replacing their best-of-breed products. Cost has risen from the original 2017 estimate of $428 million USD to nearly $1 billion today,. Cerner was given a no-bid contract for the project. EHealth Queensland is under investigation by the Crime and Corruption Commission. 

Also in Australia, SA Health will make immediate changes to its Allscripts-powered EPAS project — including applying an upgrade and “rebranding” the system – after an external report criticizes the project’s lack of accountability, poorly articulated clinical benefits, underuse of expert consultants, and lack of physician involvement. The government advocates starting over at two sites to decide whether keep Allscripts, also indicating that it will scrap the billing module for a system specifically built to meet the needs of hospitals in Australia. The project has consumed $229 million of its budgeted $301 million at the 25 percent completion mark. Politicians are arguing whether the software or the implementation is the problem and whether changing the project’s name is just a way of saving face.

You would think marketing people would know how to craft a message that doesn’t instantly make the rest of us roll our eyes, but Illinois Medical District innovation community decides that “launching a new brand identity” is newsworthy, bragging on its “clear, concise, and arresting new creative assets” and reiterating that it offers “the full suite of new branding assets” (the announcement gratingly uses the word “assets” four times in six paragraphs). Change your brand identity all you want, but expect universally negative reaction for thinking that (a) it’s important news; and (b) an announcement is necessary at all, no different than someone issuing a press release touting how much better they look after finally getting new clothes.

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A new book tells the story of Paul Le Roux, a South African computer programmer who made hundreds of millions of dollars selling opioids and other prescription drugs to US customers without ever setting foot here, dealing with small-town accomplices (doctors and pharmacists) who solved his “last mile” problem for cash as customers found his online pharmacies via paid search engine ads. His cartel was run from a laptop, openly publishing pharmacy websites whose ownership was obscured by the domain registrar and servers that be created himself. He branched out into dealing arms; created a fleet of yachts, planes, and drones to move hard drugs around the world; set up his own militia in Somalia; bought gold and laundered money; and hired mercenaries to collect money and kill opponents. He was caught by the DEA in a sting operation after a 10-year investigation by young Minneapolis DEA diversion investigator named Kimberly Brill. This “Breaking Bad” type story has Netflix written all over it.

A woman sues a hospital, claiming that she gave her permission to turn off life support for her brother, only to find that the patient she had been visiting for days was someone else with the same name and similar appearance. Family members gathered to say goodbye to Fred Williams as he died, only to find out as they were making funeral arrangements that their Fred Williams was actually in jail for assault — they had authorized pulling the plug on someone else’s Fred Williams.


Sponsor Update

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  • Audacious Inquiry employees take part in the MLK Day of Service.
  • AssessURHealth will exhibit at the Greenway Health User Exchange February 5 in Atlanta.
  • CoverMyMeds will exhibit at the NACDS Regional Chain Conference February 3-5 in Palm Beach, FL.
  • Divurgent publishes a new white paper, “Navigating Healthcare Through Today’s Cybersecurity Landscape.”
  • Hospital application performance and availability monitoring technology vendor Goliath Technologies achieves its ninth consecutive year of record growth.

Blog Posts


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Contacts

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Monday Morning Update 1/28/19

January 27, 2019 News 6 Comments

Top News

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Sleep apnea equipment and connected health vendor ResMed turns in Q2 results: revenue up 8 percent, adjusted EPS $1.00 vs. $1.00, meeting earnings estimates but falling short on revenue, sending RMD shares down an alarming 19 percent on Friday for a market cap of $13.5 billion. They’re down 8 percent in the past year vs. the Dow’s 6 percent loss, but have more than doubled over the past five years.

The company’s recent health IT acquisitions include Propeller Health, HealthcareFirst, MatrixCare, and Apacheta. It also acquired Brightree in 2016.

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ResMed said in the earnings call that the Propeller Health acquisition gives it a big footprint in the management of high-cost lung disease and also ties in well with ResMed’s at-scale digital health for sleep.

The company will spend $7 million per quarter to fund its joint venture with Verily to identify and enroll sleep apnea patients.


Reader Comments

From Stat of the Onion: “Re: readership. My co-worker and I have a bet on the number of visitors you get on HIStalk.” It runs about 1.8 million unique visits per year, although my vanity requires me to say that I intentionally don’t publish in ways that would boost the numbers in a misleading measure of influence (more frequent posts, individual articles instead of one summary, etc.) I rarely look at the stats and thus am not tempted to use reader-unfriendly gimmicks to increase them.

From Blast Furnace: “Re: Facebook. What happened to your page? Did you change pages or just stop updating it? Can I only see your posts on your website now?” I was using Facebook and LinkedIn only as a cc: for tweets indicating that I’ve published something new, but my third-party tools that made it easy kept breaking because these vendors are always fighting against apps they fear will rob them of user screen time, so I only send updates using Twitter and email updates now. Plus I feel more virtuous not using Facebook and LinkedIn because I kind of hate them both, while I’m only indifferent to Twitter.

From Toxic Waist: “Re: HIMSS19 slogan of ‘Champions of Health Unite.’ What do you think about it?” My kneejerk reaction: (a) they are misunderstanding or misusing the word “champions;” (b) attendees are mostly interested in the profitable business of healthcare rather than the human state of health; and (c) “unite” suggests that HIMSS19 is the convener of every one of these champions when clearly it is not. It’s tough trying to come up with a slogan that attempts to describe the wildly varying healthcare interests of a diverse group, but even more to come up with something that doesn’t sound overwrought or downright stupid like 2011’s “Linking People, Potential, and Progress.” I’ll admit that “Getting You To Buy Stuff With Patient and Taxpayer Money,” “Shouldn’t We Be Disrupted By Now,” and “We Have Booth Swag, Parties, and Vendors Faking Respect So You’ll Feel Important” fall a bit short of lofty.


HIStalk Announcements and Requests

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I worry about making decisions without adequate input, so please take a few minutes to complete my once-yearly reader survey. I will not only be happy, I will align our incentives by dropping your name into the Excel-powered randomization hat for a $50 Amazon gift card.

I sneaked a peek at the reader survey responses in which someone once again suggested that I review big announcements from the past to see how many panned out in historical context. I like the idea, but I don’t really know how to do that effectively (by date? by company?) Your thoughts are welcome. I was just thinking this week about IBM’s giant announcement from a few years ago that it was rolling out a ton of healthcare apps that I suspect either failed or were never actually finished.

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The most common recommendation that poll respondents have for Apple in terms of healthcare is to stay away, followed by continuing its present efforts to develop health sensors and data collection. The only other significantly chosen option was to display and integrate information from multiple systems and providers. Only 6 percent agree with stock picker Jim Cramer that Apple should buy Epic or Cerner, and even then I bet those were pot-stirrers who just want to see what would happen.

New poll to your right or here: what will you be doing during HIMSS19?

The story on hospitals running “wealth screening” reminds me of how confused I was in an early hospital job when I first heard about “the foundation.” Its well-paid SVP had a lot of fingers in the operational pie. He was always out in the community schmoozing movers and shakers using paid-for memberships in the best clubs, coordinating black-tie galas, and cozying up with vendors that we were trying to keep at arm’s length (“I’m not telling you to buy Siemens PACS, only that you tell me why not if you don’t,” he said right before jetting off with some of his hospital cronies to Germany for a junket that Siemens was paying for.) I was naive that hospitals are run pretty much like any big business, work community relationships to their advantage, play community doctors like a chess game, and plan endlessly on how to get bigger. My naiveté was also shattered the first time I saw how differently we delivered care to bigwigs in beds compared to mere mortals.

Listening: new from Long Beach, CA’s Rival Sons. Hard rock will eventually return to popularity and this band will be waiting.


Webinars

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


Acquisitions, Funding, Business, and Stock

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Phynd raises $8 million in a Series B funding round, with three of the four investors representing health systems. The company will invest the proceeds in increasing its its collaboration with Epic and other EHR vendors and to further develop its provider enrollment, management, search, and reporting platform.


Sales

  • MassHealth selects Waystar’s Whole Patient Insight risk scoring of social determinants of health risk.
  • Four agencies of Vermont Care Partners choose Netsmart’s full solution suite to support their work in mental health, substance use, and developmental disability.

Decisions

  • Phelps County Regional Medical Center (MO) will go live with American Well telemedicine in March 2019.
  • Hayes Green Beach Memorial Hospital (MI) switched from Meditech to Epic in December 2018.
  • Eureka Springs Hospital (AR) replaced Healthland (a CPSI Company) with Medhost in January 2019.
  • Bienville Medical Center (LA) switched from Healthland (a CPSI Company) to Medhost in December 2018.

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


Announcements and Implementations

Scotland Health Care System (NC) is implementing Epic.

A federal judge in Madison, WI rules that Epic’s mandatory employee arbitration clause is valid, denying the complaint brought by lawyers of current and former Epic employees that the US Supreme Court’s decision in favor of Epic was unconscionable.


Privacy and Security

An Iowa man is surprised that a hospital’s policy prevents him from viewing his 12-year-old daughter’s medical records without her consent. State law supersedes HIPAA and some leave it up to individual hospitals to decide the age at which the parent can’t view the child’s records without their permission, with the requirements intended to encourage adolescents to be honest in their conversations with providers about substance use and sexually transmitted disease. 


Other

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GeekWire profiles Vyrty’s Sync.MD, which claims to empower patients by letting them take phone photos of their medical records (how they get those is breezily unstated), store them, and then selectively share them with providers to whom they provide a QR code. Doctors can print records to a virtual printer to add them to the patient’s file, which is a good idea. The CEO’s LinkedIn (which shows zero healthcare experience) says the company’s technology involves a smart card, so there’s probably a pivot in there somewhere. Unstated in the brochure-ware is that (a) patients don’t want to screw around collecting and managing their own records, as evidenced by both Google and Microsoft failing to impose their personal health record apps on the world; and (b) clinicians don’t trust patient-managed records because they can’t tell if they are complete and it’s easier to just start firing off orders for a barrage of revenue-enhancing tests and imaging studies. Technologists who have no healthcare experience always fail to understand that hospitals and practices don’t trust the records of their peers, rightly or wrongly, and fear the legal consequence of acting on them inappropriately. My personal experience is that dentists are a lot more interested in the records of new patients than doctors.

Four men sue Texas Children’s Hospital for age discrimination, alleging that the hospital fired them from their senior computer operations analyst IT jobs by requiring them to earn Microsoft or Cisco certifications that were unrelated to their job responsibilities, then replaced them with younger employees who didn’t hold those certifications. 

It’s pretty obvious why plastic surgeons are about the only happy medical specialists, but Daily Beast asked them directly:

  • Their surgeries are scheduled in advance and thus they can control their own schedule
  • They have a high percentage of private pay patients, leaving them mostly free of EHRs, insurance companies, and hospital bureaucrats
  • Their patients provide immediate positive reinforcement
  • Their work varies between cosmetic and reconstructive
  • They work more actively on wellness, including encouraging physical activity at their conferences beyond booth-to-booth hikes (this on seems like a stretch, no pun intended)
  • They make a crapload of cash

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The New York Times notes the odd phenomenon in which Millennials – a generation that is perceived by many to be lazy and entitled — claim they can’t wait for Monday mornings and brag online about how long and hard they work in the “hustle culture” that glorifies ambition as a lifestyle. Experts note that most of the people beating that particular “work is life” drum are shareholding owners and managers, not the workers themselves, and they are insisting on harder, longer workweeks despite data showing that it doesn’t improve productivity or creativity (a la Elon Musk’s push for worker bees to put in a sustained 80-hour workweek peaking at 100 hours) is “grim and exploitative.” Allow me to say from vast experience as a wage slave and overseer of wage slaves – your employer cares only about executives and shareholders, not the breathing, interchangeable widgets that fill cubicles in a modern version of the dehumanizing assembly lines of the early Industrial Revolution. Your life is being wasted if it consists of working for someone else and spending your tiny bit of free time staring at your electronica and cocooning with Netflix. It’s an old but wise adage that nobody’s tombstone says, “I wish I had worked more” and you will see exactly how one-sided the value equation is when your beloved employer marches you out, demotes you, or reorganizes you. If you want to work that hard, make sure it’s your shingle, not a corporate one.

Amazon is using the shopping habits of its customers to target ads, allowing a physical therapy center to aim ads at nearby Amazon customers who had purchased knee braces and a credit card company to push ads at users of competing cards. As a result, experts say Amazon’s ad business is worth $125 billion, with much of the revenue coming from companies willing to pay to have their ads appear next to competing products found in customer searches. An investor calls it “insane scale” when companies can target new parents based on Amazon-stored baby registries or their exact car model entered in its “Garage” section. Amazon can also track user movement among non-Amazon sites to determine, for example, that a diet book customer is now reading CNN and might be profitably invited to buy protein bars. 

Eric Topol, MD critiques the 15 published papers covering the use of AI in medical prediction, saying that their lack of sound methodology means that “we’ve yet to see a validation study in a real-world clinical environment.”

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Microsoft’s top healthcare executive, corporate VP and computer scientist Peter Lee, PhD, acknowledges that his employer along with Google have failed in their healthcare efforts, noting that when Satya Nadella asked him to take the job, he was doubtful: “The tech industry is littered with attempts by shiny CEOs to go after a piece of this massive healthcare pie. I think pretty consistently the tech industry has gone into it with a lot of naïveté, even some arrogance. So my knee-jerk assumption was ‘Here we go again.’’” He seems to be focusing on storing genetic data.

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Federal agents arrest a California nurse for running an online pharmacy that sold 20,000 opioid pills. Carrie Markis, who earned a master’s degree in nursing science and healthcare leadership from UC Davis in 2013 (I found her in the school’s graduation video above), told customers in Dark Web chats that she buys drugs from people who resell their prescription meds for cash, eventually netting herself several hundred thousand dollars. On the bright side, reviews of her online store were nearly all five stars.

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Pay someone to swap seats if you end up next to this guy on a plane. A Pennsylvania man suffering from depression registers his alligator Wally as an emotional support animal. His mood won’t be boosted much when Wally rips his arm off.

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I love this – general practitioner Phil Grimmer, MBChB of Chippenham, Wilthsire, England tweets a photo left by a woman in the room of her mother who has dementia to reassure her about her surroundings. His tweet went viral with over 1 million views, encouraging others to post their own signs and stories for loved ones or patients under their care for cognitive impairment, either to give them comfort or to help caregivers address them in familiar ways and to treat them as people rather than patients.


Sponsor Updates

  • Lightbeam Health Solutions publishes a new e-book, “6 Strategies to Thrive in VBC.”
  • LiveProcess publishes a new e-book, “How Clinical Communication and Collaboration Technology Supports Value-Based Care Objectives.”
  • Mobile Heartbeat will exhibit at the San Diego ANIA Regional Conference 2019 February 1.
  • Netsmart will exhibit at the NY Coalition for Behavioral Health Annual Conference January 31 in New York City.
  • Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the AWHONN South Carolina Section Conference January 30 in Columbia.
  • Experian Health will exhibit at HFMA MidSouth January 30-February 1 in Tunica, MS.
  • Sansoro Health releases a new podcast, “Putting Patient Portals into Practice.”
  • Wellsoft will partner with integration vendor Interface People to offer an ED solution for Meditech customers.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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News 1/25/19

January 24, 2019 News 2 Comments

Top News

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The US uninsured rate rises to four-year high of nearly 14 percent.

The increase was driven by higher premiums, less competition as some insurers pulled out of marketplaces, and the White House’s declaration that “Obamacare is dead” coupled with its elimination of the individual mandate, shortened enrollment periods, and deep cuts in signup promotion.


Reader Comments

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From Will the Real HIMS(S) Please Stand Up?: “Re: Hims. The subscription ‘boner and hair pills’ startup will be what comes to mind to non-health IT folks, although maybe they should book a HIMSS booth considering the demographic. The company uses an HIT-like Silicon Valley formula – find an incredibly complex problem, find a disruptively quick ‘solution,’ and throw a ton of money and marketing at it.” This particular Hims offers web-based doctor consultations that always end up with mailed-out prescriptions for what customers want – generic Propecia and Viagra – without looking a PCP in the eye, all under the highly questionable label of “personal wellness.” They will also sell you overpriced vitamins that any competent doctor would assure you offer no benefit whatsoever. It’s weird how in healthcare people cough up exorbitant amounts just because they saw an ad for something that is worthless at best and potentially harmful at worst, but refuse to pay for actual, sound medical treatment – everybody just wants that pill they’ve heard about (and for someone else to pay for it). Hims targets young, tech-savvy men who, I’m willing to bet, don’t bother to buy health insurance or save money to pay unexpected medical bills. Meanwhile, that reminds of something I’ve mentioned several times from years ago, when HIMSS went on a short-lived tear to suddenly start making its staff say out its name as H-I-M-S-S, which made me want to scream a la Sam Kinison to Rodney Dangerfield in  “Back to School,” “SAY IT … SAY IT.”

From Don’t Touch the Area Under My Curve: “Re: Apple. I know you have a poll going, but what would you do in healthcare if you were Apple?” Probably nothing. Apple’s problem its lack of innovation in a mature market, compounded by the fact that it already rakes in $350 billion in annual revenue — $40 billion of that from services, about the same as the company’s annual profit – and even buying Epic, Cerner, and 10 other health IT vendors wouldn’t kick a dent in its financial universe in the unlikely event that Apple could improve their respective situations. Apple’s services revenue dwarfs everything in healthcare that doesn’t involve pharma or insurers – the App Store, Apple Care, ICloud, ITunes, and Apple Pay rake in the cash, but those are tied directly to use of it hardware (ICloud is one of few offerings that works on other platforms) and don’t require a lot of customer hand-holding or an explanation of why they are useful. Tim Cook’s priorities, other than trying to do a Lazarus on Steve Jobs, should be to make Apple’s upcoming streaming TV a killer app, redo the awful ITunes to better compete with Spotify, and consider making acquisitions in big-scale streaming content, home security, or online photo hosting / filtering (I would have gone for Sonos instead of Beats by Dre with my billion dollars, but that’s just me). If they really want to get into healthcare, how about:

  • Buy AirStrip. It seems to have fizzled out after spending $65 million (no new investment since 2014, no press releases since 2016), earning huge amounts of publicity including a demo on the big Apple stage in 2015 and offering what seemed like a sound product.
  • Buy AliveCor (whose Kardia EKG line is like Apple’s version grew up) or perhaps InPen (insulin delivery).
  • Check out that sweat sensor research work that just came out. We’re not short on phones, just unobtrusive, continuous biomedical sensors that can feed them useful health information.
  • Encourage the development of IOS-only apps that can monitor at-home seniors and connect their caregivers.
  • Buy any one of several companies that offer secure clinical communication and alarm / alert notification, making their product IPhone-only, although selling to enterprises is not Apple’s core (no pun intended) competency.

HIStalk Announcements and Requests

Last chance for HIStalk sponsors — contact Lorre to get your company included in our HIMSS19 guide, which will describe anything cool you’re doing there (giveaways, booth activities, etc.) She’ll even make you a “We Power HIStalk” sign if you really want to impress your booth visitors (well, you’ll impress me, anyway). I’m also still on the lookout for fun celebrities to hang out in our booth for an hour to welcome your followers (if you don’t have followers, you’re probably not really a fun celebrity). We’ve had everybody from former Surgeons General to Super Bowl players to noted authors squeezing into our microscopic exhibit hall space just to press flesh.


Webinars

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


Acquisitions, Funding, Business, and Stock

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NextGen Healthcare reports Q3 results: revenue down 0.6 percent, adjusted EPS $0.20 vs. $0.15, beating earnings expectations but falling short on revenue.

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Optum sues its former VP of Product Strategy David Smith for violating his non-compete after announcing his intention to head up research for the unnamed healthcare venture of Amazon, Berkshire Hathaway, and JP Morgan. The UnitedHealth Group business sees the new company as a threat even though it hasn’t announced how it will reduce healthcare expenses for the three participating companies. Optum alleges that Smith is one of fewer than 50 employees who had access to detailed profit and loss statements, also noting that he printed a confidential company market analysis exactly one minute before printing his resume and then continued printing internal documents until his last day. Smith’s attorneys argue that Optum can’t prove that he is violating his non-compete since neither they nor anyone else knows what he’ll be working on.

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Specialty-specific EHR vendor Nextech acquires competitor SRS Health for an unspecified amount.

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Hospitals are running nightly “wealth screening” analytics on inpatients and then hitting them up for donations. Hospitals such as MedStar, Johns Hopkins, Cedars-Sinai, and NYU Langone use software such as that sold by DonorSearch to identify the small percentage of wealthy inpatients by searching public real estate and donation records. They then send those patients extra amenities (like plush bathrobes) or dispatch a hospital executive to their rooms to schmooze. They are also training frontline doctors and nurses to pass along the names of patients who express gratitude so they can be approached. Ethics experts aren’t thrilled with the practice, but it’s legal since a 2013 HIPAA change that allows hospitals to use protected health information for fundraising. The article describes a retired TV engineer and Medicare patient who resented being pressed for a donation from St. Clair Hospital (PA), which last year reported $48 million in profit and CEO compensation of $1 million.


People

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Banner Health, responding to my inquiry, confirms that it has hired Deanna Wise, former EVP/CIO of Dignity Health, for what I assume is CIO (Banner didn’t confirm her exact title). She was announced on December 4 as CIO of CommonSpirit Health, the 140-hospital, $30 billion Chicago system that is being formed by the merger of Dignity Health and Catholic Health Initiatives, but she left immediately afterward.

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Greenway Health names Kali Durgampudi (Nuance) as chief technology and innovation officer.


Sales

  • Boys Town National Research Hospital (NE) will implement Meditech’s Expanse EHR.
  • Novant Health selects Genesis Automation’s inventory management system to track supply receipt and movement at 15 hospitals, integrated with Epic and Lawson ERP.

Announcements and Implementations

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Carilion Clinic (VA), Inova Health System (Washington, DC), Little Company of Mary Hospital (IL), Summa Health (OH), and TeamHealth (TN) sign on for clinical communication software from PerfectServe.

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DirectTrust reports that its users sent 110 million messages in Q4 2018 as user count increased by 35 percent and organizations served increased by 30 percent.

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NewYork-Presbyterian Hospital will use remote patient monitoring technology from Philips at Weill Cornell Medicine and Columbia University Irving Medical Center.


Other

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The Rhode Island Health Department charges four Rhode Island Hospital ED physicians with medical misconduct after they voluntarily report errors that caused wrong scans to be ordered. The hospital’s users believe the charges are unfair and will discourage safety-minded providers to self-report issues. The hospital, part of the Lifespan network, rolled out Epic in 2015.

Healthcare futurist Jeff Goldsmith doesn’t like owners of health assets that are poorly integrated under single brand name calling themselves “health systems,” noting that their poor performance should raise questions about how much value they create. He says a true health system:

  • Operates assets that work together under a common vision rather than simply owning them
  • Has at its core a clinical entity that is government by actual clinicians and that collaborates under clearly stated professional values
  • Gives patients a seamless experience and consistently excellent clinical care regardless of how those patients enter the system
  • Actively manage cost by using accurate data, clinical consensus, and collaboration

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Amazon adds “smart” hospital rooms from EIR Healthcare to its retail offerings. The MedModular units retail for $814 per square foot and include a bed and bathroom. Shipping is free, but even Amazon Prime members won’t get their new room within two days.


Sponsor Updates

  • Elsevier Clinical Solutions President John Danaher and SVP Olaf Lodbrok share predictions for 2019.
  • Redox announces it nearly quadrupled its year-over-year annual growth in 2018 and increased its network by 500 percent.
  • Docola will add Healthwise educational content for patients to its Care Communication platform.
  • Hyland Healthcare provides connected healthcare solutions to all of US News & World Report’s 20 best hospitals.
  • Gartner names InterSystems to its “January 2019 Peer Insights Customers’ Choice for Operational Data Management Systems.”
  • Kyruus and Providence St. Joseph Health will present on health system digital transformations at HIMSS19 on Thursday, Feb. 14.
  • Mobile Heartbeat will integrate Imprivata’s Mobile Device Access authentication software with its MH-Cure mobile collaboration technology for smartphones.
  • Divurgent and Gevity announce a strategic business alliance to expand their services across the US and Canada.
  • EClinicalWorks releases a new podcast, “PCMH: How Analytics Drive Better Care.”
  • Imat Solutions publishes a new case study, “HASA HIE: Liberating Health Data for Enhanced Population Health in Texas, and More.”

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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News 1/23/19

January 22, 2019 News 5 Comments

Top News

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Medicare patient readmissions within 30 days dropped sharply after CMS started penalizing hospitals financially, but the death rate appears to have increased during the same period. That raises questions over whether the lower readmission rate was created by hospitals turning away older patients with a legitimate medical need just to avoid paying penalties.

The 20-percent readmission rate turned sharply down within weeks of the penalty’s implementation (which raises eyebrows of how that happened so quickly), but a Health Affairs study attributes at least half the decline to Medicare’s simultaneous expansion of billing forms to include up to 25 diagnoses instead of the previous nine.

The corrected readmission rate reduction was 1.3 percent, about the same as reported by hospitals that were exempt from the penalties. More patients who had been admitted for heart failure and pneumonia died, however.


Reader Comments

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From Associate CIO: “Re: Cerner’s voluntary separation program. Cerner still has many overpaid (by KC standards, anyway) associates it inherited with the Siemens acquisition, Brent Shafer has questioned why Cerner has over 400 VPs, and the company has a lot of topped-out associates who have become stagnant after 20-plus years and it needs some new blood to reignite investor interest.” Unverified. My only issue with VSPs is that they target older employees and the volunteers they attract are often the better-credentialed employees who know they can find jobs elsewhere – the lower-demand employees aren’t about to sign up. There’s also the nagging feeling that the executives are second-guessing their own decisions of who to hire and how much to pay, as layoffs are a management failure. Brent as the new guy may have more energy about correcting whatever undesirable situation exists, although I wonder if, as a first-time CEO, he’s worrying too much about impressing investors by applying the easily wielded but blunt headcount scalpel to give the share price a quick goose.

From Coach Ella: “Re: HIMSS. I notice quite a few bloggers are hitting the exhibit hall floor, participating in and promoting speaker sessions as paid by vendors. Is that allowed under conference rules?” Sure. I wouldn’t do it because it’s kind of a cheap sellout to take vendor money for participating in a booth-hosted “education” session of questionable quality, but I don’t begrudge those who do, even though their presence would give me as an attendee yet another reason to steer clear.

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From Savoy Special: “Re: Health:Further. Shutting down after its two-year run of putting on a health ‘festival’ in Nashville. They are refocusing on providing advisory services to larger healthcare firms, odd since it was borne out of the Jumpstart Foundry. The format was unique in offering the opportunity to choose any track within a single large meeting room and for offering collaboration space in the middle of the conference room floor. With the growing competition for attendees from well-funded groups like HLTH, CES, and SXSW, which conference will be the next to fold up?” Health:Further (or maybe it’s now Health:NoFurther) announces that it has pulled the plug on its planned August 2019 event, spinning the news with a subhead of “from meeting to acting” in concluding that a once-a-year event can’t keep up with acquisitions and Silicon Valley’s healthcare interest, so it will pivot into an advisory business. It doesn’t make sense to me, especially since I see little evidence of the organization’s street cred for advising bigger and likely better organizations. My advice to attendees – stay home and do the work your employer is paying you to do and quit wasting company time and money screwing around at low-value conferences (which is most of them) looking for easy answers to your organization’s challenges. Imagine how un-innovative Amazon and Google would be if their executives just copied each other based on seeing what everyone else is doing via conference presentations and networking.

From Tip O’Spear: “Re: email newsletters. You should do an HIStalk one.” I’ll pass, for these reasons:

  • The “open rate” of emailed newsletters – even those that manage to bypass the invincible spam filters – is low. I’ve signed up for several of various kinds and rarely open any of them, having either lost interest or felt misled about the value I would receive.
  • Nobody needs to read industry news every single day. CNN baits you into raising your political blood pressure by making every minor story seem like breaking, relevant news that you need to follow, and other newsletters and sites mimic that reader-unfriendly practice.
  • Newsletters are usually just sterile links to online junk (mostly press releases) as “curated” by faceless, questionably credentialed writers who are willing to work cheap.
  • Newsletters suffer from the same misaligned incentives that exist with most sites – their measure of advertiser success is open rates and clicks (which encourages clickbait headlines), sensationalistic story selection, and articles that run  way too long, all intended to make you spend more time on their site than is necessary. Your time is their product.
  • When is the last time you learned something from a health IT newsletter that allowed you to perform your job better, gave you a career advantage, or led you to feel more fulfilled?

From Robert Lafsky, MD: “Re: NEJM piece on urgent care. A good look from the other side would be a piece by Atul Gawande, where he walks us through a typical day in his surgical practice, accounting for every dollar charged and every dollar collected for every action he takes. The big picture is too big and the problem is at the ground level.” RL references a NEJM piece that I’ll recap below, but in the mean time, this idea is brilliant. I would love to have Atul Gawande describe the downstream effects, especially the financial ones, that emanate like a boat’s wake from his part-time surgery practice. What’s the cost and price of the supplies and drugs that he uses without thinking? How much does he bill and what does insurance actually pay? What’s the hourly cost of running that fully staffed OR? What layers of management are involved in stocking it, cleaning it, scheduling it, and staffing it? How many of his patients experience financial hardship? What documentation is the by-product of a surgical case, how much of that does he input directly, and who benefits? What does he think of competing ambulatory surgery centers? Is he appalled that Partners HealthCare is such an aggressive market bully and pays its executives exorbitantly? (something that he might want to look into on behalf of his new employers).

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From DisCerner: “Re: [CIO name omitted], formerly of [a merged health system]. Now the CIO of Banner Health.” Unverified, so I redacted the identifying information and will update if I get confirmation from my media inquiry. UPDATE: Banner Health confirms that Deanna Wise, former EVP/CIO of Dignity Health, has been hired as CIO. She was announced on December 4 as CIO of CommonSpirit Health, the 140-hospital, $30 billion Chicago system being formed by the merger of Dignity Health and Catholic Health Initiatives, but left immediately afterward.


HIStalk Announcements and Requests

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HIStalk readers are smarter and more motivated than industry slackers, so I would be remiss if I failed to take advantage of your expertise by asking you to take three minutes to fill out my once-yearly reader survey. You’ll not only be helping me decide how to spend my HIStalk time over the next year, you’ll be entering yourself into a drawing (which will require me to spend half a day stretching my minimal, rusty Excel skills into writing a randomization formula) for a $50 Amazon gift card.

I erroneously (or at least prematurely) predicted at HIMSS18 that voice assistant add-ons would be all the rage by now, as EHR vendors seemed anxious to trade paint in trying to become the first to voice-power their software Alexa style. I haven’t heard much since from the companies that seemed to be leading the charge – EClinicalWorks, Epic, and Nuance come to mind. I’m curious if anyone is actually using those assistants and what their experience has been. I see that Vanderbilt is presenting at HIMSS19 on its work to voice power Epic.

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I’m annoyed at the overused, lame pun of “XXX will see you now,” in which “XXX” is a substitute for “the doctor.” When is the last time, other than on black-and-white TV shows, that someone actually said, “The doctor will see you now?” It reminds me of my early days in a small, rural hospital, in which the office nurses who rounded with our poorly skilled but arrogant community-based medical staff reverentially referred to their employer as “the doctor” as though no others existed. I even heard the wives of those mostly foreign-trained, exclusively male physicians – many of whom treated our nurses like lower-caste handmaidens — refer to hubby in social situations as “the doctor,” although maybe that’s a cultural thing. This particular for-profit hospital had a written policy that employees had to clear a path for incoming doctors in patient room hallways, specifically to hug the wall Parting-of-the-Red-Sea style so that the Doctor (administration capitalized it incorrectly to suck up hoping for more bonus-boosting admissions) could proceed unmolested to wreak patient harm more efficiently and then get back to the office to practice their specialty of defrauding Medicare. That sounds bitter and probably is, but our employees had to intervene nearly constantly to keep doctors from killing our patients through their obvious incompetence. Don’t serve on a hospital’s death committee if you want to preserve your healthcare innocence.

Listening: The Budos Band, a nine-piece instrumental Afro-Soul outfit from New York City that is horns-forward in a 1960s “Iron Butterfly meets Chicago and the Ventures somewhere in Africa” sort of way. I was despondent that I couldn’t get Shazam going in time to ID the song playing in the restaurant I was in, but luckily they were tracking just this band and I was able to get the artist on the next song. Their music would be edgier and more interesting than the usual tinkly piano solos for dinner music.


Webinars

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


Acquisitions, Funding, Business, and Stock

NantHealth, whose shares have fallen to $0.70, receives a Nasdaq de-listing notice now that the stock has closed at under $1 for 30 consecutive trading days. Companies usually skirt that issue by announcing a reverse stock split, which accomplishes nothing other than to confirm their failure and to allow them to keep investors at the table as they hope for an unlikely miracle. 


Sales

  • Bergen New Bridge Medical Center (NJ) joins Collective Medical’s network to support opioid monitoring, real-time event notification, and care collaboration.

People

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Quality benchmarking organization URAC hires Shawn Griffin, MD (Premier) as president and CEO.


Announcements and Implementations

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Brilliant: a “high-density parking solutions” vendor opens Manhattan’s largest automated parking system for an unnamed hospital. The robotically operated system provides 119 spaces in a 30,000-square-foot, four-floored structure, squeezing in 30 percent more cars than garages that require space for drivers to maneuver. It looks like valet parking to visitors, but the valet just drops their car off at the automated system’s loading bay. The system is integrated with the hospital’s information system so that customers can summon their cars and pay from computer tablets, allowing them to hop in and leave from the valet desk. The company’s other projects allow human-free operation, where drivers retrieve their car by app. I hate navigating through dark, tight parking garages, nearly always getting stuck behind a clueless visitor who will wait forever for someone to vacate a low-level spot when everybody knows that the entire upper level is surely empty. Pro tip: drive up a couple of levels, then go back down on the other side since few will take the risk of not finding a freshly emptied space there. Pro tip 2: it’s better to park higher if that gets you closer to the elevator since you’ll be walking horizontally, not vertically.

Allscripts offers free genetic testing to its employees via its 2bPrecise subsidiary. Free or not, I wouldn’t want my employer – who likely provides my health insurance and makes cost-benefit decisions about each employee – potentially learning my genetic predispositions.

King’s Daughter’s Medical Center (MS) goes live on Meditech’s Expanse Point of Care.


Other

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Brendan Reilly, MD pens a cynical yet insightful NEJM recap of his experience taking his wife to an urgent care center in “The Spy Who Came In with a Cold.” His observations, made while keeping mum that he’s a doctor:

  • Everybody wore the same scrubs, white coat, and stethoscope as a corporate standard, leading him to question whether everyone (or even anyone) really knows how to use the stethoscope.
  • He notes that while the clinic’s website boasts, “We’re on your side,” it fails to identify who the opposing “side” is.
  • He describes the eyes of the young doctor working as, “like she slept last night but not the night before. She looks alert but hurt, eager yet ambivalent, like she’s not sure she wants to be here but here we are, so let’s go.”
  • The doctor didn’t use the stethoscope or otoscope correctly and forgot to listen to his wife’s lungs, then diagnosed pneumonia after incorrectly interpreting an x-ray while waiting for a cross-town radiologist’s report.
  • He questions how doctor quality should be measured, noting the unreliability of direct observation and the difficulty in linking care quality to ever-increasing cost.

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A Virginia woman is sentenced to 15 years in federal prison for scamming $5 million from 50 investors in her phony telemedicine company, spending the proceeds on luxury world travel. She erred in appearing at her sentencing carrying an $1,800 leather portfolio paid for by one of her investors (a special needs teacher and recent widow), with the angry judge ordering her to surrender it since “you’re not going to be able to take it with you to prison anyway.”

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Who’s signing up for this? It’s an award-winning solution (or will be when I announce the HISsies winners).


Sponsor Updates

  • Provider management platform vendor Phynd earns ISO 27001 certification for its information security standards.
  • Pivot Point Consulting enters into a managed services partnership with PDS.
  • Access publishes a new client spotlight, “Norman Regional Health System Takes Next Step on Paperless Journey.”
  • AdvancedMD publishes a new guide, “What NOT to do When Working with a VBC RCM Outsource Supplier.”
  • Aprima’s PRM, Version 18 earns ONC Health IT Certification from the Drummond Group.
  • CarePort publishes a new case study featuring St. Vincent’s Health, “Using Ad Hoc Reporting to Reduce Excess Days and Associated Operational Expenditures.”
  • Arizona HIMSS names CTG Client Partner Patricia Allvin treasurer and VP of finance.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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Monday Morning Update 1/21/19

January 20, 2019 News 1 Comment

Top News

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Alphabet’s Verily announces that its Study Watch has earned FDA clearance as a medical device for performing on-demand ECGs.

Verily’s offering, unlike the Apple Watch, requires a prescription, perhaps because it was developed to capture health data from clinical trials participants. 


Reader Comments

From Stock Picker: “Re: Jim Cramer. What does he know about healthcare?” First, let’s recognize Cramer’s undeniably impressive credentials – Harvard BA and JD, editor-in-chief of the Harvard Crimson, small-town newspaper reporter, successful hedge fund manager (for a short time during a boom market), and co-founder of a stock website, all before he was a TV host. However, it’s always amusing when cheap-seaters (including elected officials) pontificate based on their superficial knowledge. Everybody these days thinks they are an expert on everything they’ve read about from sketchy Internet sources, holding their ground even while emotionally spouting off to an actual expert for whom the topic represents their life’s work. This is a different form of a volume-to-value challenge where loud people talk over more informed ones.

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From LinkedOut: “Re: sending an immediate boilerplate sales pitch after connecting on LinkedIn. What if I write a message specific to you and your org? Less annoying?” Only slightly, assuming you are still trying to sell me something. I didn’t join LinkedIn to be pitched, especially by people or companies I’ve never heard of. It also depends on whether you’ve paid any attention to what I actually do, which means that the LinkedIn sales messages I get for software engineering services, cybersecurity consulting, or webinars for non-health IT topics are going to bug me because my profile makes it clear those don’t apply to me. Overzealous Indian dudes in particular seem to love to invade my inbox. It’s like signing up for Match.com and having some weirdo immediately start blasting out full-frontal selfies.

From Deadlock Loser: “Re: Cerner. Did indeed announce another ‘voluntary separation plan’ right after Cliff Illig’s retirement and before the long holiday weekend. Unlike the previous two in 2015 and 2016, this one contained a threat that it would be ‘involuntary’ if certain financial goals aren’t met. Combine this with substandard benefits, readjustment in titles that led to up to 15 percent pay cuts, and blunt communications like this one that kill morale. Executives who are treated like royalty prefer to hire young, know-nothings from local Midwest colleges who are cheap and don’t know any better.” Unverified, but DL included what appears to be a copy of Cerner’s internal announcement from the company’s ironically titled chief people officer, which I’ll excerpt as follows:

Today, we are announcing to all US associates a voluntary offering created for a group of US associates who meet specific eligibility criteria … In 2019, we are expecting to meet a financial goal in order to fund important areas of investment to secure our future as a growth company. If we do not meet our corporate financial goal with the voluntary separation program, we may subsequently conduct an involuntary separation program … An associate may be eligible for the VSP if … the associate has at least 10 years of service and the associate’s combined age and years of service equals or exceeds 65.

From Minimal Shrinkage: “Re: healthcare influencers. When the conference circuit gets into high gear, their insulated conversations among themselves, event promotions, meet-ups, chats, etc. grow exponentially. For every smart, successful, succinct, and cogent healthcare person that contributes to the online discourse, there appear to be 30 others who hold almost no bona fides who produce an endless stream of meaningless, pointless, and self-aggrandized commentary. My grandfather used to tell me, ‘Don’t tell me what you’re going to do, show me what you’ve done.’ Those influencers have also reduced my interest in attending the conferences they infest — I’m not interested in seeing their regurgitated ‘takes’ on stage after not being excited to see them on Twitter and LinkedIn.” 


HIStalk Announcements and Requests

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About half of provider IT decision-makers look at either KLAS or Black Book before buying software or services, according to last week’s poll. It’s not really a fair comparison since Black Book covers broad trends with big sample sizes while KLAS digs deep into a specific topic (like population health management technology) while interviewing a small number of actual clients, so they are used somewhat differently. I agree with Former Community CIO on the best way to use KLAS, with this being my experience:

  • KLAS is outstanding in describing a market and differentiating vendors within it in ways that vendors themselves would never do for fear of pigeonholing opportunities.
  • A given report tells you who the players are and how much market share they hold.
  • The overall rankings usually jibe with gut feel.
  • Few people would argue with the top- and bottom-ranked products, but KLAS doesn’t help much to distinguish those slugging it out in the middle.
  • Provider executives feel peer pressure to avoid choosing a product that isn’t #1 in KLAS as those peers fail to recognize that one size doesn’t fit all, KLAS isn’t always right, and even top vendors can stumble or get acquired by a crappy parent that ruins the magic.
  • The user comments provide the most interesting information, although they are few in number, you don’t know the commenter’s background and employer to discern relevance, and unknown factors could make them suspect (the client is behind on releases, their IT shop is in shambles, or they merged with someone and had the system foisted on them).
  • Clients who report to KLAS are like Yelp reviewers – they are self-selected with their own agenda, they may not be representative of the entire client base or similar to the reader’s health system demographic, their vendor may influence their participation or rating, and the individual respondent’s background in a particular product may be superficial.

New poll to your right or here: What would you tell Tim Cook if he asked you how Apple should be involved in healthcare?

I invite you to complete my once-yearly reader survey. I have limited ambition, time, and appetite for change just for change’s sake, but nearly everything I do differently today than I did years ago is because I got a spark from someone’s reader survey response. That reminds me that HIStalk will be 16 years old in June, which seems unreasonable given that the initially low readership and conflicting day-job demands should have been strong motivators for me to find another hobby.

I am, as a glass-half-empty curmudgeon, always annoyed by something. My peeve this week, caused by HIMSS19 spam, is people sending an “invite” rather than an “invitation.”Maybe it’s inevitable that verbing nouns (such as “friending,” seeing an Olympian “medal,” or “incentivizing” EHR purchases) will lead to nouning verbs (which along with sending “invites” includes HIMSS listing its federal government “asks.”) It reminds me of nerdy hospital tech guys who worked for me who described their job as “administrating” a system or people (sometimes me included) who say they are “vacationing” given that “vacation” is the noun form of “vacate, ” I say while explanationing.


Webinars

None scheduled in the coming weeks. Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

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Data analytics and population health technology vendor Innovaccer closes a $35 million Series B funding round, raising its total to $51 million.

Baxter International acquires True Process, whose platform performs medical device integration and analytics.


People

The soon-to-be-combined Beth Israel Lahey Health names BIDMC CIO John Halamka, MD, MS as executive director of its recently created health technology exploration center.


Announcements and Implementations

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Researchers at Northwestern University develop a wireless, battery-free soft skin patch that analyzes sweat for PH and levels of chloride, glucose, and lactate. Possible applications include detecting dehydration (Gatorade is already on board), testing for cystic fibrosis, and potentially screening diabetics. Researchers are are working on sensors to monitor kidney function, assess post-stroke rehabilitation, and to monitor depression.

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The latest twice-yearly health IT market review of Healthcare Growth Partners says that the market is full of noise, as private equity investors are anxiously looking for investments, health IT seems attractive, and the PE firms are using CRM and other digital marketing techniques to indiscriminately blast out messages trying to beat the others at finding deals. Venture capital and growth equity players say their health IT investment strategy meets expectations, while buyout companies are less satisfied. Primary deal-killers are poor business models, deal sourcing, competition from strategic investors, and valuation. Interesting respondent observations:

  • Many startups offer gimmicky solutions and are run by inexperienced entrepreneurs.
  • Some startups aren’t ready due to lack of a go-to-market plan, an immature product, or lack of pilot sites or customers.
  • Sellers are sometimes looking for a complete exit instead of a non-controlling equity investment.
  • Funding rounds are getting bigger and occurring earlier, such that even a Series A deal involves a company with no recurring revenue and product still in pilot or even pre-pilot.
  • Seed rounds have reasonable valuations, but those from Series A and beyond are overpriced compared to other sectors.
  • Top sectors are population health management, revenue cycle management, infrastructure, and payer services.
  • The most attractive customer segments are payers / employers and health systems, while the least-attractive is patients and families.

Government and Politics

The VA issues an RFI for a software testing contractor,  with 80 percent of the job focusing on Cerner.


Other

Two patients in Scotland’s Queen Elizabeth University Hospital die from cryptococcal fungal infections that authorities believe originated in the droppings of pigeons that were nesting in a machinery room.

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Bizarre: in Scotland, a 28-year-old female hospital nurse is fired and sent to prison for impersonating a rich, male doctor by using photos of handsome men and a voice-changing machine to harass and stalk 10 women she connected with on dating sites.


Sponsor Updates

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  • The Patientco team works with humanitarian aid organization MedShare to sort and pack medical supplies for hospitals in developing countries.
  • The Chartis Group publishes a new paper, “2019 Healthcare Outlook: Strategic Imperatives for the Year Ahead.”
  • NextGate will exhibit at the 2019 IHE North American Connectathon January 21-25 in Cleveland.
  • OmniSys will exhibit at the ASAP Annual Conference January 23-25 in Kiawah Island, SC.
  • OnPlan Health publishes “The Changing Landscape of Healthcare Payment Plans” report.
  • Experian Health will exhibit at the HFMA MidSouth meeting January 30-February 1 in Tunica, MS.
  • Flagship Medical becomes the first durable medical equipment provider to join Prepared Health’s EnTouch network.
  • Surescripts will exhibit at North Carolina Epic UGM 2019 January 22-23 in Greensboro, NC.

Blog Posts


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Contacts

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

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News 1/18/19

January 17, 2019 News 6 Comments

Top News

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From Dave N: “Re: CNBC’s ‘Mad Money.’ Jim Cramer said he thinks Epic will be acquired or go public, citing Judy’s age.” The stock-picking record of the highly annoying Jim Cramer is poor, underperforming the S&P 500 index funds while exposing investors to more volatility, and this particular recommendation is especially questionable:

  • Judy Faulkner refuses to sell Epic and has told those whose will control the majority of shares after her — her heirs and the board — not to sell or go public. I highly doubt that drowning in a sea of Apple cash would be her preferred way to go.
  • Cramer thinks Epic needs scale, which they don’t — Epic makes billions with a few hundred boutique customers and doesn’t care about millions of app users paying $2.99, social media platforms counting ad clicks, or illogical fanboys who buy overpriced Apple devices as soon as they’re released.
  • Cramer wants Apple to smooth out its hardware vendor market bumps by buying its away into the software market, a strategy that has failed other desperately growth-seeking companies countless times.
  • Apple’s consumer innovation track record died with Steve Jobs, but acquiring Epic to leap headfirst into healthcare won’t make a dent in the real problem of flagging IPhone sales in the absence of any other compelling offering.
  • Cramer claims that Apple and Cerner practice information blocking (which is a stupid thing to say since it’s their customers that are the problem – providers who want to exchange information do so easily) and proposes that Apple become a universal repository for health data. Apple doesn’t need to buy Epic or anyone else to accomplish that, and it’s a weird thing for Cramer to say since he just got finished saying Epic and Cerner aren’t interoperable.
  • Notice the before-and-after result (above) of the show having to alter Jim’s inane comment that Epic focuses on small hospitals. The top version is the original cached version, while the bottom is a post-surgical shot after Jim’s foot was removed from his enlarged mouth. (I reviewed the show video and he really said that Epic is a small-hospital vendor while Cerner focuses on big ones).
  • “Neither Cerner nor Epic wants to make it easier for their systems to work together because their clients would have an easier time switching to a competitor.” Oh, Jim, how much (and how loudly) you say despite how little you know. And by the way, they actually make shirts whose sleeves don’t have to be rolled up – ask for something called “short-sleeved.”

Reader Comments

From Jelly Doughnut: “Re: population health management. Why isn’t it used more if it really saves money, which it should?” Because it saves money years down the road for someone else when the patient / enrollee has moved on to other insurers and providers. A company spending big dollars today to help a 30-year-old patient get healthy will most likely never see the benefit. We probably need some kind of lifetime patient financial scorecard to fix this, yet another healthcare example in which taking better care of people means making less money. The only real exception is with lifetime insurers such as Medicare and the VA, which get to reap the benefit of whatever savings they create.

From KC1981: “Re: Cerner. Is offering ‘voluntary’ retirement packages and is making it clear that if that doesn’t get to the total numbers needed, the next step is forced retirements and layoffs.” Unverified. I’ll get a call in to Jim Cramer.

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From Nicholas Cage-Free Eggs: “Re: HIMSS ‘news’ publications. Down here in Australia, HIMSS dismissed the award-winning contracted editor of its flagship publication after she ran an insightful, critical overview of the problems with the Australian Digital Health Agency, whose CEO is a friend of HIMSS CEO Hal Wolf. That CEO threatened to withdraw sponsorship of the HIMSS AsiaPac conference. Now HIMSS won’t run stories without the agency’s approval.” Unverified, although I’ve heard that before and the editor’s LinkedIn shows that she did indeed leave a few weeks after her story ran. It’s not exactly ProPublica over there – they should have made it clear they weren’t looking for actual news and hired a marketing person instead of a journalist. 

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From Acute Malcontent: “Re: social media influencers. There’s something to be said for the HIT crowd that seems to exist only on social media, but meanwhile, I thought you’d get a kick out of this story.” Instagram influencer Caroline Calloway – who in her mid-20s took a $500,000 book advance that she couldn’t pay back when she found out that she can’t actually write – suddenly announces after a two-year hiatus that she’s offering a national “tour” in which she will instruct attendees (at $165 per head) how to create an “Instagram brand.” Twitter roasted her for trying to recruit free helpers, arm-twisting Philadelphia and Boston ticket-holders to travel to New York City instead to make it easier for her, giving attendees packets of flower seeds instead of the promised live orchids to wear in their flowing locks, and letting 20-year-old friends with no work experience run the show. She cancelled the rest of the “tour” and claims in Fyre Festival style that it’s not her fault and she’ll give refunds. Jezebel concludes, “No one is an influencer if everyone is an influencer.” I would add a health IT corollary – you aren’t an influencer, even in its most shallow form, unless you change the behavior (especially the buying kind) of people with real influence. 


HIStalk Announcements and Requests

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It’s that just-before-HIMSS time when I ask you to take three minutes to fill out my annual reader survey. I use the results for several things – to plan for the year, to manage my ego up or down as needed by reading the positive and negative comments, and to get a mental picture of who is out there on the other side of that blank screen that I vanquish every day.

Dear overzealous sales types – if you connect with me on LinkedIn and immediately spam me with a boilerplate sales message, I will instantly remove the connection, overriding my initial impulse to report you for spamming. I know people told you to Always Be Selling, but that means you are Often Being Annoying and LinkedIn already offers plenty of that.


Webinars

None scheduled in the coming weeks. Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

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Consumer health data sharing company Ciitizen raises $17 million in a Series A funding round led by Andreessen Horowitz. CEO Anil Sethi founded the company in 2017 after selling a similar company to Apple for its health records business.

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GoFundMe reports that a third of the $5 billion raised on its platform since launching in 2010 has been used for healthcare campaigns. CEO Rob Solomon says he never though the platform’s medical category would become its most popular. “We shouldn’t be the solution to a complex set of systemic problems. They should be solved by the government working properly, and by healthcare companies working with their constituents.”

Consumer healthcare website company Everyday Health Group acquires Castle Connolly Medical, owner of the Top Doctors database.

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PerfectServe acquires competitor Telmediq for an undisclosed sum. Telmediq founder and CEO Ben Moore will become PerfectServe’s chief product officer.


People

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Chris McMahon (Turbonomic) joins Kyruus as SVP of people.

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Health insurer Oscar names Angela Calman (IBM Watson Health) as VP of communications.

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ZeOmega promotes Sandra Hewett, RN to CNO.

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Todd Stottlemyer (CNSI) joins the board of Verato.

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Nordic hires Tom Kirst (Afton-Armitage) as managing director and special assistant to the CEO.

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PatientSafe Solutions names Kathleen Harmon, MS, RN (Sphere3) as chief clinical officer.


Sales

  • Partners HealthCare chooses Visage Imaging’s Visage 7 enterprise imaging platform, eliminating multiple legacy PACS and giving the company the largest sale in its history.
  • Williamson Memorial Hospital (WV) will implement Meditech’s Expanse EHR via the company’s subscription service.
  • BridgePoint Healthcare (NJ) will deploy EHR software from HCS at its post-acute facilities in Washington, DC and New Orleans.
  • Arkansas State Hospital selects EHR and RCM technology from Medsphere.
  • Northern California behavioral health services provider Remi Vista selects Cerner Integrated Community Behavioral Health and patient portal.

Announcements and Implementations

Texas Health Resources implements MDsyncNet’s physician on-call scheduling software at eight additional hospitals.

Huggins Hospital and Catholic Medical Center of GraniteOne Health implement Oracle ERP and HCM Cloud.

Managed care company NextLevel Health Partners signs on for PatientPing’s real-time care notifications.

Critical Alert Systems will add real-time patient-generated data from medical devices and EHRs to its critical alarm surveillance solution via Bernoulli Health.


Government and Politics

In Canada, the New Brunswick Department of Health will spend $12.5 million to implement an EHR in three phases over the next several years.


Privacy and Security

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In Ontario, Health Sciences North works to recover from a computer virus discovered Wednesday morning that has affected several IT systems. A “major computer system breakdown” was also reported at Hôpital Notre-Dame Hospital in Ontario, though it’s unclear if the two incidents are related.


Other

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After going live on Epic last month, Memorial Hospital (NH) staff struggle to keep up with prescription refill requests as they transfer prescription data to the new system. The hospital has set up an “urgent refill” hotline and special walk-up window at the hospital for patients. It has also established a hotline for pharmacists having trouble with the system. Interim CEO Lee Myles admits the new system’s “complexity is amazing,” and that employees are working “ridiculous hours” to get refill workflows back to normal.

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CNBC reports that Apple is talking with three Medicare Advantage plans about offering the AppleWatch to members at a subsidized cost. The $400 latest version of the Watch features senior-friendly fall detection. Skeptics have pointed out that more evidence is needed to determine the device’s impact on outcomes, and that seniors may have a hard time manipulating and reading the device’s small controls and display.

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Medtronic develops an app that, for the first time, gives users of its pacemakers the ability to pull data from their own devices.

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Coursera adds 100 healthcare-related courses to its roster of online classes, emphasizing healthcare informatics, management, and public health.

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Atul Gawande, MD cancels his keynote at HIMSS19, which isn’t surprising given his media hiatus since becoming CEO six months ago of the joint venture between Amazon, JPMorgan, and Berkshire Hathaway. Maybe he’ll spend the time he’ll save naming the darned thing. Meanwhile, HIMSS announces that HHS Secretary Alex Azar will join CMS Administrator Seema Verma in a Tuesday evening session on interoperability and patient engagement that, based on their Twitter track records, will turn into a political rally.

A 17-year-old teenager in China who sold a kidney to black marketers for $3,000 in 2012 so he could afford to buy an IPhone 4 and IPad 2 is now a 25-year-old man who will be bedridden and on dialysis for life after his remaining kidney failed due to poor technique in the illegal surgery. Five people, including two moonlighting surgeons, went to jail and Mr. Wang was awarded $300,000 in compensation. It’s probably not this Mr. Wang.


Sponsor Updates

  • Optimum Healthcare IT will host a HIMSS19 lunch and learn session titled “Optimizing Outcomes with Real-Time Data Harmonization” on February 12.
  • Patientco adds financing options from ClearBalance to its SmartFinance patient payment technology for health systems.
  • ZappRx partners with Bayer, giving it insight into the medication access and prescription habits of patients living with Pulmonary Hypertension, and with Relapsing Remitting Multiple Sclerosis.
  • Elsevier Clinical Solutions releases a video summary of its recent Health Dialogue roundtable.
  • Clinical Alert Systems partners with Bernoulli Health for real-time clinical surveillance, advanced analytics, and intelligent alert notification.
  • Healthfinch will exhibit at the Allscripts Global Sales Kickoff January 22-24 in San Antonio.
  • Imat Solutions releases a new podcast, “Advancing Data Confidence at HIMSS 2019.”
  • The InterSystems IRIS Data Platform is now available on the AWS Marketplace.
  • Nordic hires Tom Kirst (Afton-Armitage) as managing director/special assistant to the CEO.

Blog Posts


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Definitive Healthcare Acquires HIMSS Analytics

January 16, 2019 News No Comments

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Definitive Healthcare announced this morning that it has acquired the data services business and assets of HIMSS Analytics.

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Definitive Healthcare founder and CEO Jason Krantz said in the announcement, “HIMSS Analytics has developed an extraordinarily powerful dataset including technology install data and purchasing contracts among other leading intelligence that, when combined with Definitive Healthcare’s proprietary healthcare provider data, will create a truly best-in-class solution for our client base.”

News 1/16/19

January 15, 2019 News 7 Comments

Top News

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Cerner co-founder Cliff Illig retires from the company’s board “to focus on outside interests.”

You get to do that when you’ve sold dozens of millions of dollars of CERN shares in the past few months and still hold $550 million worth.

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I feel like a kid watching Mom and Dad get divorced as companies start losing their colorful founders, making me reevaluate whether I still find them interesting.

Cerner even lost its president, so now it’s exclusively Brent Shafer’s show and I haven’t seen much Neal Patterson-like brilliance or spark from him after a year in his first CEO job.

CERN share price rose a tiny bit Tuesday,  but are down 23 percent in the past year vs. the Nasdaq’s 3 percent loss.


Reader Comments

From Beezer Gutler: “Re: Cleveland Clinic’s Empathy & Innovation Summit. HIMSS is now a ‘partner,’ whatever that means.” I can’t think of many organizations that are less qualified to than HIMSS to provide empathy advice to frontline providers, so I assume that its contribution will be to jam high-paying tech vendors into a program that should be about person-to-person interaction rather than gizmos. The June conference features odd speakers such as bigwigs from Aetna and the AMA (you have to be a pretty awful provider if you have to ask an insurance company how to be empathetic). The conference drew a couple of thousand people last year, although healthcare is notoriously full of people who love to hang around just about any conferences for which patients are indirectly paying via their inflated bills without much hope of ever seeing ROI. It’s fascinating how much money is made by running healthcare conferences – my favorite ironic example is the American Telemedicine Association’s annual conference, which suggests that they believe video is great for practicing medicine but not for watching talking heads.

From Avoiding Buyer’s Remorse: “Re: HIMSS19. What should we expect as first timers in a small booth?” You’ll get some visitors, but most will be just strollers-by looking for giveaways and taking your handouts just to be nice. You’ll feel energized and vital in being part of the “show,” but that high will go away on the plane ride home when you realize that spending the money won’t pan out in sales, and if you were an unknown before, you still are. Shooting your budgetary wad on a HIMSS exhibit as a full-year strategy makes no more sense than binge-eating for three days and assuming you won’t need food for another year. The problem isn’t HIMSS, it’s that exhibitors don’t set reasonable goals and plan well, so I suggest starting with my only partially cynical (which is quite a stretch for me) “Tips for HIMSS Exhibitors.” As holder of an expensive, questionably cost effective three-day lease on a 10×10 space myself, I wouldn’t get my hopes up – we get a lot of visitors just because readers drop by to say hello and that makes it worth it to me, but financially it doesn’t make a lot of sense to be there and you probably won’t get nearly as many folks stopping by.


Webinars

January 17 (Thursday) 1:00 ET. “Panel Discussion: Improving Clinician Satisfaction & Driving Outcomes.” Sponsor: Netsmart. Presenters: Denny Morrison, PhD, chief clinical advisor, Netsmart; Mary Gannon, RN, chief nursing officer, Netsmart; Sharon Boesl, deputy director, Sauk County Human Services; and Allen Pendell, SVP of IS and analytics, Lexington Health Network. This panel discussion will cover the state of clinician satisfaction across post-acute and human services communities, turnover trends, strategies that drive clinical engagement and satisfaction, and the use of technology that supports those strategies. Real-world examples will be provided.

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


Acquisitions, Funding, Business, and Stock

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EHR and technology services vendor Parallon Technology Solutions renames itself CereCore.

Walmart leaves CVS’s pharmacy network after failing to reach a price agreement with CVS’s huge Caremark pharmacy benefits management arm.

UnitedHealth Group beats Q4 earnings estimates as its full-year revenue grows to $226 billion and earnings to $17.3 billion. Its Optum services business brought in $8.2 billion in earnings on $101 billion in revenue. It’s good to be a healthcare middleman.


Sales

  • California largest non-profit health data network, Manifest MedEx, selects predictive analytics from HBI Solutions.
  • Lexington Regional Health Center (NE) chooses Cerner Millennium via CommunityWorks.
  • Premier Orthopaedics chooses Allscripts Professional EHR, PM, FollowMyHealth, and Payerpath for its 72-physician practice.

People

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NHS England’s chief digital officer, Juliet Bauer, will leave the organization for a job with NHS-contracted telemedicine vendor Livi.


Announcements and Implementations

CareCloud successfully deploys Medicomp’s Quippe Clinical Documentation throughout its customer base.

DocuTAP launches an urgent care-focused analytics tool called Insight that provides real-time visibility into clinical, operational, and business data.

Northwestern Medical Center (VT) goes live on CommonWell interoperability, embedded in Meditech.

Walgreens signs a deal for its 380,000 employees to use Microsoft technology that includes Office 365, mobility and security tools, and the Azure public cloud. The companies will also work together on R&D for patient engagement and chronic disease management software.


Government and Politics

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Sen. Jon Tester (D-MT), ranking member of the Senate’s Committee on Veterans Affairs, expresses his IT concerns to newly confirmed VA CIO James Gfrerer:

  • The White House’s proposed VA IT budget contains drastic cuts that don’t reflect new requirements and the VA’s history of “fumbling of IT solutions.”
  • The VA needs strong IT leadership since it “cannot continue to operate in a technology environment in which only the largest and latest crisis drives the agenda.”
  • While much of the Cerner implementation will be run by the Office of Electronic Health Record Management, the VA must go beyond just maintaining VistA and ensure that infrastructure is ready for the new system.
  • The VA must continue to invest resources in projects such as its benefits management system, disability rating system, and financial system.
  • Tester warns that CareT, a system being developed for caregiver assistance, may not support the expanded program and might require buying a commercial system, which would be “unacceptable.”
  • The Senator asked for a list of the VA’s IT projects, their priorities, and how those priorities were established. 

Other

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Baylor St. Luke’s Medical Center fires its president, chief nursing officer, and COO following media reports of patient deaths caused by substandard care.

The National Center for Health Statistics says Americans are even fatter than previously thought, which it discovered after measuring people directly rather than relying on their self-reported numbers in which they often inflate height and under-report weight. As the old saying goes, I’m not fat, I’m just short for my weight.

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Those of us who roll our eyes at “influencers” (which is also HIMSS’s new term for “social medial ambassadors who may or not have actual industry influence) will be comforted by the news that they’re being replaced by “avastars,” as companies invest millions to further developer computer-generated, AI-powered synthetic celebrities who not only can generate loyal friends with merchandise-buying potential, but that live forever. Lil Miquela has 1.5 million Instagram followers, of which I would suspect few are significant contributors to society.


Sponsor Updates

  • KLAS recognizes Arcadia for its outcomes-producing, analytics-driven insights in its “Value Based Care Managed Services 2018 report.”
  • AssessURhealth Co-founder Mallory Taylor will present at the Synapse Summit January 23 in Tampa, FL.
  • Bluetree will exhibit at the NJHIMSS 2019 Winter Event January 22 in Monroe Township.
  • The Chicago Tribune profiles Burwood Group President Jim Hart.
  • CoverMyMeds will exhibit at the ASAP 2019 Annual Conference January 23-25 in Kiawah Island, SC.
  • Dimensional Insight publishes a customer spotlight on EvergreenHealth.

Blog Posts


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Monday Morning Update 1/14/19

January 13, 2019 News 4 Comments

Top News

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The average acquired health system had annual revenue of $409 million in 2018, according to a new Kaufman Hall report on health system mega-mergers. Seven billion-plus dollar transactions skewed the average upward. 

Only 20 percent of the sellers were financially distressed, and 75 percent of the buyers were non-profit health systems that are anxious to grow. 

Kaufman Hall lists several reasons that health systems are expanding, all of them involving improving their own business rather than patient care. It notes that the line between for-profit and not-for-profit health systems is blurring, such as HCA’s acquisition of North Carolina-based Mission Health that also involves funding a local non-profit health trust.

The country’s largest health system, HCA, operates 178 hospitals with annual revenue of $43 billion. It is focusing on markets with increasing population and low unemployment.

Kaufman Hall recommends that health systems expand in markets with high growth or strong demographics, seek strong operational or clinical partners, and increase consumer engagement.


Reader Comments

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From GuyFromMadna: “Re: Apple. More power to Tim Cook if he can somehow use Apple Watch to solve the crisis of $300 insulin vials or $3,000 out-of-network ED visits. It took me back to Joe Biden’s precision medicine initiative – whatever happened to it?” No technology company or technology itself can solve our mess of a healthcare system and globally underperforming public health. Cook is one of these: (a) naive, which is probable given that companies that have delved much deeper into healthcare than Apple have met their Vietnam after confidently proclaiming themselves disruptors; (b) confusing a narrowly defined view of health that pertains only to a few undiagnosed and often harmless maladies of IPhone-only users; or the most likely answer, (c) desperately trying to feint away from Apple’s rapidly slipping relevance as investors get wary. Claiming that Apple’s best is yet to come and that it involves an industry largely unexplored by Apple is, to me anyway, just silly. Meanwhile, former VP Biden just delivered the keynote address once again at StartUp Health Festival in San Francisco, railing against data silos and most likely thinking about his inevitable presidential run. I haven’t seen any news from his Biden Cancer Initiative, just like I’m still waiting for MD Anderson to justify that “making cancer history” business (no pun intended). At least you know there’s no good treatment for cancer if even rich people are still dying of it.

From AnonymousPlease: “Re: Mid Coast Hospital (ME). Had an extended computer or network outage recently, accordingly to a family member who was told by their lab tech that the computers were down. Sounds like there was an HVAC alarm in the data center that was ignored (reset). By the second time, many servers had overheated.” The hospital’s Twitter account is frozen in mid-2017 and their Facebook doesn’t mention an outage. It seems odd that someone would ignore a data center cooling warning, so I speculate that maybe they shut the alarm off while trying to mobilize an HVAC expert to investigate and then had the temperature get away from them. It would be a tough call to proactively start turning off servers in that situation and they may not have had enough time to activate whatever failover plan they have. Modern servers should be good to at least 110 degrees F, but their individual thermal safeguards can be programmed to take them down at a user-defined temperature. It is, of course, a nightmare trying to recover individual software systems that went down hard even after the server they run on has been brought back online, requiring the enlistment of individual system experts to look at potentially corrupted databases, run disk recovery, free up phantom user sessions, and assess what information was lost.

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From Sticky Wicket: “Re: [publication name omitted.] How did they get ‘Bret’ Shafer in rewording another site’s story?” Misspelling Brent Shafer’s name and omitting his Chairman title is sloppy, but I won’t call the writer out since just a year ago she was finishing up college and working as an office assistant. That particular clickbait-heavy news aggregation site seems to hire from a single demographic of freshly-graduated, female journalism majors. It has an audience, so there’s not much else to say.

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From Visual Acuity: “Re: National Federal of the Blind lawsuit against Epic. One of our residents is legally blind and can use Cerner using ZoomText, which we installed after trying the Cerner option that allows increasing some (but not all) font sizes. The resident has less flexibility since Zoomtext must be installed on individual machines and not through Citrix. I do think Cerner (and it sounds like Epic as well) could do a better job supporting accessibility even for physicians who aren’t legally blind, but who have reduced visual acuity.” Thanks for the tip on ZoomText. It offers a Windows-only screen magnifier, another version that includes reading screen contents and keypresses, and a super-product that provides those capabilities plus keyboard navigation, customization, and more expressive screen reading. It also sells a large-print keyboard with hotkeys that control its software. I agree that clinicians, especially those over 40 when presbyopia kicks in nearly universally, might find that their fatigue level, eye strain, and headaches from frequent computer use could benefit from a screen magnifier. I should also mention that Windows 10 has a screen magnifier built in – just press the Windows logo key plus the plus sign (or navigate through the Settings/Ease of Access menu options) – but I tried it and it seems laggy, although I haven’t tried ZoomText to compare. It’s hard to envision (no pun intended) how well a screen reader would work, however, so I don’t envy someone trying to navigate an EHR as the computer reads its screen contents aloud.

From Informed Consent: “Re: partnering with IBM. I have experience with a healthcare software vendor that entered a joint project with a large client of IBM. ‘Joint project’ means that IBM took full control with their leverage and contacts even though we were providing the core of the solution for which they had no alternative. IBM insisted on ‘handling the paper,’ which means they beat us down to a sub-share of the client revenue, then took 20 percent off the top of our portion for ‘taking the risk.’ They didn’t allow us to talk to the client (‘we have the relationship’). We got sucked into providing a reasonable quote for the work, then midway through, IBM said the client’s budget had changed and, ‘You need to cut your portion to $X for this deal to work.’ This happened three times in this one deal even though they wouldn’t tell us how much they were billing our customer. We were down to 40 percent of the original quote when the client cancelled. IBM’s motto is, ‘Our clients are our clients, and YOUR clients are our clients.’ Their salespeople kept wanting intros into our client base but wouldn’t provide the same. Our CEO was excited to get a call from the IBM sales team wanting a price call for a client with similar need. I warned that even though it was their lead and their paper, by the end of the call, they will demand that we give them a minimum revenue commitment, for which we will be on the hook for THEIR unvetted client. The CEO scoffed, but sure enough, my prediction came true in our first call.” I considered HAL – err, IBM — somewhat evil even before their current financial desperation and Watson missteps. I admire some of the technology developments, especially their inadvertent creation of the modern PC industry and Microsoft by botching the original IBM PC rollout by snapping together off-the-shelf components (the failed, proprietary MicroChannel architecture came after the horse had long departed from the barn). IBM eventually walked away from the now-commoditized business by selling the PC business to China-based Lenovo, which turned out to be a much better vendor.


HIStalk Announcements and Requests

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A convincing 88 percent of poll respondents who self-identify as longstanding HIMSS members say their feelings about the organization are less positive now than five years ago.

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Gerald says that at least HIMSS now acknowledges that the annual conference is a “trade show” (or a “boat show,” as Jonathan Bush always said, although at least boat show attendees are spending their own money instead of someone else’s) instead of claiming that its primary purpose is education. He says he hasn’t attended a provider’s educational session there in the past five conferences, which is about the same as my own record.

A reader asked via a poll question what’s wrong with HIMSS. My answer as a longstanding member, off the top of my head:

  1. They run their operation like a dues-funded vendor, maximizing revenue at every opportunity.
  2. In fact, they really are a vendor, having acquired for-profit companies, conferences, and publications while somehow remaining a non-profit.
  3. They wildly overpay their executives compared to similarly-sized, non-profit member organizations (I researched this thoroughly years ago when Steve Lieber first hit the million-dollar annual compensation milestone).
  4. They sell access to their provider members to their vendor members in the “ladies drink free” model.
  5. Its “vendor points” system rewards the big vendors that are most willing to send HIMSS huge checks, giving those vendors the dominant voice over those that can’t or won’t pay more.
  6. Like most other member organizations, they get involved in government programs that have profit potential for their vendor members.
  7. They pay lip service at best to patients since there’s no money to be made in supporting better public health, outcomes, or access (much like their provider members, in fairness).
  8. Their media operation studiously avoids running anything that looks like real news unless it cheerleads the industry, filling the remaining empty space with inexpertly written filler pitching products and services that are always predicted to improve healthcare but somehow never do.
  9. They aggressively demand to be the voice of the industry even though, as in the case of the American Medical Association, many of the people in that industry aren’t members and those who are may not agree with the positions HIMSS takes on behalf of its vendor members and itself.

New poll to your right or here, as suggested by a reader: for provider IT decision-makers: which service do you consult before buying software or services?


Webinars

January 17 (Thursday) 1:00 ET. “Panel Discussion: Improving Clinician Satisfaction & Driving Outcomes.” Sponsor: Netsmart. Presenters: Denny Morrison, PhD, chief clinical advisor, Netsmart; Mary Gannon, RN, chief nursing officer, Netsmart; Sharon Boesl, deputy director, Sauk County Human Services; and Allen Pendell, SVP of IS and analytics, Lexington Health Network. This panel discussion will cover the state of clinician satisfaction across post-acute and human services communities, turnover trends, strategies that drive clinical engagement and satisfaction, and the use of technology that supports those strategies. Real-world examples will be provided.

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


Acquisitions, Funding, Business, and Stock

More JP Morgan Healthcare Conference nonsense: the entire hotel area is so packed that the moneyed minions are meeting in public parks, restrooms, and the furniture department of a nearby Macy’s, with one hotel charging $300 per hour for a table and four chairs with no service. I didn’t really need more depressing examples of what America has turned into, but this one’s at least kind of funny as long as you don’t think about who’s paying.


Sales

  • University Hospitals Cleveland Medical Center joins the global health research network of TriNetX.

Other

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The conservative-learning National Affairs ponders “The Cost of Hospital Protectionism,” with the obviously brilliant Chris Pope (kudos, seriously – it’s a tough industry to understand and explain) making these points as he looks back on recent hospital industry history:

  • The government has done little to reduce healthcare costs other than to shift the responsibility for paying them while protecting hospitals and encouraging them to inflate costs.
  • Healthcare insurance is becoming increasingly unaffordable, with premiums tripling since 1999 and entitlements expect to consume 40 percent of the federal budget by 2047.
  • Hospital overcapacity encourages hospitals to offer tests and procedures whose per-unit cost is high due to small volumes, often with poorer outcomes.
  • The American Hospital Association promoted cost-based Blue Cross insurance during the Great Depression purely to fund the growth of the expenses of its members.
  • When Medicare Part A was rolled out in 1965, the instant 75 percent payment increase encouraged hospitals to spend more on buildings, staffing, and technology. Within five years, total hospital spending rose 37 percent even though only 7.5 percent of the population gained insurance.
  • Cost-based payment created a “medical arms race” in which hospitals built expensive facilities for expensive procedures, shifting themselves from “institutions of last resort” to all-purpose providers whose costs rose 345 percent in 10 years vs. the Consumer Price Index’s 89 percent rise. As one hospital CEO said, “You could be an idiot and make a fortune on Medicare reimbursement. Any mistake you made got reimbursed.” 
  • Hospitals didn’t worry about the introduction of Medicare DRGs in 1983 because those had a 14.5 percent profit margin built in and excluded capital expenditures, physician fees, and post-acute care services, all of which then started to rise.
  • Patients with good insurance don’t care about cost because they aren’t paying, choosing instead based on convenience and amenities.
  • Commercial insurers have cut into Blue Cross’s dominance by reducing costs, choosing providers based on quality, and introducing managed care that can exclude expensive providers from their network, require prior authorization for expensive procedures, and give doctors financial incentive to reduce the use of unnecessary services. That, along with the rise of ambulatory surgery centers, has slowed the arms race.
  • Hospitals use local political influence, community pride, and vast employment to protect their interests and to have favorable legislation enacted that restricts referral of lucrative patients to lower-cost specialty hospitals that often deliver better outcomes.
  • HMOs and heavy-handed employer cost-control efforts in the 1990s caused a consumer backlash that was fueled by lobbyists for hospitals and doctors, which triggered states to limit cost control practices.
  • Mergers have left 67 percent of hospitals as members of larger systems and often the owners of many more physician practices, but instead of reducing excess capacity, the now-larger health systems are using their clout to increase prices further.

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A doctor who received the above “notice” calls out the phony American Board of Cardiovascular Disease, which is hoping that inattentive medical office workers will send a renewal check to the Falls Church, VA edifice in which it conducts its scientific deliberations (photo above – it’s in the UPS Store, not the adjacent UBreak- IFix). It doesn’t even have a website. This would be hilarious if not for Googling, which reveals many cardiologist “diplomates” who actually advertise their fake credential. The Board’s executives apparently live communally in their tiny mailbox along with those of the equally bogus American Academy of Peripheral Vascular Disease, the American Council of Christian Physicians and Surgeons, the American Academy of Surgery, the American Board of Dental Surgery, the American Association of Ethical Physicians, the American Board of Oncology,  National Diabetes Institute, and the American Board of Urogenital Gynecologic Surgery. Being a Diplomate in Internet-Primary Sleuthing in Heath IT myself (no acronym, please), I tracked down the apparent owner of all these organizations – Keith Lasko, MD, DDiv, who had his own medical license yanked by three states in 1990, after which he started all these organizations and several more like them as retribution (or perhaps correctly identifying an underserved market in fake credentials by those entrusted with the public’s health). The reverend-doctor lives on the spectacularly porn-worthy named Vivid Violet Avenue in Las Vegas, although a lawsuit I ran across suggests that his house is being foreclosed upon by “allied infidels” who want to “throw him and his children into the street as unclean dogs,” referring to his “Mosque of the Golden Rule” religious organization, where he has commendably attained the rank of Imram. He also wrote a poorly-received 1980 book titled “The Great Billion-Dollar Medical Swindle.” My conclusion – the “diplomates” are the bad guys here since there’s no way they believe their bogus credentials are real, so their only intention in buying them must be to mislead patients. The Imran is simply meeting the demand.

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The Hustle interviews the original voice of Siri, voice-over actress Susan Bennett, paid an hourly rate in the summer of 2005 to read seemingly meaningless sentences such as “Militia Oy Hallucinate Buckram Okra Ooze ”for ScanSoft (later acquired by Nuance). She found out only after hearing Siri for the first time that those meaningless syllables – which she had to read precisely as measured by an audio analyzer strapped to her throat – were then chopped up into fragments that could be reassembled to make new words and sentences. Here’s a health IT connection – some of my favorite interviews are with NVoq CEO and speech recognition pioneer Charles Corfield (April 2014, July 2017), who was an early investor in Nuance acquisition BeVocal, widely rumored to have contributed the basics of mobile device speech recognition that became Siri. He’s always amused when I amateurishly try to pin him down on his Siri contribution, chuckling and intoning in his mellifluous British accent, “I think I shall refer you to Nuance to comment on matters of Siri or otherwise.” Corfield also created the precursor to Adobe FrameMaker, the first desktop publishing program, while working on his astrophysics PhD at Columbia after graduating from Cambridge. He’s one of the most interesting people I’ve ever talked to, a lock for my HISsies vote for “industry figure with whom you’d most  like to have a few beers.” 


Sponsor Updates

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  • The Nordic team continues its partnership with The River Food Pantry in Madison, WI.
  • Lightbeam Health Solutions publishes a new white paper, “Data-Driven Solutions Providers and Payers Need for Value-Based Care Alignment.)
  • MDlive publishes a case study featuring Cone Health (NC).
  • EClinicalWorks publishes a podcast titled “How Interoperability Fine-tunes a Neurology Network.”
  • Netsmart will exhibit at the North Carolina Providers Council Annual Conference January 14 in Greensboro, NC.
  • OnPlan Health and Patientco will exhibit at the HFMA Western Region Symposium January 13-16 in Las Vegas.
  • Experian Health and Change Healthcare partner to deliver identity management solutions.
  • PatientKeeper will exhibit at the HFMA MA-RI Annual Revenue Cycle Conference January 17-18 in Foxborough, MA.
  • TheFutureofThings.com includes PatientKeeper in its list of top healthcare apps.
  • Huron announces 20 senior-level positions.
  • ZeOmega publishes a new case study highlighting how Alliance Behavioral Health is using Jiva to manage care for North Carolinians experiencing mental health challenges, addiction issues, and intellectual disabilities.

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Weekender 1/11/19

January 11, 2019 News No Comments

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Weekly News Recap

  • Apple CEO Tim Cook tells CNBC that the company’s greatest contribution to mankind will be related to health.
  • CMS Administrator Seema Verma says its requirement that hospitals post raw CDM lists will encourage developers to create tools that consumers will find more useful.
  • IBM CEO Ginni Rometty says Watson Health is still a viable part of the company’s business and that Watson for Oncology is doing well.
  • England’s NHS issues a long-term plan that calls for technology to improve the ability of patients to manage their own health and to give clinicians access to patient records from any location.
  • Healthgrades acquires Influence Health.
  • Vatica Health acquires CareSync’s care coordination and chronic care management technology following a $1 million bid made last October.
  • The Senate confirms James Gfrerer as the VA’s assistant secretary of information and technology, its first permanent CIO in two years.
  • SVB Financial Group completes its acquisition of healthcare and life sciences investor Leerink Partners for $280 million in cash.

Best Reader Comments

Maj. Gen. Payne says “I want to give you a transparent review of where we are with MHS GENESIS” and then doesn’t. Unless maybe the author of the article left out parts like “it doesn’t work yet,” or “it failed its only assessment so far” or “it has zero interoperability with community providers.” It’s one thing to not see a train wreck coming, but another to have it wreck at your feet and disavow it. (Vaporware?)

Did everyone forget about the Tata case? I understand Epic (or any other vendor) wanting to protect their intellectual property. (UGM Attendee)

But this [health system selling Epic Community Connect that refuses to participate in an HIE] would not be the vendor. It’s the hospital itself that’s trying to absorb / acquire / whatever the neighboring clinicians. Epic has nothing to do with it other than being the hospital’s EHR. It’d be the same situation if it was Cerner I assume. My guess is the ONC will put out a proposal that tackles something that isn’t actually an issue. (Epic Complainer)

My patience and sympathy for gripes concerning no-shows is sharply limited. OK, yeah, it’s socially poor form and it has economic and medical consequences. Yet when those same providers are asked to explain, justify, or even quantify wait times, they cannot. Or will not. Or we receive a long list of excuses as to why the poor on-time performance of clinicians exists. With no solutions offered, not ever. Can anyone say they have not waited in a reception room, for an appointment that didn’t start on time? Often by an hour or more? (Brian Too)

Coach, is your HIE on any national plug & play network? I believe Carequality’s terms are share one, share all. (Ex-EDI)

The Allscripts 2bprecise product was built on NantHealth’s Geonomics product, which they obtained after investing $200 million into NantHealth, only to lose nearly all of it when that division failed and was the focal point of possible legal issues. Any word on how many sites implement and use this 2bprecise product / service? (Dr. JVan)

The screenshot issue is ironic. As I recall, around 2000, Epic settled (for millions $$) a lawsuit that IDX had filed against them which stated Epic had stolen screenshots and documents from the UW Medical foundation.(HISJunkie)

As for Epic moving into tangent markets for LTC, mental health, etc. it will be very interesting to see how they go about this. Develop or buy? Considering that there are many successful vendors that own these markets, they sure do not have the time to develop, so will they break down and buy? Secondly I think that the sales argument that the organization will want to buy from a single vendor will not carry as much weight as it did selling within the hospital. (HISJunkie)

Epic doesn’t have an IP leg to stand on for the screenshot restriction, but I believe they started putting this into their contracts a while back that the organization wouldn’t allow it from their employees, and it probably hits their “good install” metrics if they do. (DrM)


Watercooler Talk Tidbits

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Reader donations funded the DonorsChoose teacher grant request of Ms. B, who asked for 30 sets of headphones for her second grade class. She reports, “When my class received our box of goodies, we opened it together and they were so happy to have new headphones. Our old headphones were taped or broken from the usage due to the prior years of teaching. We also had to borrow from other classrooms in order to have a class set. Through your donation, my students have an opportunity to build their educational skills in all areas of learning. Working during technology time as a whole has enhanced reading comprehension, math, and vocabulary development by providing them comfort as they work in their own personal space. Receiving their personal headsets has opened up a whole new world.”

Facebook employees liken their work environment to a cult, in which they are forced to pretend to love their jobs, keep quiet about the company’s many scandals, and to form fake friendships with co-workers to game the company’s peer review system that encourages employees to submit anonymous, unchallenged feedback to the employee or their manager.

A jury awards $14 million to parents in a lawsuit brought against a hospital and a radiologist in a “wrongful birth” case in which they were not warned that an ultrasound image of their 22-week fetus showed possible abnormalities that might have convinced them to terminate the pregnancy.

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Cell phone providers are selling the real-time location data of their customers, creating a gray market for “bounty hunters” who can locate any cell phone to within a few hundred yards. Companies are selling the data that is intended to be used for fraud detection and roadside assistance firms  – in violation of the privacy policies of the cell phone providers — to developers of apps for car salespeople and bail bondsmen.

A urologist removes a patient’s healthy kidney at UMass Memorial Medical Center after pulling up the wrong CT scan by looking up his patient by name alone, which displayed the images of a different patient with the same name who had the same kidney scan performed on the same day. 

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The mother of a five-year-old boy whose diabetes is continuously monitored complains that she called Johns Hopkins All Children’s Hospital (FL) to report a high reading, but doctors didn’t call her back for three days. The hospital’s endocrinology department says they will start returning the calls of diabetic patients within 24 hours.

A Qualcomm executive’s keynote at the Consumer Electronics Show is interrupted by his unmuted Alexa device, which demonstrated an uncanny use of AI (during his pitch for using AI in cars) by loudly proclaiming, “No, that’s not true.”


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