News 8/10/16

Top News

Apple CEO Tim Cook speaks about the company’s healthcare aspirations, which he shared while literally leaving the room from a Fast Company interview focusing on whether Apple has stagnated:

We’ve gotten into the health arena. We started looking at wellness. That took us to pulling a string to thinking about research. Pulling that string a little further took us to some patient care stuff. That pulled a string that’s taking us into some other stuff. When you look at most of the solutions — whether it’s devices or things coming up out of big pharma — first and foremost, they are done to get the reimbursement, not thinking about what helps the patient. If you don’t care about reimbursement, which we have the privilege of doing, that may even make the smartphone market look small.

In a possibly related rumor, a Taiwan newspaper says Apple is finalizing suppliers for a new 2017 healthcare product that will capture the heart rate, blood sugar, and other information of users. The newspaper says the product will use new iPhone health sensors as well as Apple’s pressure-sensing technology.

Reader Comments

From Limber Lob: “Re: cost of Epic’s campus. At a User Group Meeting a couple of years ago, Epic founder and CEO Judy Faulkner showed a pie chart of Epic’s costs: 80 percent people, 10 percent buildings, and 10 percent everything else. It would be interesting to see corresponding numbers for other EHR industry players.” Unverified.

From The Stygian Gigawatt: “Re: HIStalk. You run too many unverified rumors.” My position on running reader-provided rumors is thus:

• Rumors are like HIMSS hallway conversations except I’m filtering out some of the blatantly suspicious ones. Readers are free to read them or ignore them.
• Reader-reported rumors are often accurate, even if inexact (a company had layoffs, but in smaller numbers than the rumor suggested).
• Sometimes rumors I run force the hand of companies to publicly admit that they’ve done something they aren’t especially proud of.
• I allow anyone to confirm or deny unverified rumors and will give those responses the same prominence as the original item.
• Readers who don’t like reading rumors are massively outnumbered by those who do, according to responses to my annual reader survey.
• Everybody likes rumors until I run something about their company. That’s when I get indignant emails lecturing me about the sudden need for responsible journalism.
• HIStalk isn’t for everyone and I’m not offended when someone chooses not to read it. There are no teams, corporate overlords, or committees to pretty it up or dumb it down – it’s just me sitting in a spare bedroom. On the other hand, I am happy and frankly shocked that around 50,000 people do read it and I feel a lot of responsibility toward them. My goal from Day 1 (in June 2003) has been to make readers think and rumors help do that.

From The PACS Designer: “Re: ICD-10 decimal places. As we approach the launch of ICD-10 Procedure Codes (ICD-10-PCS) on October 1, thought it would be a good time to discuss some short cuts used previously in ICD-9-CM Clinical Modifications. Removing decimal places should be eliminated for ICD-10-CM as a practice when the Procedure Codes begin being used by institutions. ICD-10-CM uses decimal places and ICD-10-PCS does not use them. Granted, legacy data parameters still need to be mined for the missing decimal place data parameters, but future mining and error reductions should be top priority for everyone to be successful with the new combined coding scheme for both CM and PCS.”

HIStalk Announcements and Requests

I don’t like seeing companies whose entire executive roster is mostly made up of white men. Now I’m questioning another phenomenon I see a lot: American companies whose leadership team is nearly all men of Indian origin. Is that an positive example of diversity or a negative example of the lack of it?

I was having my teeth cleaned today and the hygienist recommend some sort of quick scaling procedure that my basic dental insurance doesn’t cover. She offered to charge me just the discounted price the insurance company would have paid, which I liked, but of course I was wondering as a patient whether I really needed the procedure at all (and all I got for my $144 was a few extra hygienist minutes of scraping around). My post-visit conclusion was that medical and dental practices make a lot of money turning routine maintenance work into an expected healthcare standard and then turning the actual work over to lower-licensed or even unlicensed employees who crank out the billables with no owner involvement. Dermatologists, for example, have figured out that they can make a lot of money selling super-expensive cosmetics, Botox injections, and aesthetic services, all of which require only the dermatologist’s presence, not involvement. American healthcare is bizarre.

We provided two iPads in funding the DonorsChoose grant request of Ms. D in Texas, who says her students have become more engaged and can’t wait to do practice work on the iPads. I’m sorry to report that this is the last set of classroom photos I have since my last round of DonorsChoose funding was back around HIMSS time when I ran out of money, but I have another really large corporate donation that I’m ready to put to work. That will give me more teacher reports and pictures to share.

Webinars

August 10 (Wednesday) 1:30 ET. “Taming the Beast: CDS Knowledge Management.” Sponsored by LogicStream Health. Presenters: Luis Saldana, MD, MBA, CMIO, Texas Health Resources (THR); Maxine Ketcham, clinical decision support analyst, THR; Kanan Garg, senior applications analyst, THR; Patrick Yoder, CEO, LogicStream health. This presentation will review THR’s systematic process for managing clinical decision support assets, including identifying broken alerts, addressing technical and clinical issues, modifying order sets, and retiring tools that have outlived their usefulness. Attendees will learn how THR uses a robust knowledge management platform to better understand how clinicians are interacting with their clinical content to maintain their order sets and reduce the number of alerts fired.

August 24 (Wednesday) 1:00 ET. “Surviving the OCR Cybersecurity & Privacy Pre-Audit: Are You Truly Prepared?” Sponsored by HIStalk. Presenter: John Gomez, CEO, Sensato. Many healthcare organizations are not prepared for an OCR pre-audit of their privacy and security policies. This webinar will provide a roadmap, tools, and tactics that will help balance policies and budgets in adopting an OCR-friendly strategy that will allow passing with flying colors.

Acquisitions, Funding, Business, and Stock

Virtual visit provider Aligned TeleHealth raises $12 million in Series A funding.

Australia-based startup Brontech creates Cyph MD, a blockchain-powered patient information exchange platform that will work across countries.

HealthStream acquires credentialing and privileging solutions vendor Morrissey Associates for $48 million in cash.

Press Ganey Holdings has reached a deal to sell itself to a Sweden-based private equity firm for $2.35 billion. The company’s May 2015 IPO raised $233 million. Shares have risen 27 percent in the past 12 months. CEO Patrick Ryan, who joined the company in 2012, owns shares worth $37 million.

Cerner will add 250 jobs and spend $75 million on facility upgrades at the former Siemens Medical Solutions Health Services offices in Malvern, PA.

Sales

Memorial Hermann Health System (TX) chooses Valence Health to support the Medicaid health plan it is acquiring from Molina Healthcare.

People

Netsmart hires Dawn Iddings (Garmin) as SVP/GM of its home care systems business.

Announcements and Implementations

Stanford Medicine (CA) will develop its clinical genomics service using Google Could Platform for analytics.

EHR/PM solutions vendor WRS Health adds electronic prior authorization functionality from CoverMyMeds to its EHR workflow.

Biometric  authentication solutions vendor EyeLock announces an iris recognition technology that works from two feet away, through glasses, and in daylight.

National Institutes of Health will use the clinical genomics solution of Allscripts-owned 2bPrecise as an early adopter, integrating genomic information into its Sunrise EHR.

PatientPing will work on a data-sharing initiative with UMass Memorial Health Care (MA). 

Government and Politics

An HHS OIG report finds that Arizona overpaid $14.8 million in Medicaid EHR incentives to hospitals. The state sent $219 million to Medicaid EHR users, of which 70 hospitals were hospitals that received $151 million. OIG suggests that the state repay the federal government, educate hospitals on how to calculate incentive payments, and review the documentation those hospitals to make sure they calculated correctly. Arizona reviewed OIG’s report and disagreed, saying hospitals provided OIG with different cost reporting data than the state used.

The FDA seeks guidance on a new draft report that outlines when medical device vendors must obtain new 510(k) pre-market clearance following a software change. The proposed regulations would require device vendors to submit their product for safety and effectiveness review if the change involves either of those attributes, while those software updates that address cybersecurity only would not require new FDA approval.

Privacy and Security

A hobbyist cybersecurity researcher who has warned several companies about flaws he found in their online security notifies Jefferson Medical Associates (MS) that their patient information is openly visible on the Internet via an unsecured database. The medical group shoots the messenger in having its legal counsel announce that he “accessed the information without our permission,” which of course is the whole point of nicely letting them know. They call his findings “criminal activity” and that he “unlawfully accessed” one of its databases, which is absurd since he didn’t do anything with the unsecured data he found. The practice also haughtily announces that it was already using an outside security contractor who concludes that, “Other than this one place that this individual found to get in, everything is secure.” I guess companies show indignation rather than appreciation since their screw-up requires reporting the incident to OCR and they have to throw someone under the bus to avoid looking stupid to the locals.

Other

Telemedicine remains illegal in technology-obsessed South Korea after legalization efforts fail due to the opposition of medical professionals. Residents also fear that only the wealthy will be able to afford telemedicine, that their data could be exposed in breaches, and that insurance companies might use the information to discriminate against them. The country’s telephone company shut down its e-prescribing program last year after charges that it had sold prescription information to pharmacies. The Korean Medical Association refuses to participate in telemedicine trial projects and in 2014 went on a one-day strike to protest planned introduction of telemedicine and for-profit hospitals.

Bruce Friedman, MD of Lab Soft News questions how conferences handle potential conflicts of interest in their selection of speakers, that discussion triggered by the AACC’s inclusion of Theranos CEO Elizabeth Holmes at its recent conference:

For me, the favoritism that the AACC leadership and planners of the annual meeting have shown toward Holmes is inexplicable. Although the incentive for the Holmes invitation could be attributed solely toward stimulating registration for the annual meeting … it’s possible that some member(s) of the organization may have had some "special" relationship with Theranos or that Theranos provided some financial remuneration to the AACC to pave the way for the Holmes invitation. I have no idea whether this is a the case, but the comments cited above do raise the question of what constitutes conflict-of-interest (COI) for members of professional societies when they participate in the selection of speakers for a conference.

A fascinating New York Times article describes what it’s like to be claustrophobic in the subway- and elevator-filled New York City.

People complain that Epic’s campus is unnecessarily lavish considering it was paid for by non-profit hospitals, so then there’s this: an investigation finds that the VA has 167 interior designers on its staff.

Sponsor Updates

• Aprima customers make over 150 blankets for the Children’s Medical Center in Dallas at its annual users conference.
• GE Healthcare looks at how its Centricity technology is impacting Olympic athletes in Rio.
• Healthgrades releases a new white paper, “How Better Information and Stronger Platforms Build Trust and Improve Healthcare for Consumers and Physicians.”
• The Radicati Group recognizes AirWatch as a leader in its market quadrant for EMM.
• Besler Consulting releases a new podcast, “The challenges of hospital and physician alignment.”
• Boston Software Systems releases a new podcast, “Automating Medicare Patient Account Verification.”
• The Nashville Business Journal names Cumberland Consulting Group to its 2016 Fast 50 honorees.
• The Dallas Business Journal runs “Three Questions with … Michael Nissenbaum, CEO of Aprima Medical Software.”

Blog Posts

• How to Score Points for ACI and MIPS Quality Reporting (AdvancedMD)
• Why do Healthcare Information Systems Account for $40+ Billion? (Catalyze)
• Ensuring Your Patients Have What They Need (CareSync)
• Navigating the Job Market: a Guide for Today’s New Grads (CTG)
• A CIO problem: 50% of doctors don’t know what MACRA is (Advisory Board)
• Nurse Triage Raises the Bar for Centralized Patient Access Centers (Culbert Healthcare Solutions)
• 5 Tips to Managing Your Time Wisely (Direct Consulting Associates)
• CCD vs HL7, which should you choose? (Galen Healthcare Solutions)
• 7 Ways to Plug High-Deductible Health Plan Revenue Leaks (Hayes Management Consulting)

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 8/8/16

Top News

Hackers breach the servers of Newkirk Products, which issues BlueCross and BlueShield insurance cards in several states, exposing the information contained on the cards of 3.3 million people. This will be one of the largest breaches ever, although the information stolen is not extensive.

Newkirk was acquired in 2011 by IT outsourcer and consulting firm DST, which sold its customer communications business to Broadridge Financial Solutions for $410 million just a few weeks ago.

Reader Comments

From Jett Cloud: “Re: Epic. I just returned from training and was shocked by the amount of activity that has nothing to do with healthcare, software, or any professional endeavor. There were constantly people playing games outside, sports, Pokemon Go, or similar things. As part of an organization that’s struggled financially and is really stretching to afford Epic, I’m a bit disgusted by the physical lavishness of the campus.” Epic people put in a lot of hours, so I wouldn’t worry that the tiny percentage of its 10,000 employees you saw playing around means they don’t work plenty hard. Most of them don’t even go out for lunch. They’re also mostly in their mid-20s, so just be amazed that despite being the offspring of hovering, overly indulgent parents they show up and get stuff done in what is the first real job many of them have had. I agree that Epic’s campus is unnecessarily extravagant, it’s part of the company’s culture but nobody put a gun to the head of customers to sign those gazillion-dollar Epic contracts that pay for it. At least both customers and Epic employees can enjoy the orchestrated whimsy instead of just the company’s executives – it’s Mahogany Row and reserved parking spots that annoy me. At one of my previous health system employers, we had to keep reminding our executives not to go off script at employee meetings and talk about their reserved parking lots, plush offices, company-paid cars, travel budgets, and big bonuses – they would genuinely forget that those in the room were working for no perks or bonuses, just a paycheck.

HIStalk Announcements and Requests

Poll respondents were fairly evenly split on whether CMS’s new hospital star rating system has value. Furydelabongo says it’s at least a good starting point even though lower-rated hospitals are predictably shooting the messenger. Mobile Man agrees that if you want healthcare to run like a business, this is how business works. Cosmos disagrees, saying hospitals are too complex to be rated by a single rating, and Michael Murphy explains further that the rating doesn’t reflect procedure volume.

New poll to your right or here: will the cost and quality impact of hospital and medical practice consolidation be good or bad? Vote and then click the poll’s Comments link to explain why.

We funded the DonorsChoose grant request of Mr. G in Wisconsin, who asked for two tablets and a programmable robot. He reports, “As many of our students are new to the field of computer science, these materials have helped to inspire them to build a strong foundation of programming knowledge as they enthusiastically dive into the content that is being taught, and seek out opportunities to help Dash and Dot complete new challenges. The pair of robots have also been a way to illustrate programming concepts that would otherwise be confined to a computer screen. For many students, this opportunity to observe and interact with the robots is key to mastering these programming skills. Finally, the robots and tablets have served as an excellent incentive to encourage positive behaviors in the classroom.”

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

Last Week’s Most Interesting News

• Advocate Health Care Network pays $5.55 million to settle HIPAA charges following an OCR investigation of three 2013 breaches in just a few weeks.
• Cerner dismisses Athenahealth’s efforts to penetrate the inpatient market in its earnings call.
• Banner Health (AZ) notifies 3.7 million people that their information was exposed in a breach of its food and beverage systems in one of the largest healthcare breaches ever.
• Theranos CEO Elizabeth Holmes didn’t address any of the company’s business-threatening issues in her presentation to the American Association for Clinical Chemistry and instead uses her podium time to pitch new blood analyzer hardware that has not yet been released or approved by the FDA.
• The FTC reverses an earlier decision to drop data security charges against LabMD.
• Apple publishes a patent that would allow iPhone users to connect with a physician, transmit their HealthKit-collected information, and then initiate a telemedicine session.

Webinars

August 10 (Wednesday) 1:30 ET. “Taming the Beast: CDS Knowledge Management.” Sponsored by LogicStream Health. Presenters: Luis Saldana, MD, MBA, CMIO, Texas Health Resources (THR); Maxine Ketcham, clinical decision support analyst, THR; Kanan Garg, senior applications analyst, THR; Patrick Yoder, CEO, LogicStream health. This presentation will review THR’s systematic process for managing clinical decision support assets, including identifying broken alerts, addressing technical and clinical issues, modifying order sets, and retiring tools that have outlived their usefulness. Attendees will learn how THR uses a robust knowledge management platform to better understand how clinicians are interacting with their clinical content to maintain their order sets and reduce the number of alerts fired.

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

Acquisitions, Funding, Business, and Stock

Outsourcer Cognizant Technology guides revenue and profit lower due to Brexit, banking, and US healthcare consolidation and spending cutbacks.

Honor, which matches seniors to home caregivers, raises $42 million, increasing its total to $62 million. One of its VC investors said his firm learned their lesson with Oscar Health, and unlike Oscar, Honor doesn’t just offer online matching – the company remains the intermediary with the user as its customer. It keeps in touch with families with its own app that also populates notes that each assigned caregiver can review. The company also offers a wellness check visit in which observational data is sent back to the user’s doctor. Services are offered only in the Bay Area and Los Angeles, but an expansion to Dallas is planned.

From the Allscripts conference call:

• Sales increased 39 percent for the quarter, or 22 percent without the contribution of the acquired Netsmart.
• The company added one new Sunrise customer.
• Allscripts expects to sell more consulting services after implementation of the “staggeringly large” number of MACRA and QPP reporting requirements.
• The company responded to an analyst’s question about how much revenue Northwell Health contributes to the total, with the answer being a single-digit percentage.

Caradigm provided this response to FlyOnTheWall’s rumor report that I ran Friday in which he said the company let 30 percent of its workforce go this past Wednesday:

Since Neal Singh was named CEO in April 2016, he has worked with Caradigm’s senior leadership team to drive our mission of accelerating the healthcare revolution with innovative solutions to promote better care, smarter spending and healthier people. In keeping with its mission, Caradigm is proactively reorganizing to provide clear accountabilities and streamline efforts to improve teamwork, drive simplicity and deliver quicker results – in order to better serve its customers. Caradigm has reorganized Product teams by key solution focus, with the aim of reducing its customers’ total cost of ownership and reducing time to go-live. Its Services organization has been reorganized to focus exclusively on customer implementations, product support, and driving the relationship and partnership experience that customers have with Caradigm. And in recognition of the fact that customers require deep clinical and technical support and expertise through their lifecycle, Caradigm has expanded the charter of the Care Transformation team. These changes required Caradigm to make difficult layoff decisions. The new organization will put Caradigm on a path for innovation to better support healthcare initiatives and enhance its customers’ experiences. Employees who had their positions eliminated have received both severance and resources to help them with their transition. Caradigm is not disclosing further details about the layoffs.

Marin Medical Practices Concepts, a California physician billing and EHR services company, pays a hacker’s unspecified ransomware demands regain access to its data. The company’s medical practice customers, which include the county’s public health clinics, had been unable to access their EHRs for a week.

More breach news from DataBreaches.net:

• Carle Hospital announces that an unnamed vendor placed files containing the information of 1,185 patients on its procurement document sharing site, unaware that other vendors could also view the information.
• Nordic Consulting notifies New Hampshire’s attorney general that one of its HR employees emailed current and former employees who were affected by a previous data breach to remind them to sign up for identity theft protection, but inadvertently attached a worksheet containing the demographic and patient information of employees covered by Nordic’s health insurance.
• Athens Orthopedic Clinic (GA) confirms that hacker The Dark Overlord has placed patient information from its breached system for sale on the Dark Web after the clinic declined to pay $335,000 to keep their records private. The Dark Overlord claims to have already sold the information of at least 5,000 of the 400,000 patients contained in the database he downloaded. He made a good business case to the clinic in pricing his services competitively with the alternative since just offering credit monitoring protection will cost more than his price.

Technology

Mayo Clinic researchers will climb Africa’s 20,000-foot high Mount Kilimanjaro this week, monitored by sensors from Philips that will help them understand the oxygen deprivation that occurs during both mountain climbing and heart attacks. A drug company is footing the bill.

Apple joins the “bug bounty” movement in which it will pay outside hackers who find and report security flaws in its products. The company will pay $50,000 for bug reports that involve gaining access to iCloud data.

Other

A New York Times article ponders whether it makes sense for hospitals to include a “did we control your pain” question on their patient satisfaction survey that might encourage doctors to over-prescribe the narcotic drugs that already have led a big chunk of America into addiction. Doctors say patients demand specific drugs and use their satisfaction surveys to retaliate if they don’t get them, cutting into the paychecks of the medical staff whose compensation is partly driven by those satisfaction scores.

A study finds that heavy, detailed media coverage of mass shootings causes more gun violence almost immediately afterward, as would-be mass killers see the fame earned by the shooter. The researchers suggests following the “Don’t Name Them” campaign in which mass murderers are deprived of their moment in the limelight by not publishing their names, photos, writings, and details about their past. That would be a fantastic idea except for the sorry state of “eyeballs at all costs” American journalism, where indeed if it bleeds it leads and no amount of public goodwill can offset those Internet page views.

A lawyer credits the autopilot feature of his Tesla Model X for saving his life when he has pulmonary embolism while driving and instructs the Tesla to take him 20 miles to the hospital ED. He’s still not sure that he shouldn’t have called an ambulance instead, but says he figured he could get to the ED faster on his own. Pricing for the Model X starts at $80,000, probably about the cost of his ED visit.

NPR profiles iNaturalist, a social network for wildlife in which users post photos of animals they’ve seen and share them with other to identify them in a form of gamification. At least one previously unknown species has been identified as a result.

Alameda County, CA replaces its long-time jail healthcare contractor after inmate deaths and allegations of poor care. One of its nurses cited inexperienced management and the implementation of new software that wastes clinician time.

I don’t think I was aware of this: the Ragon Institute of MGH, MIT, and Harvard, which has been working in HIV/AIDS vaccine research since 2009, is also supporting Zika virus research. I hadn’t heard of the institute, which is funded via a $100 million commitment from InterSystems founder and billionaire Phillip “Terry” Ragon. 

Drugmaker AbbVie tries to block introduction of a biosimilar drug that is a lower-priced competitor to Humira, which generates 60 percent of the company’s revenue. AbbVie has also filed new patents hoping to delay the entry of the new drug to the market. It’s a good reminder that the sole mission of drug companies is make profits for shareholders, not to perform societal good or to help patients. Companies by definition are not capable of having a collective conscience no matter how much their slick marketing suggests otherwise.

Somerset, PA police arrest a man caught wandering the local hospital’s halls by a nursing supervisor. He was wearing a white coat and claiming to be a doctor in the IT department, which might have been more convincing if he hadn’t then asked her for directions to that department or responded, “Yeah, are you?” when she asked if he was a doctor. Todd Knisely then claimed to be testing the facility’s security for an online journal write-up. He might be telling the truth: Googling him turns up his alter ego (the not very creative “Shadow”) and Shadows [sic] Government, where he wrote up his planned social experiment. He also offers IT security services and website management. He says he wondered about the hospital’s security when he was a patient a year ago and found that he had free run of the place – including computers and paper patient records – since the hospital had no security officers on duty. Knisely (or is that Shadow?) says his legal research indicates that he broke no laws, an interpretation not shared by officers who locked him up for impersonation, theft by deception, and receiving stolen property.

Vince and Elise introduce their “Rating the Ratings” series and offer one last chance to providers who have read or contributed to a report from KLAS, Black Book, etc. to complete my survey for future installments.

Sponsor Updates

• Experian Health will exhibit at the Illinois Rural Health Association Annual Education Conference August 10-11 in Effingham.
• PatientMatters will exhibit at HFMA Arkansas: Summer Institute August 17-19 in Hot Springs.
• The SSI Group will exhibit at the OASCA Annual Conference and Trade Show August 11-12 in Portland.
• Stanson Health enables provider compliance with the PAMA imaging clinical decision support mandate.
• VisionWare achieves Microsoft Gold Partner status.
• Huron Consulting Group closes its acquisition of HSM Consulting.
• ZirMed will host its 2016 User Group August 22-23 in Chicago.

Blog Posts

• Understanding an Overlay (PatientKeeper)
• Perinatal Nursing & Technology: Time to Accept & Embrace the Challenge (PeriGen)
• How all the King’s Horses and all the King’s Men Were Given One Single, Bundled Payment to Put Humpty Together Again (PMD)
• User Group Season Kicks Off: Upcoming Events and Conferences (Surescripts)
• Healthcare — today’s biggest ransomware target (Iatric Systems)
• 5 Tips from the Trenches: Best Practices for HEDIS 2017 (Verisk Health)
• Work and play, the Voalte way. (Voalte)

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 8/5/16

Top News

Advocate Health Care Network (IL) will pay $5.55 million to settle HIPAA charges involving three 2013 breaches in its medical group. OCR found that Advocate failed to perform risk assessments, didn’t limit access to its data center, and failed to encrypt a laptop that was stolen from an unlocked vehicle.

Advocate reported three breaches over just a few weeks in late 2013:

• The theft of four desktops containing the PHI of 4 million people from an office building.
• The breach of the network of business associate Blackhawk Consulting Group involving 2,000 patients.
• The theft of an unencrypted containing the information of 2,000 patients.

Reader Comments

From Davadora: “Re: ER holiday shift coverage scam. My daughter was rushed to an in-network ED on Christmas morning. The doctor was not in in network and will not honor any discounts negotiated by my payer. A quick check finds that the provider accepts only one insurance and it’s not even a national one. Could it be a thing that doctors troll for holiday ER shifts to bill out of network?” It’s a patient-unfriendly healthcare system when doctors bill separately from the hospitals from which they provide services and where insurance companies penalize patients who don’t have a choice, leaving patients who by definition are unwell to sort it out instead of focusing on their own medical situation.

From FlyOnTheWall: “Re: Caradigm. Let 30 percent of their workforce go Wednesday.” Unverified. I’ve asked the company to comment but haven’t heard back.

HIStalk Announcements and Requests

We funded the DonorsChoose grant request of Mrs. B from North Carolina, who asked for science activity tubs for her first graders. She reports, “The great thing about these kits is the simple fact that I can use them over and over for classes in the future. We are moving into landforms and characteristics of our Earth. It was great to get a solid foundation about what the Earth is made of. Thank you so much for supplying the funds needed to purchase the materials. I wish I could list everything we were able to do with them. Just know that your donation did not go to waste! You may have sparked a new generation of Earth Scientists.”

This week on HIStalk Practice: Anonymous administrator shares practice’s cybersecurity journey. Healthstar Physicians selects population health management services from Transcend. X-Ray Associates of New Mexico goes live on MedInformatix RIS. The nation’s second-largest school district pilots telemedicine technology. Astellas Pharma, Matter Chicago team up for cancer care innovation competition. Ohio launches $60 million+ CPC program. Stealth startup 98point6 raises $11 million. Nicole Hartung, MD of Minnesota Oncology shares best practices for engaging physicians in OCM-required care redesign.

This week on HIStalk Connect: PerfectServe CEO Terry Edwards weighs in on the Joint Commission’s waffling on texting of orders. Behavioral health company Big Health raises $12 million. Fitbit entices Adam Pelligrini away from Walgreens. IBeat secures $1.5 million.

Webinars

August 10 (Wednesday) 1:30 ET. “Taming the Beast: CDS Knowledge Management.” Sponsored by LogicStream Health. Presenters: Luis Saldana, MD, MBA, CMIO, Texas Health Resources (THR); Maxine Ketcham, clinical decision support analyst, THR; Kanan Garg, senior applications analyst, THR; Patrick Yoder, CEO, LogicStream health. This presentation will review THR’s systematic process for managing clinical decision support assets, including identifying broken alerts, addressing technical and clinical issues, modifying order sets, and retiring tools that have outlived their usefulness. Attendees will learn how THR uses a robust knowledge management platform to better understand how clinicians are interacting with their clinical content to maintain their order sets and reduce the number of alerts fired.

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

Acquisitions, Funding, Business, and Stock

Video visit provider Teladoc reports Q2 results: revenue up 45 percent, EPS $0.38 vs. –$7.20, exceeding earnings expectations but falling short on revenue. TDOC shares dropped sharply on the announcement and have shed 47 percent since the company’s first-day IPO close in July 2015.

Analytics vendor Inovalon reports Q2 results: revenue up 5 percent, adjusted EPS $0.14 vs. $0.18, meeting earnings expectations but falling short on revenue.  Shares dropped sharply Thursday and are down 25 percent in the past year, valuing the company at $2.25 billion.

Allscripts reports Q2 results: revenue up 10 percent, EPS –$0.05 vs. $0.01, meeting earnings expectations but falling short on revenue.

From the Cerner earnings call:

• President Zane Burke reports that 34 percent of sales came from outside the Millennium client base, which he attributes to an active replacement market and success against Epic.
• The HealtheIntent population health management solution has been purchased by more than 100 clients.
• Burke says of Cerner’s small-hospital CommunityWorks service in apparently calling out Athenahealth, “A recent noteworthy win for CommunityWorks was the displacement of a failed attempted go-live by a cloud-based vendor that has been making a push in recent years to expand from the ambulatory market to hospitals. We have several active opportunities to displace this same competitor in both ambulatory and small-hospital settings, suggesting their approach of spending about three times as much on much sales and marketing as they do on research and development may not be the most effective approach for their clients.”
• The company sold two PHM deals of over $5 million.
• A new children’s hospital in Dubai was scheduled to implement Epic, but moved to Cerner because of the ITWorks IT management service.
• CFO Mark Naughton says of clients who had already notified Siemens that they were dropping their systems before Cerner acquired the company, “Every one of those is still writing me their monthly check or owes me their monthly check for their contract duration, which can extend anywhere from three to five more years.”
• Only 25 percent of customers have bought Revenue Cycle, which the company sees as an ongoing opportunity.

In Australia, software vendor Global Health settles its lawsuits with SA Health over the health department’s continued use of its 1980-era Chiron patient management software as its last remaining user. SA Health will pay $3.8 million for a five-year license, about the same annual fee it was paying before Global Health refused to extend its support agreement in insisting that the product was dead. SA Health wants to keep using the system due to delays in the EPAS Allscripts Sunrise Clinical Manager rollout at Royal Adelaide Hospital.

Elation Health, which offers a $299 per provider per month EHR, raises $15 million.

Sales

Wake Radiology (NC) chooses the Vitality IQ imaging practice management tools from Vital Images.

OptumCare signs a 10-year deal to deploy Allscripts Touchworks to its physician practices.

People

Ray Wolf (Redirect Health) joins Lumeris as SVP of architecture and innovation.

Announcements and Implementations

Peer60’s new report, “Health System Brand Reputation,” looks at which health systems C-level healthcare executives recognize most for quality, innovation, and overall brand reputation. Mayo Clinic and Kaiser Permanente scored highest on public presence, but Johns Hopkins and Cleveland Clinic have the best overall reputations.

Athenahealth alerts its Miami-area customers that 1,800 of their patients are at risk for Zika virus infection based on CDC guidelines, most of them at a single health care center. 

In Australia, SA Health wins a government innovation award for its use of healthcare integration technology from InterSystems.

IDS will incorporate SyTrue’s NLP OS natural language processing system into its Voice2Dox speech-powered clinical reporting platform.

The Sequoia Project validates ZeOmega’s Jive HIE Connect for use on the eHealth Exchange.

Privacy and Security

Banner Health (AZ) notifies 3.7 million people that its food and beverage systems were breached by a hacker in June, exposing patient and credit card information.

A former clerk of Tampa General Hospital (FL) is sentenced to three years in prison for using the computer information of 644 patients to file false tax returns that earned her refunds totaling $77,000. She also sold some of the information to others.

Innovation and Research

Drone delivery vendor Zipline announces plans to begin delivery of medical supplies to remote areas of Maryland, Nevada, and Washington within a year. The company’s 22-pound, GPS-directed drones can carry three pounds of blood products and supplies that hospitals order via text message, with delivery within 30 minutes by parachute drop.

A study finds that hospitals that send the most heart attack and heart failure patients to the ICU have lower quality and worse outcomes, suggesting that the purpose of ICUs is ill-defined and may be driven by non-clinical factors.

Other

A NEJM opinion piece by Senator Elizabeth Warren (D-MA) on the contentious issue of requiring researchers to share their study data calls for more openness. She recommends:

• Medical journals should require researchers to share the de-identified patient they used along with their article submission.
• The government should enforce FDA’s requirement that researchers register their clinical trials via ClinicalTrials.gov.
• Researchers should include their plans for sharing data when registering their study.
• Clinical trial sponsors should mandate data-sharing in their contracts, with the grant recipient being responsible for covering the costs from their award.
• The medical community should find ways to share results from failed trials, which can have significant scientific impact yet are rarely published. 

Eastern Maine Healthcare Systems lays off 35 of the IT department’s 300 employees as the department tries to cut its budget by $3 million.  The department eliminated 43 jobs in 2014.

In England, Burton’s Queen’s Hospital takes six years to finally go live on an unnamed, $2 million patient records system.

GE CEO Jeff Immelt makes some refreshingly frank comments in an interview with Vanity Fair:

• He says the company’s diversification strategy made sense in the 1980s and 1990s when GDP growth was 4 percent, but now, “If I would go out today and say, ‘Guess what? I have a great idea. We’re going to buy a media company,’ I’d get shot. Or if I were to say to you, ‘Hey, look, I was really great at picking jet engines and picking TV shows’—that’s complete bull, really.”
• He says GE will apply Internet of Things information to improve industrial operations in ways software companies can’t.
• Immelt says every new GE employee will “learn to code …  whether they join in finance or IT or marketing, they’re going to code.” He’s hoping to create programming and data scientist jobs for employees who have an associate’s degree only.
• Asked about GE’s succession planning, he says, “In some ways, we are working on succession all the time. You don’t become CEO for what you know. You become CEO for how fast we think you can learn. There’s a whole bunch of things that go into it. How fast can they learn? How resilient are they? How competitive are they? Those are things that really put you in good stead.”

A study of users of the free digital advance planning tool MyDirectives finds that people can do a better job specifying their own wishes via an electronic interview rather than checking off items on a paper form. The stored advance directives can be looked up by doctors and hospitals and users can even add a video statement via the company’s mobile app. The company makes money by charging health plans for storing the emergency care plans of their members, charging providers and health IT vendors to access the database, and selling de-identified data to third parties.

The CNN journalism cesspool doesn’t appreciate the irony of placing a story about Facebook’s crackdown on clickbait headlines among its own non-newsworthy clickbait headlines.

Sponsor Updates

• Intelligent Medical Objects and Obix Perinatal Data Systems will exhibit at the Allscripts Client Experience August 9-11 in Las Vegas.
• PDR and Navicure will exhibit at the Greenway Engage user conference August 10-13 in Atlanta.
• MedData VP of Human Resources Barb Astler is named a finalist for the Crain’s Archer HR Executive of the Year award.
• Netsmart will exhibit at the MHCAR Annual BH Institute August 9 in Hot Springs, AR.
• Nordic will sponsor the Collaboration of Revenue Cycle Epic Users Conference August 10-12 in Portland.
• Elsevier Clinical Solutions, Galen Healthcare Solutions, and Healthwise will exhibit at the Allscripts Client Experience August 9-11 in Las Vegas.
• Ninety-nine FormFast customers are named to the 2016 Most Wired list.
• GE Healthcare President and CEO John Flannery continues his LinkedIn series on “The Top 10 Reasons Transformation is the New Normal for Healthcare.”
• Healthfinch CEO and co-founder Jonathan Baran joins the Young Entrepreneur Council.

Blog Posts

• Preparing for Epic implementation: Your go-live playbook [podcast] (Nordic)
• CMS’ Mandatory AMI Bundle is Cause for Chest Pain (ECG Management Consultants)
• 4 Ways to Lower Cost-per-Acquisition (Evariant)
• Top 5 Tips to Prepare for EMR Data Archival (Galen Healthcare Solutions)
• Things to Consider When Selecting a Healthcare IT Vendor (Hayes Management Consultants)
• When Hospital Leaders Say, “Just fill those open CDI positions!” (HCTec)
• Don’t want to lose patients? Here’s how IT can improve price transparency. (Advisory Board)
• 8 Ways to Make Breach Notification Letters Effective (ID Experts)
• Building New Healthcare Facilities: Connected, Smart, Efficient, Flexible and Secure (Impact Advisors)
• 5 Keys to a Successful Healthcare IT RFP (Influence Health)
• Pharma Lifecycle Plagued with Integration and Data Management Challenges (Part V – Sales and Marketing) (Liaison Healthcare)
• The next generation of Healthcare IT solutions must create value for the clinician (NVoq)
• Healthcare’s Partner for Clinical Communications (Spok)

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 8/3/16

Top News

Theranos CEO Elizabeth Holmes could have spoken on many interesting topics at AACC — the company’s troubled Edison finger-stick analyzer, her CMS death penalty for running labs, the lab results that were “recalled” because they were wrong, the spectacularly failed relationship with Walgreens, and the government’s criminal probe – but instead uses her American Association for Clinical Chemistry conference podium time to pitch a new product, the Theranos MiniLab, which contains the same old specimen processing equipment that other vendors sell, just squeezed into a smaller box.

I doubt the assembled laboratorians gave her a standing ovation since they already have all the equipment and the specimen volume they need. It’s also not likely going to be less expensive than existing analyzers. Surely the only people even more puzzled than the assembled lab multitudes were the irrationally exuberant investors who pumped money into the company thinking it was a Silicon Valley high flyer but now realizing that it is, at best, a hardware huckster whose only potential revenue can be blocked by CMS and the FDA.

For her speech, the empress wore physical clothes at least, but not her traditional black turtleneck. She should have come out in it and then done the Steve Jobs “one more thing” move to intro the MiniLab.

That sounds like an embarrassing pivot to me, wasting the time of a ton of scientists to talk up a hardly revolutionary work-in-progress, non-FDA approved gadget that may never see the light of day (and reading sing-song from a PowerPoint script in her slightly disturbing voice besides). Shame on AACC for giving her stage time without requiring her to provide the usual slides, data, and publications in advance to justify it. The best part of the day came as she was introduced to the Rolling Stones song “Sympathy for the Devil,” of which the aggregated volume from the packed auditorium wouldn’t have filled a Nanotainer.

Reader Comments

From Connecting the Dots: “Re: Aledade. Its founder Farzad Mostashari and its primary funders are undertaking a public lobbying campaign. I assume they’re doing a lot of back-channel lobbying with CMS as well. They may be right on the merits, but the changes they propose will benefit them financially as well.” Mostashari opines that “CMS needs to halt the march to health care gigantism,” while Venrock partner, Aledade board member, and former White House advisor Bob Kocher tells the WSJ audience “How I Was Wrong About ObamaCare” in staying on the same message. Both articles say that hospital and medical practice consolidation is bad for cost and quality, not to mention Aledade’s bottom line as a small-practice ACO operator. They were happy to encourage industry consolidation in their former government jobs and are now using that employment history to gain a public platform from which to offer their potentially profitable penance. That doesn’t mean they are wrong, but it does indicate that perhaps less-vested experts from outside the same White House administration would provide a more objective opinion.

From Night Train: “Re: health IT news outlets. The other sites repeat their articles and overlap each other. They also don’t investigate much – they just repeat news releases. I only read HIStalk in depth (for the amusing commentary, if nothing else). I scan the headlines in other outlets and only follow a link to a topic that might be interesting.” Peer60 helped me do a CIO/CMIO survey of where health IT people get their news and one CIO respondent emailed this comment afterward. I’m very happy with the results so far. Nobody’s ever done anything like that as far as I know. Thanks for responding or at least for not sending me a nasty message for invading your personal inbox space, which I found from my earlier Epic survey happens every now and then. It takes 2 seconds to delete an unwanted message vs. 60 to craft an indignant response, so I’m a bigger fan of the former.

From Spillway: “Re: grammar pet peeve. Business people using ‘incent’ and ‘incentivize’ as an ugly substitute for ‘encourage.’” I’m struggling with “incent” being wrong since that leaves “incentive” without a verb form. At least it’s better than one of my most-hated IT non-words, “administrate.”

From Straight Talk: “Re: Vince Ciotti’s analysis of ratings services. How much longer are vendors going to be held hostage to these companies and pay the exorbitant fees? Everybody complains about how much they charge and how little value they derive from the reports, yet they continue to purchase the drivel they publish.” They are volunteers rather than hostages, free to stop paying anytime they want. Therefore, I would challenge the assertion that they don’t receive value, even if it’s the extortionate kind where they’re afraid how they will be ranked if they don’t pony up. I’ve received quite a few responses from my survey of hospital and practice executives who have read those reports or contributed data to them. The most striking answer so far matches my experience – people feel pressured to complete a survey even though they aren’t the organization’s best-qualified  person. I still feel ashamed that many years ago, I provided an IT-centric view of a radiology information system to KLAS even though I had no hands-on experience with the product as a user.

HIStalk Announcements and Requests

We provided a programmable robot kit for Media Specialist Ms. B in South Carolina in funding her DonorsChoose grant request. She added the robot to the media center’s MakerSpace, where students can program it on the iPad.

Webinars

August 10 (Wednesday) 1:30 ET. “Taming the Beast: CDS Knowledge Management.” Sponsored by LogicStream Health. Presenters: Luis Saldana, MD, MBA, CMIO, Texas Health Resources (THR); Maxine Ketcham, clinical decision support analyst, THR; Kanan Garg, senior applications analyst, THR; Patrick Yoder, CEO, LogicStream health. This presentation will review THR’s systematic process for managing clinical decision support assets, including identifying broken alerts, addressing technical and clinical issues, modifying order sets, and retiring tools that have outlived their usefulness. Attendees will learn how THR uses a robust knowledge management platform to better understand how clinicians are interacting with their clinical content to maintain their order sets and reduce the number of alerts fired.

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

Acquisitions, Funding, Business, and Stock

Cerner announces Q2 results: revenue up 8 percent, adjusted EPS $0.58 vs. $0.52, meeting revenue expectations and beating on earnings.

Drug maker GSK and Verily Life Sciences (the former Google Life Sciences) will invest $700 million to create Galvani Bioelectronics, which will develop miniaturized implantable devices to alter nerve impulses in treating chronic conditions such as arthritis, diabetes, and asthma.

The patent office awards McKesson Health Solutions a patent for the inner workings of McKesson Provider Manager. My eye was drawn to the spelling of “HIPAA” as “HIPPA” inside and its reference to Portico Systems, the provider management system vendor McKesson acquired in 2011. 

A study finds that a small group of biosimilar drugs — which are nearly identical versions of patented biologics — are as safe and effective as their expensive counterparts that have caused 54 percent of the growth in prescription drug spending since 2010. The study addressed the anti-tumor necrosis factor drugs Enbrel, Humira, and Remicade, which collectively sell $20 billion worth each year. The top eight biologic drugs whose patents are about to expire are projected to generate $200 billion per year for drug companies by 2020, but biosimilars will cost considerably less.

Sales

Salinas Valley Memorial Healthcare System (CA) will add Web Ambulatory and Oncology to its Meditech 6.1 migration, while Meadows Regional Medical Center (GA) will upgrade to 6.1 and add Critical Care, Web Ambulatory, Surgical Services, and BCA. 

East Jefferson General Hospital (LA) chooses Kaufman Hall’s Axiom Software for budgeting, long-range planning, capital planning, and performance reporting.

Wyckoff Heights Medical Center (NY) chooses Allscripts Sunrise and Staff Augmentation. According to the hospital’s website, Meditech is the current vendor.

Stormont Vail Health (KS) selects Orion Health’s Rhapsody Integration Engine.

People

Michael Saad is named VP/CIO at University of Tennessee Medical Center after serving as interim.

London-based cancer survivor and Cerner trainer Robin Chard dies of a heart attack Sunday while riding in the Prudential RideLondon charity bike event to raise money for cancer research. He was 48. Donations to his Just Giving pledge page, from which he hoped to raise $500 for Cancer Research UK, have reached $77,000 since his death was announced.

Announcements and Implementations

VMware AirWatch announces AirWatch Express for fast setup of apps, email, and Wi-Fi on mobile devices. The cost is $2.50 per device per month and the company offers a 30-day free trial.

Clockwise.MD announces that 10 million patients have used its online scheduling service.

Stanley Healthcare uses InterSystems HealthShare to integrate its RTLS product with hospital EHRs.

Government and Politics

Former White House healthcare policy adviser Bob Kocher, MD says in a Wall Street Journal op-ed piece that he was wrong in favoring hospital and medical practice consolidation to improve quality. Now he says that having providers owned by a single organization is “more likely to be a barrier to better care” as independent primary care doctors create more savings and quality improvement than big, hospital-centric health systems. Kocher also says he underestimated the time it would take for doctors to effectively use EHRs, with his estimated 3-5 year timeline lengthened by delays demanded by organized medicine. He concludes, “Large health systems deliver ‘personalized’ care in the same way that GM can sell you a car with the desired options. Yet personal relationships of the kind often found in smaller practices are the key to the practice of medicine.” Reader comments were sometimes savage, pointing out that the never-practiced physician Kocher was all for government meddling in healthcare until he left to work for VC firm Venrock and small-practice focused Aledade and only then published his pseudo-apology for it in suggesting even more government regulation that is also self-serving.

Aetna joins other big insurers in threatening to cut back on its money-losing exchange-sold policy business, saying those patients are seeking more care than the company expected and that drug costs are a big problem.

A New York doctor is convicted of Medicare fraud after billing the government for submitting $25 million in claims for surgeries he didn’t actually perform, some of them on patients who had died. Most interesting to me, other than the magnitude of the fraud that took HHS a long time to uncover, is that nobody asks Medicare patients to validate the services they supposedly received. It seems to me they should have some responsibility for reviewing the bill and perhaps even being rewarded for seeking less care that is questionable or unnecessary. CMS might also want to watch daytime TV to see what products are pitched to seniors as being free by companies that make it clear they know how to check the right boxes (accurately or not) to get Medicare to foot the bill. Anyway, back to this case — the Pakistani-born weight loss and wound care doctor was previously reported as billing Medicare $85 million in just two years, of which the government obligingly paid $7.7 million. He billed 600 surgeries on one 81-year-old woman, making $300,000 on her alone. His lawyer proclaims his innocence, blaming the doctor’s poor handwriting and lack of knowledge about CPT codes.

Privacy and Security

A Ukrainian hacker downloads 100,000 internal Word and PDF documents of a urology group owned by Mount Carmel Health System (OH), some of which contained PHI. All of the practice’s documents are freely available on the hacker’s shared Google Drive. 

Technology

It’s always interesting when technology does nothing but make readily available information more available, such as when people cry “privacy invasion” when Zillow reports home and tax data that it mostly gets from less-obvious but still-public government files. Homeowners are going ballistic over Google’s phone GPS apps Waze and Maps, complaining that they are sending high traffic volume through their shortcut streets that few people knew about before.  Neighbors are falsely reporting street blockages to the Waze app and erecting homemade “No Through Traffic” signs hoping to force re-routing, although Waze says that practice doesn’t work because other drivers will instantly report that they don’t see the accident , also warning that it will suspend users who file false reports. The company says its job is to spread traffic most efficiently over the available road grid even though homeowners don’t like having their secret shortcut exposed. 

Other

Nebraska Orthopaedic Hospital (NE) postpones surgeries Friday and Monday after unspecified computer downtime.

Hospital ICUs are loosening their ICU visiting hours after studies find that patients do better with their families around. That’s hardly a surprise, and given the frequency of hospital mistakes, it’s good for everyone for patients to have visitors to serve as a second set of eyes. Hospitals are just about the last organizations to limit visitor hours like prisons or 1960s college dorms.

Sponsor Updates

• Aprima will host its user conference August 5-7 in Dallas.
• CapsuleTech, Clinical Architecture, and CoverMyMeds will exhibit at the Allscripts Client Experience August 9-11 in Las Vegas.
• CenterX will exhibit at the NCPDP Workgroup Meeting August 3-5 in Cincinnati.
• Optimum Healthcare IT achieves the top rating among consulting services vendors in the KLAS Midterm Performance Review, earning a score of 94.9. 
• Crossings Healthcare releases the latest edition of its newsletter.
• The local newspaper interviews new CTG President and CEO Bud Crumlish.
• Cumberland Consulting Group completes Revitas implementation for BPO client Ferring Pharmaceuticals in 90 days.
• Vital Images is showcasing its imaging interoperability solutions at AHRA in Nashville this week.

Blog Posts

• Meeting MIPS: 4 Major Ways to Measure Up for MACRA (AdvancedMD)
• With Business Mobility, It’s Personal and Professional (AirWatch)
• IT and Disease Management: Heart Failure (Arcadia Healthcare Solutions)
• How HIT Vendors Price Their Solutions (Catalyze)
• CareSync Clients Are Well-Positioned For MACRA Success. Why? (CareSync)
• Enhancing Team and Leadership Performance through LEAN Principles (Culbert Healthcare Solutions)

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 8/1/16

Top News

A newly published Apple patent suggests that the company is interested in allowing iPhone users to connect with a physician, send the doctor their HealthKit-collected information, and then initiate a telemedicine session from their iPhones.

The inventor is Todd Whitehurst, MD, PhD, a former Apple director of hardware development who now holds the same position at Google Life Sciences. He has previously worked on implantable devices for glucose monitoring, drug infusion, and neurostimulation. Whitehurst holds more than 50 patents involving implanted medical devices and has applied for many dozen more.

Reader Comments

From Frank Poggio: “Re: evidence-based medicine. It’s really evidence-based political medicine, as evidenced by the mammography battle three years ago. Every doctor and patient should read ‘Snowball in a Blizzard’ by Steven Hatch, MD. It says doctors are guessing all the time but have led the public to believe the Marcus Welby / Dr. House version of their role, making patients and families angry when there is a misdiagnosis or treatment failure. It will take a very long time and big attitude change to reverse the misconception.” Hatch wrote the book following 2009’s guidelines by the US Preventive Services Task Force that called for a reduction in mammograms because their diagnostic value is less than previously believed, which cause outrage in women (and in providers who make a lot of money performing mammograms) who felt the recommendation was a form of rationing. Interestingly, Hatch concludes that doctors pay less attention to patients with symptoms that are hard to interpret because the doctors are frustrated by their own limitations.

From Hundred Dollar Baby: “Re: Covenant Health. I looked up attestation data to see which systems their hospitals use.” This is great, thanks. According to the attestation data, seven of Covenant’s hospitals (including the big ones) run McKesson Horizon, one uses Meditech 6.0, and one is a Medhost user. All of the systems will apparently be replaced with Cerner. Hospitals that bought McKesson’s sketchy vision of integrating all of its acquisitions to form a cohesive system are paying big to correct their mistakes, but on the other hand, evidence was ample to predict the current state.

From Specific Gravity: “Re: Preservation Wellness Technologies. Rumor has it that the patent troll, which lost its infringement lawsuit against Epic, is now suing Epic’s customers.” Unverified. The company doesn’t even bother to run a website in pretending that it’s a real business rather than a patent troll. I provided some background a couple of months ago:

The “inventor” apparently runs Carlo Coiffures, a beauty salon in New York. The lawsuit was brought by a Texas corporation with a Texas mail drop address that filed the suit in the rural Eastern District of Texas, which attracts 25 percent of the patent lawsuits filed in the entire US because that district’s troll-friendly practices make it hard for defendants to get a ridiculous lawsuit dismissed. A fascinating episode of “This American Life” describes a building in Marshall, Texas (population 24,000) whose long corridors contain locked offices representing the only physical presence of companies whose entire business is filing frivolous patent infringement lawsuits.

HIStalk Announcements and Requests

Thirty-seven percent of hospitals told AHA surveyors that they allow patients to electronically submit their own information to the hospital, but only 12 percent of my survey respondents reported having that option as patients. New poll to your right or here: as a patient, how much value would you place on CMS’s hospital star rating system? Click the poll’s Comments link after voting to explain why you do or don’t trust CMS’s data as a predictor of hospital quality.

Vince Ciotti is working on his review of healthcare software rating services such as KLAS, Black Book, and others. If you work for a hospital or medical practice and have read a software rating report in the past year from any company, can you take a couple of minutes to complete my survey to give Vince a broader look at that market? You’re also welcome to send me your thoughts. Thanks.

We funded the DonorsChoose grant request of Mr. F in Florida, who asked for programmable robot for his elementary school technology class. He reports, “Thanks to your donations, my students were able to bring their coding skills to practical use by controlling the Sphero robot. Not only did my students wait desperately for their turn with the Sphero, but they used their time to learn how to code it to do even more. I thank you for your generosity and faith in my class as well as myself to put your donations to good use.”

I had another busy day of unfollowing low signal-to-noise Facebookers who post frequent political rants, relentless mugging selfies, and updates about teams and sports that don’t interest me (which is all of them). I rarely look at Facebook but it felt good to take action, sort of like that dashboard-mounted toy that releases stress by letting you shoot imaginary death rays at bad drivers. 

I’m wondering if death rates rise early in each calendar year among people who buy their health insurance through Healthcare.gov or state exchanges. Open enrollment runs November 1 through January 31 and many folks have to start over because their insurer pulls out or changes the plans it offers. They have to:

• Try to find a decently qualified PCP who will take a new patient.
• Get a “new patient” appointment sooner than several months out with that new PCP.
• Obtain referrals for ongoing conditions if the new plan requires it or if their old specialist doesn’t take their new insurance.
• Hope for no surprises that their maintenance meds, especially the expensive specialty ones, are covered by their new plan (since insurance companies  can’t tell you cost or coverage until the policy takes effect, they’re buying blind).
• Avoiding getting medical care because of the multi-thousand dollar deductible that resets January 1, meaning they have to pay every expense out of pocket.

Listening: new from reader-recommended Look Park, mellow, folky-style pop with lots of hooks by Chris Collingwood from the unfortunately defunct Fountains of Wayne. I’m also pondering the definition of “country” music – it seems you just stick a cowboy hat on a random musician’s head (some not even US-born, like Keith Urban), add fiddle and pedal steel to the otherwise pop mix, and dumb down the lyrics to include only mournful warblings or throaty backwoods swagger affecting a fake Southern accent. I’m not entirely sure it’s even a real genre any more except as an easier route to pop stardom, where the faux country trappings are quickly dropped (see: Taylor Swift).

Last Week’s Most Interesting News

• CMS adds star ratings to its Hospital Compare website, with some highly regarded hospitals performing poorly and criticizing CMS’s methodology as flawed, especially for academic medical centers and hospitals in economically challenged areas.
• Consumer health site Sharecare acquires the population health business of Healthways.
• A report finds that 88 percent of known Q2 ransomware infections involve healthcare organizations.
• ONC announces funding availability for a cyber threat information sharing service as previously called for by the White House.
• University of Mississippi Medical Center pays $2.75 million to settle HIPAA charges related to the 2013 theft of a laptop.
• Athenahealth announces poor quarterly results and the planned year-end departure of EVP/COO Ed Park.

Webinars

August 10 (Wednesday) 1:30 ET. “Taming the Beast: CDS Knowledge Management.” Sponsored by LogicStream Health. Presenters: Luis Saldana, MD, MBA, CMIO, Texas Health Resources (THR); Maxine Ketcham, clinical decision support analyst, THR; Kanan Garg, senior applications analyst, THR; Patrick Yoder, CEO, LogicStream health. This presentation will review THR’s systematic process for managing clinical decision support assets, including identifying broken alerts, addressing technical and clinical issues, modifying order sets, and retiring tools that have outlived their usefulness. Attendees will learn how THR uses a robust knowledge management platform to better understand how clinicians are interacting with their clinical content to maintain their order sets and reduce the number of alerts fired.

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

Recent webinars and their associated YouTube video views are:

• Your Call is Very Important (185)
• Provider-Led Care Management: Trends and Opportunities in a Growing Market (198)
• Ransomware in Healthcare: Tactics, Techniques, and Response (896)
• rise of the small first letter vendors (223)
• Six Communication Best Practices for Reducing Readmissions and Capturing TCM Revenue (132)
• Looking at the Big Picture for Strategic Communications at Children’s Hospital Colorado (222)

Acquisitions, Funding, Business, and Stock

Meditech reports Q2 results: revenue up 3 percent, EPS $0.44 vs. 0.46.  Product revenue was flat while service revenue increased 4 percent.

Cognizant acquires Toronto-based digital design firm Idea Couture.

Sales

UNC Health Care (NC) chooses Phynd to manage and share the information of its 20,000 providers across six hospitals.

Beacon Health System (IN) will implement Cerner’s Millennium Revenue Cycle.

People

Colleen McFarlane (US Preventive Medicine) is named CEO of radiology best practice platform vendor Radiology Protocols.

Arno Laeven, who founded the Philips Blockchain Lab in the Netherlands in January 2016, will leave the company, according to reports.

Stanson Health promotes Jeremy Orr, MD, MPH to chief medical officer.

Announcements and Implementations

In Canada, Interior Health is recognized as the first health authority in British Columbia to provide patients with online access to their records, using Meditech’s MyHealthPortal.

National Decision Support Company will incorporate appropriate imaging criteria from the National Comprehensive Cancer Network in its CareSelect Imaging.

A Navicure survey finds that while most healthcare organizations value data analytics and reporting, 55 percent don’t have such a solution, although half of those are planning to implement one. Nearly three-fourths of respondents say data analytics help them improve cash flow by reducing A/R days.

Privacy and Security

I’m giving public credit to DataBreaches.net, which has become my go-to source for breach reports and from which most of the items below originated. It’s brilliantly run by an anonymous mental health professional.

Crozer-Keystone Health System (PA) notifies 900 bariatric surgery patients that their information was exposed when an employee emailed all of them using CC: instead of BCC:. I’m beginning to think that the average hospital employee isn’t sharp enough to trust with a fully capable email client. Maybe they should either have to pass a competency exam or be forced to use a dumbed-down email client that protects the organization from their inattentiveness since the “we trust everybody to do the right thing with Outlook” isn’t working too well. The reduced functionality front end could restrict the ability of users to:

• CC more than a handful of recipients.
• Click embedded links to sites that have not been previously whitelisted.
• Open attachments from external senders that have not been previously whitelisted.
• “Reply to all” to more than a handful of recipients (that’s not a privacy risk, just an annoying practice, especially when they start emailing everyone to angrily tell them to stop emailing everyone).

Prosthetic & Orthotic Care (MO) notifies patients that hacker The Dark Overlord hacked its systems on July 9. DataBreaches.net brings up an interesting point – should OCR require the covered entity to tell patients that their information is for sale on the Dark Web as it is in this case? The Dark Overlord used his signature method to gain access, a zero-day exploit in Microsoft’s Remote Desktop Protocol.

Also experiencing a breach via remote access is Jefferson Medical Associates (MS).

The FTC reverses overrules a previous decision to drop data security charges brought against lab testing firm LabMD, now saying that LabMD’s security practices failed to address even basic security to protect the information of 750,000 patients, resulting in undetected installation of file-sharing software that left the information of 9,300 patients freely available for 11 months. Note that this action plus ONC’s observation that only FTC has jurisdiction over non-covered entities and you might infer increased FTC involvement going forward. Above is Friday’s response by LabMD President and CEO Michael J. Daugherty. My November 2015 summary of the original ruling was:

The first incident was reported by Tiversa, a security vendor who was trying to sell its services to LabMD. A former Tiversa sales manager said its warning to LabMD was “the usual sales pitch” and said no breach actually occurred. The second involved documents recovered in an identity theft investigation. The judge ruled that any consumer risk was theoretical and scolded the FTC for relying on Tiversa’s “unreliable” claims. It appears that Tiversa is still in business selling peer-to-peer cyberintelligence services, while LabMD shut down after being buried in court costs and customer defection due to the now-dismissed charges. LabMD was never charged with a HIPAA violation, only with deceptive trade practices, which seems to make little sense in this case (as the judge validated).

Other

Another medical transport aircraft goes down as a Cal-Ore Life Flight plan crashes in Northern California, killing the pilot, flight nurse, medic, and patient. The flight’s operator was Air Medical Group Holdings, which was acquired by a private equity firm last year for $2 billion.

A bravely brilliant JAMA editorial questions whether it makes sense for NIH to be spending so much money on precision medicine research, which in 2016 earned $15 billion of NIH’s $26 billion in grant funding. It notes the general failure in trying to apply complex genetic information to clinical practice even in relatively simple forms, such in sickle cell anemia where detection of the causative gene 60 years ago still hasn’t provided any treatment options. It questions whether NIH should instead refocus on blue sky research that has obvious public health benefits instead of projects that are “constrained by current narratives” (in other words, chasing the latest shiny scientific object). Other points made in the article:

• The financial and clinical benefits of EHRs haven’t materialized due to lack of interoperability, the poor quality of information they collect, and their high cost.
• Most of the improvements in mortality, morbidity, and life expectancy have come from public health efforts, not medical research or interventions.
• Genetic research will probably not create big-picture improvements in care and outcomes since it will at best create high-cost, highly targeted interventions for small numbers of people, not even counting the inevitable overdiagnosis and overtreatment that intensive monitoring encourages.
• The authors recommend that NIH engage independent assessors to review the value received for research that promised specific deliverables, such as personalized medicine.
• The article questions whether NIH should be spending federal taxpayer money in funding projects to discover new drugs, tests, and technologies or instead leave that work to private industry.

I’m impressed that John P.A. Ioannidis, MD, DSc of Stanford Prevention Research Center had the courage to challenge the precision medicine-driven funding frenzy that has taken federal money away from public health programs that could have provided an immediate and far greater ROI on public health. As I’ve said many times, the US is great at heroic, expensive (meaning: profitable) medical interventions that suck up ever-increasing chunks of our federal and state budgets, but we lag much of the world in public health, exporting most of our public health expertise. Check out his interview earlier this year with “Retraction Watch” and his “Evidence-based medicine has been hijacked” article from March 2016, in which he fearlessly criticizes the trend:

As EBM became more influential, it was also hijacked to serve agendas different from what it originally aimed for. Influential randomized trials are largely done by and for the benefit of the industry. Meta-analyses and guidelines have become a factory, mostly also serving vested interests. National and federal research funds are funneled almost exclusively to research with little relevance to health outcomes. We have supported the growth of principal investigators who excel primarily as managers absorbing more money. Diagnosis and prognosis research and efforts to individualize treatment have fueled recurrent spurious promises. Risk factor epidemiology has excelled in salami-sliced data-dredged articles with gift authorship and has become adept to dictating policy from spurious evidence.

A NEJM article advocates expanding the five rights of medication ordering (right patient, drug, dose, time, route) to six, requiring prescribers to provide an indication (what the medication is for). The authors say it would reduce errors (where pharmacists might see “hydroxyzine” with an indication of “hypertension,” allowing them to call to see if they really meant “hydralazine”) and to educate patients on what each medication is for. Another strong point for me would be to allow researchers to determine from electronic data sets why a particular drug was chosen, or for payers to be able to detect prescribing without a valid diagnosis or vice versa. Challenges include extra prescriber effort, privacy concerns, how to code (if at all) the indication and how to handle multiple indications, and the system redesign required to handle the extra data element. I’ve been a fan of this idea for many years going back to when it was included on paper standardized order forms and it makes perfect sense. In fact, just as physicians are supposed to be planning discharge upon admission, maybe they should indicate and reaffirm the desired endpoint of the drug prescription, i.e. when might it be stopped based on patient response instead of just putting people on drugs for life with nobody really remembering why, which should be a big help to continuity of care since nobody likes taking responsibility for blindly discontinuing someone else’s order.

I bet attendees of the American Association for Clinical Chemistry could scalp tickets to Monday’s 45-minute talk and the following Q&A by Theranos CEO Elizabeth Holmes. My prediction is that she’ll be so scared and over-coached to avoid referencing information that is proprietary or related to the company’s criminal probe that she will either cancel with a medical or other emergency excuse or will deliver a glossy performance to an audience expecting facts and humility who will rebel at the absence of both. Maybe a black turtleneck is the opposite of a white lab coat. The damage is already done to AACC for inviting her in the first place, as pathologist Geoff Baird, MD, PhD says, “Would you have Al Capone come and talk about his novel accounting practices? Is it acceptable to allow someone to talk about science if they’ve used that science so horribly inappropriately?”

A Florida pediatrics practice mails letters to eight mothers who had criticized it on Facebook, telling them to find a new pediatrician. The mothers were appalled that they were no longer welcome at the business they had flamed, running to the local TV station to complain, with one dramatically telling the reporter in milking her moment in the limelight, “I just started stressing, and I got dizzy, and I fainted” (obviously she’s challenged by the concept of replacing a doctor she didn’t like anyway). Lots of people have courage only of the Internet kind, confidently bold in their online commentary but meekly shamed by its real-life result. The practice – like an accountant, lawyer, or plumber – can choose whoever they want as customers (if only teachers had that same right). This is like writing a Yelp restaurant review complaining that all the food was inedible, and not only that, the portions were too small.

Maybe these folks are goofing on healthcare with all those lame apps out there. Media people swoon, hundreds of people sign up for the email list, and would-be Silicon Valley investors fill the inbox of Pooper, “the Uber for dog poop,” in which app users snap a photo of the dog’s excrement to summon a Prius-driving scooper to clean it up. People keep emailing the company looking for scooper jobs. The app is an elaborate prank from a couple of guys who plan to do more of them, who explain, “We’re going to continue to put content out there that makes people question what they’re reading in the news, what they’re looking at online, and on a deeper level, what their relationship is to technology … people should be thinking about it and questioning what roles apps and the gig economy play in their lives.”

Sponsor Updates

• KLAS names HealthCast as the top-rated single sign-on vendor in its 2016 midterm report, with the company earning a score of 92.
• T-System will exhibit at Symposium by the Sea August 4-7 in Naples, FL.
• Talksoft is rated highest in the KLAS Patient Outreach 2016 Performance Report.
• TeleTracking will celebrate its 25th anniversary and record-breaking registrations at its annual client conference October 9-12 in Naples, FL.
• Valence Health Vice President of Market Solutions Ryan Smith contributes an article on hospital employee health plans to Trustee magazine.
• Huron Consulting Group will exhibit at the Studer Group’s What’s Right in Healthcare Conference August 2-4 in Chicago.
• ZeOmega publishes a case study on how SignalHealth uses its Jiva HIE to deliver patient information to its provider network.
• Xerox is a Health 2.0 Ten Year Global Retrospective nominee.
• Experian Healthcare will host a West Regional User Conference August 4 in San Diego.
• The local paper features PatientPay in its look at fintech startups in the Research Triangle area of NC.
• The local business paper cites Peer60 in its profile of Agfa HealthCare.
• The SSI Group will exhibit at the FHCA Annual Conference & Trade Show August 7-11 in Orlando.
• Sunquest Information Systems will exhibit at the AACC 2016 Annual Meeting & Clinical Lab Expo July 31-August 4 in Philadelphia.
• Surescripts will exhibit at the Aprima 2016 User Conference & VAR Summit August 4-6 in Dallas.
• InterSystems will exhibit at the AACC Annual Scientific Meeting and Clinical Lab Expo July 31-August 4 in Philadelphia.
• Intelligent Medical Objects will exhibit at Aprima’s 2016 User Conference + VAR Summit August 4-6 in Dallas.
• Pittsburgh Magazine interviews MedCPU President and Co-Founder Sonia Ben-Yehuda.
• NEA Powered by Vyne announces the release of version 4.1 of its FastAttach electronic claims attachment health information exchange solution.

Blog Posts

• Creating Alignment Between IT and the Business (Tierpoint)
• Why “No Assembly Required” is a Welcome Phrase for Fraud Investigators and Parents Alike (Verisk Health)
• Visage 7 Speaks (Visage Imaging)
• Devil of a Time (VitalWare)
• Most wired customers. (Voalte)
• Post-Discharge Communication Tips to Help Patients Avoid Readmission (West Corp.)
• Estimating patient financial obligation: in Florida, it’s the law (ZirMed)
• A Strategic Approach to Clinical Content Updates and Maintenance (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 7/29/16

Top News

CMS adds star ratings to its Hospital Compare website, which also offers a data download option. Of the 78 New York City hospitals listed, one (Hospital for Specialty Surgery) earned five stars, while 29 hospitals have a one-star rating.

University of Miami Health System, which earned one star, predictably argues that the methodology is flawed and that its patients are sicker, complaining that academic medical centers and safety net hospitals are treated unfairly by the rating system.

Two hospital systems that made US News & World Report’s “Best Hospitals” list earned only two stars from CMS – UPMC and Barnes-Jewish Hospital. Both point out that scores vary among their similarly run hospitals, in their minds proving that ratings are skewed by patient demographics of the hospital’s geographic area.

Reader Comments

From Gordie Gecko: “Re: NantHealth. Check out its progressive tanking in the market. Patrick Soon-Shiong is trying to announce new deals, but one success doesn’t mean he’ll always be successful. People on the inside still don’t know what the future is.” NantHealth went public a couple of months ago with a first-day closing share price of $18.59, but shares have since dropped 45 percent to around $10. Allscripts bought 15 million shares right after the IPO, so the company is down around $50 million in just a few weeks. NantHealth hasn’t filed its first earnings report yet, but its IPO documents showed an annual loss of $72 million on $58 million in revenue.

HIStalk Announcements and Requests

We funded the DonorsChoose grant request of Mr. D in Pennsylvania, who asked for three iPad Minis and cases. He reports that his students are using them to work on math and reading skills, to log their science activities, and to do research for their social studies assignments.

This week on HIStalk Practice: Cerner VP of Population Health Services Mike Heckman explains the role healthcare tech plays in managing on-site clinics for employers. Practice Fusion CMO & VP of Informatics Richard Loomis, MD shares interoperability advancement plans. Zoom+ VP defends the company’s executive exodus. AristaMD closes an $11 million Series A. Athens Orthopedic Clinic alerts patients to The Dark Overlord’s hack. Medstreaming acquires Physician Billing Partners. Epic, Allscripts, EClinicalWorks lead the vendor way in EP MU attestations. American Well CTO Jon Freshman outlines the ways in which vendors must differentiate themselves if they want to survive telemedicine’s bubble.

Webinars

August 10 (Wednesday) 1:30 ET. “Taming the Beast: CDS Knowledge Management.” Sponsored by LogicStream Health. Presenters: Luis Saldana, MD, MBA, CMIO, Texas Health Resources (THR); Maxine Ketchum, clinical decision support analyst, THR; Kanan Garg, senior applications analyst, THR; Patrick Yoder, CEO, LogicStream health. This presentation will review THR’s systematic process for managing clinical decision support assets, including identifying broken alerts, addressing technical and clinical issues, modifying order sets, and retiring tools that have outlived their usefulness. Attendees will learn how THR uses a robust knowledge management platform to better understand how clinicians are interacting with their clinical content to maintain their order sets and reduce the number of alerts fired.

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

Acquisitions, Funding, Business, and Stock

McKesson announces Q1 results: revenue up 5 percent adjusted EPS $3.50 vs. $3.14, falling short on revenue expectations but beating on profit. Revenue for the Technology Solutions business was down 2 percent, but still generated a profit of $179 million. Shareholders again voted down a proposal that would have limited executive golden parachutes, which in CEO John Hammergren’s case, involves several hundred million dollars if the company changes hands. This is probably the last time I’ll report MCK’s earnings since they are scurrying quickly away from healthcare IT.

AristaMD, which offers a referral management system, raises $11 million.

Consumer health site Sharecare, founded in 2010 by Dr. Oz and WebMD founder Jeff Arnold, acquires the population health business of publicly traded Healthways. The business and its 1,700 employees will remain in Franklin, TN. Healthways announced in 2015 that it was exploring strategic alternatives.

Oracle will buy ERP vendor NetSuite for $9.3 billion. Oracle Chairman Larry Ellison already owned nearly half of NetSuite’s shares, having funded the company when it was founded by a former Oracle executive.

Leidos announces Q2 results: revenue up 2 percent, adjusted EPS $0.68 vs. $0.77, meeting revenue expectations but falling short on earnings.

Cambia Health Solutions makes a strategic investment of unspecified amount in medical procedure buying site MDsave. I tried the four-year-old site and found that few providers offer services on it – searching for a flu shot in Cleveland turned up a handful of doctors in Tennessee and Virginia and seeking a bargain-priced colonoscopy in San Diego showed the closest willing provider at 331 miles away in Nevada.

LabCorp will acquire prenatal genetic testing company Sequenom for $302 million in cash.

Struggling would-be health insurance disruptor Oscar will cut its New York provider base in half for 2017, trimming its network from 77 to 31 hospitals as it raises rates significantly. I predict Oscar will be gone within 24 months, with one of its big insurance competitors spending very little to buy the smoking wreckage.

Sales

I mentioned that Covenant Health (TN) has chosen Cerner, and based on information I found on the  Web, I concluded that the health system is a Meditech customer. I was wrong – while Cumberland Medical Center does indeed run Meditech as I had found, the rest of Covenant does not. Covenant bought CMC in 2014.

People

Dorothy Fisher, MD (Sentara Quality Care Network) joins Forward Health Group as chief clinical officer.

HBI Solutions hires Alan Eisman (Information Builders) as SVP of sales and business development.

Accretive Health names Doug Berkson (Berkson Consulting) as SVP.

Government and Politics

A state report finds that Oregon hospitals boosted their aggregate profit by 54 percent in 2015 because of the Affordable Care Act’s Medicaid expansion, which turned their charity care into revenue-generating work whose cost was mostly footed by federal taxpayers.

Privacy and Security

Fertility app vendor Glow urges users to change their passwords after it finds a problem with the “connect a partner” feature that could expose the user’s data to third parties.

Other

A review of the rates of mortality, readmissions, and adverse events in 17 hospitals immediately before and after their 2011-2012 EHR go-live finds no significant negative impact. That’s not really surprising since common go-live problems (late meds, missed charting entries, staff confusion) aren’t going to kill patients even though they make their encounter less pleasant.

A JAMIA article defines the work required for informatics research to support precision medicine:

• Implement electronic consent and specimen tracking.
• Develop data standards to support integration and exchange.
• Develop ways to discover and translate clinically relevant biomarkers.
• Use rules and technology to ensure the quality of large datasets to make sure they will continue to be useful in the future.
• Create a precision medicine knowledge base.
• Extend EHRs with APIs that can integrate external data and that will support the development of third-party workflow and data visualization tools.
• Engage consumers outside of provider settings with user-friendly data collection tools.

Greater Madison Chamber of Commerce launches its HealthTech Capitol program and website, which “is working to establish Greater Madison as the world-class leader for health technology.” It lists 18 companies as members, with annual dues running $260 to $1,010 depending on membership level and company headcount.

ZDoggMD reflects on his medical career in his latest video, set to the tune of by Lukas Graham’s “7 Years.” EHRs get an unflattering mention.

Sponsor Updates

• Crossings Healthcare Solutions publishes its Q2 newsletter.
• Catalyze delivers HITRUST CSF certified compliant cloud solutions for Amazon Web Services workloads.
• Besler Consulting releases a new podcast, “Auditing and monitoring for compliant physician documentation and coding.”
• Boston Software Systems releases a new podcast, “Mass Updates to Your Meditech System.”
• CompuGroup Medical will exhibit at the AACC Scientific Meeting & Clinical Lab Expo July 31-August 4 in Philadelphia.
• Extension Healthcare will exhibit at the 2016 Defense Health Information Technology Symposium August 2-4 in Orlando.
• The HCI Group is again listed on the Jacksonville Business Journal’s list of “50 Fastest Growing Private Companies.”
• Healthgrades announces the 2016 Women’s Care Award recipients.
• Healthwise is certified as a Great Place to Work.
• Santa Rosa Consulting launches a Transition Management Office service.

Blog Posts

• Self-service analytics: Empower your team to make data-driven decisions [podcast] (Nordic)
• Meaningful Use Updates: 90-Day Reporting Period and More (Impact Advisors)
• 10 Ways To Prevent Delays in Delivery of Time-Sensitive Secure Text Messages (Spok)

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 7/27/16

Top News

ONC issues $250,000 in funding opportunity announcements for a cyber threat information sharing service. The application package indicates an award date of September 16 and indicates that it will choose an organization that is already performing similar cyber threat services. It expects the program to be self-funding since those organizations already charge fees for their services.

A second $150,000 cooperative grant has been issued from the Assistant Secretary for Preparedness and Response.

The grants were issued is response to a 2015 executive order that promoted private sector cybersecurity information sharing via Information Sharing and Analysis Organizations.

Reader Comments

From Pierre La Terre: “Re: health IT rag pointless stock photos. Who’s the miscreant in the green shirt?” Publications think we’re not smart enough to read news unless there’s a picture, so they struggle when there’s nothing relevant to run given that they’re just re-wording press releases and crafting zippy headlines from afar. This particular well-worn photo of a green-shirted volunteer undergoing a mock sobriety field test in 2009 came from Wikimedia Commons and lives on as an uncredited breaking health IT news photo. Any resemblance to anyone involved in the HHS fraud case is unintentional.

From Grammar Warrior: “Re: grammar pet peeve. To ‘insure’ is to protect against financial loss. To ‘ensure’ is to make sure something happens. Ensure you get it right, people!” My recent peeves aren’t new: the use of “anymore,” which despite appearing in some dictionaries, will never look right to me instead of “any more.” I’m also annoyed at the phrase “build out” in trying to give physical attributes to some abstract IT concept, like “building out the EHR” (even if you like the analogy, which I don’t, the “out” is superfluous). Also, using “that” to refer to people (“people that complain bug me”) or using “who” to refer to organizations (“the vendor who screwed up is well known.”)

From Todd Margaret: “Re: top health IT Twitterati. One of the winners lists HIStalk among ‘critical community leaders’ whose primary means of disseminating information isn’t Twitter.” I glance pretty regularly at Twitter to get a quick read on what people are thinking, but most heavy Twitter users aren’t all that influential except maybe to each other. The “influence” equation must address reader reach, reader decision-making authority, and the writer’s ability to provide information that changes the minds of those decision-makers. Twitter is best at quickly capturing prevailing opinion about big-bang events rather than influencing anyone directly.

HIStalk Announcements and Requests

We provided the elementary school class of Ms. Johnston in Colorado with five tablets and headsets in funding her DonorsChoose grant request. She provides an update: “My students could not believe that someone would give us such a great gift and they took great pride in the care of our technology. In fact, one of my students, was so moved by the donation that she was designated as a classroom tech. She was excited to carry the role as she checked on their battery powers every morning, she cleaned the technology station, she wiped the headphones down at the end of the day, and she took leadership to ensure that other students were being careful. Thank you so much for this wonderful gift. These students have been given a rare opportunity to learn and apply technology in new and creative ways. This was a memorable experience for each of us. Thank you.”

Vince Ciotti is putting together “Rating the Ratings,” a series that will review the services offered by KLAS, Black Book, HIMSS Analytics, and others. Vince would be happy to incorporate your anonymous thoughts and experiences if you send them my way. Readers have made quite a few comments over the years about their company being suspiciously overlooked, being asked to buy something to be included, and wondering why specific clients were chosen when participating in some of the services.

Webinars

August 10 (Wednesday) 1:30 ET. “Taming the Beast: CDS Knowledge Management.” Sponsored by LogicStream Health. Presenters: Luis Saldana, MD, MBA, CMIO, Texas Health Resources (THR); Maxine Ketchum, clinical decision support analyst, THR; Kanan Garg, senior applications analyst, THR; Patrick Yoder, CEO, LogicStream health. This presentation will review THR’s systematic process for managing clinical decision support assets, including identifying broken alerts, addressing technical and clinical issues, modifying order sets, and retiring tools that have outlived their usefulness. Attendees will learn how THR uses a robust knowledge management platform to better understand how clinicians are interacting with their clinical content to maintain their order sets and reduce the number of alerts fired.

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

Acquisitions, Funding, Business, and Stock

Recode profiles Nomad Health, a startup whose site matches doctors to temporary assignments.

Huron Consulting Group will acquire Healthcare Services Management, with HSM CEO David Devine joining Huron as managing director. 

Venture capital-backed Boston hospital operator Steward Health Care earns its first profit, although all of it came from changes in how it funds pensions. The company still refuses to submit state-mandated financial statements, however, saying its information is proprietary.

Sales

Covenant Health (TN) chooses Cerner’s clinical, financial, and population health management systems. I think they’re a Meditech shop.

Memorial Sloan Kettering Cancer Center chooses HealthLoop for patient engagement in its newly opened surgery center.

Meditech lists several customers that are moving forward with its new Web EHR.

People

Former Military Health System CIO Eric Huweart joins government contractor Apprio as VP of military and veteran healthcare.

Wyman F. Bowers, JD, MBA (Midlands Orthopedics) is named the first CEO of the South Carolina Health Information Partners HIE.

Staffing provider AMN Healthcare hires Matt Zubiller (McKesson) as SVP of corporate strategy.

Announcements and Implementations

Athenahealth issues its MIPS Guarantee that its customers won’t lose money under the final MACRA rule, but the terms contain catches: (a) it’s only for new AthenaOne clients who go live on AthenaNet; (b) the customer gets only monthly service credits rather than cash and the total can’t exceed the amount of their monthly payment; and (c) if the customer drops Athenahealth, they forfeit their remaining credit. It’s a good marketing strategy to ramp up the customer count that Wall Street is watching intently.

Medication management app vendor Medisafe releases a version of its product for drug companies that addresses adherence, patient engagement, dose reminders, and study recruitment.

HealtHIE Nevada will offer community-based providers such as diabetes educators and behavioral health therapists subscriptions to Kno2, which will allow them to exchange documents with doctors and hospitals via Direct messaging to improve continuity of care. The Boise-ID-based company offers a $20 per month, one-user plan that provides a Direct address, allows address book searches, supports messaging and document routing, and allows creation of Direct messages from scanners and multi-function printers.

Crossings Healthcare Solutions will resell Cerner real-time end user experience monitoring from Goliath Technologies. 

Intermountain Healthcare, the AMA, and online health coaching vendor Omada Health will work together to offer diabetes prevention programs for the at-risk patients of large healthcare systems across the country.

Government and Politics

An HHS OIG survey of 400 hospitals finds that half have experienced unplanned EHR downtime, and of those, one-fourth report that it delayed patient care. Software was not the cause of downtime in any reported case – the most prevalent downtime issues were hardware failure, loss of Internet connectivity, and power failure. Only a third of respondents have a read-only EHR backup system in place that alerts users visually that the main system is down. OIG repeats its previous recommendation that OCR implement a permanent audit program to assess HIPAA compliance.

ONC updates its Health IT Dashboard with the latest count of MU-attesting hospitals by inpatient system vendor. Cerner, Meditech, and Epic lead the pack.

Former National Coordinator and Aledade CEO Farzad Mostashari, MD says in a an editorial in The Hill that MACRA will speed up consolidation of hospitals and practices without necessarily improving cost or outcomes. He recommends that CMS allow small practices to join together in virtual networks, compare small practices only against each other, and cap the potential losses under MACRA that as written can be more than 100 percent of a practice’s Medicare revenue.

Privacy and Security

Healthcare leads all industries in ransomware infections, according to a security firm’s quarterly report, making up 88 percent of all detected ransomware incidents.

Innovation and Research

The California Cancer Registry pilots real-time data collection of de-identified patient data from pathologists at 12 hospitals. They are using electronic reporting forms developed by the College of American Pathologists to capture discrete data elements rather than free text information. Public health officials hope to publish real-time surveillance data, identify cases for research, and improve quality.

Other

The Pharmaceutical Research and Manufacturers of America, which has tried to convince Congress that drug companies charge high prices only to support desperately needed research, accepts as members two companies that spend next to nothing on R&D. Horizon Pharmaceuticals bought an old drug and raised its price 600 percent the same day, with the former $2 pain pill now costing nearly $40. New member Jazz Pharmaceuticals makes nearly all of its money from a single drug whose price it doubled in two years. Actually neither company should be admitted to an organization that includes “of America” in its name since both “moved” to Ireland after acquiring companies so they could dodge paying US taxes.

In Australia, a newborn dies and another suffers permanent brain damage after a hospital contractor mistakenly installs nitrous oxide in an oxygen outlet.

In England, NHS geriatrician Kate Granger, MBChB dies of cancer at 34. Her cancer experience with an impersonal health system motivated her to create the widely adopted #HelloMyNameIs campaign that urges doctors and nurses to introduce themselves to patients and to make eye contact before treating them. She donated all of the proceeds from sale of her books and other activities to Yorkshire Cancer Centre, having hit her $328,000 goal just three days ago. She had previously received the MBE and, just before she died, a handwritten thank you letter from England’s new prime minister that started with, “My name is Theresa.”

Sponsor Updates

• Lexmark Healthcare is selected as one of eight imaging technology vendors to participate in RSNA’s Image Share Validation Program.
• PM/EHR vendor MedEvolve will offer its physician practice customers payment solutions from InstaMed.

Blog Posts

• In Just 3 Months, 25% of Patients at Marietta Memorial Engage Using MEDITECH (Meditech)

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 7/25/16

Top News

University of Mississippi Medical Center (MS) will pay $2.75 million to settle HIPAA charges related to the 2013 theft of password-protected laptop by a visitor to the hospital’s medical ICU. OCR’s investigation uncovered the fact that entry of a generic WiFi username and password provided access to an unsecured Microsoft Access database that contained the information of 10,000 patients.

OCR concluded that UMMC’s “organizational deficiencies and insufficient institutional oversight” prevented it from undertaking risk management activities even though the hospital knew it was vulnerable. It also noted that the hospital did not perform the required patient notification following the laptop’s theft.

Reader Comments

From Sieve Crusher: “Re: US Digital Service. They’re actively recruiting. Experience in the EHR world is applicable to government work in many ways – long-time employees, legacy systems, and a culture of poor user interfaces. Silicon Valley experience isn’t needed – the government can use folks of talent. There’s also 18F, an earlier companion effort that allows remote work instead of relocation to DC, but they are backlogged with applicants.” It sounds pretty fun for someone without a family or already in the DC area since no relocation assistance is provided – it’s a one-year commitment with benefits provided and a casual work environment. Not everybody can say they spent time working for the White House.

From HER Auto Correct: “Re: article saying that EHR use decrease costs. I don’t believe it.” The 2014 article concludes that per-admission costs are 10 percent lower in hospitals that use advanced EHRs. I really dislike studies in which Database A is linked to Database B to reach a lofty conclusion implying causation vs. correlation. This is one of those. The authors sampled a 2009 inpatient treatment database and matched it up to the sometimes-accurate HIMSS Analytics database of what EHR each hospital uses. “Cost” was derived from applying the cost-to-charge ratio of each hospital to its billed charges, which is a pretty blunt measure of a hospital’s actual incremental cost, although it’s usually all we have to work with. There’s also the question of ensuring a representative sample of hospitals in all sizes and locations and selecting patients of similar complexity. All that aside, correlation is not causation and most hospitals are already using advanced EHRs, so I don’t see any practical application of the conclusions. A better study would have been to choose 10 hospitals that implemented EHRs and see how their individual costs changed afterward, although the huge problem persists in trying to factor out all other variables. One last observation: bias exists in even the topic of the study – do hospitals really expect to reduce costs by implementing EHRs? The fact that even the financially distressed hospitals don’t de-install them and go back to paper suggests a self-assessed positive ROI that may or may not be financial.

HIStalk Announcements and Requests

Poll respondents were evenly split on their opinion of the Affordable Care Act. Comments suggested that it worked fairly well if the goal was to people insured rather than to control costs or influence personal health choices. Mary C notes that ACA didn’t provide healthcare reform, only insurance reform, while Dave says insurance companies have had to resort to high-deductible plans to shield themselves from the unaddressed issue of cost control, although he also notes that individual patients benefited since ACA eliminated coverage denial of pre-existing conditions and lifetime limits. Most commenters noted that the “affordable” part is a misnomer since ACA policies cost a lot more with fewer choices and it’s just not possible to cover all of those newly insured people for the same cost, especially given that a lot of care involves expensive, late-stage interventions of limited value. HIT Project Manager boldly opines that Medicare and Medicaid should gradually phase out paying for treatment of chronic conditions that are caused by preventable behaviors, using EHRs to identify patients who ignore advice related to obesity and smoking and making them pay fully out of pocket for their treatments. Bill says just buying insurance for a bunch more people is running up the federal deficit without any evidence that quality or cost has improved. The most positive thread of commentary is that while ACA is a long way from perfect, it can be fine tuned over time.

New poll to your right or here: for those with a recent hospital visit: does the hospital allow you to electronically submit your own data into their records? I’m sure some hospitals provide a way to import wearable or questionnaire-type patient information to populate their EHRs, but I doubt it’s the 37 percent of them that a recent AHA survey found.

I was thinking as I reviewed the journal article above that I really bristle at using the word “reimbursement” to define payments to providers. You aren’t getting reimbursed – you are sending a bill and someone pays it. Especially if you run a private medical practice, a business no different than a auto body shop in expecting insurance companies to pay up.

We bought a robotics kit and books for the North Carolina gifted class of Ms. S, who explains the photos above in describing how she put the materials to work immediately. “I gave the kids the option to participate in a district competition at the end of May, explaining that many students had a big head start on them — they had begun working last fall, whereas we had started months later. However, my students were willing to take on the challenge! They competed their work through a combination of quick understanding (impressive!) and teamwork. I’m pleased to say that the construction claw project won first place in the competition! All of my students said they enjoyed the experience and would like to participate in robotics again next year. That is wonderful news, especially from students who may not be able to attend robotics camps or programs outside of the school setting.”

Last Week’s Most Interesting News

• ProPublica begins publishing the  letters OCR sends in summarizing and closing HIPAA complaints.
• Philips acquires Wellcentive.
• An HHS report to Congress identifies the lack of applicability of HIPAA to non-covered entities, such as app vendors, and outlines the non-HIPAA enforcement authority of the Federal Trade Commission.
• ONC publishes an online tool that grades the interoperability readiness of a submitted C-CDA document.
• The VA hires KLAS to provide an overview of the EHR vendor landscape.
• AMIA cautions the FDA that EHR information is not necessarily of research quality, suggesting that it focus electronic data collection efforts on clinical data warehouses or HIEs.
• Hacker The Dark Overlord posts for sale the digital assets of integration vendor PilotFish Technology and says he pushed an update to all of its clients that allowed him to steal their EHR information.

Webinars

August 10 (Wednesday) 1:30 ET. “Taming the Beast: CDS Knowledge Management.” Sponsored by LogicStream Health. Presenters: Luis Saldana, MD, MBA, CMIO, Texas Health Resources (THR); Maxine Ketchum, clinical decision support analyst, THR; Kanan Garg, senior applications analyst, THR; Patrick Yoder, CEO, LogicStream health. This presentation will review THR’s systematic process for managing clinical decision support assets, including identifying broken alerts, addressing technical and clinical issues, modifying order sets, and retiring tools that have outlived their usefulness. Attendees will learn how THR uses a robust knowledge management platform to better understand how clinicians are interacting with their clinical content to maintain their order sets and reduce the number of alerts fired.

Acquisitions, Funding, Business, and Stock

The newly formed Providence St. Joseph Health acquires doctor house call scheduling app vendor Medicast, which had previously raised $2 million but hasn’t had new funding in the past two years.

Athenahealth announces Q2 results: revenue up 17 percent, EPS $0.34 vs. $0.32, falling well short of expectations for both.  The company also announced that EVP/COO Ed Park will leave his position by the end of the year, but will likely join the company’s board. Park holds $2.3 million in stock after selling $2.2 million worth so far in 2016. ATHN shares dropped 9 percent Friday following the announcements, having shed 3.1 percent in the past year.

From the Athenahealth earnings call:

• The company has converted 40 percent of its clients to AthenaClinicals Streamlined, with those clients averaging a 10 percent improvement in same-day encounter close rate. The company notes, however, that it is working closely with a “minority” of clients who liked their old workflow better and hints that it expects to take a short-term hit on its Net Promoter Score.
• Eighty hospitals are using AthenaOne for hospitals.
• The company launched AthenaInsight.com to share information collected from its user network.
• The company admits that it’s not sure whether sales are tracking against target due to seasonality and a bottleneck in servicing inpatient demand, but also notes that the HITECH wave of “I need an EMR or I’ll be shot” is ending and that it has to adjust to the pre-HITECH world of developing by its own schedule rather than just hitting MU-driven functionality dates.
• Athenahealth notes that its population health management product has provided “a lovely little tailwind on our growth” since it can work with Epic and Cerner and that has allowed the company to add those users back to its prospect list.
• The company’s hospital win rate is 32 percent.
• Jonathan Bush says the company made a “terrible operational miscalculation” when it started allowing senior support reps to travel to client sites to provide go-live support, which caused longer telephone hold times just as Streamlined was being rolled out.
• Of the Streamlined rollout, Bush said, “Streamlined’s big mistake was that it was not an agile deployment. This was not, you get a skateboard, and then you put it back out with a handle on it, then you put it back out with a little motor on it, then you put it back out with sides, and eventually it’s a car. This was, take a skateboard, hide it, and show back up two years later with something you think will be a car, and all of the feedback that all of the customers would have had along the way comes raining down on you at once. So, we’ve had to do a lot of tuning of Streamlined once it came out of the garage. We will not be doing that kind of hide it away for years and then do a great reveal of something radically different any more in the future.”
• Bush allowed Ed Park to summarize his career in ending the earnings call, introducing him as, “The man who brought me here, who made every theoretical PowerPoint promise I made either go away or turn into actual functioning reality at scale, Ed Park.”

People

CTG CEO Cliff Bleustein, MD resigns “by mutual agreement” after 16 months on the job. He has been replaced by SVP/GM Bud Crumlish. I interviewed Bleustein two months ago. CTG shares are down 18.5 percent in the past year, giving the company a market value of $88 million.

Video visit vendor MDLive names Sanjay Patil, MD (Care Connectors) as EVP/GM of health systems strategy and transformation.

Announcements and Implementations

A new Peer60 report on cardiovascular information systems finds that hospitals expect their procedure volume to increase significantly, with the biggest driver by far being their addition of service lines, but also due to adding more providers, population growth, an aging population, and better insurance coverage. Epic and Philips are the most-recommended CVIS vendors, although nearly half of respondents say they are considering replacing their current system. Epic is the most-often considered new system by far, while McKesson is equally dominant as the vendor most likely to be displaced.   

Government and Politics

The Department of Justice charges the owner of 30 Miami-area skilled nursing and assisted living facilities with running a $1 billion Medicare fraud scheme, the largest healthcare fraud case in US history. Philip Esformes, who is also a noted philanthropist, is accused of placing patients in his facilities who didn’t quality for that level of care, then billing Medicare and Medicaid for medically unnecessary services. He and his two co-conspirators are also charged with taking kickbacks to refer those patients to community mental health centers and home care providers who also rendered medically unnecessary services. Esformes paid $15.4 million to settle charges of exactly the same thing 10 years ago, but was able to hide his identity until HHS-OIG and the FBI used advanced data analysis and forensic accounting to unravel his current operation. His father, Rabbi Morris Esformes, was charged with taking kickbacks in 2004 when he boosted his $4,000 investment in a pharmacy to $7 million in profit when its was sold two years later by sending the pharmacy all of the business from his Chicago nursing homes, which were also the subject of complaints about poor care that he attributed to anti-Jewish sentiment.

British Columbia’s health minister orders an immediate third-party review of Island Health’s $132 million Cerner implementation following physician complaints that the system is endangering patients and the switch back to paper of one hospital’s ICU and ED in one hospital nine weeks after go-live.

Acting CMS Administrator Andy Slavitt is apparently not impressed with the EHRs out there.

Privacy and Security

Laser & Dermatologic Surgery Center (MO) notifies 31,000 patients that their information was exposed when its computer systems are hit with ransomware. The clinic declined to pay and instead successfully restored its systems.

The health information of nearly everybody in Denmark was exposed last year when a state office mailed two unencrypted CDs that the post office instead delivered to a China-owned bank. The CDs contained the cancer, diabetes, and psychiatric information of 5.3 million people. The bank employee realized the postal service’s mistake and took the package to the intended recipient.

Police arrest two Florida paramedics who were fired after posting pictures of themselves in their ambulances with incapacitated patients, sometimes posing them in humiliating fashion in attempting to one-up each other.

It appears the Twitter account used by hacker The Dark Overlord has been deleted and he hasn’t been heard from in a few days. I don’t know what that means

Technology

Microsoft adds appointment-booking capability to Office 365, allowing users to choose the service they need, search for for available dates and times, and book the appointment from their PC or mobile device with confirmation and reminders to follow. Users can also cancel or reschedule their own appointments. Microsoft stuff doesn’t always catch on and I doubt this product would pass HIPAA muster, but otherwise it cold be interesting for healthcare.

The Gates Foundation creates Chronos, a tool to help grantees meet the foundation’s open access requirement that their research be published broadly and with unrestricted access and re-use, including the underlying data sets. The service will pay publisher article processing charges, check compliance with policies, and track the impact of publishing activity, all to allow grantees to focus on their research rather than the processing of publishing it.

Other

The Cleveland business paper covers MetroHealth’s use of 25 EHR scribes in its ED, which reports higher-quality and more timely documentation completion.

An editorial in the Lancet ponders the role of peer-reviewed medical journals in a publishing world turned upside down by the Internet, the endless quest for profitable eyeballs, and technology that “has transformed artisans into professionals.” It frets about open access journals, research misconduct, and the lack of reproducibility in many scientific studies.

The government of Indonesia arrests 23 people, including three doctors, after finding vials of vaccine that actually contained only sterile saline in 37 hospitals and clinics. An estimated 5,000 children have received fake vaccine, inciting parents to mob a Jakarta hospital and beat one of its doctors. The government caught one person who had adulterated vaccines years ago, but fined him only $100, and had not acted on vaccine manufacturer complaints of counterfeit products going back to 2011. The government vows to re-vaccinate millions of children at no charge and has established a vaccine distribution oversight group. 

Sponsor Updates

Blog Posts

• Delayed or not, it’s time to prepare for MACRA (Nordic)
• Health care is on FHIR  (The Advisory Board Company)
• Your telehealth summer reading: Highlights from MedPAC, AHRQ, and NEJM  (The Advisory Board Company)

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 7/22/16

Top News

ProPublica begins posting OCR’s “closure letters” indicating the resolution of HIPAA-related complaints, noting that most of the letters involve the VA and CVS Health.

Reader Comments

From Sharing CIO: “Re: Velocity Technology Solutions. My hospital was down also. They acknowledged a hardware failure that was exacerbated by human error, poor judgment, and a failed communication strategy. This is our second outage this year – the other one was Dell, who also had hardware failure combined with the fact that humans are not perfect.” More and more people are realizing that “cloud” is synonymous with “someone else’s data center” plus the hopes that a focused vendor will operate it better than they themselves. Most of the time that’s the case, but when things go wrong, the IT department is like end users in being stuck trying to get status updates, pestering the technicians who should be trying to restore systems rather than explaining why they’re down, and backseat driving the process.

From Stealers Wheel: “Re: my article. See this link!” I never know what to do when someone sends me the PDF of a book they’re working in, a LinkedIn article they wrote, or a link to a something they’ve written for a competing healthcare IT news site. I don’t really want to read someone else’s articles or using HIStalk to promote them, so I usually don’t reply because I know someone’s ego is involved.

From LinkedInGuy: “Re: Epic. An ex-Google VP disses it.” At least he’s assertive in his cluelessness in smugly dismissing the entire healthcare IT industry on the basis of a single screenshot he doesn’t consider pretty. He’s awfully proud of his former Google background (working on games and products I’ve never heard of), so perhaps he should consider the rousing failure of Google Health, or for that matter, the horrendously awful UI and user-unfriendliness of Gmail and Google Docs, which make most healthcare software look positively cool by comparison. He seems confused  by the screen shot that he found on the Web since “most docs” don’t use a single specific EHR and the screen he illustrates is not Epic –  it’s actually a 2011-era screenshot of the Chart Talk EHR, a minor EHR player. He probably felt well informed with his tweet, but anyone who knows healthcare would infer the opposite.

From Pointy Head: “Re: work-life balance. Shouldn’t you be willing to sacrifice early in your career for later payoff?” That’s reasonable as long as you realize that the payoff might never come. There’s also that point in your career where you have to accept the reality that your career altitude has reached its zenith unless you change employers or jobs. I once worked for a health system executive who gave rather blunt but accurate advice to director-level people that applies to most everyone: if you yearn to be a C-level executive and either (a) your employer has already passed you over; or (b) you’ve hit 40, adjust expectations accordingly or perhaps start your own business if you feel your potential has been overlooked. Right or wrong, people in their 40s and certainly 50s shouldn’t confuse the hamster wheel they’re on with a career ladder in thinking they’ll get called up to the big show since the odds aren’t great. Those are the folks I hate to see busting their humps thinking they’ll somehow be rewarded accordingly.

HIStalk Announcements and Requests

We funded the DonorsChoose grant request of Ms. McMahon, who requested maker space materials for her North Carolina elementary school media center. She reports, “The STEAM activities in our media center have ignited the creative spirit in my students. They just can’t wait to show me what they have created and just love to have their creation up for display or to see their picture on our website or news program. I have noticed a great improvement in the children who were often discipline problems in the past. They are engaged and excited and just hate it when its time to leave. There is high time on task and with a few rules in place – they abide by them well so that they don’t lose the privilege of working in our Creation Stations!”

I’ve been busy un-following dozens of people on Facebook who keep droning their heartfelt but one-sided and sarcasm-heavy political commentary. I really, really wish for enhancements to Facebook and Twitter that would force users to categorize their emanations into “work,” “politics,” and “114 photos of my angelic child,” allowing me to focus on the limited segments of their thought stream that I care about instead of just muting them completely. Social media have dumbed a lot of people down in filtering the news and opinion they follow, making them believe that nearly everybody thinks like they do and emboldening them to react with vitriol and personal contempt when faced with the inevitable other side of the argument. It’s like modestly talented executives who mistake the butt-kissing of their carefully chosen yes-men underlings as confirmation of their inherent brilliance. Unfortunately, real life is beginning to more and more resemble high school.

This week on HIStalk Practice: NASA deploys telemed technology in deep-sea expedition. HHS announces $9 million in grants to help improve opioid-addiction treatment in primary care practices. AHIP points to telemedicine to help alleviate physician shortages in certain states. R-Health launches independent, physician-led ACO in Southeastern Pennsylvania. Consumer sentiment reaches underwhelming levels of outrage over latest HHS privacy/security report. Surprise, surprise: Physicians do have favorite patients (and they aren’t even the most compliant.)

This week on HIStalk Connect: 2bPrecise Chief Medical Officer Joel Diamond, MD shares his thoughts on the future of precision medicine.

Listening: Cloves, who is actually 19-year-old Australian singer-songwriter Kaity Dunstan. I would say that she reminds me a lot of Adele, other than the fact that my fastest reflex is hitting “scan” on the car radio when a song by the ubiquitous Adele comes on and I’d actually stick around for Cloves.

Webinars

None scheduled soon. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

Oncology precision medicine decision support vendor N-of-One raises $7 million in a Series B round, increasing its total to $11.7 million. CEO Christine Cournoyer used to be president and COO of Picis.

Theranos hires a chief compliance officer and VP for regulatory and quality, the former being McKesson assistant general counselor for regulatory law Dan Guggenheim.

Sales

Tampa General Hospital (FL) chooses LogicStream Health’s sepsis bundle and clinical process measurement to reduce central line-associated blood stream infection.

Adventist Health System chooses MModal’s transcription and front-end speech recognition for its 41 facilities, where it will also pilot MModal’s computer-assisted physician documentation system. .

People

Pharmacy kit restocking software vendor Kit Check hires Cameron Ferroni (What’s Next Consulting?) as chief product officer.

Solid state storage array vendor Pure Storage hires Vik Nagjee (Epic) as VP/CTO of global healthcare solutions. He helped develop Epic’s hosting business.

Announcements and Implementations

Cambia Health Solutions will merge its HealthSparq and SpendWell Health offerings under the HealthSparq name, offering users the ability to compare procedures and providers and then use SpendWell’s “buy now” technology to book appointments.

University of Pennsylvania Health System (PA) will build a 540,000 square foot, 18-story Center for Healthcare Technology in downtown Philadelphia, with Penn Medicine’s IT department being a major tenant.

Scotland’s Digital Health & Care Institute innovation center hires Scottish tennis star Andy Murray as its ambassador.

The PillPack pharmacy uses APIs from PokitDok (Pharmacy Plan and Pharmacy Formulary ) to help its Medicare customers understand drug coverage and co-pays.

Government and Politics

A fascinating article profiles the White House’s  US Digital Service, a group of mostly former Silicon Valley engineers that bypasses government red tape and contractors in saving taxpayers many times its $14 million annual budget by creatively solving IT problems that have long stymied federal IT lifers. It mentions Digital Service at VA (photo above), another skunkworks project that developed a new VA benefits appeals system, created a consolidated website at Vets.gov, and figured out a way for the VA and DoD to exchange scanned documents. Everybody loves the groups except fat cat IT contractors and the internal federal government bureaucracies that created the messes the kids are sent to clean up. I liked this passage about how the group broke the VA-DoD document logjam in just a few weeks:

They did not pick a toy task, but embarked on a challenge that had bedeviled the military for years. Unbelievably (except for in government), the DoD and VA use different systems for medical records, and the two systems get along just about as well as North and South Korea. Moving a medical history from one to the other — a pretty common task, since service people by definition become veterans upon discharge or retirement — could only be done by physically scanning the military records and sending files to the VA. But even that often failed, because the VA system was very finicky about file formats … “We had good people working on that, some of our best people,” says Secretary Carter. But they hadn’t cracked the problem, and indeed, hadn’t shipped anything for over a year. Nor were they thrilled at the idea of a bunch of hacker-types appearing in medias res. “At first the people who were working on the program were insulted at the suggestion they needed help,” admits Carter. “So some of them needed to be nicely helped to understand that was a good thing.”

Privacy and Security

A corporate payroll employee of the Phoenix-based Sprouts supermarket chain falls for a phishing scam in sending the 2015 W2 statements of all 20,000 employees in response to an email disguised to look as though it came from a company executive, with some employees already reporting that the scammers are trying to steal their IRS tax refunds.

Technology

BIDMC CIO John Halamka, MD touts third-party apps that layer on top of EHRs, listing three cloud-based systems BIDMC will deploy:

The Right Place (electronic referrals for moving inpatients to post-acute care facilities).

PatientPing (encounter notification).

Collective Medical Technologies (team communication for managing patients who are regularly seen in multiple settings, such as EDs).

Other

South Shore Hospital (MA), whose proposed acquisition by Partners HealthCare was nixed last year due to anti-trust concerns, tries to raise $222 million in donations to pay for a campus expansion ($62 million) and its Epic implementation ($160 million).

Four noted experts offer their ideas for fixing healthcare:

• Change the all-or-nothing FDA review of drugs into a a Consumer Reports-type rating of safety, efficacy, and degree of available evidence and let physicians and patients decide how to use them.
• Give patients control of their electronic information as a “consumer-mediated health information exchange.”
• Improve drug competition by speeding up FDA approvals and holding drug companies responsible for cost effectiveness by putting them at risk for outcomes.
• Publish provider performance and cost data similarly to how businesses publish standardized accounting reports.
• Pay hospitals based on quality in a more consistent manner, incorporating patient-reported outcomes and collecting data electronically.

Sponsor Updates

• Winthrop Resources creates a light-hearted video about its new offering, a financial service for IT infrastructure for healthcare data centers.
• GetWellNetwork announces that 35 hospitals and clinicals implemented its Marbella mobile rounding and patient experience solution in the first six months of 2016.
• ZeOmega integrates Forecast Health’s patient risk analytics into its Jiva population health management product, adding the capability to perform predictive modeling based on social determinants of health.
• Optimum Healthcare IT is recognized as one of Northeast Florida’s fastest-growing companies.
• The St. Louis Business Journal profiles TierPoint CEO Jerry Kent.
• Valence Health will exhibit at the MAHP Summer Conference July 20-23 in Acme, MI.
• Verisk Health publishes the latest edition of The Globe newsletter.

Blog Posts

• 10 Policies and Procedures for Secure Text Messaging (Spok)
• What Is Predictive Analytics (and Why Do You Need It)? (Evariant)

Contacts

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

Philips Acquires Wellcentive

Royal Philips announced this morning that it has acquired population health management software vendor Wellcentive. Terms were not disclosed.

Atlanta-based Wellcentive and its 115 employees has been placed within the Population Health Management group of Philips, which Wellcentive CEO Tom Zajac will lead.

Philips CEO Connected Care and Health Informatics CEO Jeroen Tas was quoted in the announcement as saying, “With this strategic acquisition, we will strengthen our Population Health Management business and its leadership, as health systems gradually shift from volume to value-based care, and provide more preventative and chronic care services outside of the hospital. Our sweet spot is at the point of care as we give consumers, patients, care teams, and clinicians the tools, such as remote monitoring solutions and therapy devices, to optimize care. Wellcentive’s solutions will provide our customers with the ability to collect data from large populations, detect patterns, assess risks, and then deploy care programs tailored to the needs of specific groups.”

I interviewed Wellcentive CEO Tom Zajac in August 2015.

Morning Headlines 7/20/16

Examining Oversight of the Privacy & Security of Health Data Collected by Entities Not Regulated by HIPAA

An HHS report to Congress points out the lack of applicability of HIPAA privacy and security to non-covered entities such as app vendors, saying it will work with stakeholders to address gaps and adding that the FTC has some enforcement power.

Individuals’ Ability to Electronically Access Their Hospital Medical Records, Perform Key Tasks is Growing

An American Hospital Association survey finds that more than 80 percent of hospitals allow patients to view and download their medical record information, a significant jump since 2013.

How ‘digitizing you and me’ could revolutionize medicine. At least in theory

Eric Topol, MD of Scripps Research Institute defends the administration’s decision to give Scripps a $120 million precision medicine grant to collect and study the data of 1 million volunteers.

C-CDA Scorecard (Beta Release)

ONC creates an online tool that allows testing a C-CDA document to see how well it performs against certification criteria and advanced interoperability rules.

News 7/20/16

Top News

A new HHS report prepared for Congress notes the obvious fact that non-covered entities such as wearable and app vendors are not regulated by HIPAA, a situation it calls “a gap in oversight” that people (including vendors) don’t always understand. That gap can’t be addressed by HHS since it has no power to regulate anyone other than covered entities.

The report suggests that the FTC identify best practices. It notes that FTC’s authority includes protecting consumers from possible relevant unfair or deceptive company practices such as not following their own privacy policies, failing to disclose how consumer information is used, or failing to secure the consumer information they collect.

It’s surprising to me how often knowledgeable industry insiders cry “HIPAA violation” when the party involved is clearly not a covered entity, such as when ESPN ran a photo of an NFL player’s medical records. Anyone can violate your privacy, but only a covered entity or their business associate can violate HIPAA.

The report notes that people who share their information with non-covered entities aren’t clearly protected by federal law. It also references the little-known FTC Health Breach Notification Rule that requires PHR vendors that are not covered entities to report breaches of their systems.

Reader Comments

From Lawson CIO: “Re: downtime. We experienced almost a week of downtime with our Lawson system running on Velocity Cloud starting July 1. It must have have hit many hospitals. How many others experienced it?” Affected readers using Velocity Technology Solutions are welcome to report. I reached out to the company but they declined to respond, saying they are contractually prohibited from disclosing information to anyone other than customers.

From Security Officer: “Re: The Dark Overlord’s most recent hack. The hacker gained access to a specific PilotFish dataset, but not for our environment. Do you have more information?” The Dark Overlord says he “used their [PilotFish’s] code to find exploits in all their clients … I signed a backdoor to get into their clients because I had access to their certificate signing. It got pushed out in an update a few weeks ago.” He also showed samples of the client EHR records he claims to have taken. The Dark Overlord has not previously overstated his accomplishments, so while there’s no proof so far that he breached every PilotFish client and took their PHI, I would operate under the assumption that he has and take action accordingly. I would expect his next move to be approaching those individual clients to demand payment since PilotFish turned down his demands. Confounding the issue is that some of PilotFish’s clients are HIEs and thus the information he claims to have stolen may have come from many providers, although maybe it cross-references a client table that he won’t bother linking to figure out the source.

From Kyle Smith: “Re: VA hiring KLAS to advise it on commercial EHRs. It was a sole-source selection, claiming that only KLAS can do the job. I’m sure KLAS loves the kind words, but this doesn’t really sound like an accurate reflection of the work of other folks in the industry.” What we taxpayers will get for our $160K VA payment to KLAS is a six-month membership and bringing in three KLAS people for four, half-day overview meetings. Apparently the VA thinks it needs KLAS to tell it to choose between Cerner and Epic. It is probably not realistic that they would just ask DoD how its Cerner implementation is going before deciding.

From Mr. Buyer Beware: “Re: Definitive Healthcare. For those using it as their hospital data source, they are doing automatic renewals, but they increase the price without notice. Thoughts, Mr. H?” I would have to see your agreement, but I would be surprised if it doesn’t include at least some provision for increases pegged to cost-of-living percentages or something like that. They can adjust the price however they want if the contract doesn’t name a fixed price for the agreement’s term, which then might be a good indication that you as a customer shouldn’t have signed it. Ditto the automatic renewal – if the contract doesn’t say it renews automatically, then you can refuse to pay assuming that you’re willing to stop using their services. Either way, it’s a nice courtesy (and good business) for a company let customers know about the new price well in advance so they can budget for it.

From Lifeline: “Re: taking time off from work. Like Dr. Jayne said, too many people associate their job with their identity and can’t give it up.” Job titles are like clothes – we hide behind them to prevent people from seeing us as we really are. When someone asks, “What do you do?” they are really asking, “Who are you?” with the assumption that your job defines your persona, and people often answer in that same mindset (especially executives who can’t bear the thought of not decisively differentiating themselves from us less-accomplished rabble). Folks who brag on being fully engaged in their jobs while on vacation have deathbed lessons to learn: (a) your employer and co-workers care much less about you than you think; (b) you are going to be devastated when you get fired or retire and realize all of that one-sided loyalty was misplaced as your work goes on without missing a beat in your absence; and (c) for the 99 percent of people who work at a particular job only because they need the money but would really rather be doing something else, spending more time working means spending less time living. It’s sad that people allow their identity to be subsumed into that of their employers in a form of self-enslavement. Employers have learned to maximize profits by swindling employees out of what should be their free time, now demanding their nearly undivided attention via an ankle bracelet posing as a smart phone and paying what seems like OK money for a job as long as you don’t do the per-hour math. We only think we’re immortal and the people crying graveside won’t be co-workers or customers (or in my case, readers). Welcome to the grand illusion.

HIStalk Announcements and Requests

The DonorsChoose grant request of Ms. Hughes from South Carolina was simple: her fourth graders just needed dry erase boards and markers, which we provided. She reports, “The resources provide an easy way for the students to practice drawing models, pictures, and equations all of which are used to solve a variety of math problems. The students were so excited to see the new materials when they arrived. They kept going on about how nice it was of someone to give them to us!”

Webinars

None scheduled soon. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

Cerner names its $4.45 billion, 10-building Kansas City office park that’s under construction the Innovations Campus. The first of 3,000 software engineers will move in next year, although the project won’t be finished for 10 years. The 4.7 million square foot complex — Cerner’s seventh campus outside its headquarters — was designed to house 16,000 workers. The company announced several campus design features:

• A staircase whose metal perforations contain quotes from Cerner’s founders in binary code form (I assume one of them won’t be “Tick, tock.”)
• A 100-person staircase “collaboratorium.”
• A metal panel for each of the company’s 340 patents.
• A 188-foot tall outdoor statue depicting DNA.

Sweden-based exercise and diet tracker Lifesum raises $10 million.

People

Alan Eisman (Information Builders) joins HBI Solutions as SVP of sales and business development.

Cerner hires Jeff Hurst (Florida Hospital) as SVP of RCM and president of RevWorks.

LifeImage names Janak Joshi (Deloitte) as CTO.

Santa Rosa Holdings promotes Tom Watford to CEO. He replaces company founder Rich Helppie, who will remain board chair. The company’s businesses include Santa Rosa Consulting, Santa Rosa Staffing, InfoPartners, and Fortified Health Solutions.

Gerald Greeley (Lahey Health) joins Signature Healthcare (MA) as CIO.

Janet Guptill (Tatum) joins the Scottsdale Institute as executive director. She replaces Shelli Williamson, who will become vice chair of the board.

Announcements and Implementations

In England, Wrightington, Wigan and Leigh NHS Foundation Trust  goes live on Allscripts Sunrise.

Catalyze earns HITRUST CSF certification for Amazon Web Services.

Meditech implements Access Passport for its internal electronic forms and signatures.

Government and Politics

The VA awards Leidos a prime T4NG contract in which 24 contractors are eligible to compete for $22 billion worth of IT services, network engineering, cybersecurity, and other IT work. Leidos was not included in the original list of 21 winners announced in March 2016.

An American Hospital Association survey finds that 92 percent of hospitals allow people to view their medical records online, up from 43 percent in 2013. The most widespread adoption of technology for patients is the ability for them to pay their bills online, which is offered by 74 percent of hospitals, and two-thirds of hospitals say patients can securely message providers.

A Health Affairs blog post notes that while insurers can’t be required to submit their claims to a state’s all-payer claims database, many still will do so, giving researchers a good-enough set of information. It also notes that there never was an “all” claims database since they don’t include services for which insurance wasn’t billed.

AMIA warns FDA that while most providers are using EHRs, their data is not necessarily of research quality. AMIA suggests that FDA focus its research data collection on data warehouses, whose information has been better standardized and encoded, as opposed to relying on EHR information that was intended primarily to support individual patient encounters.

ONC offers a C-CDA Scorecard that evaluates an electronically submitted C-CDA document in two ways: providing a pass/fail score to indicate whether it meets 2015 Edition Health IT Certification for Transitions of Care, and (b) issuing a letter grade indicating conformance with HL7’s advanced interoperability rules, which means the system’s vendor is more likely to be able to support interoperability.

Technology

Drug maker GlaxoSmithKline launches a mobility study of 300 rheumatoid arthritis patients using Apple’s ResearchKit.

Other

The San Francisco paper finds that UCSF Medical Center CEO Mark Laret earns an average of $556,000 each year from serving on the boards of two of the hospital’s vendors, Varian Medical Systems and Nuance Communications, who have paid him more than $5 million on top of his $1.6 million annual compensation from the hospital.

Eric Topol, MD answers tough questions about precision medicine and the $120 million in NIH grants his employer, Scripps Research Institute, has received to recruit volunteer study participants. He says about the idea of  addressing patient-specific health risks instead of sequencing their genomes,

Look, we’ve had all this risk factor and lifestyle knowledge for decades. Do we have everybody practicing a healthy lifestyle? No. I don’t want to diminish the importance of it, but a lot of people have the healthiest lifestyle in the world and they get struck by things like autoimmune diseases and Alzheimer’s.  It’s not either/or, but we need to take advantage of the fact that we can know so much about any given human being — what they are at risk for, or the environmental factor that’s causing the risk.

Kaiser Health News notes the upswing in micro-hospitals that offer EDs and primary care services but only a few inpatient beds. Sounds swell except they are usually built by big health systems trying to squeeze out competitors and bolster their bottom lines since companies that buy fancy medical equipment or build new buildings always find a way to create the demand to pay for them (not to mention the inherent inefficiency in staffing an always-open but potentially low volume building in the unfocused factory model). Walmart puts profit-boosting, scaled-down versions of their stores only where well-off people shop and hospitals are no different, so don’t expect to see mini-hospitals springing up in the downtrodden part of town. As one of my previous health system employers always said, we serve all, but market to few. As much as everyone likes to think it isn’t true, you won’t find the best hospitals and best doctors in poor or rural areas. Also true is that we’re all paying for those fancy health system buildings, the big salaries they hand out, and the enormous employee headcount that sucks up all the parking spaces for miles.

A report finds that 70 percent of physician assistants are working in specialties rather than primary care.

A drunk, off-duty NYPD officer is charged with running over four pedestrians, killing 21-year-old MIT student Drew Esquivel, who was also working on an EHR for underserved areas.

HIMSS is running a hospital CMIO’s video pitch that claims to answer the question of why being named EMRAM Stage 7 was valuable to the hospital. The answer: it let the hospital’s IT employees feel good about their accomplishments. In other words, the hospital received no value whatsoever except IT bragging rights, about which the locals who are footing the bill could not care less. Magazines and websites create a lot of vanity-driven contests and awards that providers puzzlingly don’t see as pointless.

Maine’s HHS typos the hotline number on the debit cards it gives to food stamp recipients, with the listed number actually ringing up a telephone sex line. Most surprising to me (beyond the fact that food stamps are now issued by debit card, which is a great fraud-tracking idea) is that such services still exist, although they apparently now charge directly via toll-free numbers instead of those 1-900 lines that funded a lot of late-night TV advertising in the 1990s.

Sponsor Updates

• Bernoulli Enterprise is nominated for the Health 2.0 10-Year Global Retrospective Awards in the category of Tech Company.
• Besler Consulting releases a new podcast, “Skyrocketing Costs and the Emergence of Rate Setting.”
• CapsuleTech and Direct Consulting Associates will exhibit at MHealth + Telehealth World 2016 July 25-26 in Boston.
• The local business paper features CoverMyMeds in a profile on startup jobs and spending.
• Galen Healthcare Solutions publishes a new case study, “Critical Clinical Information Demystified with Database Training.”
• Healthfinch joins the Matter community of healthcare entrepreneurs.
• Meditech recaps its history in the acute care market in Canada.
• Forbes interviews Healthgrades SVP and Head of Digital Mayur Gupta.
• InstaMed publishes a new case study, “Pediatric Practice Automates 90 percent of Patient Payment Collections with InstaMed.”
• Medecision CMO Ellen Donahue-Dalton joins the Women Business Leaders of the US Health Care Industry Foundation’s advisory board.
• ITx honors Orion Health Product Strategist David Hay with the Excellence in Health Informatics award.
• Patientco funds treatment for six patients through a partnership with Watsi.
• The local business paper profiles the applicants for Cincinnati health commissioner, including Robyn Chatman of Sagacious Consultants.
• Stella Technology announces its rebranding.

Blog Posts

• How Does the Cloud Reduce Data Loss Risk? (Catalyze)
• What Is Interoperability? (AdvancedMD)
• Wait Time Management: Why The Problem With Waiting Isn’t Waiting (Clockwise.MD)
• The Evolution of Device Management (AirWatch)
• The Final Word: Risk (Arcadia Healthcare Solutions)
• Navigating Healthcare for our Child: Things We’ve Learned (CareSync)
• A Focus on Enterprise Readiness, Not Just Getting Ready (Divurgent)
• Pediatric Post-Discharge Follow-Up: How to Get it Right (ECG Management Consultants)
• Top 3 Takeaways from #AAPL2016 (Evariant)
• Chronic Care Management: Steps in the Right Direction (CareSync)
• 7 Things to Know for Successful Provider Education (Hayes Management Consulting)
• On-Demand Access To vCISO Meets This Client’s Needs (Orchestrate Healthcare)
• Will Social Security Numbers Finally be Removed from Medicare Cards? (ID Experts)
• With Multiple EMRs, Care Management and Real Online Patient Engagement Can’t Happen (Influence Health)
• Healthcare Analytics in the Cloud: Delivering Answers “as a Service” (InterSystems)
• What does your “data-inspired future” look like? (Liaison Technologies)
• It’s Twice as Nice to be Named a 2016 Top Workplace (MedData)
• Sharing IT Insights Amid Rapid Change (Netsmart)
• A Recipe for CPOE Optimization (PatientKeeper)
• Patients Always Come First, Except When They Don’t (PMD)
• Alert: New E-Prescription Quality Guidelines (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.

Monday Morning Update 7/18/16

Top News

Hacker The Dark Overlord, who has breached at least three healthcare organizations and then listed their patient data for sale when they refused to pay him, advertises for sale the digital assets of a healthcare IT vendor that appears to be PilotFish Technology, which offers integration tools and middleware to several industries that include healthcare. He’s asking $500,000 for HL7 source code, signing keys, and a licensing database. He says he stole the information by gaining full root-level access to the company’s servers. The Dark Overlord listed the information for sale after the company declined to pay him the $500,000 to keep quiet.

The hacker says he has inserted a backdoor in PilotFish’s software that was pushed out in its most recent update and has since stolen the EHR records of all of the company’s customers.

Not only is PilotFish’s business at great risk, so is the information of its customers, among them Utah Health Information Network and the State of Connecticut. PilotFish launched its healthcare business in February 2014.

The Dark Overlord breaches systems using Remote Desktop Protocol exploits, so I’ll recommend again that everybody either secure it or shut it down. He also seems to prefer targeting SRS EHR clients. His latest round of tweets suggests that at least one of the providers he hacked paid him to keep quiet last week.

Reader Comments

From Sharon M: “Re; LabCorp. I’m surprised HIStalk did not cover the IT crash that affected five states. Are you so biased that you only print the favorable reports about HIT?” This comment comes from a frequent anti-EHR troll who assumes multiple identities in unsuccessfully trying to avoid being called out, which even without the technical clues would be obvious since 99 percent of readers complain that I’m too critical of health IT instead of accusing me of being a cheerleader for it. I haven’t seen any mention of LabCorp problems anywhere, so given that I did not personally have tests performed recently in those five states, I have zero information about any downtime and have received nothing from users (including the phony Sharon M). In other anti-technology news, a traffic light went out for an hour recently, so it’s time to replace all of those unreliable devices with stop signs.

From Lysander: “Re: redirects. Why do you redirect the link from HIStalk.com to HIStalk2.com? I know it was originally related to a hosting switch, although if I know your style, that inside joke might be part of the fun.” It’s been nearly 10 years since I switched from a proprietary-technology web host while temporarily running both sites to prevent readers from getting lost. That change isn’t easy to undo, I’ve learned. I had my web host look into it yet again Friday night after your inquiry and they messed things up a bit temporarily, plus the change would probably screw up links to years’ worth of articles. I’ll add that to my inside joke collection (along with smoking doctor logos) and the list of things I’m too lazy to worry about.

From Little Bit: “Re: mission and vision statements. I remember an academic medical center whose mission didn’t have one word about patients in it. There’s also an EHR vendor who talked a lot about their ‘Do Right’ principle, although I think they veered away from that one.” I’ve worked for executives who turfed off creation of mission and vision statements (they didn’t even understand the difference) to their underlings and it was a disaster. The back-stabbing, suck-up directors fought for attention in trying to distill a large, complex operation into a single overinflated, pithy sentence (it ended up with a lot of commas).  My takeaway: leaders without vision and character might as well have a crappy, eye-rolling vision statement that will be forgotten immediately because it’s not going to help anyway. My other takeaway is that committees are a poor substitute for leadership since they suck the life out of everything they do, and as such, should be limited to an advisory role to a clearly defined leader rather than to have actual power themselves. Give the buck a place to stop.

HIStalk Announcements and Requests

Three-quarters of poll respondents don’t think levying HIPAA fines improves privacy or security. New poll to your right or here: what is your overall opinion of the Affordable Care Act? You can’t just leave us hanging by voting without explaining, so click the poll’s Comments link afterward to elucidate.

Welcome to new HIStalk Platinum Sponsor Evariant. The Farmington, CT company offers enterprise-class CRM platforms for patients, consumers, and physicians that empower the marketing and physician relations teams of leading hospital networks. Evariant’s patient and consumer marketing CRM system drives targeted service line growth with attributable ROI, while its patient acquisition and engagement platform allows hospitals to target appropriate audiences for marketing as well as for education and wellness programs. Hospitals use its physician engagement technology to track referral patterns and physician loyalty in designing effective physician outreach activities. The company offers a free e-book titled “Creating Extended 360° Patient and Physician Views with Big Data Analytics.” Client success stories include Orlando Health, Wake Forest Baptist Health, University of Chicago Medicine, and Dignity Health. Thanks to Evariant for supporting HIStalk.

I found this Evariant client testimonial from University of Chicago Medicine on YouTube.

Mrs. Roepke in Missouri had never had a DonorsChoose grant request fully funded until we provided her elementary school class with interactive math stations. She says her students cheered when they opened the box and saw the electronic flashcards and are using the many tools that were included in their small group work, to the point that they even refer to the game while working in other groups, which she calls “a proud teacher moment.”

I’ve realized what I hate about the phrase “pop health,” other than the fact that it’s an annoying shorthand for “population health,” which in this industry is invariably misused in describing “population health management” or “population health management technology,” which are entirely different things. Reporters and bloggers who bandy the term about from their cheap seats in their unwillingness to enunciate the daunting four syllables of “population” haven’t earned the right to lapse into jargon. Just like it’s insulting to Marines when people who have never served in the military shout out “Semper Fi.”

Listening: the almost-new album of one of my favorite bands, the highly listenable and brilliant Nada Surf, whose stock in trade is thoughtful lyrics, sweet harmonies, and ragged independence. Their catchy, sometimes jangly power-pop is hard to beat and they exhibit the maturity of a band whose lineup hasn’t changed in nearly 25 years. I’m offsetting that with the hard-rocking operatic Finnish metal of Nightwish, who I didn’t realize has commendably added the incomparable Floor Jansen (After Forever) as lead singer.

Last Week’s Most Interesting News

• The VA takes more Congressional heat for lack of DoD interoperability and hints harder at replacing VistA with commercially available software in a Senate Appropriations Committee hearing.
• A survey finds that most doctors haven’t heard of MACRA and hate the idea of tying their income to their quality.
• OHSU pays $2.7 million to settle two HIPAA charges involving only 7,000 patients in incidents involving a stolen laptop and residents using Google Docs to store patient information.
• Imprivata and Valence Health are acquired.
• HHS issues ransomware guidance in declaring that a reportable HIPAA breach has occurred any time PHI is encrypted by malware.
• CMS levies a death sentence on lab processor Theranos, banning Elizabeth Holmes from clinical laboratory ownership for two years and halting Medicare and Medicaid payments to the company.

Webinars

None scheduled soon. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

GE Healthcare’s management consulting group signs a five-year collaboration agreement with ThoughtWire, which offers machine intelligence software that GE Healthcare will roll out as real-time process alerting and decision support.

Sales

University of Virginia Health System selects Evariant’s Physician Relationship Management and Physician Market Solver solutions for physician alignment.

The Medical Information Network – North Sound (WA) HIE adds Jiva Population Health Management to its ZeOmega rollout.

People

Commonwealth Health (PA) names Denis Tucker (Main Line Health) as CIO.

Government and Politics

England’s Secretary of State for Health and digital health supporter Jeremy Hunt is reappointed under new Prime Minister Theresa May.

The Defense Health Agency awards a five-year, $70 million to EHR Total Solutions. I found next to nothing about the company, which seems to exist purely to get military contracts. It previously reported $9 million in annual MHS contracts, so this will raise its total a lot.

A US District Court orders MedSignals CEO Vesta Brue to pay $4.5 million for grant fraud. Her Lexington, KY companies received five NIH grants to develop electronic pillboxes, but she spent the money on plastic surgery, jewelry, and massages. She will also pay restitution and serve jail time for grant fraud related to Telehealth Holdings, Inc., a company operated by her partner Jerome Hahn.

GE Healthcare sues 23-bed West Feliciana Parish Hospital (LA), complaining that it unfairly chose Hitachi Medical Systems to provide imaging equipment at a price below GEHC’s bid.

I’m tiring of the Pokemon Go phenomenon as quickly as I did other pointless, imitative fads like the Ice Bucket Challenge and the phrase “threw up in my mouth a little bit,” but this is cool: C.S Mott Children’s Hospital (MI) is using the game to get hospitalized children to leave their beds and interact with employees and other patients. That won’t be offset by the hospital influx of dolts who are hurting themselves in their rare interactions with their actual physical surroundings while staring at their phones, but it’s a small plus. Speaking of which, as I predicted last week, game developer Niantic announces monetization plans in which it will offer retailers the ability to sponsor locations on a cost-per-visit basis in hopes of boosting their foot traffic. I predict the game will be a cringingly-recalled embarrassment in six months, just like Second Life and Google Glass.

The former IT administrator of an Alaska health system faces 99 years in prison after pleading guilty to  possessing and distributing 2 million images and 13,000 videos of child pornography that obtained using the hospital’s network. He was not charged for distributing another disturbing image, the photo above from his LinkedIn profile.

The Houston paper covers the “cost versus choice” out-of-network conundrum in describing a 175-bed, oncologist-owned hospital that brings in annual revenue of $1.5 billion despite not accepting any form of insurance. Aetna sued after finding that the hospital was reducing the patient responsibility portion of its bills to in-network levels by applying a “prompt pay discount,” but was sticking Aetna for their full part of the out-of-network charges (such as $200,000 to treat an abscess). Aetna claimed racketeering, while the hospital counter-sued for being blacklisted. The judge denied Aetna’s demand for $225 million in refunds, saying it’s up to Aetna to decide what part of medical costs it pays in applying usual and customary limits.

Bizarre: several doctors in India, one of them a government official, are arrested for running a child trafficking ring from their hospital, caught as they tried to sell a four-month-old. Police are also investigating whether the doctors are running their hospital legally and whether they have actual medical degrees.

Sponsor Updates

• T-System will exhibit at the FHIMA Annual Meeting July 18-21 in Orlando.
• Stella Technology is sponsoring and exhibiting at the Redwood Mednet conference in Santa Rosa, CA this week.
• Datanami.com profiles TransUnion’s management and use of big data.
• Valence Health will host its value-based industry conference, Further 2016, September 14-16 in Chicago.

Blog Posts

• Swedish Medical Group Clinics Optimize Care Delivery with Versus Advantages Clinic (Versus Technology)
• EHRs, Interoperability, and Workflow (TeleTracking)
• OCR is doing a good thing by making us “Eat our Vegetables” (Iatric Systems)
• Hurricane Warning: Is Your Business Ready? (Tierpoint)
• Taking Action on Maternity Care Viability (Verisk Health)
• First-class calling. (Voalte)
• Report from AHIP16 – The Expanding Role of Pharmacy in Patient Care (First Databank)

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 7/15/16

Top News

VA CIO LaVerne Council, testifying to the Senate’s Committee on Appropriations about the future of VistA, defends the status of interoperability with the DoD. She is grilled about why the military’s diagnostic images of newly discharged veterans can’t be viewed by the VA, forcing them to start over, and why Cerner’s suicide prevention algorithms can’t populate the Joint Legacy Viewer. She answers a pointed question about why the VA and DoD can’t use the same system by saying that no existing system can meet the needs of both. Council confirms that every VA VISN has a customized instance of VistA, meaning it’s really 130 similar but not identical systems.

VA Chief Information Strategy Officer David Waltman phrased an answer to a question as “until we move to a COTS solution on the digital health platform,” leaving little doubt that the VA hopes to buy a commercial product. Senator Bill Cassidy, MD (R-LA) was impressive in asking insightful questions about interoperability and federated data capabilities.

Council says the VA has engaged KLAS to build its business case (at a cost of $160,000, Politico reports) in reviewing products and options, hoping to give the next administration a business case by the end of the year. I’m not sure what KLAS has to offer that everybody doesn’t already know (it’s either Cerner or Epic – skip the RFI/RFP and just visit some sites, negotiate hard, and swallow the urge to rule out Cerner just because DoD chose it).

Reader Comments

From Dr. Nicholas Van Helsing: “Re: Theranos. I posted a few weeks ago that it was clear the Emperor had no clothes. But put a mysterious woman dressed in black turtlenecks and a somewhat strange alto voice out front and people buy it. A similar image was creatively groomed 15 years or so for Kim Polese of Marimba. Every industry rag had a story about her every month, and then she complained that the press never left her alone. She hasn’t amounted to much, but at least Marimba sold for $239 million and only deal with software, not lives. Her next venture tanked – anyone know what she’s doing today? I think Liz is headed the same way. QED.” Polese made a lot of covers because of her appearance (despite holding a biophysics degree and being influential at Sun Microsystems for coming up with the name Java) and because women-led tech companies were rare back then. That was a reflection of widespread industry chauvinism more than any ego failings she might have had. Marimba created Castanet, a technology to allow fast downloads, but the company’s fame never approached her own, especially after it hired a PR firm who decided to make her the real story. You’ll be interested to know that she landed in healthcare as board chair of ClearStreet, which offers technology to help employers and employees manage their healthcare spending.

From Dilettante: “Re: HIStalk. I don’t believe that it’s just one person writing and reading every item that appears. Tell me who is on the team and where the company offices are located.” I get that a lot. I write every word of every news post myself, with the rare exception when I take a day off and Jenn covers. I don’t leave the otherwise empty spare bedroom (no schmoozing, speaking engagements, or sucking up – that’s the beauty of being anonymous) until I’ve written something that I’ll still be proud of years later, long after thousands of readers have forgotten it. Until I lose the ability or interest to continue doing that in a way that I think is better than anyone else, it’s just me alone feeling like I’m whispering in the ear of a single reader who is just like me in having a short attention span, a low threshold for BS and corporate incompetence, and a strong interest in doing the right thing for patients and those who pay their bills. Everybody has some weird, questionably useful talent (wiggling ears or solving a Rubik’s cube, for example) and this happens to be mine.

HIStalk Announcements and Requests

We funded a significant DonorsChoose project (donating $500, which was matched by Chevron) in providing Mrs. Veltri’s Pennsylvania elementary school class with an iPad Mini and STEAM tools, books, and games. She reports, “Packages came to our door and our students could not contain their excitement. You should have seen their faces as they began to open boxes that gave them tools to explore new aspects of education. At this young age students need to explore science, technology, engineering, and mathematics to set their foundations for later on in their schooling. The blocks and tiles get them learning about these concepts at a young age and in a very exciting way!”

I asked Jenn to write an article about the return on investment vendors get for exhibiting at the HIMSS conference. Contact her if you would be willing to give some company perspective (anonymously if you would rather).

This week on HIStalk Practice: Enli Health Intelligence partners with Dell Services. Hawaii hopes to ease physician shortage with expanded access to telemedicine. Relatient partners with Uber. Flatirons Practice Management adds Mediware billing tools. HealthTap acquires Docphin. Drchrono partners with AHIMA to help HIM students. Colorado Springs Health Partners rolls out Clockwise.MD at urgent care facilities.

This week on HIStalk Connect: Involution Studios debuts digital healthcare cards. Tel Aviv University develops temporary emotion-mapping electronic tattoos. Eleven year-old helps Boston Children’s Hospital promote telemedicine legislation. Avizia and Progyny secure new funding rounds. Drones help coordinate care for wild ferrets.

Listening: new from Anderson/Stolt, a collaboration between former Yes singer Jon Anderson and former Flower Kings/Transatlantic guitarist Roine Stolt. Yes is on its sad last cash-cow legs, even more pathetic than the so-called Beach Boys with no original members left and a tribute band singer mangling its classics, so this is a pretty good substitute for the band’s prime 1970s years with Anderson / Squire/ Howe / Wakeman / White (or maybe Bruford if you’re a purist). Prog fans will be transported to the years when Yes and Genesis ruled the airwaves and concert stages. Anderson sounds great for a guy who’s 71 and who got fired from Yes in 2008 after serious lung problems kept him off the road and thus from playing the aging band’s primary keyboard instrument (the cash register). He’s also touring this fall with fellow Yes alumni Rick Wakeman and Trevor Rabin.

Webinars

None scheduled soon. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

Teladoc obtains a $25 million loan and $25 million line of credit.

Care coordination software vendor Caremerge raises $14 million, increasing its total to $20 million.

Telemedicine software and services vendor Avizia raises $11 million, increasing its total to $17 million.

In Canada, Telus Health announces that it will acquires the Canadian EHR business of Nightingale Informatix, which is used by 4,000 physicians.

Patient experience software vendor Docent Health raises $15 million in a Series A funding round, increasing its total to $17 million.

Publicly traded Alere recalls all of its PT/INR blood coagulation testing systems as mandated by FDA, which found that the company’s software update did not fix a previously documented problem with incorrect results. Abbott had agreed to acquire the company for $5.8 billion last year but then tried to back out after Alere was investigated for foreign corruption probes, so naturally they’ll be trying even harder now. 

People

Randy Fusco (Change Healthcare) joins patient engagement system vendor HealthGrid as EVP of product R&D.

ID Experts hires Kimberly Holmes, JD (OneBeacon Insurance Group) as SVP and counsel for cyber insurance, liability, and emerging risks. 

Johns Hopkins All Children’s Hospital (FL) names John McLendon (MedStar Health) as VP/CIO.

Chris Hammack (Patientco) joins population health management consulting group Aegis Health Group as SVP of sales and business development.

Announcements and Implementations

In Singapore, Farrer Park Hospital goes live on Meditech 6.0.

Medecision launches Aerial for Medicaid and Medicare Advantage, a population health management system.

Colorado Springs Health Partners (CO) goes live with online check-in by Clockwise.MD at all three of its urgent care facilities.

PMD adds real-time discharge alerts to its software, allowing practices that participate in Medicare’s Transitional Care Management program  to be paid for performing follow-up within 48 hours of discharge. The company offers software for charge capture, secure messaging, health information exchange, and care coordination.

Government and Politics

Six Republican Senators introduce the EHR Regulatory Relief act that would mandate a 90-day Meaningful Use reporting window in trying to “pull the electronic medical records system out of the ditch, transforming it into something that doctors and hospitals look forward to rather than dread.” The proposed legislation would also modify the all-or-nothing MU requirements and extend the availability of hardship exemptions. Senators John Thune (R-SD), Lamar Alexander (R-TN), Mike Enzi (R-WY), Pat Roberts (R-KS), Richard Burr (R-NC), and Bill Cassidy (R-LA) are members of the Senate’s working group Re-Examining the Strategies Needed to Successfully Adopt Health IT, which somehow ended up with the contrived, catchy non-acronym REBOOT.

Meanwhile, CMS Acting Administrator Andy Slavitt tells the Senate Finance Committee that CMS is open to postponing MACRA and shortening its reporting periods.

A Politico article calls the Affordable Care Act “the secret jobs program” in which the administration–  facing a tanking economy and the loss of millions of jobs — chose preserving healthcare employment over controlling healthcare costs in deciding not to cap healthcare spending or address provider efficiency. Healthcare employment has grown 23 percent since 2005 vs. just 6 percent in non-healthcare jobs. The excellent article notes that the “poison pill” that’s included with all those jobs is ever-growing healthcare costs (healthcare creates its own demand) footed by employers, patients, and taxpayers, noting that doctors are outnumbered by non-doctors by 16 to 1, with nine of those being paper-pushers. Experts say the investment is a poor one if health doesn’t improve. Legislators have declined to face the issue because “every job is a good job” and all of them have big-employer hospitals in their districts, with healthcare and social assistance providing the highest employment in 56 percent of Congressional districts.

HHS lists a position for an IT security specialist, which contains mostly unsurprising duties except for the last two that cover prosecution and corrective action.

A Deloitte survey of physicians finds that only 50 percent of the non-pediatricians have heard of MACRA, with 32 percent of them saying they’ve heard of it but don’t actually know what it is (maybe CMS should hire drug salespeople to spread the word since they seem to get doctors to pay attention, at least when they bring lunch). Nearly 80 percent of respondents say they would rather be paid under fee-for-service or salary arrangements instead of value-based payments. Three-quarters think performance reporting is burdensome and 79 percent don’t like the idea of tying their incomes to quality (that might be the scariest number of all).

An HHS report says national health spending will hit the $10,000 per person mark for the first time this year and will continue to grow at around 6 percent annually through 2025 as the economy improves, healthcare prices rise, and baby boomers get older. It predicts that spending may be moderated by higher out-of-pocket costs and says insurers will increasingly narrow their networks in trying to avoid price increases.

Privacy and Security

Oregon Health & Science University will pay $2.7 million to settle charges stemming from two 2013 data breaches involving 7,000 patients, one the theft of a surgeon’s unencrypted laptop from his vacation home and the other caused by medical residents who stored patient information in cloud-based Google Docs. That’s a big penalty considering there’s no proof anyone actually saw or used the patient information.

Other

Healthcare Growth Partners publishes its mid-year health IT market review, which always dazzles me with its insight and brilliant writing. It notes the change since 2005 in which “solvers” (companies that do the right thing in generating profits while maximizing returns for many) now outnumber the previously dominant “exploiters” (companies that exploit inefficiencies to maximize returns for a select few), as the fee-for-service model rewards exploiters and value-based care rewards solvers. It notes that companies with just $10 million in revenue have a wide variety of investors to choose from in the immature health IT market. Respondents were mixed on whether an health IT investment bubble exists, but those who think it does point mostly at early-stage companies. There’s too much information to summarize adequately, so take a look – unless you are already an M&A expert, you’ll learn a lot by reading the report.

Greater Baltimore Medical Center (MD) celebrates its EHR go-live with what it calls a company barbeque (which it wasn’t – it was a cookout with no low and slow smoking involved). I assume it was Epic ambulatory that went live.

A funny spoof from the Gomerbloggers.

Weird News Andy helpfully provides ICD-10 code Y93.C2 (activity, hand held electronic device) for treating the idiots who are harming themselves by ignoring the real world in favor of the Pokemon Go variety. He provides examples: (a) two men fall off a San Diego cliff after cutting through a protective fence in their pursuit of a character; (b) a guy crashes his car and tears up a woman’s yard while driving and chasing an imaginary monster; and (c) a 21-year-old generously absolves the game’s maker for falling off his skateboard while hunting characters, saying, “I don’t think the company is really at fault.” Meanwhile, officials at the United States Holocaust Museum, Arlington National Cemetery, and Poland’s Auschwitz Memorial ask the game’s vendor to take their sites off its monster-hunting list to keep them from being overrun by disrespectful players. The CEO of the company that developed Pokemon Go says his goals were to get people to exercise, to encourage them to explore their neighborhoods, and to serve as an icebreaker in getting strangers together, all of which could allow the game to meet the definition of a health app except that people actually use it.

Sponsor Updates

• Ingenious Med Chief Innovation and Product Officer Todd Charest speaks at the Gwinnett Chamber of Commerce’s Wearable Technology Forum.
• InstaMed is featured in the Deloitte Health Care Current.
• Fifty-nine Meditech customers achieve the “Most Wired” distinction for 2016.
• Netsmart will exhibit at the ASU Annual Summer Institute July 19 in Sedona, AZ.
• Experian Health will host its Northeast Regional User Conference July 19 in Philadelphia.
• Following up on an Earth Day-related pledge, PatientPay donates to The Nature Conservancy for the restoration of longleaf pine forests in the North Carolina Sandhills.
• Teknovation.biz interviews PerfectServe CEO Terry Edwards.
• Sunquest Information Systems will host its 35th Annual User Group Conference through July 15 in Tucson, AZ.

Blog Posts

• Why Your Facebook Ad Won’t Work (Influence Health)
• How can Microsoft Make the Most of its LinkedIn Acquisition? (Liaison Healthcare)
• Optimizing Medicaid Population Management (Medecision)
• Is It Time for a Check-Up? (Spok)
• Two-thirds of Healthcare Leaders Know It’s Hip to Be Square. Do You? (Navicure)
• MACRA is Coming: 5 Key Things You Can Do to Get Ready (Orion Health)
• At HFMA’s 2016 ANI, Patient Payment Technology Evolves with Provider Strategy (Patientco)
• Managing the “Heart and Soul” of Your Healthcare Delivery System (Phynd Technologies)
• Let’s Start Talking (PMD)

HIStalk sponsors named among the 100 winners of Modern Healthcare’s “Best Places to Work in Healthcare 2016” are:

• CloudWave
• CTG
• Cumberland Consulting Group
• Divurgent
• Encore, a Quintiles Company
• Galen Healthcare Solutions
• Hayes Management Consulting
• Health Catalyst
• Impact Advisors
• Imprivata
• Nordic
• Santa Rosa Consulting
• The Advisory Board Company
• The Chartis Group,

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The War on Wearables

HIStalk looks at the bad rap wearables have been getting lately. From class action lawsuits against Fitbit to digital health snake oil comments, wearables have major ground to cover when it comes to winning over providers as medically reputable devices.
By @JennHIStalk

Industry headlines would have you believe that it’s not the most opportune time to be in wearables. The consumer-friendly devices, most of them of the fitness-tracking variety, face abandonment rates of between 33 and 50 percent after the first six months of use, not to mention increasing scrutiny as to the accuracy of their measurements.

And then there’s the comment heard ‘round the health IT world: “From ineffective electronic health records, to an explosion of direct-to-consumer digital health products, to apps of mixed quality. This is the digital snake oil of the 21st century.”

The comments of AMA CEO James Madara, MD during the association’s annual meeting last month was provocative to many. Although it did have a certain clickbait ring to it, his stance was born out of an underlying concern by many in the medical field that digital health tools — of which wearables take up an increasing percentage — have yet to be fully accepted by physicians. Whether it’s accuracy, usefulness, easy integration with EHRs, or reimbursement for time spent sifting through all that data, wearables haven’t achieved the panacea status many entrepreneurs would have providers and consumers believe they’re capable of.

The Physician’s Perspective

And yet there seems to be no going back. Companies continue to work wearables into their product roadmaps, even in the face of questionable data accuracy. Elmurst, IL-based Power2Practice, for example, announced Fitbit integration with its EHR for integrative medicine last month. UK-based personal health record company Medelinked has announced a similar arrangement with Jawbone.

Clinical researchers don’t seem deterred, either. The Dana-Farber Cancer Institute’s new breast cancer weight loss study has equipped all of its participants with Fitbits to track activity and weight. The examples of academic and corporate enthusiasm for wearables could — and likely will — go on, suggesting that, like the ancient medicinal properties of snake oil, there is a grain of truth to their purported value.

Danny Sands, MD, a practicing physician at Beth Israel Deaconess Medical Center (MA), co-founder of the Society for Participatory Medicine, and chief medical officer at several healthcare companies admits to wearing a Fitbit because he likes receiving reminders that he needs to pick up the pace on a daily basis.

“I think that’s a positive step in the right direction, if you’ll excuse the play on words,” he jokes. “We have to remember that these are consumer devices. They’re not accurate clinical devices. For some people, having the Fitbit on is a motivator. I have seen firsthand how my encouragement to get a Fitbit helped one of my patients get moving and make profound changes in his life. Unfortunately, the vast majority of people who use these tracking devices don’t need to. They’re being used by the young, healthy, and wealthy, not by my patient with three chronic conditions who really should be wearing one.”

“As a primary care doctor,” Sands explains, “one of the things that is so hard and so frustrating is this issue of behavior change – how to motivate patients. If this is one more tool we can use to help motivate our patients, then I figure there’s something to it.” He adds, however, that not all physicians are comfortable recommending wearables and apps, either because they’re not familiar with what’s on the market or have no interest in diving into the back-end issues of receiving that deluge of data.

“You have to ask yourself, as a physician, is this data useful to me,” Sands says. “There it gets a little more complicated, because, first of all, there’s the issue of accuracy. Second, there’s the issue of integration with my workflow/EHR. Third, and perhaps most importantly, it’s about the volume of data that these things generate. This is only going to be useful to me in my practice if it’s information I want to see on a patient that I want to keep track of. Perhaps I’m in some sort of value-based payment contract where I have an incentive to try and keep my patients healthy. I need to figure out how to separate the signal from the noise. I need a system that’s going to show me just the data that’s important to me.”

Sands obviously isn’t convinced by the snake oil rhetoric. “Time and time again we’ve seen that a computer program in the absence of human beings providing something as well is not going to make a big difference in people’s lives. You need systems in place. You need some interface with the healthcare system. If you want to show measurable benefits, then you really have to have human beings there – some touchpoint with the healthcare system.”

The Quality vs. Quantity Conundrum

ACT | The App Association, the Washington, DC-based nonprofit that represents software companies in the mobile app community, has been keeping a close eye on the evolution of wearables in the healthcare space. “Connected devices that we think of as wearables are undergoing a significant transition,” says Executive Director Morgan Reed. “As sensors and technology improve, these devices are rapidly blurring the line separating highly accurate medical devices and something you might pick up at an airport kiosk.”

“The struggle,” he adds, echoing Sands’ comments, “will be taking all of that accurate information and presenting it to a care provider in a meaningful way. This is a place where the balance between quality versus quantity comes into play on the physician side. EHRs – loved or loathed – aren’t so much barriers, but instead have created a new paradigm in which medical apps and connected device makers must create technology that integrates seamlessly with those systems. An ideal interoperable system gives care providers access to a lot of data, but instead of just dumping it into one place, the system highlights the data that the physician needs the most, and makes it available in a usable format. Open APIs are a big part of the solution. The tech industry, regulators, and physicians need to work together to determine how best to create and implement these APIs and related standards.”

Workflow Integration will be Key

Companies like Validic are helping physicians navigate the still-murky waters of wearables integration. The Durham, NC-based company recently partnered with SAP to enable its enterprise healthcare clients to easily access patient data from wearables, clinical devices, and consumer health apps using Validic’s digital health connectivity tools. Co-founder and CTO Drew Schiller believes partnerships like these will help wearables move past the early days phase they seem to be stuck in.

“Consumer wearables as a market is still maturing, with only one IPO and a couple of exits,” Schiller explains. “We are still in the early phases of using these devices in healthcare. Given this, it’s unsurprising that there have been challenges getting adoption from providers. The ‘time to drawer’ is a concern, indicating that these devices may not have yet reached full utility.”

“The biggest barriers today have to do with presenting meaningful information in existing workflows,” he adds. “One barrier is that we are still working to understand the applications and necessary reporting mechanisms for healthcare. There are dozens of ongoing pilots, projects, and grant-funded studies looking to address these needs, and organizations like Node Health are working to bring these disparate efforts together in one place and disseminate learnings.”

“I wouldn’t say that categorically certain wearables are more conducive to integration,” Schiller points out. “However, having a single point of entry for all wearable data certainly makes things easier. Additionally, if an endpoint from the wearable already has a classification and a place in workflow, that makes the logistics of implementation much easier.”

The Biggest Impact

Despite their current shortcomings, wearables seem poised for improvement in terms of provider acceptance, ease of use and integration, overall sophistication, and, most importantly, impact on patient care.

“In the immediate term, wearables enable people to take a more active role in their health,” says Reed. “This represents a shift toward prevention instead of treatment once someone is sick. In the longer term, insights powered by mission-specific wearables and apps will be huge for physicians and patients. Patients can use connected devices to help manage chronic conditions like diabetes or complete post-operative physical therapy, all while physicians monitor progress and identify potential risks.”

Moore adds that one of the most critical issues facing the healthcare system is that of the rapidly aging US population. “By 2050, there will be 83.7 million Americans over the age of 65 – that’s more than double the number just four years ago,” he points out. “Eighty percent of them will have at least one chronic condition, and a large portion will live in rural areas far from family members that could offer support. Wearables and apps are key to empowering this population, helping them to live healthier – and independently – for much longer.”

“Looking forward,” he adds, “advanced personal emergency response systems will be wearables packed with sensors and enabled by mobile apps that can track blood sugar, blood pressure, heart rate, biomarkers for medication adherence, and geofencing for Alzheimer’s patients. The sensors in these devices will then connect to a loved one’s phone, a physician’s tablet, and a medical record system. This increasingly connected approach to healthcare will lower costs and empower aging populations to live at home longer.”

Schiller concurs that wearables will be key to helping care for an increasingly elderly population. He also points out that the devices will help make up for the physician shortage we’ve all heard so much about. “We face a generation of physicians preparing for retirement and a dearth of PCP replacements. We simply won’t have the skilled workforce to maintain business-as-usual practices in healthcare. We must better leverage technology to scale reduced healthcare resources with an eye toward preventing sickness before it becomes chronic. Wearables will play a central role in this revolution.”

Present Benefits are Possible

While the revolution is in the works, wearables, for all their documented shortcomings, are capable of offering near-term benefits to physicians and patients. “Those benefits will depend on the supporting infrastructure and tools the health system and/or EHR vendor has put in place,” Schiller says. “For example, Cerner and Meditech have built smart alerting and dashboarding into their patient portals leveraging a growing list of patient-generated data from remote monitoring devices, including wearables. Health systems such as Sutter Health have realized tremendous success with wearables in comprehensive remote patient monitoring programs for chronic diseases like hypertension. Programs like these will help a physician better treat patients by knowing precisely how well or how poorly a patient is progressing in their care.“

“Long term,” he adds, “physicians will benefit from a shift toward preventative and monitoring measures. This will enable PCPs to know how their patients are doing without physically seeing them, allowing them to spend more time with patients who need care the most.”

Time – and the Market – will Tell

“We are currently witnessing Moore’s Law as applied to wearable devices,” Schiller concludes. “Wearables on the market 18 months ago are significantly inferior to the capabilities of those on the market today, and we expect to see another jump in functionality and sophistication within the next six to 12 months. I could make some specific predictions, but it makes sense to instead state more generally that the consumer technology industry will rise above these challenges to make useful, compelling, and practical devices.”

Evolent Health Will Acquire Valence Health for $145 Million

Evolent Health will acquire the majority of Valence Health for $145 million, the companies have announced. The deal, which involves $35 million in cash and the remainder in Evolent shares, excludes Valence’s state insurance cooperative contracts, which will continue to operate under a newly created entity.

Evolent CEO Frank Williams said in a statement, “The addition of the Valence Health business will provide increased scale and client diversification, and we expect it to accelerate our target timeline to Adjusted EBITDA break-even in 2017 by one to two quarters. We believe this transaction will strengthen our business strategically and financially and position it for continued growth well into the future."

Chicago-based Valence Health offers technology and consulting services to providers moving to value-based care. The company last year hired as its CEO Andy Eckert, who had previously served as CEO of Eclipsys, TriZetto, and CRC Health as well as currently serving as board chair of Varian Medical Systems.

Evolent Health, which also offers integrated solutions that help providers shift to value-based care, was formed in 2011 with The Advisory Board Company and UPMC and went public in June 2015. It has a $1.2 billion market cap as share price has risen 3 percent in the year since its IPO.

I interviewed Evolent President and Co-Founder Seth Blackley in August 2015 and interviewed Valence Health then-CEO Phil Kamp (now chief strategy officer) in March 2015.

Thoma Bravo To Acquire Imprivata for $544 Million

Imprivata will be taken private by an affiliate of private equity firm Thoma Bravo for $544 million in cash, giving shareholders a 33 percent premium to the last closing stock price.

Imprivata President and CEO Omar Hussain was quoted in a statement as saying, “We’re tremendously excited about Thoma Bravo’s investment in our company and believe this transaction represents a great outcome for our current shareholders. Given Thoma Bravo’s successful track record in both security and healthcare IT, today’s partnership is an endorsement of Imprivata’s corporate vision and our relentless focus on the customer experience — a value which has established us as the vendor of choice in healthcare IT security. We are now in a stronger position to pursue market opportunities through innovating and expanding the products and services we offer.”

Thoma Bravo’s other active healthcare IT investments include Global Healthcare Exchange, Hyland Software, Mediware, and SRS Software. It also owns Bomgar Corporation, which offers remote support and identity management solutions. 

Imprivata offers single sign-on, secure virtual desktop access, patient IT, secure messaging, and two-factor authentication. The company went public in June 2014. Share price has decreased 11 percent since.