News 7/13/16

Top News

HHS issues HIPAA guidance for ransomware attacks, saying that a reportable HIPAA breach has occurred if the malware encrypts PHI. The only exception is if the covered entity or business associate can demonstrate that the risk of PHI compromise is low, which would be difficult to accomplish in a ransomware attack.

HHS says a breach has not occurred if the user’s data was encrypted, but with a big exception –  users who are logged into a PC have made the information on their hard drive available during their session, so if that user clicks on a phishing link or opens an infected web page that triggers ransomware encryption, impermissible disclosure has occurred.

Reader Comments

From Geno Petralli: “Re: Xcite Health. A client says they’ve been bought by Athenahealth and the EncounterPro/Xcite Health program will be sunsetted and everyone moved to Athena by 1/10/17.” Here’s Athenahealth’s official response (from the head PR person) to my inquiry about this reader’s rumor:

A few hours later, I received this “partnership” announcement from Xcite Health, confirming the reader’s statement that EHR/PM vendor Xcite Health is shutting down as of January 10, 2017 and is suggesting that its now-orphaned clients switch to Athenahealth.

From Roll Liftface: “Re: HIT100 winners. This guy doesn’t appear to have a job beyond self-promotion. Next year you should mock the process by getting your readers to nominate Carrot Top or Prince.” I haven’t heard of at least half of the tweet-happy winners, who seem to participate in a lot of mutual back-scratching among the Twitterati. Twitter isn’t the real world and the job titles of some suggest more success in the former than the latter. I’m sure part of the motivation beyond self-validation is employment, but I think companies would be wary of hiring someone who spends that much time and energy tweeting.

HIStalk Announcements and Requests

Elementary school librarian Ms. H in Texas created a maker space that we stocked with programmable robots and other technology kits in funding her DonorsChoose grant request. She reports, “The younger students were in awe of this technology! I had a few even say ‘It’s Magic’ and I had to respond ‘No, it’s science!’ I had first graders screaming with joy when they got their Ozobot to follow the path they had created for it.”

Webinars

July 13 (Wednesday) 1:00 ET. “Why Risk It? Readmissions Before They Happen.” Sponsored by Medicity. Presenter: Adam Bell, RN, senior clinical consultant, Medicity. Readmissions generate a staggering $41.3 billion in additional hospital costs each year, and many occur for reasons that could have been avoided. Without a clear way to proactively identify admitted patients with the highest risk of readmission, hospitals face major revenue losses and CMS penalties. Join this webinar to discover how to unlock the potential of patient data with intelligence to predict which admitted patients are at high risk for readmission.

Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

The Wall Street Journal publishes fascinating factoids about Theranos CEO Elizabeth Holmes, including that her admiration for Steve Jobs (as evidenced by her black turtlenecks) led her to maintain an Apple-like secrecy about company news until the “one more thing” type public reveal. She also hired an Academy Award-winning director to film videos of herself. She is also escorted everywhere by an earpiece-wearing security detail that refers to her as Eagle 1. The article notes that her presentation to the American Association for Clinical Chemistry next month won’t include the information she originally intended since FDA said she couldn’t, so she’s going to instead focus her talk on Theranos company history (yawn). WSJ’s readers always provide insightful comments:

• Hey, investors in Eagle 1–do you guys really know what you’re doing? Heaven forbid that you actually consult with someone who actually KNOWS SOMETHING about diagnostics.
• I just hope that this story helps to shed light on the loophole in the law that allowed Theranos to promote tests that were not scientifically validated or to bring a spotlight to the many start-ups that continue to raise funds on the basis of hype and revenue growth, but without any real business plan or hope of profit.
• This is what the VC’s seemed to really lust after, the idea that Theranos was going to move the bulk of blood testing out of doctor’s offices disrupt LabCorp and Quest as if they were stodgy old taxi companies. Theranos was really an "Uber for _____" and a data hoovering company. How many more clinically relevant (but smaller and less sexy) medical companies could have been funded with the money that was wasted on this?
• I hesitate to draw any parallels between Holmes and Jobs because Jobs actually built products that worked as advertised.
• I know a former employee of Theranos. This person got out when they realized this company was all smoke and mirrors. Also, this person told me that the whole Elizabeth Holmes story is all PR driven fluff (boldly dropping out of Stanford, starting the company on her own, etc.). Holmes actually has a lot of political connections in DC and is related to the Fleischmann Yeast fortune. Why are there so many politicians on the Theranos board and very few MDs?
• It is possible that the famous Reality Distortion Field attributed to Mr. Steve Jobs might have been taken one step too far in this one case.
• She is working in that exciting grey area between novel scientific breakthrough and scam.
• Seems "Fake it ’til you make it" doesn’t work with medical technology.

Protesters picket Washington State clinic operator Zoom because it doesn’t accept Medicare or Medicaid, which the company logically replies is exactly its business model in offering quick, technology-powered local care for which Medicare pays poorly if at all. Protesters, many of them representing unions and those who want universal healthcare, issued a statement saying that population segmentation causes inefficient, lower-quality healthcare. Zoom’s CEO responds, “Don’t think that we have to be all things to all people.”

Stella Technology acquires Zigron Healthcare to expands its web and mobile app development, ETL, BI, QA, and user experience design services.

ECG Management Consultants acquires the healthcare consulting division of Kurt Salmon US.

Emergency medical services software vendor ESO Solutions – which offers an EHR and healthcare data exchange platform — receives a growth equity investment from Accel-KKR.

I missed this from a couple of weeks ago: investors including Blue Shield of California buy out MeYou Health, which offers behavior modification and social tools for health plan members. The new CEO is Rick Lee, co-founder of the acquired and then failed Healthrageous. MeYou Health company was previously owned by Healthways.

Aprima will consolidate its North Texas offices and 250 employees in Richardson, TX.

Sales

In the UK, Pennine Care NHS Foundation Trust chooses FormFast for its paperless health initiatives.

Rady Children’s Hospital – San Diego (CA) selects Strata Decision Technology’s StrataJazz for decision support, cost accounting, and contract analytics.

East Texas Medical Center Regional Healthcare System (TX) chooses Orion Health’s Rhapsody Integration Engine.

People

Jennifer Karstens (Encore Health Resources) joins Orchestrate Healthcare as area VP.

Announcements and Implementations

The American Heart Association’s Institute for Precision Cardiovascular Medicine will award 14 data-related grants in the next year and will provide winners access to Amazon Web Services to analyze and share their information. The grants will cover data mining, data methods validation, development of data analysis tools, and fellowships for scientists interested in computational biology training.

NCQA awards Premier its first Electronic Clinical Quality Measures Certification, verifying its ability to report clinical data for HEDIS and CMS EHR inventive measures.

Government and Politics

President Obama writes a JAMA paper (bylined as “Barack Obama, JD”) describing the impact of the Affordable Care Act. He describes the decrease in uninsured citizens and the elimination of cost-sharing for preventive services and lifetime coverage limits. He says reform needs to continue via CMMI, ACOs, MACRA, precision medicine, and the Cancer Moonshot. He asks Congress to revisit his original proposal to offer a Medicare-like public plan that would add competition in areas served by a small number of insurers. He also wants Congress to force drug companies to disclose their actual production costs and to give CMS the authority to negotiate prices for expensive drugs. The President warns of the influence of special interest groups:

The second lesson is that special interests pose a continued obstacle to change. We worked successfully with some health care organizations and groups, such as major hospital associations, to redirect excessive Medicare payments to federal subsidies for the uninsured. Yet others, like the pharmaceutical industry, oppose any change to drug pricing, no matter how justifiable and modest, because they believe it threatens their profits. We need to continue to tackle special interest dollars in politics. But we also need to reinforce the sense of mission in health care that brought us an affordable polio vaccine and widely available penicillin.

CMS announces that the median deductible on marketplace-issued health insurance policies is $850, down from $900 last year, when the subsidies the federal government gave to 60 percent of those policy-holders is figured in. The announcement glosses over the 40 percent of people who bought insurance from Healthcare.gov and state exchanges without federal handouts for their premiums and deductibles, the latter of which for silver-level plans are often the maximum allowed $6,800 for single coverage. As is nearly always the case in the US, the rich and the poor do well at the expense of the middle class.

The Congressional Budget Office calculates that the national debt will rise to 141 percent of the economy’s size within 20 years, eclipsing the previous high of 106 percent that followed World War II. Entitlement programs such as Medicare and Social Security are mostly responsible, along with interest payments on the ever-increasing US red ink.

Privacy and Security

A hospital in China apologizes to the parents of 6,000 newborns whose nursery videos were stolen by hackers and posted on the Internet. Experts say many website developers in China lack even basic security knowledge, adding that the hackers were probably just practicing their skills since the videos have no value otherwise.

A secretary fired by Jackson Health System (FL) for giving ESPN a photo showing the surgery schedule of football player Jason Pierre-Paul, whose finger was amputated following a fireworks accident last July 4, sues the hospital, claiming she’s had nightmares and headaches following what she says were false accusations. The hospital stands by its decision, saying they have electronic proof that she looked at Pierre-Paul’s chart at least four times and left work early the day the information was leaked. 

Other

A hospital in the Netherlands asks players of the wildly popular week-old, GPS-powered virtual reality Pokemon Go smartphone game to stop hunting the game’s imaginary monsters on its campus after several of them wander into its restricted areas. AMC’s tweet above translates to, “There is a sick Pokemon in AMC – we will take care of him. We would appreciate your not visiting.” Other businesses are facing similar headaches: a woman demands that a music festival let her daughter on its private property to play, a cafe bans the game because customers were taking up space for hours, and officials expect game-players to be injured or killed by wandering into roadways or onto railroad tracks while absorbed in gameplay. Players have run across dead bodies, been mugged in sketchy areas in the middle of the night, and admitted playing while driving. At least people who usually sit and stare at their phones all day long will finally get some exercise. I’m sure Nintendo / Niantic are quickly plotting ways to monetize their surprise hit, such as charging businesses to host destinations or to allow users to sell accomplishments back and forth, but it will probably be killed off by the next shiny object (a la Words with Friends and Second Life) before they roll something out.

I received an email touting a healthcare IT job site’s newly published “Health IT Stress Report,” which despite being overloaded with cute infographics and lofty yet lame conclusions, is based on only 470 survey respondents whose method of selection and response rate were unstated. That usually means someone stuck a survey on their website and harvested any willing, self-selected, statistically unrepresentative people who felt like filling it out.

In Canada, a survey of unstated methodology finds that only 21 percent of Quebec residents have used online health tools, causing the cheerleading digital health company authors to incorrectly conclude, “leaving 79 percent of Quebecans wanting digital tools that would allow them to take control of their personal health” (apparently the authors reckon that every single Quebec resident wants digital health tools even though they didn’t ask them.) Respondents were a lot more interested in online banking and social media even though they obligingly answered the leading questions offered about interoperability, electronic prescribing, and EHRs.

Weird News Andy labels this plastic surgeon as “selfieish.” The Ukraine doctor, whose motto is “Love is free, medicine is not,” specializes in breast augmentation and posting selfies and videos taken with his unconscious naked patients on social media. The shameless self-promotion is working – he has a year-long backlog of patients. 

Sponsor Updates

• Edward-Elmhurst Health (IL) says its physicians are saving two hours per shift by using Nuance’s Dragon Medical One cloud-based clinical speech recognition.
• Besler Consulting releases a new podcast on the comprehensive Care for Joint Replacement appeals process.
• ECG Management Consultants will present at the HFMA Region 7 Conference July 18 in Lake Geneva, WI.
• PMD CEO Philippe d’Offay is spotlighted in a Q&A about secure messaging for providers.
• Forward Health Group will participate in the National Governors Association Summer Meeting 2016 July 14-17 in Des Moines, IA.
• Impact Advisors will participate in the “Run to Home Base” fundraiser for veterans on July 25 at Fenway Park in Boston.
• Glytec CMO Andrew Rhinehart, MD offers an overview of DPP-4 inhibitors.
• HCS will exhibit at the Health Forum/AHA Leadership Summit July 17-19 in San Diego.

Blog Posts

• 10 Reasons to Attend Connect Atlanta 2016 (AirWatch)
• Four tips to improve office productivity & accelerate payments (AdvancedMD)
• How to Hack-Proof Your Medical Practice (Aprima)
• Yes, We Really Do Take Patient Calls At All Hours (CareSync)
• Tips for Employee Onboarding (CTG)
• Improving Patient Access: What’s Your 3rd Next Available Appointment? (Culbert Healthcare Solutions)
• You’ve got 1,000 questions; we’ve got answers: Nordic’s collective knowledge sharing tool (Nordic)
• Networking with Purpose (Direct Consulting Associates)
• Before Jumping on the Bandwagon … Know Your Clinical Communication Platform (Extension Healthcare)
• 5 Common EMR Data Migration Questions (Galen Healthcare Solutions)
• 4 Steps to Creating Super Users for Your System Implementation (Hayes Management Consulting)
• Interviewing – Revisiting the Practice (HCTec)
• Interface Engine Selection – 3 Things to Consider (The HCI Group)
• Treat Patient Visits Like Business Meetings? (Healthfinch)
• What a Canadian Rock Star can Teach us About Death and Dying (Healthwise)

Contacts

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

Monday Morning Update 7/11/16

Top News

In what should be the death blow to lab processor and Silicon Valley technology wannabe Theranos, CMS bans CEO Elizabeth Holmes from any clinical laboratory ownership or involvement for two years and shuts Theranos off from receiving further payments from Medicare and Medicaid.

Theranos proved its incompetence even in its response to CMS’s warning letter: the company sent CMS five password-protected flash drives containing supporting information that was so screwed up that CMS couldn’t figure it out, with reports for the same accession number spread over multiple drives, information on the drives that didn’t match the contents of an accompanying paper binder, and random fax coversheets that were not associated with patient test reports (would you really want your specimens processed by a company that can’t keep documents straight?)

The company’s response to CMS’s death sentence inexplicably says it will keep Holmes as CEO, but hints that it might pivot away from the specimen processing business, possibly believing it can license its technology. That Theranos movie Jennifer Lawrence has signed up to do will either never be finished or it will hit theaters long after anyone still cares.

Meanwhile, pathology informaticist  Bruce Friedman, MD of Lab Soft News raises a good question: the American Association for Clinical Chemistry couldn’t resist giving Elizabeth Holmes stage time to promote her dying enterprise at their annual meeting that starts July 31, but shouldn’t they be even more embarrassed now that she’s been banned from the industry in which all of those actual experts work and maybe think about rescinding their questionable offer? She’s an even worse choice than some of the awful ones HIMSS has made (Dennis Quaid comes to mind). I’m starting my campaign to bring Martin Shkreli to the HIMSS stage.

Reader Comments

From Captain Ron: “Re: Epic’s search for a data visualization suite. Microsoft PowerBI, Qlik, and Tableau were in the running. After doing bake-offs, Epic decided to choose none of the above. They will support customers on any BI product they choose. Guess it’s up to the customers to build content for themselves against Clarity and Caboodle.” Unverified. 

From Neo Vespers: “Re: Glenwood Systems, Waterbury, CT. I’m a consultant looking for users of its GlaceEMR – my client is having problems and I can’t find other users.” I’ve never heard of the company or product, but perhaps someone will jump in.

From DJ D-Deadly: “Re: Politico’s e-Health News. They called you are a dirt-disher!” I resent smug attempts at cleverness in dismissing what I do as being National Enquirer-like simply because I report rumors that usually turn out to be partly or fully accurate, especially when sites make that observation even while running something they read on HIStalk and thus calling into question their entire thesis. I consider it a wash since they described me as “oracular,” which I plan to use in casual conversation every now and then. They also linked to HIStalk, unlike most of the time when reporters simply regurgitate what they’ve read here in passing it off as their original reporting.

From The PACS Designer: “Re: AI versus RI. Here in mid-2016 we’re on the cusp of a huge change in how healthcare is practiced. While artificial intelligence (AI) has been championed for decades as a solution to improved learning, healthcare will be moving toward real intelligence through the greater use of ICD-10. With the more specificity, the last year under ICD-10 Clinical Modifications (CM) has given practitioners some experience with this new format. Now on October 1 this year here in the US, we’ll begin to see the benefits of real intelligence or (RI) using ICD-10 Procedure Codes (PCS). Eric Topol from Scripps has an article highlighting where we are going with changes in healthcare through increased levels of patient engagements.” 

HIStalk Announcements and Requests

McKesson’s planned sale of its EIS business that includes Paragon will benefit Cerner the most, poll respondents say. However, nearly as many expect Meditech to gain ground from the sale. BP opines that McKesson made a mess of its acquisitions by sucking the energy out of them, noting particularly that the company spent $500 million developing Horizon Enterprise Revenue Management only to shut it down in favor of small-hospital Paragon. He or she blames offshore-onshore waffling, scope creep, cost, and competing internal projects that left provider executives disappointed and many McKesson employees bitter after never-ending waves of restructuring. Perhaps Kd’s wry comment is the most insightful – McKesson will benefit most because it’s dumping a cash sinkhole that it doesn’t really care about anyway.

New poll to your right or here: do HIPAA fines and settlements broadly increase privacy and security?

Mrs. S from Georgia says her students are using the iPad and quiz contest software we provided in funding her DonorsChoose grant request to reinforce their math skills by competing with each other.

I can’t decide if I’m comforted or horrified that even as the headlines get worse and the potential demise of our democracy seems to be creeping ever closer, disengaged citizens who are isolated from the real world by a self-created fantasy aura of phone geegaws are now obsessed with Pokemon Go. Want to fiddle while Rome burns? There’s an app for that.

Last Week’s Most Interesting News

• England’s NHS scraps its plans for a national database of EHR-extracted patient information after review committees criticizes its opt-out and consent policies.
• A Congressionally-established review committee recommends that the VA replace its old software systems – including VistA – with commercial products.
• NIH awards $55 million in grants for the recruitment of 1 million Americans for the long-term study of their personally collected data and gives Scripps Translational Sciences Institute a five-year, $120 million grant to develop apps, sensors, and processes for recruiting the “citizen scientists.”
• Catholic Health Care Services of the Archdiocese of Philadelphia pays $650,000 to settle HIPAA charges from the 2014 theft of a company-issued iPhone that contained the information of 412 patients, the first time a business associate has been charged with HIPAA violations.
• ONC announces its intention to measure national interoperability progress by using the responses to to existing AHA and CDC hospital surveys.
• A security firm’s tests find that hospitals are not always keeping the PCs and servers that control biomedical equipment current with operating system and antivirus updates, creating a digital soft spot for hackers.

Webinars

July 13 (Wednesday) 1:00 ET. “Why Risk It? Readmissions Before They Happen.” Sponsored by Medicity. Presenter: Adam Bell, RN, senior clinical consultant, Medicity. Readmissions generate a staggering $41.3 billion in additional hospital costs each year, and many occur for reasons that could have been avoided. Without a clear way to proactively identify admitted patients with the highest risk of readmission, hospitals face major revenue losses and CMS penalties. Join this webinar to discover how to unlock the potential of patient data with intelligence to predict which admitted patients are at high risk for readmission.

Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

People

HHS promotes acting CIO Beth Anne Killoran to the permanent position, noting that her IT experience with the Department of Homeland Security gives her strong cybersecurity capabilities.

NHS England names Keith McNeil as chief clinical information officer and Will Smart as CIO. McNeil, who is a physician, resigned as CEO of Addenbrooke’s Hospital last year just before Cambridge University Hospitals NHS Foundation Trust (which includes Addenbrooke’s and The Rosie Hospital) was placed on “special measures” for a number of patient care problems; he was also CEO when the Regulator Monitor investigated the trust’s financial challenges following its $300 million Epic rollout. Smart was CIO at Royal Free London NHS Foundation Trust, which is a Cerner shop.

Genetic testing IT systems vendor NextGxDx names Rob Metcalf (Digital Reasoning) as CEO. He replaces founder Mark Harris, PhD, who will take a demotion to chief innovation officer.

Government and Politics

The Department of Defense gives Cerner another no-bid contract for hosting its MHS Genesis EHR project, raising the project’s hosting costs from $50 million over 10 years to $74 million through the end of 2017. DoD says the extra cost won’t affect the overall $4.3 billion project budget. The Pentagon seems annoyed by the higher cost and says it may recompete the hosting contract next year. 

Technology

I’m questioning the quality of Wired’s breezy reporting in claiming that medical records are a “hot commodity” on the Dark Web, or as it dramatically intones, “the hidden recesses of the Internet” (accompanied by unrelated pictures lifted from Flickr users). They might well be a hot commodity as has been amply reported elsewhere, but this story adds nothing to the discussion. The reporter didn’t uncover a single new fact in simply reciting uncredited headlines from elsewhere and taking as gospel what some IBM guy told her about the Dark Web. She makes the puzzling assertion that hackers intentionally delete patient allergies from their medical record, which I’ve never heard of. She claims that doctors “are reluctant to use dual-factor authentication” without citing any source. She finishes by rambling off topic about steps patients can take to protect their information: don’t email information forms, make sure someone is standing by the fax machine if you fax something (does anyone really do that?), and ask why providers need your Social Security number. The overripe headline is like a movie trailer that baits movie-goers with the best scenes in ringing up their ticket purchase without delivering anything in return once they’ve settled into their seats. It’s pretty scary to see the low standard to which journalism is held these days, where desperate tricks to lure temporary eyeballs somehow continue convincing clueless advertisers to underwrite dumbed-down work.

Other

Ambulatory physicians at  University of Michigan Health System weren’t any more satisfied with Epic than with the homegrown CareWeb it replaced, a two-year study finds, refuting the common belief that post-implementation physician satisfaction improves over time in a J-curve. Instead, most measures exhibited L-curve behavior where they dropped and stayed below baseline. Physician job satisfaction decreased after Epic went live and didn’t catch up in the 25 months afterward; a majority of the doctor respondents believed throughout the two years that Epic hadn’t improved patient safety over the old system; and the EHR’s positive contribution to physician job satisfaction dropped from 62 percent with CareWeb to 8 percent with Epic.

I’ve received several “vote for me” messages via people on LinkedIn and Twitter who desperately want to be named to the pointless HIT100 list of prolific tweeters. Are they really going to be proud of winning, sprinting breathlessly to update their resumes with a faux award and feeling good about their place in the universe for having won it by strong-arming their social media contacts to support them, which suggests that those folks probably wouldn’t have chosen them otherwise?

A Wall Street Journal report says anger is building among patients who are treated in an in-network hospital but who are stuck with non-covered bills from the hospital’s out-of-network specialists. Three-fourths of ACA-issued policies provide no out-of-network coverage at all except in emergencies, and since out-of-pocket maximums don’t apply to out-of-network charges, the patient faces unlimited costs at the non-discounted rates that nobody else pays. ED doctors complain that insurers have reduce their payments knowing they have to treat their patients anyway, while insurance companies say that ED docs reject in-network rates so they can charge whatever they want on out-of-network bills.

China launches a year-long campaign that urges angry patients and their families to refrain from attacking the employees of its overloaded hospitals.

Sponsor Updates

• Valence Health will exhibit at the AHA Leadership Summit July 17-19 in San Diego.
• Huron Consulting Group will present at the AHA Leadership Summit July 17-19 in San Diego.

Blog Posts

• The Advisory Board offers RTLS Resources, Case Studies (Versus Technology)
• The 5 Biggest Headaches for Retail Pharmacists (West Corp.)
• Cutover: The Missing Link for a Successful Go-Live (Impact Advisors)

Contacts

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

News 7/8/16

Top News

England’s NHS scraps its plan to create Care.data, a huge national database of patient information that was to be extracted from provider EHRs.

NHS planned to sell the partially de-identified information of patients who didn’t opt out to drug companies and other willing purchasers, but decided to end the program after two commissioned reports criticized its opt-out and consent policies as being less than transparent.

Reader Comments

From Jolter: “Re: Athenahealth. The company is not immune to the same challenges as competitors, as feedback on this software rating site about their Streamlined upgrade says. I had caught wind on their last investor call that Streamlined isn’t well regarded within their customer base. Instead of worrying about unbreaking healthcare, they should be unbreaking AthenaClinicals.” Physician customers say Streamlined has changed Athenahealth’s EHR into a click-intensive “opaque, cumbersome product” that “has made a mockery of the Athena system” that is now “the worst system I could have ever imagined,” with Athena’s support reps blaming Microsoft or whatever browser the customer is using for their many problems. A pulmonologist says Athena is “crippling my practice” and claims the company is censoring its client forum. Athenahealth is also getting publicly ripped by many customers on Facebook over the forced upgrade. One doctor summarizes Streamlined as, “When it works, it stinks. When it does not work, it really stinks.” It’s tough to keep riding the “disruptor” horse when you’re a publicly traded company worth $5.5 billion, have an installed base of customers to maintain, and need to fawn to impatient investors who constantly demand improving profits. Imagine the outraged fun Jonathan Bush would have with this seemingly major stumble if he ran Epic or Cerner. Athena has quite a few product and acquisition balls in the air, so this is where they get to prove that they earned their seat at the Wall Street table as something more than a future-promising puppy nipping at the heels of dowdier but much larger and experienced competitors.

HIStalk Announcements and Requests

We funded the DonorsChoose grant request of Mrs. D from Nevada in providing math learning games for her kindergarten students. She reports, “As I pulled each math activity out of the box, they cheered, begging me to open it! …  the students thought it was ‘amazing’ and ‘so cool’ that a complete stranger would give us math games … The real gift within that box was the gift of knowledge and understanding. For some of my students, these math games are more than just math games, they are clarity and a road to success and confidence. I have witnessed so many ‘light-bulb-moments’ while using these games. Knowing my students are grasping complex mathematical concepts (for their age) is the greatest experience!”

This week on HIStalk Practice: Sciton gets into practice support. MyIdealDoctor adds behavioral health to its telemedicine services. VITL presses for a less burdensome patient opt-out policy. HHS ramps up opioid prevention efforts, including mandatory PDMP use at FQHCs. Urgent care clinic closes in the face of telemedicine competition. AAPS caves to Brexit clickbait.

Webinars

July 13 (Wednesday) 1:00 ET. “Why Risk It? Readmissions Before They Happen.” Sponsored by Medicity. Presenter: Adam Bell, RN, senior clinical consultant, Medicity. Readmissions generate a staggering $41.3 billion in additional hospital costs each year, and many occur for reasons that could have been avoided. Without a clear way to proactively identify admitted patients with the highest risk of readmission, hospitals face major revenue losses and CMS penalties. Join this webinar to discover how to unlock the potential of patient data with intelligence to predict which admitted patients are at high risk for readmission.

Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

Scotland-based Craneware announces record sales for the year ending June 30, with revenue rising 60 percent on $58 million worth of contracts.

Sales

UC Irvine Health (CA) chooses Infinite Computer Solutions and Optimum Healthcare IT for EHR migration.

People

Nat’e Guyton, RN, PhD (Trinity Health) joins Spok as chief nursing officer.

Bob Sullivan (IBM Watson Health) joins interactive patient technology vendor Sonifi Solutions as GM of its healthcare division.

Bob Kyte (Adventist Risk Management) replaces the recently retired Don Kemper as CEO of Healthwise.

Announcements and Implementations

Validic joins SAP’s Connected Health ecosystem, offering users of SAP Health Engagement the ability to integrate patient-generated health data.

Government and Politics

ONC issues a white paper contest for the potential uses of blockchain in healthcare, with submissions due July 29. Up to eight winners get their  travel expenses paid to present their paper at a NIST-hosted workshop September 26-27 in Gaithersburg, MD.

The government of South Australia finally funds the initial planning project for the migration of SA Health’s long-sunsetted patient administration software. The system’s vendor, Global Health, sued the government for breach of contract after it repeatedly refused to stop using the 1980s-era system, of which it is the only remaining user. The SA government has been focused on its troubled Allscripts EPAS rollout, but the state’s rural hospitals aren’t included in the implementation plan and also haven’t committed to upgrading to the current Global Health product.

Peer60 is doing research on Brexit’s impact on England’s NHS. I was curious about its preliminary results even though they’ve surveyed only 80 hospital leaders so far (out of 200+ responses expected). Respondents offered some interesting comments:

• “Prior to the referendum, both campaigns threatened Armageddon if we left/stayed in EU. They both also said we’d each receive a puppy and have champagne for breakfast if we left/stayed in EU. We’d also be better looking and lose weight if we left/stayed in the EU. None of these have come true. The distinct lack of definitive outcomes, even now, make it difficult to have an opinion, apart from the long-standing one that Westminster is full of liars and has absolutely no interest in the well-being of UK citizens.”
• “Welcome to the third world.”
• “More likely to have positive impact as will help with controls re: EU residents who do not pay UK national insurance and taxes from using NHS resources –  this service will need to be funded in the future. We can work through the staffing issue by working differently, researchers will find ways to continue to collaborate. Impact is in needing to find work around and other change.”

John Halamka suggests that CMS eliminate existing EHR certification requirements and instead require vendors to demonstrate only five specific EHR capabilities:

• Use OAUTH2/OpenID to verify trusted exchange partners.
• Use a FHIR-based query to request an electronic endpoint address.
• Use a RESTful approach to push data to an endpoint.
• Use a FHIR-based query to request the location of a patient’s records.
• Use a FHIR-based query to exchange a common data set of key elements.

The Federal Trade Commission drops its anti-trust challenge of the proposed merger of the only two hospitals in Huntington, WV following the state’s passage of a law that was intentionally written to shield hospital mergers from federal scrutiny. The FTC walks away with a warning that hospitals can work together to deliver clinical integrated care without buying each other in reducing competition, noting specifically that while it rarely intervenes in such hospital mergers, its quality and cost red flags were raised in the Huntington market.

The independent Commission on Care, established by Congress to review the VA following the wait times scandal, includes among its recommendations that the VA replace its “antiquated, disjointed clinical and administrative systems” with commercial software products and that it establish a VHA Care System CIO position reporting to the chief executive. The chair and vice-chair of the commission are both CEOs of provider organizations that use Epic (Henry Ford Health System and Cleveland Clinic).

Privacy and Security

A federal appeals rules that anyone who shares a password may be violating the Computer Fraud and Abuse Act, which is intended to address hackers. The case in question involved an employee who gave his company password to former employees, but the ruling could technically allow people to be prosecuted under federal law for sharing their Netflix log-ins.

Innovation and Research

NIH awards $55 million in precision medicine grants to study the self-contributed data of 1 million volunteers, with the lead recruiting centers being Columbia University Medical Center (NY), Northwestern University School of Medicine (IL), the University of Arizona (AZ), the University of Pittsburgh (PA), and the VA. Vanderbilt, Verily, and the Broad Institute will provide data analytics. In addition, Scripps Translational Science Institute and Eric Topol, MD (whose summary of the project is above) will  get $120 million over five years to develop apps, sensors, and processes to recruit the “citizen scientists” and give them the ability to share their collected information with their physicians. The scientist in me loves the idea, but the public health angel on my other shoulder wishes we would focus on the less-sexy blocking and tackling of reducing infant mortality, managing expensive chronic conditions, addressing social determinants of health, and resolving the ugly dichotomy of expensive “healthcare” vs. “health” in applying equal vigor to chasing goals that move the overall health needle further without having as their primary motivation the eventual lining of someone’s pocket.

Technology

The Wall Street Journal suggests that Apple fanboys resist the urge to pounce on the just-released public beta of iOS 10, warning that it’s buggy (not surprising for a beta release) and a pain to revert back to the prior version if things go wrong. The article tries to talk up a few new features, but they seem lame.

Other

Mylan Pharmaceuticals has jacked up the price of decades-old emergency allergy auto-injection EpiPen to nearly $600 per two-pack over the past few years, giving cash-poor, high-deductible insurance consumers and public service agencies the choice to either go without the drug or draw up the much-cheaper generic ampules into syringes as needed for emergency doses. The drug was prescribed 3.6 million times last year as Mylan turned its 2007 acquisition into a billion-dollar product that provides 40 percent of its profits, pushing federal legislation that encourages schools to stock the injections and to recommend two doses instead of one per allergic episode. Mylan, which has a market cap of $22 billion and makes a lot of money selling drugs to the federal government via Medicare, shifted its headquarters offshore in 2015 to dodge US taxes.

The number of HIEs has dropped from 119 to 106 as federal funding ended, a study finds, with half of the surviving ones reporting that they are not financially viable. The most prevalent HIE problems include lack of a sustainable business model, the inability to integrate HIE information into provider workflow, and lack of funding.

Another study in Health Affairs that reviewed AHA’s IT survey data finds that hospitals that use their area’s dominant EHR (usually Epic or Cerner) engaged in a lot more data exchange than their competitors that run other EHRs, which the authors speculate is because it’s easier to exchange information with other Cerner or Epic shops and that those vendors will help make it happen. My takeaway is that hospitals in a mostly-Cerner or mostly-Epic region that use different EHRs have to spend more money to exchange information and are thus less likely to do so, especially if their competitors are indifferent or hostile to the idea.

AdvancedMD tweeted out this photo of their team-building Lego derby. It’s always fun to see the folks in the trenches.

Smokers are less likely to buy health insurance than non-smokers, apparently because they are unwilling or unable to pay the higher smoker premiums allowed by the Affordable Care Act. The penalties levied for not being insured don’t seem to be working, especially when they represent only a small fraction of the cost of insurance.

I’m not entirely convinced that this Microsoft email is genuine even though he company has apologized for it, but it’s still funny to picture some low-level, corporately oppressed recruiter (whether it be at Microsoft or Epic) trying to relate to the kids he or she is recruiting by inviting them — in their cringe-worthy, baby-talk vernacular – to stop by for “hella noms” and  “dranks” just like someone’s white bread mom scanning Urban Dictionary looking for hip phrases to drop at the most embarrassing moment possible.

Sponsor Updates

• Aprima announces that its EHR/PM meets MACRA/MIPS requirements.
• ID Experts will present at the SANS Data Breach Summit August 18 in Chicago.
• Navicure will exhibit at Mississippi MGMA July 13-16 in Biloxi.
• Experian Health will exhibit at the Nebraska Association of Healthcare Access Management July 14-15 in Grand Island.
• The SSI Group will exhibit at the FSASC Annual Conference & Trade Show July 13-15 in Orlando.

Blog Posts

• Owned Media is the Best Media (Influence Health)
• What Does a Radio Shack Ad from 1991 Have to Do with Healthcare Payments? (InstaMed)
• This Isn’t “Logan’s Run” (Orion Health)
• Freedom (but no fireworks) for Physicians (PatientKeeper)
• 3 “must haves” for simplifying complex clinical communications (PerfectServe)
• Five Irresistible Reasons to Choose PeriCalm (PeriGen)
• What is a Provider to You? (Phynd Technologies)
• There’s a FHIR in the House, Don’t Get Burned (Summit Healthcare)

Contacts

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

The House Call Comeback

HIStalk looks at the resurgence of house calls, aided in part by government-sponsored value-based care programs, a need for increased market share, and growing consumer demand for app-enabled convenience and pricing transparency.
By @JennHIStalk

In today’s technology-driven society, the concept of the house call may seem quaint, evoking Norman Rockwell-esque images of the neighborhood physician toting his black bag down Main Street to Grandma’s house. Mobile health tools, however, are turning that image on its head as providers look to increase market share by increasing patient access points.

While house calls have always been around to some degree, digital health startups like Pager, Heal, and PediaQ are putting a new spin on what it means to “go to the doctor.” Even more traditional home care companies like Visiting Physicians Association are placing more emphasis on the role technology plays in caring for the elderly and chronically ill, often with the aid of government-backed incentives.

This new era of house calls is not without its detractors, however. Some physicians are quick to point out that patients can’t establish a true, trusting relationship with this new generation of house-call providers, and that care coordination will suffer. Others, especially those in more metropolitan areas, point to struggles for market share between the local health system, urgent care centers, and app-based house call companies.

Consumers will likely have the last word, as their increasing insistence on convenience and easy access, plus heightened awareness of healthcare costs, leads them away from higher-priced health system monopolies into the arms of the more tech-savvy (but somewhat unproven) competition.

Smart Phones Make the Difference

Dallas-based PediaQ has made technology a core part of its business model. Founded in 2014, the app-based pediatric house call provider has raised $6.4 million to date and has already expanded beyond Dallas to three additional cities in the Lone Star state.

“PediaQ has been developed as a function of change in our culture towards on-demand services, as well as innovation in creating new access points for health systems that are expanding their networks to capture market share,” explains CEO Jon O’Sullivan, adding that the cultural shift to making purchasing decisions via smart phone played a big part in PediaQ’s decision to steer clear of brick-and-mortar locations. “I’ve been on the business strategy side of provider services in healthcare for over 25 years now, and for much of that time I worked with health systems that sought to expand their market share through their provider networks. Throughout that time, I’ve watched the healthcare market evolve to a much more consumer-driven equation.”

While PediaQ’s funding seems to indicate investor confidence, O’Sullivan points out that building trust with customers and the surrounding healthcare community has taken time. “Initially, like any new brand, we had to spend a majority of our resources on consumer education,” he says. “However, once parents started using PediaQ and were able to experience the ease and comfort of a house call for a sick child, the results were nothing short of phenomenal. The main catalyst for our consumer activation and expansion very quickly became the users themselves.”

When it comes to perceived competition with local PCPs, O’Sullivan points out that the company sees itself as an augmenter and supporter of the relationships its customers have with their PCPs. “We’re not out to replace that relationship,” he says, “which is reflected in the fact that PediaQ focuses on after-hours care and ensures that the medical record from the visit is delivered to the PCP the next day.”

Easier Access, Less Windshield Time

Aside from apps, telemedicine has probably had the biggest impact on the resurgence in house calls. It has certainly given companies like Aspire Health and MedZed an edge over more traditional home care companies, especially when it comes to “windshield time.”

Technology has been crucial to the nascent success of Atlanta-based MedZed, which identifies itself as a telemedicine-enabled home care company that provides “21st century house calls” for high-risk and needy patients.

“We decided we had to go into the home in order to service these people,” says MedZed co-founder and chief medical officer Neil Solomon, MD. “We were also well aware that it’s very expensive to pay a doctor or even a nurse practitioner to drive all over the place, especially in certain geographies that are either very spread out or have heavy traffic, like Los Angeles. You can only do maybe four or five visits in a day if you’re driving. It’s inefficient. Plus, there aren’t enough doctors to do this in order to scale this kind of business.

“Our model utilizes telemedicine to make the delivery of care much more efficient,” Solomon says, adding that the first half of a MedZed visit is spent between a care provider and patient going over medications, screenings, and assessments, while the second half is spent on remote consult with a physician, all of which is documented in MedZed’s Drchrono EHR.

“All of our care providers can see the same notes in our EHR,” Solomon explains. “We can export those notes in a fashion that other EHRs can read. We can import laboratory and pharmacy data from other sources so that we can see the full picture of the patient.”

MedZed seems to have distinguished itself from other modern-day house call companies in that it has written its own software for HIPAA-compliant video conferencing and logistics.

“Writing the logistics software was challenging,” Solomon admits. “It helps determine where to send each care provider during the course of the day, figures out drive times, and interfaces with the PM systems of MedZed-affiliated physicians so that they can easily access our video consults. We couldn’t find software on the market that could do all of that.”

Palliative Care Made Easier

Founded in 2013 with high-profile help from former Senator Bill Frist, MD, Nashville, TN-based Aspire Health incorporates telemedicine as well as a number of other technologies into its business model, which focuses on home care for seriously ill and end-of-life patients. Aspire Health Chief Medical Officer Andrew Lasher, MD has seen technology make a tremendous impact on the company’s ability to provide compassionate palliative care to its patients in 11 states and Washington, DC.

“Patients and families are more connected than ever,” he points out. “Secure video conferencing can be an incredible adjunct to high-touch care at the bedside, and in some cases can act as a stand-alone visit. Much of what we do at Aspire is communicate – clearly and compassionately – with vulnerable patients and the people who love them. These family members often live far away, and we can use telemedicine to bring a distant family member to the bedside. There are also medical conditions that can be evaluated perfectly well with video, and many patients will tell you that the conversations they have with a doctor or nurse practitioner through telemedicine is every bit as sacred and impactful as the ones they have in person.”

“There are a number of other technology supports that can support care of the seriously ill,” Lasher adds. “We’re only just beginning to scratch the surface with remote-monitoring devices that help keep track of blood sugar, blood pressure, and that connect isolated patients to Aspire and community-based resources in moments of crisis. We’re seeing that these sorts of devices can integrate fairly seamlessly and in no way hurt the patient experience. Patients can often be reassured through technologic connection, and it only makes the care we provide more personalized.”

Aside from telemedicine, the Aspire team is also looking at solutions around the storage and transmission of advance care-planning documentation, solutions around immediate notification of when patients go to the ER or hospital, and placing tablets in patient homes that enable Aspire caregivers to monitor symptoms and needs on a daily basis. “Anything that helps us relieve a patient’s suffering or avoid an unnecessary and dangerous hospital stay is something we’ll investigate,” says Lasher. “I expect that we’ll be doing more with technology in the next year as the evidence base increases and the offerings improve.”

Analytics and Home Monitoring will be Key to Independence at Home

Home monitoring technologies are also in the cards for the Visiting Physicians Association, a key participant in the Independence at Home program for Medicare beneficiaries with complicated chronic health problems and disabilities. The pilot house call program, now in its second year, helped save Medicare $25 million in its first year thanks to reduced costs associated with improved medication adherence and fewer ER visits and hospital readmissions. Nine of the 14 participating practices, five of which are run by VPA, earned bonuses totaling nearly $12 million.

“VPA has achieved favorable results because of the technology we deployed into the home setting,” explains Dave Viniza, chief information officer of US Medical Management, VPA’s management services organization. “Our Aprima EHR has offline capacity second to none. Our physicians have a full patient medical record regardless of the connectivity of the patient’s home. Because we were searching for consistent, informed, real-time medical decision-making, VPA also deployed StatusScope, a home-grown application that keeps providers informed, during their visits, of recommended disease-driven protocols.”

“VPA has also used predictive analytics to identify the most at-risk patients and prevent unwanted ER visits,” he says. “By reducing those, we reduce unnecessary and unwanted hospitalizations. We’re continuing to develop those analytic tools. We’re implementing an enterprise data warehouse and dashboard analytics system, as well as implementing a care management system that will automate and streamline the development of non-physician care plans and patient management.”

“We’re also investigating appropriate home-monitoring tools for our patients,” Viniza adds. “We would like to marry the monitoring to predictive applications so that we can improve early identification of approaching medical needs. The end goal is to continue reducing ambulatory-sensitive ER and hospital utilization.”

Opportunity Abounds

While there’s no doubt that this new era of house calls is being fueled by technology, the industry-wide shift to value-based care – however slow it may be – is also helping things along.

“Patients prefer to be at home when they can be,” Lasher says. “That’s especially true for patients with chronic or life-limiting conditions. They know that the hospital isn’t always the best place to be, and that the best treatment for them may occur in their home – treatments that can help them live longer and feel better. For Aspire, seeing our patients where they live is a real privilege. Value-based care is such an accurate statement, since, for the vast majority of our patients, their own personal values make it clear what kind of care they want, and how it should be delivered.

“Clearly, there’s a lot of opportunity to expand what can be done outside the hospital or clinic, and to care for people on their own turf, rather than in a medical setting,” he adds. “Black doctors’ bags are going to be back in style, if they’re not already.”

News 7/6/16

Top News

ONC will measure MACRA-mandated national interoperability progress using metrics from two existing surveys: the percentage of providers who say they are sending and receiving information (AHA’s Information Technology Supplement Survey) and the percentage who say they actually use the information of other providers to make clinical decisions (CDC’s annual EHR survey).

Reader Comments

From Addison in Madison: “Re: Epic non-competes. Epic’s modus operandi is to demand new agreements with any change in status / business. Your employer has perhaps been steady for a while, so they are operating under an old agreement. It is when something changes that Epic introduces their new demands. What changed for Accenture was the acquisition of Sagacious. Same with Navigant’s Epic-related acquisitions. When that happened, Epic put the agreement back on the table, with the new stipulations. You can expect the same if your firm is ever acquired or does any acquiring.”

From Voice of Reason: “Re: Epic non-competes. The reason Epic might be doing this is because both Sagacious and Vonlay were bought out by Accenture and Huron Consulting Group respectively. Epic might be thinking since Accenture and Huron provide a variety of consulting services, their Epic consulting division might pass on proprietary info to their other divisions that might compete with Epic. I don’t think Nordic has these restrictions since they only deal with Epic consulting.”

From Dr. T: “Re: Epic non-competes. what may happen is when Epic learns of the new facility you are going to, there is a quiet conversation with the old employer. Then they call the new employer and say, ‘We won’t do business with that person.’ Guess what happens? You don’t have a job, you can’t prove who talked to which manager/exec, and you don’t have the deep pockets to fight it. I saw it myself and almost had to get the toes out to keep counting how many times it happened with an old employer.”

From DrM: “Re: Epic non-competes. I predict Epic’s approach to the consultants will be what brings down the whole non-compete house of cards for them. Does anyone else find it strange that, shortly after starting up their own consulting firm, they impose rules on competing consulting firms that will (purely coincidentally, I’m sure) reduce the number of available consultants? Other companies have lost anti-trust suits for doing less. I also hope in the trial they bring up their trade secrets so they can be told the definition of trade secrets, i.e., you actually have to try to keep them a secret.”

From Apt Moniker: “Re: Twitterati. I, too am never sure whether Twitter means anything in real life. However, senior execs often watch their own Twitter accounts, although not the company one.” Twitter, Facebook, and LinkedIn are, at least for individual businesspeople, vanity platforms. Heavy users like feeling followed and it gives them a place to tout their self-perceived wonderfulness in humble-bragging to others who are doing exactly the same thing in a never-ending stream of self-promotion. Twitter in particular is full of updates that are simply links to questionable source material with the apparent goal of being the first to highlight something new or to appear to be better read. My experience is the same as what big web publishers have reported – I can get a ton of tweets and retweets linking to my original HIStalk page and it doesn’t boost site traffic one bit. From that I conclude that the Twitterers are happy just to read that the page exists, but free of the motivation to click the link to see what it actually says.

From See My I/O: “Re: leading CMIOs. Here’s a link to the top 15.” Sorry, that’s just the usual time-wasting magazine crap story, or in this case, a pointless but painful to watch slideshow. There’s no stated methodology behind the list – the magazine apparently just chose some names they recognized and proclaimed those CMIOs as “leading” in trying to amass clicks that advertisers might mistake for influence.

HIStalk Announcements and Requests

We funded the DonorsChoose grant request of Mrs. H, whose Arkansas elementary school science class needed activity tubs for their Friday projects and labs. She reports, “The students really enjoyed the force and matter experiment in which they had to attach a balloon with a straw to a string and release it to see who’s balloon traveled the fastest. The conversations we got from students were amazing and after each group went students discussed what they could do better next time to make their balloon travel quicker. These were some fun times — we are so competitive.”

I pledged transparency to a reader who asked me awhile back to list not just new HIStalk sponsors, but also those companies that don’t renew. I don’t like doing that because I take it as a personal failure, but I promised. With that, I’ll say goodbye and thanks to the following companies with whom I parted ways in the past year because they were acquired, went a different direction, tightened their belts, or lost the employee who was my only contact there.

AirStrip
Anthelio Healthcare Solutions
AT&T
Aviance Suite
Awarepoint
Burwood Group
CareTech Solutions
CitiusTech
DataMotion
Greencastle Group
Greenway Medical Technologies
MBA HealthGroup
McKinnis Consulting
MedAptus
Oneview Healthcare
PDS
Porter Research
Provation Medical
Sensato
Streamline Health
VMware
XG Health Solutions

Webinars

July 13 (Wednesday) 1:00 ET. “Why Risk It? Readmissions Before They Happen.” Sponsored by Medicity. Presenter: Adam Bell, RN, senior clinical consultant, Medicity. Readmissions generate a staggering $41.3 billion in additional hospital costs each year, and many occur for reasons that could have been avoided. Without a clear way to proactively identify admitted patients with the highest risk of readmission, hospitals face major revenue losses and CMS penalties. Join this webinar to discover how to unlock the potential of patient data with intelligence to predict which admitted patients are at high risk for readmission.

Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

Digital pathology startup Proscia raises $1 million. The founder and CEO just earned his BS from Johns Hopkins. I’m amused that the company’s write-up says the team has filed “over eight patents” and been involved with “more than four technology companies,” making me wonder what’s wrong with just saying “nine” and “five.”

UnitedHealth Group sues publicly traded American Renal Associates Holdings for fraud, complaining that the dialysis company convinced its Medicare- and Medicaid-eligible patients to instead sign up for UnitedHealth insurance at no charge, arranging to have their premiums paid by a charity whose funding comes from providers who benefit from having better-insured patients. Government programs pay American Renal Associates about $300 for a dialysis treatment while it can bill UHG $4,000 for the same session, giving the company a profitable loophole in billing more in claims than it costs to pay for the patient’s insurance. The Affordable Care Act requires insurance companies to accept all people regardless of their health, but HHS has been vague on whether it’s OK for charities that receive most of their funding from providers to pay individual premiums directly.

Sales

Mayo Clinic will implement Visage Imaging’s Visage 7 enterprise imaging platform throughout its radiology practices.

Announcements and Implementations

Carefluence earns the first API certification issued under ONC’s criteria, with Carefluence Open API 1.0 earning certification for patient selection, data category request, and data request. I note several misspellings on its home page, including a claim that it was designed to “demistify” interoperability, which suggests fog removal. The company’s website has minimal information (such as location and management team), but it appears to be connected to the equally reticent technology vendor ModuleMD.

Among the winners of MD Buyline’s user satisfaction surveys are Aesynt (pharmacy robotics), CareFusion (pharmacy automation), Epic (EHR), GE Healthcare (cardiology PACS, perinatal information systems, RTLS,and time and attendance), Healthcare Insights (financial decision support), McKesson (staff scheduling), Philips (PACS), Premier (ERP), SCC Soft Computer (laboratory information system), Siemens Healthineers (cardiology PACS), and Vital (3D advanced visualization).

Government and Politics

The government of South Australia continues to defend its over-budget and delayed $315 million EPAS patient care system even as the auditor-general warns that the project is underfunded and unlikely to deliver $113 million in savings. The Allscripts Sunrise system is live at some sites and will be phased in when the new flagship Royal Adelaide Hospital opens.

Privacy and Security

Catholic Health Care Services of the Archdiocese of Philadelphia will pay a $650,000 HIPAA settlement related to the 2014 theft of a PHI-containing, company-issued iPhone that was not password protected. The phone contained the information of 412 residents of the six nursing homes it owned and managed. OCR found that CHCS had not published a policy about taking mobile devices off campus and had not developed a risk analysis and risk management plan. Most interesting is that CHCS was charged as a business associate rather than as a covered entity since it was the corporate parent of the nursing homes and provided technology services to them.

Atlantic Health System (NJ) sends 5,000 randomly selected employees an email saying they’re getting raises, telling them to just confirm by clicking a link and entering their employee ID number, data of birth, and ZIP code. One-fourth of them opened the email and two-thirds of those provided their personal information. The email was actually a phishing test that mimicked known hacker practices such as using an originating email address ending in .com instead of .org. Several employees complained that the promised raise wasn’t real, but on the upside, quite a few reported the email as suspicious and warned co-workers not to fall for the trap.

Innovation and Research

Researchers find statistical bugs in the software that interprets functional MRI results, leading them to question the validity of 40,000 studies.Poor archiving and data sharing practices mean the existing studies can’t be re-analyzed with better software.

Technology

London’s Moorfields Eye Hospital is sharing de-identified eye scans with Google DeepMind, which is developing artificial intelligence for early detection of diabetic retinopathy and macular degeneration.

An Apple iOS 10 update this month will allow iPhone users to sign up as organ donors with the Donate Life America registry and be flagged as an organ, eye, and tissue donor on the phone’s Medical ID emergency information display.

Other

Neuroradiologist Shyam Sabat, MD calls for BMJ to retract the “shoddy science” tabloid-like pseudo-study it published in May that claimed medical errors are the third-leading cause of death in the US. His analysis of the paper finds that four studies were improperly combined into a meta-analysis that really left just one 2004 Healthgrades study of Medicare recipients, which the authors then wildly extrapolated to all inpatient admissions. He concludes,

How a reputed group such as the BMJ could not see through these simple but outrageous statistical blunders is anyone’s guess. Did the overwhelming incentive to get a spice tabloid-type, eye-catching headlined paper prevent the editorial process from taking common sense decisions? The result is that the US medical community is being ridiculed by media and people not only from the US but the whole world who cannot understand how US medical system is so incompetent despite spending the maximum in the world and attracting the best talents from all over the world.

The Boston Globe notes the trend of doctors working night shifts in hospitals, where “nocturnalists” oversee the activities of overworked residents, reduce the number of calls to attendings, and get patients out of the ED and into beds when indicated.

Cleveland stakes its claim as “The Medical Capital” by launching a rebranding initiative, a new website, and a new testimonial video. In other words, you should take their word for it because they blew through a ton of marketing money in proclaiming themselves #1. Maybe it will draw business, but I can recall many weed-infested empty lots bordering desolate highways festooned with signs proclaiming that area to be some town’s “high-tech corridor” that never quite caught on.

Dear naive people who cry foul when drug companies raise the prices of critical drugs for no good reason, saying those companies are “putting profits ahead of patients:” that’s exactly what for-profit companies are supposed to do. It’s unconscionable when health systems and insurance companies hide their huge bottom lines behind non-profit status, but for-profit corporations exist for a singular purpose, to deliver maximal profits to shareholders. The understandable outrage would be better focused on advocating for government-led drug price involvement like the rest of the world uses, which leaves US consumers footing the bill for most drug company profits and research investment.

Powell Valley Hospital (WY), which struggled for years to get its $2 million NextGen hospital EHR working well enough to earn Meaningful Use money, learns that the product’s new owner, Harris Computer Corporation, won’t add MU Stage 3 capabilities to the product. Harris has offered to replace NextGen with QuadraMed for just the installation cost, but the hospital would still need to spend over $1 million. Harris confirmed that it will provide only break-fix support for the NextGen hospital system, saying it acquired the product because NextGen was going to shut it down anyway.

A former naturopath (ND) who left a lucrative practice after observing a colleague administered an unapproved cancer drug says that “naturopathic services are quackery” and scoffs at ND ambitions to be recognized as primary care physicians. She writes,

Essentially, naturopaths want to be allowed to take shortcuts. Instead of attending medical school, naturopaths attend their own, self-accredited programs with low acceptance standards and faculty who are not qualified to teach medicine. Instead of a standardized and peer-reviewed medical licensing exam, naturopaths take their own secretive licensing exam that tests on homeopathy and other dubious treatments. What little medical standards that seem to be tested on the exam have been botched, like the one question in which a child is gasping for air and the correct answer on how to treat is to give a homeopathic remedy.

Sponsor Updates

• Clockwise.MD will exhibit at the UCAOA Regional Conference in Philadelphia on July 14-15.
• Audacious Inquiry comments on MACRA NPRM V5.
• Boston Software Systems launches a podcast series covering EHR migration, system optimization, and the sunsetting of legacy systems.
• CareSync is featured in a USF Health article on Tampa’s digital health opportunities.
• ClinicalArchitecture will exhibit at the Military & Government HER & Health IT Symposium July 13-14 in Arlington, VA.
• Cumberland Consulting Group will attend the 340B Coalition Summer Conference July 11-13 in Washington, DC.
• Elsevier will develop a free benchmarking report detailing the current landscape of cancer research and collaborations as part of the national Cancer Moonshot initiative.
• Healthfinch joins the Athenahealth Marketplace.

Blog Posts

• Meditech 6.x Outperforms Other EHRs on CMS Quality and Value Measures (Meditech)
• Advanced Practice Training: AdvancedInsight Reimbursement Analysis (AdvancedMD)
• Curing Weak Patient Engagement with mHealth Apps (AirWatch)
• Burgers and Fries and Data (Arcadia Healthcare Solutions)
• Live from HFMA ANI 2016 (Besler Consulting)
• MACRA: Reporting for Quality’s Sake (Caradigm)
• Oncology Care Model: 196 Physician Group Practices and 17 Insurance Companies to Participate (Carevive Systems)
• When an EHR Isn’t Enough (ECG Management Consultants)
• Meditech 6.X: Facing Transition Decisions (Galen Healthcare Solutions)
• MACRA 101: 9 Things to Know (Hayes Management Consultants)
• Building Rapport – Relationships for Success (HCTec)
• Go-Live Support: Procedures & Reporting (The HCI Group)
• Declaration of Health Independence (Healthwise)

Contacts

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

Monday Morning Update 7/4/16

Top News

A security firm’s research finds that PCs and servers controlling hospital medical equipment often run outdated operating systems that are vulnerable to old malware such as the Conficker worm, giving hackers an easy back door into the hospital’s network. The report notes that hospitals are usually zealous in protecting end user PCs, but sometimes forget the computers that run CT scanners, dialysis machines, and other FDA-approved medical devices.

A case study involves a top hospital whose X-ray equipment was running Windows NT 4.0, which the security firm observed being penetrated in time to stop it. Honeypots created at another hospital found hackers hitting Windows XP-based systems for radiation oncology and fluoroscopy.

Reader Comments

From Orlando: “Re: Epic’s non-compete provisions. I wonder if they’ll try this in California?” California’s position on non-competes is that anything that restrains competition is automatically void. However, we’re back to the fundamental problem: no matter how questionably enforceable a non-compete agreement is, the employee has to decide whether to sign it and hope it will all work out when they leave because their only other option is to mount a long, expensive legal challenge either before or after their departure. Readers have pointed out that both Epic and Cerner have aggressive, mandatory non-compete agreements with employees but rarely enforce them if the employee leaves in a civil manner. Another challenge is that Epic could kill an employment offer from a third-party consulting firm or a health system by simply placing an off-the-record phone call. “You’ll never work in this town again” is pretty much true if you cross someone at Epic an try to jump ship to work for someone who relies on Epic’s goodwill, regardless of what legal terms you did or did not sign.

HIStalk Announcements and Requests

McKesson’s health IT legacy will be modest, suggest poll respondents who characterize its contributions as poor (45 percent) or fair (43 percent). Commenters blamed disconnected and poorly managed acquisitions, a lack of healthcare IT focus similar to other companies that entered health IT with a big splash and later slunk out quietly (Siemens, GE, AT&T, IBM, and Oracle), and leadership pulled from the sales ranks. New poll to your right or here: which company will benefit most when McKesson sells its EIS business that includes Paragon?

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

We funded the DonorsChoose grant request of Mrs. Robles from Arizona, who says the iPad Mini and multimedia receiver we provided to her middle school class has been “a game-changer for all of us” as the students have been more inspired to work harder at math using the lessons and discussions she assigns.

Also checking in is Miss V from Utah, who had said in her grant request that she was “sometimes embarrassed as their teacher because we are a STEM school and yet I don’t have a single math manipulative in my classroom.” We bought her several sets, leading to her update: “The manipulatives you donated are more versatile than I ever thought possible, we use the counters for language bingo, shapes, math, and much more. Since we have received your donation, math in our classroom has become a lot more interactive and hands on. Miss V. and the math detectives will be solving hard math problems for years to come thanks to your amazing gift!”

Here’s how you know you’re in a low-growth geographic area: the clerk at Walgreens asks for your telephone number to look up your Balance Rewards Card and enters it wrong as you’re reciting it because they weren’t expecting a non-local area code. That suggests: (a) the area hasn’t grown enough to need more than one area code, and (b) they don’t get many people moving in since most would keep their old cell number containing their original area codes.

Last Week’s Most Interesting News

• A hacker offers the patient databases of three providers for sale after those organizations decline to pay him or her to keep them private.
• Teladoc announces plans to acquire consumer engagement software vendor HealthiestYou for $155 million in cash and stock.
• AMIA announces the requirements for taking its informatics certification exam.
• McKesson announces that it will divest its Technology Solutions business into a new joint venture company that it will co-own with Change Healthcare and that it will exit the business following the new company’s 2017 IPO. McKesson will also seek strategic alternatives for its Enterprise Information Solutions business, which includes the Paragon hospital information system.
• Allscripts brings back three original executives from its EPSi financial planning business and files a lawsuit against competitor Strata Decision Technology, accusing the company and former Allscripts chief marketing and strategy officer Dan Michelson – hired by Strata as CEO in 2012 – of using confidential Allscripts information to improve the KLAS rankings of StrataJazz in displacing Allscripts’ EPSi from the #1 spot.

Webinars

July 13 (Wednesday) 1:00 ET. “Why Risk It? Readmissions Before They Happen.” Sponsored by Medicity. Presenter: Adam Bell, RN, senior clinical consultant, Medicity. Readmissions generate a staggering $41.3 billion in additional hospital costs each year, and many occur for reasons that could have been avoided. Without a clear way to proactively identify admitted patients with the highest risk of readmission, hospitals face major revenue losses and CMS penalties. Join this webinar to discover how to unlock the potential of patient data with intelligence to predict which admitted patients are at high risk for readmission.

Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

UK-based Network Locum, which matches hospitals with available locum tenens doctors, raises $7 million.

Xerox will lay off 95 employees of its Orlando-based Medicaid administration program due to “the business decision of a single client.” 

Sales

East Jefferson General Hospital (LA) chooses NThrive – the former MedAssets, Precyse, and Equation – for revenue cycle outsourcing.

Government and Politics

The Brexit-induced devaluation of the British pound could leave NHS unable to afford expensive drugs manufactured elsewhere, experts fear.

Go Andy Slavitt. You’re going to miss him when he leaves his federal job soon.

The federal government erases $171 million in loans made to students of bankrupt, for-profit Corinthian Colleges, which at its peak ran 100 campuses serving 75,000 students who received $1.4 billion per year in federal student loans. The students who voluntarily chose the aggressively marketed but questionably useful training programs (some healthcare-related) offered by Corinthian Colleges get to walk away from their debt as does the company itself, leaving federal taxpayers holding the bag for the unwise decisions made by everyone except themselves.

Other

Vancouver’s Island Health will press on with its $135 million Cerner implementation despite last week’s unanimous no-confidence vote by its medical staff, who warn that the system’s electronic order entry is changing, cancelling, and overriding their orders. ED and ICU physicians have already gone back to paper orders after voicing similar patient safety concerns.

Catholic Health Initiatives will get out of the health insurance business after incurring big losses, adding big non-profit health systems to the list of organizations that believed they could compete with much-hated big insurers despite having minimal expertise in assembling a good risk pool and managing member health. 

Endocrinologist Joseph Aloi, MD of Wake Forest Baptist Medical Center (NC) describes in an interview how he uses Glytec’s Glucommander software to manage diabetic ketoacidosis. He notes that the #1 concern in treating older diabetic patients is hypoglycemia and it’s often caused by inpatient transfers out of dialysis, patients who aren’t eating, or NPO patients whose routine insulin dose isn’t adjusted. They’re looking at using Epic as a teaching tool to warn physicians if an insulin drip is discontinued and there’s no order for basal insulin, a practice used successfully used by Sentara.

I was wondering while watching fireworks Sunday night if any NFL’ers blew their fingers with firecrackers off this year.

This is a pretty funny tweet, although I wouldn’t have been as kind in not calling out the fact that there’s no such thing as EST until the clocks move back in November. Why do Americans struggle so much with the simple concept of EST in the winter, EDT in the summer? (or just plain ET year round for those who just can’t keep them straight.) I’m not clear on what the HIT100 is, but it seems to reward and excite the Twitterati. I used to feel proud when a big company re-tweeted me until I realized it was a 24-year-old marketing assistant charged with tweeting something positive about the company. It’s not like Neal Patterson is manning or even reading Cerner’s Twitter since most decision-makers have more important things to do than screwing around with social media.

This must be doubly digital medicine: a robotic rectum developed by Imperial College London for practicing rectal exams.

Sponsor Updates

• Over 500 WeiserMazars employees volunteer at over 20 community organizations in five states during its second annual “Days of Service.”
• ZeOmega receives a perfect SOC 2, Type 2 Report following an audit of its IS services.
• Xerox is named a leading contact center outsourcing service provider in Everest Group’s 2016 report.

Blog Posts

• Improving Hospital Efficiency through Data Driven Analytics (TeleTracking)
• Hybrid IT: It’s About More Than Infrastructure (Tierpoint)
• Go-Live Support: Procedures & Reporting (The HCI Group)
• Busted 2016: Prominent Healthcare Fraud Schemes (Verisk Health)
• Summer’s Health Melts the ICD-10-CM Code Freeze (VitalWare)
• The powerful potential of smartphones. (Voalte)
• 5 Steps Towards a Modernized Healthcare Contact Center (West Corp.)
• 5 Reasons You’ll Want to Attend this Year’s ZirMed User Group Conference (ZirMed)
• Dynamic Diagnostic Support (Zynx Health)

Contacts

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

News 7/1/16

Top News

Massachusetts General Hospital (MA) notifies 4,300 patients that their information was exposed in a February 2016 breach of dental practice systems vendor Patterson Dental Supply. Dental system security guy Justin Shafer notified the company in February that all instances of its Eaglesoft software are insecure because the database uses a default username of “dba” and a password  of “sql.”

The company expressed its thanks in May 2016  by filing a Computer Fraud and Abuse Act claim in which it notified the FBI that Shafer had illegally accessed its server, leading to a pre-dawn raid on his home by a dozen armed agents who hauled him away in handcuffs.

SRS commented on the screenshots I ran showing hacker TheDarkOverlord (who I’ll refer to as “he” even though he or she hasn’t divulged gender) sitting on an SRS EHR log-in screen as he apparently used Remote Desktop Protocol (RDP) to steal their client’s patient data:

Protecting our clients’ patients’ information is a top priority at SRS. Upon receiving notification that patient data from one of our clients may have been compromised, we immediately launched an investigation. While our investigation has concluded that the SRS system itself was not compromised, we are working in partnership with our client to assist in any way we can. At this time, the matter has been turned over to the appropriate authorities.

The hacker published several SRS screen shots showing full patient information. SRS is right, though – accessing a system by breaching RDP isn’t taking advantage of a vulnerability of any system other than RDP. It’s just logging in using someone else’s credentials. The real question is how he obtained the log-in information. RDP can store system usernames and passwords that can be displayed with readily available utilities. It would be interesting to know whether the clinic had set up RDP for its own users or whether a software vendor had configured it for remote support use.

Justin Shafer (see above) speculates that the SRS client is Athens Orthopedic Clinic (GA) based on partially readable information in the SRS screen shots. DataBreaches.net contacted the clinic and received this response from its CEO:

In the last 48 hours, we were made aware of a potential data breach relating to our online patient records. Today, we also received an email requesting that we comply with the hacker’s request (which has been published in various forms online.) We take the privacy of our patients very seriously, as well as the laws that guide patient privacy, and we are investigating what may have happened through the proper channels. When we have more information to share with you and your readers, we will be in touch. Kayo Elliott, CEO, Athens Orthopedic Center.

TheDarkOverlord also named the Midwest provider from whose system 98,000 records were stolen and then listed for sale: Midwest Orthopedic Pain & Spine in Farmington, MO.

The hacker says he contacted each provider and offered to destroy his copies of their records if they paid him, with the alternative being that he would offer their records for sale. All of the providers declined. Note that this is extortion rather than a ransomware attack since he didn’t lock the users out of their own databases – he just demanded money in return for not publishing the records. He also apparently accessed the systems using manual intrusion methods rather than automated malware.

I scoured the Web for how to secure RDP:

• Use strong passwords.
• Keep both client and server versions current since older versions have many vulnerabilities.
• Enable network-level authentication.
• Administrator-level users can run RDP by default, so either remote unneeded administrator access or remove the administrator account from RDP access and add a technical group instead.
• Set a local security polity limiting the number of password attempts.
• Change RDP’s listening port so it can’t be easily seen in hacker network scans.

Here’s a chillingly factual description of how to hack RDP to steal the sysadmin password. The hacker uses address resolution protocol scanning software to find device IP addresses; captures the data stream when an RDP client connects to the RDP server (such as when a vendor connects to provide technical support); and then looks for passwords in the sniffer file, visible as individual user keystrokes (or the hacker can use a brute force password cracker).

Vendors, you might want to give your customers some emergency security guidance about configuring RDP, TeamViewer, LogMeIn, or any other remote support tool your support agreement requires.

Reader Comments

From Green Tomato: “Re: forcing consulting firm employees to sign Epic’s non-compete agreement. Here’s a copy of what my employer insists we sign. Interesting contents: (a) it completely restricts access to Epic code without ‘pursuant to a customer schedule’ language, so the company has already run into engagements that require review of Epic code; (b) it restricts access to the Chronicles database, again costing my company a couple of engagements because they needed to query Chronicles to support a customer; and (c) it includes the hugely overreaching and offensive clauses declaring that we can’t work for an Epic competitor for one year after leaving our current jobs. I’ve heard that other consulting companies have signed agreements without the non-compete clause. I am standing up to my employer in not signing the agreement and will likely lose my job in the next few weeks. Without getting a group together for class action lawsuit, I’m essentially screwed, and even with a group it would be an uphill battle.”I don’t have the expertise to evaluate the legality of a company requiring its employees to sign another company’s non-compete agreement, but firing someone for declining to sign would seem to sit in wrongful termination territory. The fact that your employer even put this in front of you is indicative of just how scared companies are of getting on Epic’s bad side. I invite legal opinion, although I think you are correct that, right or wrong, you would need a lot of time and money to mount a challenge, and by the time you prevail, you will have moved on. You also have the document in Word, so you could add “not” in a key place (such as, “This restriction will not apply to you”), print it, and sign it hoping that nobody notices your edit.

From ThisChangeIsNotGood: “Re: McKesson and Emdeon. They fall short in integrating acquired products and their customer service lacks. Change Healthcare and Relay have KLAS scores that lag almost 10 points behind their competitors. Why will bringing two challenged organizations together be good for customers? The obvious answer is that it won’t – it’s just a very profitable transaction for Blackstone. They acquired Emdeon for $3 billion and used at least $1.5 billion in debt, so this deal gives them $1.75 billion in cash ($250 million in profit) plus they still own 30 percent of the resulting entity. The release mentions $150 million in cost reductions which has to be mostly employees – the companies are huge cash generators because their customer contracts are old and those customers are drastically overpaying. The question is how long hospital CFOs will tolerate out-of-market prices with mediocre solutions and customer satisfaction.” There’s also the question about the degree of alienation felt by McKesson Technology Solutions customers and whether they see that getting better or worse once they’ve been dealt off to NewCo since, most importantly to McKesson, they buy a lot of non-IT stuff that McKesson actually cares about.

From HIStalkFan: “Re: [vendor name omitted.] VP of operations is leaving after the international sales VP left in the past month as well. The company has fired 20 folks in the past few months and seems to be losing business fast.” I left out the name of the cardiovascular information systems vendor for now since the VP is still listed on the company’s executive page. 

From Luke: “Re: VistA. Says its 40-year-old code is hard to manage, unlike that of commercial products.” Maybe, but Epic has been around nearly that long and Cerner Millennium was built in the 1990s. All three products have been enhanced continuously since they were developed, so it’s not like running an un-updated copy of Windows 3.11. The problem with both the DoD and the VA is that they’re going to hand billions over to contractors no matter what product they use and will probably botch their implementations via poor planning and oversight.

HIStalk Announcements and Requests

Mr. H says his Texas after-school STEM class is “beyond excited” about the STEM kits we provided in funding his DonorsChoose grant request. The students have built a robot arm and analyzed pond water, with one student proudly exclaiming while experimenting with a marble roller coaster, “We are engineers in the making!”

Listening: Gary Clark, Jr., accurately characterized by the reader who recommended him as “born two generations too late, Jimi Hendrix crossed with Stevie Ray Vaughn.”

This week on HIStalk Practice: ManagementPlus launches revenue cycle solutions for eye care practices. Jonathan Bush waxes lyrical about his political plans. Allergy Partners develops app to help its patients track meds, triggers, symptoms. VillageMD partners with New Hampshire-based practices to assist with value-based care transitions. HHS selects 200 physician practices to participate in its Medicare Oncology Care Model. "Dr. Trump" promises perfect healthcare for all.

Webinars

July 13 (Wednesday) 1:00 ET. “Why Risk It? Readmissions Before They Happen.” Sponsored by Medicity. Presenter: Adam Bell, RN, senior clinical consultant, Medicity. Readmissions generate a staggering $41.3 billion in additional hospital costs each year, and many occur for reasons that could have been avoided. Without a clear way to proactively identify admitted patients with the highest risk of readmission, hospitals face major revenue losses and CMS penalties. Join this webinar to discover how to unlock the potential of patient data with intelligence to predict which admitted patients are at high risk for readmission.

Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

Marketing intelligence vendor Definitive Healthcare acquires competitor Billian’s HealthData.

Teladoc will acquire telehealth consumer engagement platform vendor HealthiestYou for $155 million in cash and stock. Scottsdale, AZ-based HealthiestYou lost money on $10 million in FY2015 revenue, while Teladoc confirms that it will lose around $50 million in 2016. HealthiestYou offers price comparison and provider search. It seems like a ridiculous multiple for Teladoc to pay for an app that doesn’t seem all that interesting or related to its core telehealth business, but they must know what they’re doing.

Google Capital takes a $46 million position in publicly traded marketplace Care.com, which matches families with caregivers.

Allscripts sues its former chief marketing and strategy officer Dan Michelson – hired by competitor Strata Decision Technology as CEO in 2012 – as well as Strata, claiming that Michelson “has in his possession an external hard drive containing highly confidential and trade secret Allscripts documents and information.” Allscripts claims that Michelson has disclosed its information to Strata employees in violation of his Allscripts employment agreement. The lawsuit also notes that Strata hired several other Allscripts employees, several of whom worked in sales for EPSi, the Allscripts financial planning product that competes with Strata’s StrataJazz. Allscripts contends that it lost the #1 KLAS spot for Decision Support – Business in 2014 to StrataJazz because of the exposed information, causing EPSi to drop to fourth place in the 2015 report.

Sales

GoHealth Urgent Care chooses Orion Health’s Rhapsody integration engine to connect with its health system partners.

Government and Politics

Vice President Biden, questioned at a cancer summit about why medical institutions that receive government grants don’t always publish their research data, responds angrily, “I’m going to find out of it’s true. And if it’s true, I’m going to cut funding. That’s a promise.” NIH Director Francis Collins says the 2008 law requiring taxpayer-funded researchers to submit their clinical trials data to NIH-run ClinicalTrials.gov does not provide an enforcement mechanism, but he expects changes that will allow NIH to levy fines on those who don’t comply or the power to ban them from receiving further grants.

The Wall Street Journal says health insurance deductibles should become the next health policy debate now that 91 percent of the US population has coverage. Since 2004, co-pays have dropped, worker wages have increased modestly, and deductibles have jumped 256 percent to become the #1 health cost concern of consumers as well as the preferred tool for employers trying to rein in annual premium increases.

Congress works on a financial bailout of Puerto Rico, where 9 percent of its population has moved to the US, causing its hospitals to struggle with unfilled beds and an exodus of clinicians that may cause a further downward spiral in employment and business investment. Puerto Rico’s governor observes that its residents pay the same Medicare tax as mainland residents, but it gets less federal funding than the states. Lenders have cut off further loans as debt soars, with one surgeon noting that the hospital’s electricity was turned off for non-payment in the middle of a surgery he was performing.

Other

AMIA announces the eligibility requirements to take the exam for its Advanced Health Informatics Certification, an alternative to the physician-only clinical informatics subspecialty. Until an unspecified time until which the majority of graduate informatics programs are accredited, the requirements are:

• Employment in an operational health informatics role.
• Attainment of a health professions graduate degree plus a master’s in health informatics (for which 36 months of informatics experience in the US or Canada can be substituted). Examples of acceptable degrees are MSN, MPH, NP, PA, DDS, DNP, PharmD, DO, and MD.
• 18 months of informatics work experience.

AMIA’s next steps are to develop the exam’s core content, choose a certifying entity, and launch the accreditation of graduate health informatics programs.

Commonwealth Fund President and former National Coordinator David Blumenthal, MD, MPP says that instead of trying to convince providers to share their patient information, a better way to eliminate information blocking is to put patients in control of their own records as a “consumer-mediated health information exchange.” Patients or their paid vendors would manage and distribute their own information to parties they specify, which could include researchers or public health authorities. Blumenthal says the next steps would be to certify and/or regulate the organizations that will help patients share their information and to give those organizations access to provider EHRs.

Informaticist Harris Stutman, MD ended his “Jeopardy” run Wednesday, earning second place for the day but taking home three-day winnings of $63,500.

BMJ ponders whether it’s OK for conferences to ban live-tweeting of their educational sessions. Arguments for: (a) presentations may include unpublished results and preliminary conclusions; and (b) the presenters may have granted a copyright to journal that is publishing their work. The author suggests that conferences make their tweeting policy clear and that speakers indicate on their title slide whether they are OK with having attendees tweet out photos of their other slides and handouts.

Sponsor Updates

• Audacious Inquiry announces that its Encounter Notification Service is delivering1 million ADT notifications per month.
• Boston Software Systems launches an EHR migration and optimization podcast series.
• Netsmart helps prepare health and human services providers for CARF and The Joint Commission accreditations.
• Representatives from 30 healthcare organizations in Canada visited Toronto’s Humber River Hospital, which claims to be North America’s first full digital hospital, to learn about its Meditech 6.1 system.
• CloudWave is named by Hewlett Packard Enterprise as Preferred Healthcare Network Partner.
• Red Hat will host its annual summit will take place May 2-5, 2017 in Boston.
• Sagacious Consultants releases the June 2016 edition of its Sagacious Pulse newsletter.
• SK&A publishes its annual pharmacy compliance report.
• Sunquest Information Systems hosts a Cancer Moonshot Summit in Tucson, AZ.

Blog Posts

• How Long Should Organizations Take to Notify After a Breach? (ID Experts)
• Earned Media is the Best Media (Influence Health)
• Engineering Solutions to Improve Quality of Care (Ingenious Med)
• The Journey to EMR Adoption: Persistence Pays Off (InterSystems)
• Medical Image Exchange: Which Docs Use it Most? (LifeImage)
• 4 ways to set yourself up for effective data governance (The Advisory Board Company)
• The Biggest Risk of Social Media for Physicians? Not Using It! (Meditech)
• Preparing for the Health System of the Future: 3 Strategies You Should Know (Navicure)
• Managed Services: Your EHR challenges, our solutions (Nordic)
• A Different Kind of Patient Record (Orion Health)
• Re-imagining Healthcare IT (PatientKeeper)
• Is Your Old EMR and Open Door for Hackers? (Mica Health)
• Building an effective care team collaboration strategy: 4 focal points (PerfectServe)
• Addressing the Address Issue in the “Good Neighbor” Policy (Phynd Technologies)
• If You Value Health Data, Set it Free (PMD)
• Spotlight on the Heart of MUSE 2016 (Summit Healthcare)
• Finding Success in Health IT Adoption for LTPAC (Surescripts)

Contacts

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

News 6/29/16

Top News

McKesson will divest its Technology Solutions business into a new joint venture company that it will co-own with Change Healthcare (the former Emdeon), with plans to take the new company public sometime in 2017. McKesson will own 70 percent of the new company and Change Healthcare will own 30 percent.

McKesson will retain its RelayHealth Pharmacy business as well as its Enterprise Information Solutions division, but will “explore strategic alternatives” for the latter, which includes its remaining go-forward hospital information system Paragon along with less-attractive products like Star, HealthQuest, and OneContent. McKesson seems to have lost most of its Horizon customers to Epic or Cerner after they declined to move to Paragon under McKesson’s Better Health 2020 program, so this latest move will likely cause more defections.

The new company will take on up to $6.1 billion in debt to fund the transaction.

Blackstone Group bought publicly traded Emdeon, which operated under the WebMD name through 2005, for $3 billion in 2011 and took it private in a leveraged buyout. It renamed the company Change Healthcare in September 2015 after January 2015 plans for a $5 billion IPO never materialized.

McKesson struggled from the beginning with its $14.5 billion acquisition of HBOC in 1998, dogged by a massive accounting scandal, the resultant firing of several executives who were involved, aging product lines, and a lack of corporate focus. The company, like several before it, dabbled in health IT dispassionately but with the added baggage of having wildly overpaid for an immediately impaired asset. MCK share price dropped and didn’t recover for 12 years under John Hammergren, who was quickly promoted to co-CEO in the leadership void in 1999, eventually becoming the country’s highest-earning CEO.

This transaction, along with the eventual disposition of Enterprise Information Solutions, will once again remove McKesson from the software business.

… but not the day after the transaction closes.

Your trivia questions for today:

• Who was named as Hammergren’s co-CEO in the 1999 announcement that McKesson Chairman Charlie McCall and CEO Mark Pulido had been fired over HBOC’s accounting irregularities?
• What was the name of McKesson’s short-lived online business that was launched in the heady dot-com days of 2000 and led by Hammergren’s former co-CEO, giving Hammergren full control?
• What accounting company failed to detect widespread fraud as the auditor of both McKesson and Enron?

Reader Comments

From ProGoogler: “Re: Change Healthcare. Blackstone finally dumps Healtheon / WebMD / Emdeon / Change onto McKesson? Surprising that Change would dump all assets into a company they’ll only have a 30 percent stake in. HIStalk followers–what’s the take on this?”

From Silly Boy: “Re: McKesson and Change. Throwing their trash into a doomed-to-fail company, ridding themselves of all liability, and getting $1.5 billion each in cash out of it? Wow.” You forget to mention the advantageous tax accounting McKesson will use to walk away.

From Robert Higgins: “Re: dress while traveling. See this LinkedIn post, which says everybody should dress up while traveling on business because they represent the company and you should be extraordinary rather than ordinary.” I can’t imagine anything more mind-numbingly ordinary than a bunch of mid-level company hotshots wearing suits everywhere they go hoping to impress strangers who apparently value cloth over character. Real power players wear whatever they want (see: Mark Zuckerberg, Steve Jobs, etc.) while their un-creative, lemming-like underlings choke on ties. I’ve attended venture capital sessions at the HIMSS conference and my biggest takeaway was that the real money guys looked like they had just dropped by after a family cookout, while back at work my fellow IT management team members would illogically don their always-handy suck-up jackets for internal meetings or restroom trips.

HIStalk Announcements and Requests

The Tennessee elementary school students of Mrs. Jones have shown “amazing growth” in benchmark assessments, she reports, after practicing reading and math on the the three Kindle Fires we provided in funding her DonorsChoose grant request.

I don’t really do anything with LinkedIn except look up people’s job histories, but you are welcome to join the 2,477 people who have connected with me there, of which 351 have written me really nice recommendations. There’s also the HIStalk Fan Club created by Dann many years ago, now up to 3,617 members, many of them CEOs, CIOs, CMIOs, etc. I might tell my mom about it just to see her puzzled double take since surely she views me fondly and accurately as her low-profile ne’er-do-well.

Webinars

July 13 (Wednesday) 1:00 ET. “Why Risk It? Readmissions Before They Happen.” Sponsored by Medicity. Presenter: Adam Bell, RN, senior clinical consultant, Medicity. Readmissions generate a staggering $41.3 billion in additional hospital costs each year, and many occur for reasons that could have been avoided. Without a clear way to proactively identify admitted patients with the highest risk of readmission, hospitals face major revenue losses and CMS penalties. Join this webinar to discover how to unlock the potential of patient data with intelligence to predict which admitted patients are at high risk for readmission.

Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel. Ask Lorre about her “Summer Doldrums Special” sale.

This Tuesday’s webinar by West Healthcare Practice drew nearly 500 registrants and will no doubt generate many YouTube page views after the fact. I always give my first-pass critique of our webinars and rarely have any change suggestions for West. Lots of readers are apparently interested in what Henry Ford is doing with contact centers (including me).

Acquisitions, Funding, Business, and Stock

Allscripts acquires RealCost.io — a decision support company founded by former EPSi executives Tim Rutledge, Ralph Keiser, and John Gragg – and will put the three men back on the Allscripts EPSi financial planning product line to serve as chief product architect, CEO, and COO of Allscripts EPSi, respectively. Eclipsys acquired EPSi in 2008 for $53 million in cash, followed by the acquisition of Eclipsys by Allscripts for $1.3 billion in 2010. All three left Allscripts from 2008 to 2011.

VistA vendor Medsphere and ambulatory PM/EHR vendor ChartLogic will merge.

EHR data sharing vendor Medal raises $3.8 million. Co-founder and CEO Lonnie Rae Kurlander is a 27-year-old medical student at Boston University.

MedAssets-Precyse renames itself nThrive. Pamplona Capital Management bought MedAssets for $2.7 billion in November 2015 and combined its RCM business with Precyse, another of its recent acquisitions.

Sales

Mercy Technology Services adds three clients: Riverview Health (IN) for Epic hosting, McLeod Health (SC) for data analytics, and Peninsula Regional Medical Center (MD) for Epic implementation support.

People

Medical informaticist Harris Stutman, MD (MemorialCare Health System) returns as “Jeopardy” champion Tuesday night following his wins on the Friday and Monday programs that earned him $39,700.

Premier promotes Leigh Anderson to SVP/CIO, replacing the departing Keith Figlioli.

Microsoft promotes Simon Kos, MBBS to chief medical officer. It appears he went to work for industry (InterSystems, then Cerner) directly out of residency without actually practicing medicine.

Announcements and Implementations

Analysis by TransUnion Healthcare finds that patients experienced a 13 percent increase in their deductible and out-of-pocket maximum costs in 2015 at $1,278 and $3,470, respectively. “Patients are becoming the new payer,” the report concludes.

Vital IMages launches its application-neutral archive that connects proprietary data sets for interoperability and workflow.

Government and Politics

In England, Health Secretary and “Remain” supporter Jeremy Hunt calls for additional Brexit referendum votes or other “democratic endorsement of the terms” by which the UK will extricate itself from the European Union. He is considering running for Conservative leadership as prime minister, urging full trading access but with immigration restrictions. Hunt said previously that NHS would face budget cuts and staff shortages should the UK exit from the European Union, a statement pro-Brexit supporters characterized as fear-mongering. Meanwhile, “Leave” campaigners appear to be backtracking on their assertion that withdrawing will free up $467 million each week, of which they had promised that a large portion would be sent directly to NHS to improve healthcare services.

Privacy and Security

A hacker offers for sale the records of 655,000 patients from three unnamed US provider databases and reports that some of the information in them has already been sold. DeepDarkOverlord says he or she exploited an unstated vulnerability in RDP (remote desktop protocol) to take control of the provider computers and steal their patient data, after which he or she offered to return the data for a ransom that the providers elected not to pay. The prices range from $100,000 to $411,000 for each of the three databases:

• An Access database of 48,000 patients from an unnamed healthcare organization in Farmington, MO.
• A plain text database of 210,000 patient records stolen from a Midwestern provider
• A plain text database of 397,000 patient records retrieved from an unnamed Georgia provider.

Apparently one of the hacked providers uses the SRS EHR, based on the hacker’s screen shot of  him or her taking over a Windows 2008 server at the unnamed Georgia site.

The same hacker is also offering a 9.3 million patient record database from an unnamed insurance company, stolen using the same RDP exploit. Security researchers tested sample data and believe it’s an old database since many of the telephone numbers and email addresses it contains are no longer valid.

Technology

Comcast Business creates its largest Eastern US network in providing 100 Gbps Ethernet connectivity between the campus of Penn State Health Milton S. Hershey Medical Center (PA) and the university’s data center.

Other

A survey finds that EHR-using physicians are less satisfied and more burned out, with physician satisfaction low for performing both EHR documentation duties and CPOE. Family medicine, ED, and orthopedic surgery are big trouble spots, while surgeons and ever-affable pediatricians are happier. Interestingly, the method of documentation didn’t affect the burnout rate much – it was about the same for dictation, voice recognition, handwriting or typing, and using scribes. Only 36 percent of respondents said the EHR has improved patient care and just 23 percent said it has increased their efficiency.

Bob Wachter, MD cashes in on the success of his book “The Digital Doctor” in hiring himself out as a thought leader and video star to malpractice insurer The Doctors Company, a role he describes as, “My partnership with The Doctors Company will provide its 78,000 members and other physicians nationwide with the tools and information needed to thrive in today’s rapidly changing digital landscape.”

Sponsor Updates

• FormFast publishes a new white paper, “Delivering ROI: The Case for Electronically Capturing Patient Signatures.”
• FujiFilm will exhibit its Synapse product line at SIIM 2016 June 29-July 1 in Portland.
• A study finds that hospitals that use Nuance’s clinical documentation improvement solutions score better in patient mortality ratings.
• Meditech held its Nurse and Home Care Forum June 15-17 in Foxborough, MA.
• Glendora Community Hospital (CA) goes live on electronic forms from Access and signature pads from Wacom in the ED and admission areas.
• Bernoulli CIO John Zaleski will speak at the IEEE Chase 2016 Conference on Connected Health June 29 in Arlington, VA.
• Besler Consulting wins a B2B Marketer Award for Best Contribution to Sales Account-Based Marketing.
• Carevive Systems shares its latest poster presentation, “Implementation of Survivorship Care in a Network Hospital Setting.”
• CTG and Catholic Health Systems will co-host a symposium, “Exploring the Impact of Security Threats: Is Your Organization Prepared,” June 29 at CTG headquarters in Buffalo, NY.

Blog Posts

• A Banner Year for Bundles (ECG Management Consultants)
• Clinical Communication & Collaboration: Tying it all together (Part 5) (Extension Healthcare)
• Innovation Through Collaboration (Iatric Systems)
• Your organization is now live with a new EHR … what about the legacy stuff? (Galen Healthcare Solutions)
• 8 Things About Healthcare Analytics That May Surprise You, Part 2 of 2 (Hayes Management Consultants)
• Advanced Practice Training: AdvancedInsight Collections Per Total RVU (AdvancedMD)
• Gartner: VMware AirWatch Scores Highest in 3 EMM Use Cases (AirWatch)
• What in the Health IT is PQRS GPRO? (Arcadia Healthcare Solutions)
• Smart mHealth Platform Redefines Adherence (Wolters Kluwer Clinical Drug Information)
• 7-Step Technology Checklist for PHI Protection (Catalyze)
• Architecture of Substance Intolerance (Clinical Architecture)

Contacts

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

McKesson Spins Off Its Technology Solutions Business with Change Healthcare

McKesson announced this morning that it will move its Technology Solutions business into a new company that it will co-own with Change Healthcare (the former Emdeon), with plans to take the new company public sometime in 2017.

McKesson Chairman and CEO John Hammergren said in statement, “This is a bold, innovative transaction that creates a company with an enhanced ability to help customers address their increasingly complex financial and clinical challenges. The new company will establish a more efficient suite of end-to-end payment and claims solutions, as well as clinical capabilities, while unlocking the value of our MTS businesses in a tax-efficient manner. We look forward to partnering with Change Healthcare’s management team and employees to create this new enterprise and to help customers reduce complexity, lower costs, and ultimately provide better care.”

McKesson will receive cash proceeds of $1.25 billion and will own 70 percent of the separate company. Change Healthcare, which is contributing all of its assets except for some minor pharmacy components to the new company, will get $1.75 billion in cash and a 30 percent ownership stake.

McKesson will retain its RelayHealth Pharmacy business. It will also keep its Enterprise Information Solutions division, but will “explore strategic alternatives” for that product line. That means that McKesson’s go-forward hospital information system, Paragon, is up for grabs.

McKesson’s John Hammergren will serve as chairman of the new company, while Change Healthcare President and CEO Neil de Crescenzo will become CEO.

The new company will take on $6.1 billion in debt to fund the transaction, of which $2.7 billion will be used to pay down existing Change Healthcare debt.

Monday Morning Update 6/27/16

Top News

HHS considers running an ethical hacking program to identify cybersecurity vulnerabilities, encouraged by results from the Pentagon’s recent pilot program. The concerns of such a program are that, (a) hackers would by definition be encouraged to seek exposed confidential patient information, and (b) they are likely to find a lot of it, thus requiring someone to take action.

“Hack the Pentagon” was the first bug bounty program run by the US government. It drew 1,410 participants this past April and May and paid $71,200 in bounties, or an average of $588 for each verified vulnerability. Most of the reported vulnerabilities involved cross-site scripting, but one participant discovered a significant SQL injection bug.

The DoD used the HackerOne bug bounty program that provides hacker invitations, a leaderboard, hacker messaging, payments, and workflow.

Reader Comments

From Venus de Milo: “Re: Epic’s new product name. Userweb shows a whole treat titled, ‘We are excited to announce Caboodle as the new name for Epic’s enterprise data warehouse.’” It’s a quirky name, but I like it. At least they don’t use eye-rollingly unoriginal names like Insight.

From Brownian Movement: “Re: Epic. The company forces the individual employees of consulting firms sign a non-compete directly with Epic. If you work for a consulting firm and have access to an Epic client’s system, you can’t work in software or sales for an Epic competitor for one year after leaving the consulting firm.” The non-compete agreement that Epic requires its own employees (and those of its customers) to sign is almost certainly not legally defensible, so it’s even more likely that such agreements signed by the employees of other companies couldn’t withstand a legal challenge. However, Epic’s industry clout and legendary legal firepower cause everybody to sign the paper anyway. Most of the griping happens only when someone wants to change jobs, but the sit-out period would be over before any expensive legal challenge could be completed. Think about Epic’s heavy-handed control – Epic’s new customers are required to let the company administer tests to their employees who want to work on their Epic project. Epic scores the tests secretly, providing only a hire/no hire recommendation. If you score well, you get to work on the Epic project team and thus get to retain your job. Score less well (by whatever standards Epic uses) and you’ll be banished to the legacy maintenance team with all the other rejects, thus assured of losing your job once Epic is live and your legacy system babysitting skills are no longer needed. It is reasonable to expect companies to stack the deck in favor of their own interests unless someone musters a challenge.

From Follow the Money: “Re: DOJ’s bust for a measly $900 million in Medicare fraudulent billing. Reminds me of a poem by James Roche.”

The Net Of Law

The net of law is spread so wide,
No sinner from its sweep may hide.
Its meshes are so fine and strong,
They take in every child of wrong.
O wondrous web of mystery!
Big fish alone escape from thee!

From Stiffie: “Re: healthcare IT writers and reporters. I looked up their lightweight credentials and made you a table of who is out there dispensing analysis and advice.” I don’t necessarily agree since most publications simply rewrite press releases to resemble original reporting, so it would be a waste for them to hire someone with actual industry experience. If these folks can find and keep an executive-level audience, more power to them because it’s not easy.

HIStalk Announcements and Requests

Two-thirds of poll respondents disagree with the AMA’s opinion that technology reduces the efficiency of care delivery. Some of those respondents correctly noted that “efficiency” is in the eye of the beholder, whose personal data capture efforts might – like paying income taxes — detract from their own performance in deference to the greater good. New poll to your right or here: how would you characterize McKesson’s contribution to health IT?

Mrs. Riley’s Maryland second graders are using the 25 sets of headphones we provided in funding her DonorsChoose grant request to access Internet tools and educational games. They are less distracted by the noise of what other students are doing and she can differentiate the simultaneous activities being pursued by her special education subgroups.

My WiFi range extender was performing erratically, so I replaced it with the $30 Netgear N300. You just plug it into a wall jack near the end of the wireless coverage range of your router, connect your smartphone or tablet to the newly created network (whose name, unless you change it, is your existing network’s name plus _EXT at the end), then enter the network password on the setup page.  I’m getting five bars and high speeds far from the router and it’s never hiccupped even once in several weeks. It’s a great solution for coverage problems (distant bedrooms, garage, workshop, or patio) or if you want to stream Netflix from a spot where coverage is too weak to support a high-quality picture. The little gadget even has an Ethernet port if you need to hardwire something.

Listening: Eye Empire, an apparently defunct band that offered the compelling combination of alt metal chops with understandable vocals rather than screaming and grunting, not that there’s anything wrong with that. For an even harder edge with a biker bar vibe (since they love featuring strippers in their videos), there’s always Southern hard rockers Texas Hippie Coalition, which sounds and looks like Charlie Daniels fronting Pantera.

Last Week’s Most Interesting News

• The newly installed president of the American Medical Association says his practice doesn’t use an EHR, preferring to pay the penalty rather than participate in Meaningful Use.
• An HHS OIG analysis finds that one-third of Medicare recipients were prescribed potentially addictive opioids last year at a cost of $4.1 billion.
• HHS credits analytics for helping it identify the 301 people it arrested for Medicare fraud.
• The VA continued its hints about eventually de-emphasizing or replacing of VistA in favor of a commercial product.
• McKesson is reportedly trying to sell its health IT business to Change Healthcare (the former Emdeon).
• A federal report recommends national quality reporting, real-time data sharing, use of best practices, and civilian-military cooperation in reducing 30,000 unnecessary trauma patient deaths each year.

Webinars

June 28 (Tuesday) 2:00 ET. “Your Call Is Very Important.” Sponsored by West Healthcare Practice. Presenters: Cyndy Orrys, contact center director, Henry Ford Health System; Brian Cooper, SVP, West Interactive. The contact center is a key hub of patient engagement and a strategic lever for driving competitive advantage. Cyndy will share how her organization’s call center is using technologies and approaches that create effortless patient experiences in connecting them to the right information or resource. Brian will describe five key characteristics of a modern call center and suggest how to get started.

Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel. Ask Lorre about her “Summer Doldrums Special” sale.

Acquisitions, Funding, Business, and Stock

How health IT stocks performed in Friday’s Brexit-triggered selloff, which I expect to be reversed Monday as investors realize that several mechanisms exist to reverse the UK’s decision and that the timeline is long in any case:

Dow: down 3.4 percent
Nasdaq: down 4.1 percent
S&P 500: down 3.6 percent
Allscripts: down 2.7 percent
Athenahealth: down 0.8 percent
Cerner: down 3.1 percent
McKesson: down 3.8 percent
Quality Systems: down 3.1 percent

People

Paula McCann, VP/CIO of East Texas Medical Center Regional Healthcare System, is appointed to the Texas Health Services Authority board.

Rosanna Morris, RN, MBA, chief nursing officer and Epic EHR implementation co-leader of Nebraska Medicine, is named CEO of Beaumont Hospital (MI).

Announcements and Implementations

IDC Health releases yet another worthless health IT vendor revenue ranking with methodology unspecified. Assuming its information is correct – which I don’t when privately held companies are involved – I don’t know exactly what anyone would do with that information other than, (a) the PR people in companies named to the list who brag on the bestowment of questionable awards; and (b) the uncritical health IT rags that milked this anemic “news” for several paragraphs of slightly reworded press release text. As a customer, I wouldn’t necessarily be delighted that my vendor has more revenue than its competitors, especially if the portion I contributed wasn’t worth what I received in return. Bigger is definitely not associated with better. Perhaps it is appropriate that IDC in text messaging parlance stands for “I don’t care.”

Austin-based revenue cycle technology vendor DaVincian Healthcare, which has raised $50 million in funding, wins a contest for using Amazon’s Alexa to solve financial payments problems. The winning system allows patients to receive prescription refill reminders, ask questions about their prescriptions, and send messages to their providers. I think a lot of people are like me, though – I bought Alexa but never use it since the benefit is unclear if you’re already near a phone and I don’t really know what all it does since Amazon is cool like Apple in not providing a manual. It seems to be best suited for ordering even more stuff from Amazon. The video features a robotic phony doctor decked out in the obligatory scrubs, white coat, and the doctor ego elevation tool (a stethoscope) sitting in what looks like a spare bedroom in front of a desk full of books puzzlingly turned around backwards (they probably didn’t have any actual medical books handy). In fact, the windows in the doctor’s office look exactly like the ones in the patient’s living room and in his daughter’s house, so perhaps they all live together in Alexa-powered health IT communal bliss. Fun aside, it’s a nicely done video and the product is interesting if someone can validate the extent to which Alexa customers have integrated it into their daily lives.

Government and Politics

HHS names Aaron Miri, CIO and VP of government relations of Imprivata, as the privacy and security representative of the HIT Policy Committee. Appointed to the HIT Standards Committee are new members:

• Rajesh Dash, MD (Duke University School of Medicine)
• Kay Eron (Intel)
• Peter Johnson (retired)
• Kyle Meadors (Drummond Group)
• Terrence O’Malley, MD (Massachusetts General Hospital)
• Andrey Ostrovsky, MD (Care at Hand)
• Wanmei Ou (Oracle)
• Larry Wolf (Strategic Health Network)

In Australia, the CIO of Queensland Health and CEO of eHealth Queensland resigns after just seven months on the job to take a private sector position. He was placed under investigation three weeks after taking the job following a nepotism complaint. He was hired by his wife, a Queensland Health executive.

China uses the death of a student from treatments he found from Internet searches to tighten the government’s control over the Internet, requiring search providers to censor “rumors, obscenities, pornography, violence, murder, terrorism, and other illegal information” along with limiting the display of paid ads. That won’t affect Google, at least for the moment, since the Great Firewall has blocked it almost continuously in the years after the company declined to censor search results.

A Vermont citizen advocate wants to know, “What does Vermont have to show for its $50 million investment in VITL?” in referring to Vermont Information Technology Leaders. He questions why patients don’t own their data and claims that VITL’s contract with its technology vendor Medicity requires it to transfer all of its intellectual property and patient information to the company.

Privacy and Security

A newly signed Illinois law requires covered entities that report a data breach to OCR to also notify the state’s attorney general even if the incident doesn’t meet the state’s definition of a breach.

Technology

Here’s your “Jeopardy” question for the week. The answer is, “A study surprisingly finds that you really can go blind from playing with this in the dark.” The correct question: “What is a smartphone?”

Other

A Peer60 medical image sharing report finds that McKesson is leading in installations and recommendation scores, with LifeImage leading the pack by a wide margin among vendors being considered by first-time adopters. The least-desirable image sharing technology is, thankfully, CDs, while cloud networks toped the list and site-to-site sharing came in #2. The highest-risk vendors for replacement are Sectra and Philips, with their  biggest threat being customers who are pursuing a single-vendor strategy and superior technology.

PBS covers the ordeal of a heart bypass patient who verified that the hospital and surgeon accept his insurance, only to get stuck with a $2,200 bill from an ICU doctor who doesn’t. The patient asks reasonable questions of an unreasonable healthcare non-system: “Out of nowhere, somebody who you never heard of, I don’t remember meeting, sends a bill. Why is he not accepting the insurance?  Why is he out of network?” The answer isn’t so simple, of course – hospitals take hundreds of insurances whose coverage varies widely, with the real problem being that hospital bills aren’t all-inclusive even though you might logically wonder why not. The article profiles another patient who was left on the hook for a $5,000 out-of-network plastic surgeon’s bill after rushing to the ED with deep ankle cuts. The hospital answered the reporter’s inquiry with a dry, concise response: “The current system is not optimal.”

Sponsor Updates

• Sunquest will host the Tucson Cancer Regional Moonshot Summit on July 29.
• Craneware will exhibit at the HFMA ANI conference in Las Vegas this week and will co-present a session about pharmacy revenue integrity.
• Optimum Healthcare IT joins CHIME as a foundation partner.
• T-System celebrates 20 years of advancing care delivery and financial outcomes for EDs, freestanding emergency centers, and urgent care.
• ZDoggMD will make an appearance at TeleTracking’s annual conference, October 9-12 in Naples, FL.
• TierPoint is recognized in Gartner’s June 2016 “Magic Quadrant for Disaster Recovery as a Service” report.
• TransUnion, VitalWare, Huron Consulting Group, and Zynx Health will exhibit at the HFMA ANI Conference June 26-29 in Las Vegas.
• Valence Health Chief Strategy Officer Phil Kamp will speak at the HFMA ANI Conference June 26-29 in Las Vegas.
• Visage Imaging and Vital Images will exhibit at SIIM 2016 June 29-July 1 in Portland.
• Wellsoft EDIS publishes a new case study on its work with Kingston General and Hotel Dieu Hospitals.
• ZirMed client Baptist Health will share how it leveraged the company’s revenue cycle solutions at the HFMA ANI Conference June 26-29 in Las Vegas.

Blog Posts

• Clinical Alerting: Moving Beyond Nurse Call (Spok)
• Tips to Help Drive Your Population Health Journey and Avoid the Potholes (Verisk Health)
• Hospitals turn to Voalte for a communication do-over. (Voalte)
• Don’t Compromise Your Enterprise – Understanding the Role of Notifications in Your E9-1-1 Solution (West Corp.)
• Advanced Health Risk Assessments that Work (Xerox)

Contacts

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

News 6/24/16

Top News

The Justice Department charges 301 people (including 61 doctors, nurses, and other licensed professionals) with $900 million worth of Medicare fraud, with many of the cases involving prescription fraud and compounding pharmacies. HHS OIG credits its use of real-time billing data and analytics to identify outliers to investigate.

Reader Comments

From Caboodler: “Re: Epic. Just announced that their data warehouse product will be renamed from Star to Caboodle. This has got to be a new low in their ‘cute and clever’ naming convention.” Unverified, but I’ll be on the lookout for an accompanying product named Kit.

HIStalk Announcements and Requests

Mrs. Hendrickson says her Ohio middle school students are using the voice recorders we provided in funding her DonorsChoose grant request during “read to self” improvement time. She’s also sending the recordings home for the parents to review. She adds, “My students who struggled most seem to have made the most growth with the recorders.”

This week on HIStalk Practice: HHS announces $100 million in funding to help small practices with MACRA. Doctors Care becomes the first urgent care chain in South Carolina to offer telemedicine. American Well expands, welcomes new executive. PediaQ raises $4.5 million. FQHCs in West Virginia partner with Aledade to form a first-of-its-kind ACO. Eye Care Leaders Group gets into consulting. The Maryland Health Care Commission awards telemedicine grants to independent practices. Yard work inspires Dr. Gregg to coin the phrase “EHR litter.”

This week on HIStalk Connect: Samsung unveils its vision for Human-Centered IoT. Digital health insurance startup League raises $25 million. MassChallenge announces the $25.8 million Massachusetts Innovation Catalyst Fund. Online therapy provider Talkspace raises $15 million. Burner unveils a witty break-up app.

Webinars

June 28 (Tuesday) 2:00 ET. “Your Call Is Very Important.” Sponsored by West Healthcare Practice. Presenters: Cyndy Orrys, contact center director, Henry Ford Health System; Brian Cooper, SVP, West Interactive. The contact center is a key hub of patient engagement and a strategic lever for driving competitive advantage. Cyndy will share how her organization’s call center is using technologies and approaches that create effortless patient experiences in connecting them to the right information or resource. Brian will describe five key characteristics of a modern call center and suggest how to get started.

Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel. Ask Lorre about her “Summer Doldrums Special” sale.

Acquisitions, Funding, Business, and Stock

Reflexion Health, which offers Microsoft Kinect-powered tele-rehabilitation software, raises $18 million in a Series B funding round, increasing its total to $30 million. It seems pretty cool, although basing a company on a consumer electronics gadget is risky, as those startups that built their business around Google Glass can attest.

Shares in Quality Systems (NextGen) hit their five-year low this week. Above is the one-year share price chart for QSII (blue, down 73 percent) vs. the Nasdaq (red, up 73 percent), with the company’s market cap at $726 million.

Sales

Eos Healthcare chooses the iTraycer medical device inventory management system from Jacksonville, FL-based Medical Tracking Solutions.

People

American Well promotes Jon Freshman to CTO.

Announcements and Implementations

Vital Images launches Version 7 of its Vitrea advanced visualization software that includes scalable deployment options, personalization, and standardized user interface across all modalities. Vitrea can also turn patient scans into 3D printing-ready files.

Visage Imaging releases new versions of its mobile apps for its enterprise imaging platform with enhancements that include barcode scanning, Touch ID fingerprint authentication, and multitasking views.

Six Sutter Health and Alameda Health hospitals in Northern California implement PreManage ED from Collective Medical Technologies to flag ED frequent flyer patients across their facilities. The Salt Lake City-based company’s real-time EDIE (Emergency Department Information Exchange) system has also been used in Oregon and Washington to reduce unnecessary ED visits.

Cedars-Sinai will offer discharged patients a ride home via HomeHero, a startup in the Cedars technology accelerator that claims to be “the #1 rated healthcare startup in the country.” HomeHero offers non-medical transportation and home assessments for $22 per hour, offering a customer app that allows choosing a provider and booking services in Los Angeles, San Francisco, and San Diego. The CEO’s failed previous venture was Flowtab, an app that connected bar patrons with the bartender for ordering and paying for drinks.

Experian Health announces new products that include Denials Workflow Manager, Compliance Manager, and Patient Financial Clearance.

Government and Politics

Medicare spent $4.1 billion last year to provide 12 million of its beneficiaries (one-third of Medicare recipients) with opioids such as OxyContin and fentanyl, with those patients averaging five such prescriptions filled. The AMA’s righteous indignation toward “digital snake oil” should perhaps be refocused on the free-wheeling prescribing of its members that is addicting and killing a lot more people than lame consumer apps.

Department of Veterans Affairs Under Secretary for Health David Shulkin MD says Wednesday in testimony to the Senate Committee on Veterans Affairs that the VA’s proposed digital health platform “is not dependent on any particular EHR” and that its VistA Evolution funding will deliver value “regardless of whether our path forward is to continue with VistA, a shift to a commercial EHR platform as DoD is doing, or some combination of both.” He adds that the Joint Legacy Viewer is a read-only connection between the VA and DoD systems, but eHMP (Enterprise Health Management Platform) will replace the 20-year-old CPRS as a provider point-of-care tool in 2017.

Other

An study finds that state-run prescription drug monitoring programs reduce opioid-related overdose deaths by 1.12 per 100,000 population. The authors note that West Virginia is the nation’s major outlier – despite implementing such a program in 2002, its overdose death rate is nearly twice as high as the next-highest state.

An interesting article by Mike Klag, MD, MPH, dean of the Johns Hopkins Bloomberg School of Public Health, observes the correlation between the decline in health of US citizens with their stagnant incomes in which the top 1 percent of earners have increased their annual wages 138 percent since 1979 while the bottom 90 percent had only a 15 percent increase in those 37 years, which is associated with an alarming disparity in survival. As is the case with most health measures, the US lags pitifully behind other high-income countries, coming in #43 in deaths of children under 5.

The European Union considers a law that would require companies to pay “electronic persons” social security taxes for robots they use. Governments are worried that such automation will raise unemployment, increase wealth inequality, and undermine employment-based social security programs.

The new president of the AMA says his orthopedic hand surgery practice doesn’t use an EHR, explaining that “I just take the [Meaningful Use] penalties.” I don’t see a website for his practice, either. As an orthopod, he’s probably not amused by the hilarious video above, although I shouldn’t generalize since the orthopedic surgeons I’ve known are among the most prolific jokesters about their profession. 

Sponsor Updates

• Ingenious Med, Leidos Health, and Navicure will exhibit at the HFMA ANI Conference June 26-29 in Las Vegas.
• PDR’s Jeffrey Wiltrout is recognized as a PM360 Elite Disrupter.
• LifeImage and National Decision Support Company will exhibit at SIIM 2016 June 29-July 1 in Portland.
• MedData is named a 2016 Top Workplaces, Workplace Achiever by The Cleveland Plain Dealer.
• T-System celebrates its 20-year anniversary as a leading provider of health IT solutions for episodic and emergency care this week.
• Meditech will exhibit at the Michigan Health & Hospital Association Annual Meeting June 29-July 1 on Mackinac Island, MI.
• Netsmart shares takeaways from its first annual Public Health Summit.
• Recondo Technology, Experian Health, Patientco, PatientMatters, Relay Health, and The SSI Group will exhibit at the HFMA ANI Conference June 26-29 in Las Vegas.
• Point-of-Care Partners expands its e-prescribing state law review resource to include new state mandates.
• Summit Healthcare supports Boys & Girls Clubs of Central Florida, this year’s recipient of the Heart of MUSE charity.

Blog Posts

• Medical Identity Theft: a Deadly Side Effect of Healthcare Data Breaches (ID Experts)
• Influencer Perspective: Slack Adoption (Influence Health)
• Why Time and Place Still Matter in a Connected World (InterSystems)
• Lunch with the Accountable Care Learning Collaborative (Medecision)
• Relieving the data and analytics pressure: 3 Nordic solutions (Nordic)
• Transparency: Shouldn’t Healthcare Consumers Enjoy It the Way Amazon Customers Do? (Orion Health)
• Sum-Sum-Summertime (PatientKeeper)
• Can the NHS go Paperless by 2020? (Lexmark)
• Single Sign-on Increases Security in Healthcare IT (Phynd Technologies)
• Why Analytics Training Should be Higher on Your Priority List (Sagacious Consultants)
• Operating at Peak Efficiency (Streamline Healthcare)

Contacts

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

The Hypocrisy of a Simpler Patient Bill

HIStalk gauges industry reaction to the HHS patient bill design challenge, which aims to highlight the need for easier-to-understand statements and more patient-centered engagement.
By @JennHIStalk

Medical bills, especially traditional paper statements, are not known for being easy reads. More often than not, they are a mixture of codes, abbreviations, dates, and — if a patient is lucky — breakdowns of services and supplies rendered.

The eyes of most patients stray immediately to the balance due, the derivation of which is typically shrouded in mystery. What makes perfect sense to a provider’s or payer’s accounting department causes sticker shock in patients, who feel helpless because they don’t understand what they’re being charged for. The bill inevitably sits unpaid for several weeks while patients wait for some sort of “deux ex machina” that never comes.

It is this frustrating fiscal conundrum that HHS is looking to address with its “A Bill You Can Understand” design and innovation challenge. Announced in early May, the challenge –which “seeks to draw attention to the complexity of medical billing and how patients are impacted” — has two components. One prize will be given to a participant that designs the easiest-to-understand bill. Another will be given for creating the best transformational, patient-centered approach to improving the medical billing system. Earning either prize will be no small feat.

Stop the Insanity

HIStalk readers have wasted no time in sharing their withering opinions of the challenge. Frank Poggio, founder and CEO of The Kelzon Group, got straight to the heart of the matter:

This is the height of hypocrisy. Does CMS think providers on their own created the insane billing requirements and processes? It started with Medicare Part A, then B, then D. Co-payments, deductibles, out of network, referral approvals, contractual allowances, UC charges, and on and on. Next, billing systems will have to deal with VBP, P4P, bundled payments, MACRs, and more. Providers never asked or suggested any of these — they just have to figure out how to carve up charges/costs and services and put it all on a one-page bill. A 1995 analysis found that the Federal Register contains 11,000 pages dealing with an IRS 1040 submission, but hospital billing required 55,000 pages to describe. If CMS really wants to simplify the patient bill, they need to go to a single-payer system. Until they do that (not likely), the patient bill will continue to be the mess it has been for the last 50 years. Who do I call to collect my $5k?

Poggio has a point, of course, but that doesn’t mean attempts shouldn’t be made to streamline the patient billing process, especially when recent studies have found that the most significant patient payment challenges include a patient’s inability to pay or pay on time and the need to educate them about their financial responsibility.

While the challenge hopes to address the education piece, it also opens a Pandora’s Box of questions related to price transparency and consumer empowerment. How can patients become savvy healthcare shoppers if the cost of services they ultimately select aren’t properly explained to them, not to mention agreed upon by all parties involved ahead of time?

A Step in the Right Direction

Ten healthcare organizations, including Cambia Health Solutions, have signed on to test and implement solutions submitted to the challenge. It’s an apt fit for Cambia given its history of focusing on improving transparency within its regional health plans and direct health companies, plus its emphasis on incubating transparency innovation within its collaborative Cambia Grove space.

“At Cambia, we are relentlessly focused on creating a healthcare system that removes confusion, mystery, and pain that it creates for consumers – a system built to engage with and flawlessly serve individuals and their families with respect at every turn and in every encounter,” says CHS President and CEO Mark Ganz. “Producing a medical bill that is simple, straightforward, transparent – and therefore truly accountable to patients – is a huge step in the right direction.”

HFMA Director Sandy Wolfskill echoes Ganz’s comments, adding that, “This new HHS challenge is focused on the medical bill for the patient, so receiving a standardized, understandable bill from all healthcare providers should help patients immediately understand what they owe and why they owe it. There is a very realistic chance that bills will be resolved more quickly.”

Wolfskill also believes that a truly understandable bill will ultimately help patients feel more in control of their care. “As patients, especially those with high-deductible health plans, begin to exercise their options to shop for more affordable, quality care,” she explains, “they will begin to expect that providers are transparent around price and quality, and can explain prices in a way that allows patients to compare providers.”

Ignorance Isn’t Bliss

When it comes to challenge detractors, Wolfskill advises HIStalk readers to remember that “HHS is challenging providers to produce an understandable bill for what the patient owes for the service – and assembling that information is totally in the hands of the providers. Yes, there are multiple stakeholders, but at the end of the day, the provider has all of the information needed, including the impact of the provider’s financial assistance policies, to communicate effectively with the patient about the financial responsibility involved.”

“Rather than ignore this challenge from HHS,” she adds, “providers should realize that this medical billing challenge is simply another step in the transparency journey. HFMA has publicized industry guidance and best practices around price transparency and patient financial communications, and sees this HHS initiative as another component in developing a high-quality, comprehensive financial care approach for patients to compliment the high-quality clinical care already being provided.”

Billing’s Bottom Line

While steps in the right direction and forward momentum on the transparency journey are positives for patients, the challenge and its results may be more of a marketing exercise than a truly game-changing attempt to create an industry standard.

“I think the challenge is a great exercise, but there are ultimately too many competing interests,” explains Patientco founder and CEO Bird Blitch, adding that there will be technological challenges for those providers who use different inpatient and outpatient billing systems. “I think everyone is passionate. People have to think objectively about the payment piece and not just about sending the bill. Payment is what we need to be thinking about, not billing. If we focus on that, then we’ll be answering the right question of how to bill better.”

Blitch brings up a good point. While many providers are beginning to think about patient bill design from a marketing and patient satisfaction perspective, the bottom line of patient billing is still payments received. Patient satisfaction scores could improve in tandem with bill design, but the success of any design standards adopted as a result of the challenge will ultimately be measured in lower provider billing costs related to more timely patient payments.

Better Bills Start with Consumer Friendliness

“If you’re building it to increase patient satisfaction, great,” Blitch says. “Then, you’ve got to understand patient dissatisfaction. I think the biggest thing I might look at from a billing perspective is that it’s written from the standpoint of an accountant. If you look at a lot of these bills, they’re columns, debits, and credits. Most consumers don’t have accounting majors, and so when we look at designing the bill, we look at how consumers are understanding and consuming Web content. We look at not only color psychology, but iconography, even the actual user experience. How do their eyes track? Eye motion up, down, and around the bill happens within split seconds of opening the letter, and that matters. I don’t think providers are looking at it that way yet. They’re still looking at it from the accountant’s viewpoint. The challenge’s stance is that you’ve got to tear your current design down and start over.”

“We all need to be thinking about this from the consumer’s standpoint, but I think we also need to ask, ‘Why are we doing this?’ This is not a bunch of snake oil,” he emphasizes. “We’ve all had terrible billing experiences. Change will happen when it is driven by consumers, or when it is driven from the bottom up. No one thought that the banking industry could be disrupted, but online bill pay did. No one thought that Walmart could be disrupted, but Amazon has done it. No one thought that Blockbuster could be disrupted, but Netflix did it. When you empower the consumer, when industry gets out of the way and lets them choose and gives them freedom to understand, they will respond accordingly.”

(Dis)Satisfaction will Lead to Savvy Shopping

As Blitch mentioned, healthcare’s many stakeholders are passionate about this topic. Whether it’s patient satisfaction or payments received (and it’s becoming increasingly difficult to separate the two), the medical bill of the future will be a key component of a patient’s healthcare journey – perhaps even the deciding factor when the question of follow-up care arises.

The HHS design challenge has at the very least placed a spotlight on the need for more patient-friendly billing, and that’s no small thing given that 47 percent of consumers are paying more attention to their healthcare bills than they did a year ago. That figure will likely increase as premiums and deductibles continue to soar, hopefully making savvier healthcare shoppers of us all.

Morning Headlines 6/22/16

McKesson considers IT unit merger with Change Healthcare

Reuters reports that McKesson is considering merging its health IT business unit with Change Healthcare, the former Emdeon.

Healthcare RCM: Trends in Alternative Payment Model Adoption

A Peer60 report explores adoption of alternative payment models, finding that hospitals under 500 beds are far less likely to transition to new payment models than larger organizations.

VA Won’t Use Law That Allows Expedited Firing of Executives

The VA will no longer use its authority to expedite the firing senior executives after the Justice Department ruled the provision unconstitutional because it denies employees the right to appeal their firing.

CancerLinQ—ASCO’s Rapid Learning System to Improve Quality and Personalize Insights

Robert Miller, MD director of the American Society of Clinical Oncology’s CancerLinQ big data project, describes how the platform works and the value it offers front line oncologists.

News 6/22/16

Top News

Reuters reports that McKesson is discussing a merger of its Technology Solutions IT business with Change Healthcare (the former Emdeon) as MCK sheds its non-pharmaceutical business lines in trying to prop up its share price, which has dropped 24 percent in the past year.

It’s not likely MCK will get anywhere near the $14.5 billion it massively overpaid for book-cooking HBOC in 1998 since most of HBOC’s original product lines are dead or dying, customers were alienated by the poorly devised and executed Better Health 2020 program in 2011, and there’s not much new to crow about other than RelayHealth. But getting out of the IT business should at least temporarily buy time of the “unlock shareholder value” type.

The industry will once again relearn the oft-told lesson that health IT toe-dippers who earn most of their money in unrelated sectors will always bail out for greener pastures while shafting the customers who believed the lofty predictions and promises made by executives who have long since left for greener pastures themselves. I’ll wait patiently while you ponder your answer to, “Name something amazing McKesson has done in its 18 years in health IT.”

Reader Comments

From Lou: “Re: LinkedIn recommendation. I left this for you." That made my day – thanks.

From Able Bodied: “Re: Presence Health (the merger of Resurrection Health and Provena Health). Has decided to go all Epic. Provena uses Meditech. Interesting considering the cost of Epic and that Presence Health bonds have been downgraded by Moody’s to nearly junk status because of poor financial performance and a questionable outlook for the next 18 months. Can you say a merger with a larger system? Word on the street is that they are talking to Ascension.” Unverified. New management at Presence has taken a lot of write-downs, laid off hundreds of people, and had to borrow more than $500 million at the end of May after losing $186 million last year. Resurrection moved from McKesson Horizon to Epic in 2011.

HIStalk Announcements and Requests

I spent quite a bit of time Monday resolving a hack on my AT&T cell phone account. I called the company immediately after receiving $2,300 in emailed payment updates. A hacker had somehow added himself as an authorized user of my account, bought two iPhones on contract, then paid the contracts off in a Washington Apple store.  AT&T telephone support backed out the charges, but I had to go to the AT&T store to have the SIM card replaced. I also changed my password to a stronger one (I admit that my years-old one was weak) and added a second-level security challenge of a four-digit PIN. It’s interesting that my credit card wasn’t compromised since nobody – including AT&T employees – can see the actual credit card number, only the last four digits, but once you’re in the account you can make purchases using it. I was thankful yet again that I use the magnificent LastPass to manage all my passwords for a princely $12 per year, meaning I log on seamlessly to all sites despite having created strong passwords like my new AT&T one.

My overused word of the week: “seasoned,” a meaningless adjective peppered (pun intended) throughout LinkedIn by executives who describe themselves as such instead of allowing the reader to simply peruse their past experience and decide for themselves. I’m also occasionally annoyed by LinkedIn profiles written in the third person or that don’t contain complete sentences and thus give the appearance of being written by a Godcam-like observer instead of the profile holder, such as, “Proven track record of consistently increasing business performance.” If you want to stand out on LinkedIn, be yourself instead of spitting out inflated, boring bullet lists extolling personal greatness. Also, invest in a professional headshot instead of cropping the grainy image of your head from a family photo (or inexcusably not including a photo at all, suggesting body image issues).

I received an email link to the HIMSS member survey today and, as happens every year, bailed out after wading through three dense pages of questions with no end in sight. They just can’t seem to understand that (a) the time requirement should be reduced and clearly stated in the email; (b) the survey should show a progress meter; and (c) making every answer required instead of just assuming the don’t know/not applicable choice as the default is annoying. It looks like a survey designed by a committee of people who don’t know much about surveys.

Mr. Weber (who is a Teach for America teacher) reports that his Hawaii middle schoolers are using the two Chromebooks and assorted supplies we provided in funding his DonorsChoose grant request to dig deeper into math and to perform college readiness work during his advisory time. He adds, “My students were thankful for everything. They wondered who could donate so much to our school without even knowing them. They sincerely appreciated the generosity of strangers, and I think it made them think about ways that they could contribute to society in the future.”

Webinars

June 28 (Tuesday) 2:00 ET. “Your Call Is Very Important.” Sponsored by West Healthcare Practice. Presenters: Cyndy Orrys, contact center director, Henry Ford Health System; Brian Cooper, SVP, West Interactive. The contact center is a key hub of patient engagement and a strategic lever for driving competitive advantage. Cyndy will share how her organization’s call center is using technologies and approaches that create effortless patient experiences in connecting them to the right information or resource. Brian will describe five key characteristics of a modern call center and suggest how to get started.

Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel. Lorre’s getting bored because of the industry slowdown that kicks in every year right about now, so ask her nicely for her “Summer Doldrums Special” that we always run through Labor Day and you’ll get a great deal.

Acquisitions, Funding, Business, and Stock

Pharmacy restocking software vendor Kit Check raises $15 million in a Series C round, increasing its total to $37 million.

The New York Times profiles the struggling Oscar Health, a self-proclaimed insurance disruptor that uses technology to offer consumer-friendly policies. The company, which has raised $728 million and is starting a New York health center to deliver care itself, is losing money because:

• It sells policies only on insurance exchanges, which have enrolled fewer people than expected.
• It’s getting stuck with sicker patients with expensive pre-existing conditions whose coverage is guaranteed by ACA.
• All insurers are realizing that they priced their exchange policies too low to break even, although Oscar’s competitors have the advantage of being able to make up their losses elsewhere.

Philips acquires Northern Ireland-based digital pathology software vendor PathXL.

Sales

The Koble-MN HIE, health data intermediary, and health information organization chooses Orion Health’s Amadeus precision medicine platform.

People

Release-of-information systems vendor Verisma names Marty McKenna (Allscripts Analytics) as president and CEO.

Paul Boemer (FIS Healthcare Solutions) joins PatientPay as EVP.

Announcements and Implementations

Denver Health (CO) goes live on Bernoulli’s Nuvon VEGA medical device integration.

A new Peer60 revenue cycle report finds that about two-thirds of hospitals don’t plan to participate in value-based payment programs, with those under 500 beds being more hesitant to change. They worry about getting stuck with non-compliant patients as competitors cherry-pick the patients that show higher levels of value and thus generate more revenue. Interestingly, the second-most reported expected impact of value-based payment is eliminating IT vendors who can’t demonstrate solid return on investment, with hospitals apparently happy to give them a pass until money gets tight.

The US Patient and Trademark Office issues Aventura its eighth patent, this one covering how the company’s Sympatica situational awareness platform updates virtual resources and applications based on user location in managing roaming computing sessions.

Quintiles opens a healthcare technology and apps accelerator in Research Triangle Park, NC, staffing it with simulation analysts, wearables experts, and user interface designers.

C.L. Brumback Primary Care Clinics (FL) goes live with Forward Health Group’s PopulationManager and The Guideline Advantage.

Scottsdale Institute publishes a report describing the IT challenges involved in creating clinically integrated networks.

Government and Politics

California auditors find that CalVet, the state’s VA operation, has wasted $28 million since 2007 on a since-cancelled EHR contract for veterans homes. The auditors blame CalVet for poor project oversight. CalVet had decided to replace Meditech because veteran histories could not be viewed across facilities, choosing SolutionsWest Consulting (later Brekken Technology) as a replacement even though it was not Meaningful Use certified.

Medicare finally realizes that its fraud-incenting “pay and chase” practice of paying providers first then asking questions later doesn’t make sense as it tests a program in five fraud-famous states (IL, FL, MI, MA, and TX) in which home care providers will have their claims reviewed in advance before CMS pays for those services. CMS previously found that 60 percent of the home care claims it paid were “improper.”

The VA won’t fast-track executive firings now that the Justice Department has ruled that VA employees have the right to appeal their termination to the Merit Systems Protection Board. Rep. Jeff Miller (R-FL), chair of the House veterans panel, said of the VA’s decision not to use the authority given it by Congress in response to the wait times scandal, “Everyone knows VA isn’t very good at disciplining employees, but this decision calls into question whether department leaders are even interested in doing so."

Other

Oncologist and informaticist Robert Miller, MD, medical director of the American Society of Clinical Oncology’s CancerLinQ cancer big data project, describes how the “learning system for oncology” works. CancerLinQ, built on SAP’s HANA platform, extracts data from oncologist EHRs via several methods and standardizes the information with a terminology rules engine and natural language processing. Doctors can query the identifiable information of their own practice’s patients, while de-identified analytics reports are provided by the CancerLinQ team. CancerLinQ provides real-time practice performance analysis against standard quality measures and gives oncologists observational data to support clinical decisions. The article concludes with an excerpt from a journal editorial:

However, how is an individual clinician to proceed when faced with a patient in the exam room with a rare tumor for which evidence-based clinical practice guidelines do not exist, and the patient is not a candidate for a trial? Or a patient with a common malignancy like breast cancer coexisting with a myelodysplastic syndrome with del[5q]? Or the much more common scenario of a patient with compromised renal function faced with the decision as to the advisability of potentially nephrotoxic, but curative adjuvant chemotherapy? The availability of a powerful tool like, CancerLinQ, that can provide insights into the real world outcomes of similar patients, when combined with existing trial-generated evidence and full patient consent, may be transformative to the practice of the art of medicine in these difficult situations.

UCSD Health CIO Chris Longhurst, MD, MS tweeted out this photo from the CHIME/AMDIS CMIO Boot Camp, held this past Sunday through Tuesday in Ojai, CA.

A study finds that doctors who accept inexpensive drug company-paid lunches prescribe more of the brand-name drugs the company sells to their Medicare patients. Perhaps the AMA could look into this instead of chasing imaginary “digital snake oil” or maybe CMS should just buy every doctor a fast food lunch to get on their good side about MACRA. My experience with doctors is this: while maybe a fourth of them apply quid pro quo in intentionally returning the drug company favor by altering their prescribing habits, most of them instead simply overestimate their own objectivity and intelligence in being able to distinguish drug company propaganda from rigorous scientific review. In other words, they actually think they were educated rather than sold to. Drug reps love playing to a doctor’s inflated ego in getting them to do their bidding.

CNBC profiles a former Microsoft designer who was paralyzed by a medical mistake at Overlake Hospital Medical Center (WA). He received a $20 million settlement and a seat at the table as Overlake reviews what went wrong in his case and how systems design work might prevent other errors.

The 66-year-old bass player of Foghat (“Slow Ride”) is left unable to play music due to the side effects of lung cancer chemotherapy. A 2012 CT scan revealed a lung mass and the suggestion “to exclude the possibility of a primary lung neoplasm,” but he wasn’t notified of the finding and nobody followed up. The tiny growth has since spread, is inoperable, and carries just a 4 percent survival likelihood. He’s suing.

Sponsor Updates

• AirStrip is featured in an Ultera Digital podcast on health IT marketing.
• GetWellNetwork Founder and CEO Michael O’Neil is named EY Entrepreneur of the Year for 2016 in the health category in the Mid-Atlantic region.
• Besler Consulting releases a new podcast, “Healthcare Retrospect Part 1: All Americans Were Uninsured.”
• Strata Decision Technology receives “Peer Reviewed by HFMA” designation for the second time.
• Boston Software Systems releases a new podcast, “Migrating Legacy Systems to Epic.”
• Optimum Healthcare IT hires Larry Kaiser as director of marketing.
• Impact Advisors publishes a white paper, “Cutover Plan: The Missing Link to a Successful Go-Live.” 
• Divurgent will exhibit at HFMA’s ANI Conference June 26-29 in Las Vegas.
• E-MDs will host its annual User Conference & Symposium June 23-25 in Austin, TX.
• HealthGrid will deliver patient education content from Healthwise via its patient engagement solution.
• EClinicalWorks will exhibit at 2016 Optometry’s Meeting June 30-July 2 in Boston.
• Glytec’s Glucommander and EGlycemic Management System are featured in five studies presented at the American Diabetes Association scientific sessions.
• Greencastle Associate Consulting’s Jim Blanchet earns PMP certification from The Product Management Institute.
• HCS will exhibit at the Texas Hospital Association Behavioral Health Conference June 23-24 in Austin, TX.

Blog Posts

• Advanced Practice Training: AdvancedInsight Visit Coding Graphs (AdvancedMD)
• New BYOD Adoption Kit: The Missing Piece to BYOD Success (AirWatch)
• A successful approach to making time for optimization (Nordic)
• The Advantages and Measures of Outsourcing in Healthcare (Catalyze)
• Filling the Care Management Tool Box (Caradigm)
• Dental Emergencies: Using ED Visits for Dental Problems (Wolters Kluwer Clinical Drug Information)
• My Doctor Believed Me! (CareSync)
• What’s new with the CHPL (Certified Health IT Product List) and Certification Surveillance? (Iatric)
• Ohio Passes Prior Authorization Reform Act; Mandates Acceptance of EPA Solution (CoverMyMeds)
• The Population Health Jungle (CTG)
• The CIO of the Future – Long Live the CIO (Culbert Healthcare Solutions)
• Building Your Personal Brand (Direct Consulting Associates)
• Three Steps for Aligning Cost and Compensation (ECG Management Consultants)
• Unified Communications and Advanced Clinical Presence (Part 4) (Extension Healthcare)
• Galen’s Top 10 Reasons to Migrate Your Data (Galen Healthcare Solutions)
• The Top 10 Reasons Transformation is the New Normal for Healthcare – Reason 2 (GE Healthcare)
• 8 Things That May Surprise You About Healthcare Analytics – Part 1 of 2 (Hayes Management Consulting)
• Changing the Culture – Small Changes Matter in Innovation (HCTec)

Contacts

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

Monday Morning Update 6/20/16

Top News

A government report estimates that 30,000 US patients die unnecessarily from trauma each year since trauma center death rates vary widely such that “where you are injured my determine whether you survive.” It urges creation of a national trauma system driven by best practices that includes both military and civilian systems and pre-hospital providers such as ambulance services.

The leading cause of death among people under 46 years old is trauma (motor vehicle accidents, gunshots, and falls).

The report from the National Academies of Sciences, Engineering, and Medicine recommends that trauma centers create real-time access to patient-level data that would also be used in a national quality improvement program.

Reader Comments

From Former Westminster, CO Employee: “Re: McKesson. I worked on Horizon for 15 years. Upper management refused to listen to QA, support, implementation, and development and would demand that change requests be closed with known software bugs shipped to clients to meet project deadlines. Hospitals would then report the bug, which would be re-opened as a Hot Fix Solution as the cycle repeated. Management was more concerned about running a tight ship and laid off many critical people. Paragon will suffer the same because the management culture has not changed.” Unverified.

HIStalk Announcements and Requests

Most poll respondents would struggle to pay an unexpected medical bill of $5,000 to $25,000, which is a lot better than the 47 percent of Americans that a federal study found would struggle to pay a $400 emergency bill. New poll to your right or here: do digital tools reduce the efficiency of care delivery as the AMA contends?

Here’s a fun enhancement idea for the new iPhone patient data EHR query: let the app automatically file an HHS data-blocking complaint for unsuccessful requests.

Mr. Martinez is using the document camera we provided in funding his DonorsChoose grant request to record his live presentations so that students in his California high school classroom can review portions they missed or to keep up when they’re absent. He’s recording additional examples and placing them on his website so that students can follow along on their own time.

Also checking in is Mrs. Evans from Florida, who says many of her elementary school’s students had never used a tablet until we provided six of them for her gifted class.

Listening: new from Radiohead, slower and more melodic (some might say “wimpier”) than previous masterworks like “OK Computer,” but sometimes you have to let good bands evolve and give their new stuff a multiple-play chance to grow on you.

Last Week’s Most Interesting News

• Apple adds C-CDA records import capability to iOS 10, giving iPhone-using consumers the theoretical ability to request and capture their basic medical information from provider EHRs.
• AMA passes a resolution supporting creation of an ONC-administered health IT safety center.
• Doctors in Australia demand that patient update access to their own medical records be revoked, saying they can’t trust the information.
• The AMA’s EVP/CEO lashes out at “digital snake oil,” broadly panning the health-related software that is available to doctors and consumers.

Webinars

June 28 (Tuesday) 2:00 ET. “Your Call Is Very Important.” Sponsored by West Healthcare Practice. Presenters: Cyndy Orrys, contact center director, Henry Ford Health System; Brian Cooper, SVP, West Interactive. The contact center is a key hub of patient engagement and a strategic lever for driving competitive advantage. Cyndy will share how her organization’s call center is using technologies and approaches that create effortless patient experiences in connecting them to the right information or resource. Brian will describe five key characteristics of a modern call center and suggest how to get started.

Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel. Lorre’s getting bored because of the industry slowdown that kicks in every year right about now, so ask her nicely for her “Summer Doldrums Special” that we always run through Labor Day and you’ll get a great deal.

Acquisitions, Funding, Business, and Stock

TransUnion acquires Auditz, which offers point-of-service patient revenue products.

Cerner shares continue their recent slide, closing at prices not seen since July 2014. Above is the one-year price chart of CERN (blue, down 22 percent) vs. the Nasdaq (red, down 6 percent).

Announcements and Implementations

LeadingAge Center for Aging Services Technologies creates an EHR adoption model for long-term and post-acute care providers.

Government and Politics

The government of South Australia continues its years-long legal pleading to software vendor Work Systems, whose 1990s-era, DOS-based patient records system is still being used by 64 of South Australia’s health sites. The vendor demands that state government stop using its software since its license for a retired version has expired, but the government argues that forcing it to stop using the system would endanger patients. South Australia is in a bind because its Allscripts-powered EPAS project is behind schedule and over budget with only three sites live amidst widespread doctor protests that the system endangers patients.

Karen DeSalvo, MD, MPH and her HHS team wore blue to support Men’s Health Week last week.

An independent analysis finds Healthcare.gov to be the second-most secure consumer website.

The VA engages Underwriters Laboratories to help improve the cybersecurity of its medical devices.

Other

It’s been said that “a true test of a man’s character is what he does when no one is watching,” which is an apt summary of a new study that finds increased rates of hospital hand-washing when clinicians know they are being observed. Easy-to-spot infection prevention nurses saw a 57 percent rate of hand-washing compliance, while less-recognized volunteers saw staff washing their hands when they should only 22 percent of the time.

An excellent analysis by Arcadia Healthcare Solutions that I hadn’t previously noticed until NPR ran a story on it finds that the cost of care provided to dying patients in their final 30 days varies widely by where they die. Patients who expire in a hospital consume $32,000 worth of services, while those who pass away in nursing homes, hospices, and at home cost $21,000, $18,000, and $5,000 respectively. Saddest of all is that 40 percent of patients died in a hospital, something that few people want. The company offers several interesting dataset visualizations on its site.

I also missed this New York Times op-ed piece from a few weeks back in which a University of Oslo professor pans the idea of a “cancer moonshot,” saying the Catch-22 of cancer is that it can’t be cured and thus keeping people alive longer means they’re more likely to get cancer again. He recalls that President Nixon called for a cancer moonshot of his own in 1971 and the National Cancer Institute has spent $90 billion since then even as cancer rates increased. He concludes that the effort wasn’t wasted, however: “We’re a lot better at fighting cancer. We just can’t cure it,” but warns of “the rhetorical spin that drives the cancer enterprise.” He urges that doctors save lives via the “boring stuff” of getting patients to stop smoking, use sunscreen, eat better, and exercise, saying that will do more good than “promising the moon.”

Sponsor Updates

• Vital Images will exhibit at SCCT 2016 June 23-26 in Orlando.
• Zynx Health will exhibit at AMDIS 2016 June 21-24 in Ojai, CA, as will LogicStream.
• Integris and The Chartis Group will present “Centralized Scheduling for a Physician Enteprise” at the HFMA National Institute June 26-29 in Las Vegas.

Blog Posts

• Access to Care – a Cornerstone of Healthcare (TeleTracking)
• How to Fine Tune Your Investigation Approach (Verisk Health)
• Fall in Love with ICD-10-PCS Cardiovascular Coding (VitalWare)
• Hand-in-hand. (Voalte)
• Crawl, Walk, Run: Know Where You Are in Your Modernization Journey (West Corp.)
• What’s in a Name? (Xerox)
• Automating manual revenue cycle processes and reducing hands-on tasks. (ZirMed)

Contacts

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

Morning Headlines 6/17/16

Hands-on: Apple brings HL7 CCD health records to HealthKit in iOS 10

iOS 10 includes an enhancement that will let iPhone users to download and store their health records from providers capable of transmitting a CCD.

Navicure Partners with Bain Capital Private Equity to Continue Growth and Expand Healthcare Technology Platform

Navicure receives a strategic investment from Bain Capital Private Equity. Financial terms were not disclosed.

AMA Throws Support Behind Development of a National Health IT Safety Center

AMA house delegates approve a proposal formally supporting the creation of a National Health IT Safety Center.

Doctors want patient control over e-health records revoked

The Australian Medical Association argues that patients should not be able to control what is entered into their personal health records. AMA president Michael Gannon, MD explains, “If patients are able to control access to core clinical information in their electronic medical record, doctors cannot rely on it.”

News 6/17/16

Top News

Apple’s iOS 10 will allow users to request copies of their medical records from their smartphones, provided their provider’s EHR can export a Continuity of Care Document. Users can also import records from Safari and Mail. The translated medical summary can be stored directly in Health.

Reader Comments

From Meltoots: “Re: CMS and EHR vendor snake oil. MU was an unmitigated disaster for safety, security, usability, efficiency, and physician burden, yet it continues with a new name. Everyone wants to move away from fee-for-service, yet we have no idea how to attribute quality care from multiple doctors to a single patient. This is a not-so-secret CMS push to put providers into large practices so they can crank down on payments. Providers have had enough.” The other concept at work is that hospitals, which have performed so pitifully and indifferently in coordinating patient care and managing populations, are figuring out how to reap the lion’s share of the money that will be spent to improve it. It’s also interest that just as it’s hard to detect Medicare fraud because providers work under the NPI of other providers in group settings, it’s equally hard to determine using billing data which of them is individually responsible for wise or unwise care decisions.

From Gray Sky: “Re: Medhost. Has had outages for the past two weeks for all hosted applications. Inside information points to a storage information where customer data has been erased. The company continues to investigate options to restore the data to a reasonable point in time.” I ran this rumor Tuesday with the vendor name omitted pending the company’s response, which Medhost has provided:

Medhost supports software applications in over 1,100 facilities across the United States, Canada, and Puerto Rico. Over the past several weeks we have experienced system outages impacting a total of three hosted facilities. In one instance, the outage was extended for several days. Medhost utilized both system vendors and consultants as well as its internal resources to determine the cause of these outages and to act to prevent any future outages. The extended outage was due to failure of the operating system. Medhost applications were not a contributing factor to this system outage and no customer data was lost. All customer systems have been restored and are working as designed. While we view any outage as unacceptable, we will use this as an opportunity to improve availability and resiliency of the Medhost systems. Medhost Direct historical uptime availability exceeds 99.99 percent, and no hosted facility has experienced an outage of more than 14 hours in over two years.

From  Credenza Cowboy: “Re: Martha Jefferson’s errant EHR click that mistakenly labeled the patient as deceased. They aren’t live on Epic yet.” I didn’t realize that, although I attended a years-ago Cerner user meeting at which their IT director was present, so maybe they are on Cerner. Either way, it’s an interesting tip-of-the-iceberg type user error that fortunately, in this case anyway, had no clinical impact. Sentara bought the Charlottesville, VA hospital in 2010.

From Pensive Moment: “Re: digital snake oil. Do  you agree with the AMA?” Mostly no. The AMA’s solution to all problems is to put doctors in charge of everything despite their poor track record of following evidence-based guidelines, delivering whole-person health, and serving as patient advocates without bias toward their personal incomes. They have also demonstrated their own snake-oil gullibility in letting drug and medical device companies dictate their clinical behavior via shady but effective sales tactics that sometimes result in sub-optimal or even dangerous medical decisions. You will notice minimal reference to care teams in the AMA’s impassioned stand that, as usual, assumes the “Doctor as God” position in excluding all other clinicians and in pushing AMA’s commercial interests. The AMA is right that many apps (especially the consumer-facing ones) are of questionable value and that doctors have been shafted in being expected to document everything for the benefit of bureaucrats. They’re also correct that much of what doctors don’t like was handed down to them from insurance companies and the government (whose checks they don’t mind cashing, however, as evidenced by their continued participation). The AMA’s bloviating is what you get when each clinical profession has its own membership organization looking out for the interests of its dues payers while claiming to represent patients who are – along with the 80 percent or so of US doctors who aren’t AMA members, including a bunch who quit after AMA endorsed passage of the Affordable Care Act — invariably absent from its proceedings. All of the solutions offered by the AMA for “digital dystophia” involve AMA-led products and services, so from now on, let’s blame them.

From Limelight Seeker: “Re: our event. Please promote the upcoming tweetchat, webinar, or video I’m involved with.” I will say only this: quite a few overexposed pontificators — especially social media self-gratifiers and cheap-seats observers — are short on credentials to be educating the rest of us. My accomplishment-driven twit filter is powered by LinkedIn.

HIStalk Announcements and Requests

Welcome to new HIStalk Gold Sponsor Catalyst Healthcare Advisors. The eight-year-old company offers consulting services in strategy, finance, operations, and technology (IT strategy, system selection, contract negotiation, and system implementation, optimization, and integration). The company led Yale-New Haven’s expense reduction project in helping the health system save $350 million annually. Among its other 200 clients are Baylor, Indiana University Health, Community Health Network, and Good Samaritan Hospital. You may know founder and CEO Steve Furry, who has been in healthcare consulting for 35 years, and senior advisor Parker Hinshaw, who founded maxIT. The company just announced the hiring of two new sales executives covering the West and Midwest. Thanks to Catalyst Healthcare Advisors for supporting HIStalk.

Ms. Marlowe says her North Carolina kindergarten class is benefitting greatly from the Chromebook we provided in funding her DonorsChoose grant request, with the students specifically enjoying listening to stories online.

Listening: reader-recommended Richmond-based singer-songwriter Lucy Dacus, an up-and-comer who sings thoughtful and warm indie folk music that reminders the reader of the magnificent Cowboy Junkies and me of Kristin Hersh of Throwing Muses. 

This week on HIStalk Practice: CMS announces $10 million in grants to help practices transition to new payment models. Midwest Orthopaedic Consultants goes with care coordination tech from PinpointCare. AMA adopts long-awaited ethical guidelines for telemedicine practice. CureMD adds Izenda business intelligence tool to its PM software. Emergency Care Specialists launches joint venture with Answer Health Telemedicine. Facebook develops suicide prevention tools and protocols. Culbert Healthcare Solutions VP Randy Jones equates revenue cycle KPIs to “the ritual of the snipe hunt.”

Webinars

June 28 (Tuesday) 2:00 ET. “Your Call Is Very Important.” Sponsored by West Healthcare Practice. Presenters: Cyndy Orrys, contact center director, Henry Ford Health System; Brian Cooper, SVP, West Interactive. The contact center is a key hub of patient engagement and a strategic lever for driving competitive advantage. Cyndy will share how her organization’s call center is using technologies and approaches that create effortless patient experiences in connecting them to the right information or resource. Brian will describe five key characteristics of a modern call center and suggest how to get started.

Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

As I mentioned in an update to Monday night’s post following a response to my inquiry to Navicure, Bain Capital Private Equity makes an unstated strategic investment (presumably taking a majority interest that meets the definition of an acquisition) in the company. Among the sellers is JMI Equity, which took a minority position in Navicure in 2009. JMI bears the initials of John Moores Inc., whose other accomplishments (beyond being an IBM programmer) include founding BMC Software, serving as lead financier of Peregrine Systems and ServiceNow, and formerly owning of the San Diego Padres.

Sales

The soon-to-open Sacred Oak Medical Center (TX) chooses Medsphere’s OpenVista EHR.

In Scotland, NHS Fife chooses InterSystems TrakCare, the twelfth Scottish Health Board to do so. 

People

Clinical rules modeling vendor Applied Pathways hires Steve Lefar (Sg2) as CEO. Founder and CEO John Feldman will continue as board chair.

Madhu Sasidhar, MD (Cleveland Clinic) joins consumer engagement platform vendor Envera Health as CMIO.

Announcements and Implementations

Congratulations to the HIStalk sponsors who took 40 spots in the 2016 HCI 100:

• Xerox (#7)
• GE Healthcare (#9)
• Allscripts (#13)
• Nuance (#14)
• The Advisory Board Company (#17)
• Leidos (#21)
• Roper Technologies (#23)
• Wolters Kluwer (#26)
• Quality Systems/NextGen Healthcare (#27)
• Meditech (#29)
• InterSystems (#31)
• EClinicalWorks (#33)
• MModal (#39)
• Verisk Health (#41)
• West Corporation (#42)
• Premier (#44)
• Experian Health (#45)
• Merge Healthcare, An IBM Company (#46)
• NTT Data (#47)
• Netsmart (#50)
• Spok (#52)
• Lexmark Healthcare (#57)
• Medhost (#58)
• Evolent Health (#59)
• Elsevier (#63)
• ZirMed (#66)
• Nordic (#67)
• Orion Health (#74)
• Imprivata (#75)
• Burwood Group (#79)
• TeleTracking Technologies (#81)
• Medecision (#82)
• The HCI Group (#83)
• T-System (#91)
• CTG (#92)
• Capsule (#93)
• Cumberland Consulting Group (#95)
• Caradigm (#97)
• Surgical Information Systems (#98)
• Zynx Health (#100)

The local paper notes that FHN Memorial Hospital (IL) is testing Meditech 6.1 in its $8 million OurFHN project, expecting an October go-live.

Government and Politics

The American Medical Association approves a policy supporting the creating of an ONC-administered National Health IT Safety Center. The policy proposal was submitted by Matt Murray, MD, chair of the Texas Medical Association’s IT committee, driven in part by work done by Texas-based health IT researchers Dean Sittig, PhD and Hardeep Singh, MD, MPH.

The US Supreme Court rules that the VA must always give exclusive preference to veteran-owned small businesses when issuing contracts, overriding the VA’s argument that it is only required to meet specific annual contracting goals. The court says the VA must show preference to veteran-owned bidders as long as the competition meets the Rule of Two (at least two bidders are expected to submit offers and the amount of those bids is expected to be reasonable).

New York’s attorney general forces legal website Law360 to stop requiring employees to sign non-compete agreements unless the employee has insider knowledge of trade secrets. Law360’s terms required all employees, even those fresh out of college, to sit out a year before taking another job in the same industry. The attorney general of Illinois is also upset that the non-compete clause in the employment agreement of sandwich chain Jimmy John’s prohibits employees from taking a job with another sub sandwich company for two years after quitting.

Privacy and Security

A former IT employee sues Aspen Valley Hospital (CO) and its privacy officer, claiming that the hospital’s HR director/privacy officer disclosed the employee’s HIV status over cocktails with the hospital’s HR recruiter at a conference after noting a large medical claim for his antiviral medications. The employee filed a complaint with the hospital and then HHS as a HIPAA violation, after which he says he was disciplined, demoted, and then fired after 11 years at the hospital.

Other

The Australian Medical Association calls for the capability of patients to manage their own medical records to be removed, saying that doctors don’t participate in the national My Health Record data-sharing program because they can’t rely on patient-provided information. The AMA wants patients locked out of making changes to core set of database elements that includes the meds list, allergies, discharge summaries, pathology and imaging results, weight, height, blood pressure, and advance directives. They also want eventual restriction of patient changes to ECG results, blood type, vaccination history, infectious disease status, surgery history, and even the patient’s chosen emergency contact. The AMA says the changes will increase trust and therefore physician usage of the system, which is nearly non-existent.

A Nielsen survey finds that 89 percent of PCPs claim they often remind patients about preventive screenings, but only 14 percent of patients say they receive them. Only 5 percent of the two-thirds of Americans who are overweight say their doctors suggested a weight loss program. Half of patients aren’t seeing doctors who can view their history via an EHR. Only one in four patients can contact their doctor by email or patient portal question submission, with older people more likely to avoid use of available technology.

This has a small amount of health IT relevance: the mold-breaking YouTube teen vlog series “lonelygirl15” is being re-launched after 10 years by its creators, which include Miles Beckett, MD, CEO of electronic credentialing vendor Silversheet. I interviewed him in April 2016.

Theranos CEO Elizabeth Holmes will present at the American Association for Clinical Chemistry’s annual conference in August, with her submitted abstract suggesting that her talk will be long on defensive self-promotion and short on offering the definitive clinical validation data that scientists long to see. I’m not clear about why a college dropout should be presenting at a clinical conference or why the education committee would accept a presentation titled “Theranos Science & Technology: the miniaturization of lab testing,” but it will probably be an overflow session. I will be disappointed if the attendees don’t boo her off the stage.

In China, a hospital janitor is arrested hiring friends to direct out-of-towners looking for the hospital to a specific room he had rented inside it, where he delivered ineffective but expensive treatments. The health department has closed the hospital as a result. That type of scam is common in China, where hospitals routinely rent out rooms to anyone willing to pay.

Sponsor Updates

• InstaMed releases its annual report on trends in healthcare payments.
• InterSystems, Intelligent Medical Objects, and Meditech will exhibit at AMDIS 2016 June 21-24 in Ojai, CA.
• Liaison Technologies wins a Stevie Award for Favorite New Product from the American Business Awards.
• Visage Imaging validates the interoperability capabilities of its Visage 7 Enterprise Imaging Platform at the IHE Connectathon 2016 held in Bochum, Germany.
• MedData will host a job fair June 22 in Grand Rapids, MI.
• The HIMSS SIIM Enterprise Imagine Workgroup publishes its second white paper.
• Validic and Omnicom Health Group will partner to counsel healthcare companies on connected health.
• Netsmart will exhibit at the Washington Behavioral Health Conference June 22 in Yakima, WA.
• Nordic receives RightSourcing’s Gold Supplier Award.
• Qpid Health and Streamline Health will exhibit at AMDIS 2016 June 21-24 in Ojai, CA.
• The latest KLAS report ranks Sagacious Consultants as the highest-rated firm for revenue-cycle optimization.

Blog Posts

• Mobile Devices Expanding Threats to Healthcare Data (ID Experts)
• Is MIPS “Stacking the Deck” Against Solo Providers? (Impact Providers)
• Do You Have the Right Marketing Mix? (Influence Health)
• The Rise of Apple in Healthcare IT (Spok)
• Why Mammosphere? (LifeImage)
• Patient Payments: How to Make the Right Statement to Get Paid (Navicure)
• How the Internet of Things will lead us to Healthcare Utopia (Orion Healthcare)
• Is MIPS “Stacking the Deck” against Solo Providers? (Impact Advisors)
• Connecting Providers and Patients through their Healthcare Journey with Mobile (PatientSafe Solutions)
• Healthcare Providers: Watch Out for Hidden Payment Processing Charges (Patientco)
• Making a Difference (PatientKeeper)
• We’re on FHIR! Why Health IT Software Developers Should Care About Open APIs (First Databank)
• Those Sticky Fingers can be Cut Off (PatientPay)
• Nurses need innovative care team collaboration technology (PerfectServe)
• How some nurses can leave earlier than others (PeriGen)
• Unifying Provider Data Solves Many Healthcare Challenges (Phynd Technologies)
• Eating Your Own Dog Food – and Why That’s a Good Thing (PMD)
• MUSE 2016 Insights: Forward Thinking for New Opportunities and Solutions (Summit Healthcare)

Contacts

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