Vice President Joe Biden launches the Genomic Data Commons at the University of Chicago with $70 million from the National Cancer Institute. As part of the Cancer Moonshot and Precision Medicine initiatives, the commons will receive, store, and organize clinical and genomic data, and offer it to cancer researchers in user-friendly formats.
Webinars
June 28 (Tuesday) 2:00 ET. “Your Call Is Very Important.” Sponsored by West Healthcare Practice. Presenters: Cyndy Orrys, contact center director, Henry Ford Health System; Brian Cooper, SVP, West Interactive. The contact center is a key hub of patient engagement and a strategic lever for driving competitive advantage. Cyndy will share how her organization’s call center is using technologies and approaches that create effortless patient experiences in connecting them to the right information or resource. Brian will describe five key characteristics of a modern call center and suggest how to get started.
Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.
Acquisitions, Funding, Business, and Stock
Cerner President Zane Burke tells the Kansas City Business Journal that CEO Neal Patterson “remains very active and involved” during his treatment for soft tissue cancer, for which he was diagnosed in January. “In many respects, this will help both him and us as he focuses on his next chapter at Cerner and for Cerner. I think … being a consumer of healthcare will have significant impacts as he comes back into the day to day. I think the consumer is going to have a much stronger voice as we move forward.”
HCS moves to expanded office space in Wall Township, NJ.
Hospital purchasing analytics startup Valify raises $2 million in Series A funding led by Frist Cressey Ventures and Step 5 Capital. The Frisco, TX-based company, which has raised $2.75 million since launching in 2014, will use the funds to hire additional sales reps and developers, and for R&D.
Theranos reports that it has voided or corrected less than 1 percent of blood test results, seemingly a far cry from the tens of thousands of results it said it was planning to cancel or change last month. Perhaps the math adds up, though it’s not likely the secretive company will release exact numbers.
Madison, WI-based healthcare API vendor Redox joins the six-month Cisco Entrepreneurs in Residence (Cisco EIR) program in Silicon Valley.
Google’s Verily Life Sciences venture comes under fire as development of its much-hyped cancer-detecting “Tricorder” device, smart contact lens, and Baseline human health study continue to flounder. Several anonymous Verily employees claim that the Tricorder, originally scheduled for launch more than two years ago, has been touted internally more as a buzz generator than as a project capable of true clinical impact.
Sales
The California Emergency Medical Services Authority signs a contract with Audacious Inquiry for the ONC-funded development of a Patient Unified Lookup System for Emergencies. The standards-based system will leverage the state’s existing HIE infrastructure when activated during disasters, and ultimately build new connectivity between providers .
People
Virginia Mason Medical Center (WA) promotes former CIO and CFO Suzanne Anderson to CEO.
Jay Lechtman (Quantros) joins Riskonnect as senior director, market strategy and development.
Apple hires Rajiv Kumar away from Lucile Packard Children’s Hospital (CA), presumably to work on healthcare-related activities. Kumar developed a HealthKit-enabled diabetes monitoring system last fall in his role as medical director of clinical informatics.
Announcements and Implementations
Cardiology Associates of North Mississippi goes live on MedAptus charge capture software for services provided at North Mississippi Medical Center.
Delta Regional Hospital (MS) switches back to Meditech, confirming a late-April reader rumor that the 325-bed acute-care facility was in the process of ripping out Cerner.
Government and Politics
CMS issues a nearly 300-page final rule on MSSP ACOs outlining changes to the program’s benchmarking methodology, a new alternative participation option that encourages participants to enter performance-based risk arrangements sooner, and policies for addressing payment corrections.
Technology
Presidiohealth adds T-System’s EDIS software to its new PM technology for freestanding emergency centers.
Other
This article highlights the social media fame several plastic surgeons have attained thanks to their love of Snapchat and penchant for posting graphic procedures. Michael Salzhauer, MD (aka Dr. Miami) attempts to put an educational spin on his soap opera-like snaps: “A good percentage [of those watching] are people either in the medical field or interested in pursuing careers in medicine — maybe 30 percent, based on the messages we get. Another 30 to 40 percent are people who are thinking about having surgery, either immediately or sometime in the future.”
Sponsor Updates
AirStrip President Matt Patterson will speak at MD&M East June 14-16 in New York City.
IDC ranks AirWatch as the largest enterprise mobility management vendor in terms of market share for 2015.
Aprima will exhibit at Sleep 2016 June 13-15 in Denver.
Audacious Inquiry offers its “Health IT Framework to Support Alternative Payment Models” for download.
Besler Consulting releases a new podcast, “How to Fix Common Physician Documentation Mistakes.”
CapsuleTech will exhibit at the HIMSS New York State meeting June 16 in the Bronx.
Carevive Chief Clinical Officer and co-founder Carrie Stricker, RN will speak at the Biennial Cancer Survivorship Research Conference June 18 in Washington, DC.
CitiusTech will exhibit at AHIP June 15-17 in Las Vegas.
CoverMyMeds will exhibit at the American Diabetes Association Scientific Sessions June 11-13 in New Orleans.
Cumberland Consulting Group Managing Partner Rachel Wixson is featured in the Forbes self-made women issue.
Elsevier Clinical Solutions CEO Ron Mobed is featured in STEMconnector’s “100 CEO Leaders in STEM.”
Healthwise is honored with a 2016 When Work Works Award for its workplace strategies as part of the national When Work Works project.
Spok releases a new infographic highlighting customer success statistics and the ROI of communication technology.
Wellcentive will host its annual National Consultant and Analyst Summit June 8-9 in Atlanta.
The latest KLAS advisory report recognizes Nordic as a top performer, and The Chartis Group as one of the top five comprehensive firms.
I’m a little slow on the typing this week, owing to a little craft-related accident. Although I expect to make a full recovery, I’m glad I’m up to date on my tetanus immunizations. I’m also glad I wasn’t crafting alone, so I had someone to drive me to my office so my partners could get a good chuckle about taking care of me. I was selected to receive a patient satisfaction survey and was happy to give them five stars. My crafting buddy got a kick out of seeing what happens when a doctor phones ahead for their own urgent care visit and offered lots of moral support (and only a few snarky comments).
Fortunately, I had finished most of what I needed to do this weekend before the incident, so it was a good excuse to catch up on the Netflix mailers that have been mocking me from across the living room. I also spent some time editing a research article that a friend is working on. It’s around the release of test results (laboratory and radiology/diagnostic) through patient portals and how their use is impacting patient engagement and provider behaviors.
When I first started working on patient portals about eight years or so ago, there was a lot of anxiety about releasing results directly to patients. In particular, my physicians were concerned about being able to review results first and contact patients before they saw them on the portal. Our hospital brought in some “hired guns” to help us achieve clinician buy-in – a couple of CMIOs from hospitals that had done this previously and lived to tell. We ended up setting a pretty significant delay on the release of results to make sure we allowed for plenty of time for physicians to contact patients first.
A lot has changed since then, including physician attitudes. Meaningful Use set the expectation that visit summaries would be available to patients fairly quickly, and physicians were forced to respond. Additionally, organizations are sending full visit notes and other documentation to the patient, not just lab results or summaries. With my trip to the urgent care today, I had my visit note within an hour of arriving home. My colleague surveyed physician leaders at various institutions to obtain data on how they are releasing results. The data is interesting. Most hospitals still have delays, which coincide with the deadlines imposed by Meaningful Use. Some release inpatient labs sooner than outpatient, and some don’t release inpatient labs at all. The majority of respondents said that they don’t release sensitive lab results – sexually transmitted diseases, drug testing, genetic testing, etc.
Organizations were fairly split on the release of pathology results – some don’t release them at all, and others release but on a longer timeline, usually seven to 10 days. Several responded that they release but only based on a manual release process – no automatic triggers. A couple of respondents said they didn’t know what their institution’s release policy was and one respondent said they didn’t think there was a policy in place. One reply discussed the hospital’s plan to completely revamp their release strategy, with plans to immediately release non-sensitive blood testing and plain film radiology as soon as those tests are flagged with a final status.
In talking to my friend about her work trying to round up the results, she had some interesting stories to tell. Although many of the stories are anecdotal, they are interesting nonetheless. One hospital had decided to go to an immediate release policy and then had to go back on it, blocking release of labs from the Emergency Department. It seems that patients were getting their results from the lab before the ED staff had a chance to review and act on them, and there were several incidents of patients becoming aggressive because they knew results were available and hadn’t been addressed.
In addition to changes in how physicians address test results after the fact, the paper notes some changes to ordering behaviors. Respondents stated they were more likely to counsel patients on the potential significance of results at the time of ordering, so that the plan would be in place before the test was ever ordered. This would seem to be a big win for patient engagement, as well as for practice efficiency. I know I tended to do this when I was in traditional primary care practice, because shared decision making is a lot easier in the exam room than over the phone.
Patient portal access for adolescents continues to be a major issue, with some organizations locking out patients from ages 12 to 18. Some allow limited access for parents during the adolescent period, where others allow full parental access but require the adolescent to consent to it. Nearly all respondents grappling with the adolescent issue cited the concern that a chart with blocked information or hidden information would be a patient safety issue, although they acknowledge that there are state laws and other regulatory factors at play that make the situation difficult.
One of the other questions asked in her survey was around the ownership of the decision to release or not to release data, and when. She specifically asked whether that has changed since the institution of the patient portal. Most organizations have made changes to their release strategy and I would bet these strategies continue to evolve. In my opinion, the most significant change has been the addition of patient/family advisory groups to the discussion. We didn’t see that very often in the early days and it’s a welcome addition in my book. I haven’t edited a scholarly article in a while so it was a nice exercise, and hopefully my penmanship wasn’t too atrocious with my stiff index finger. She’ll be submitting it formally in a few weeks and I can’t wait to see it in published form.
For me, though, it’s back to Netflix. What’s your favorite streaming series? Like to binge watch? Email me.
Rumors surface – again – that McKesson is considering selling or merging its McKesson Technology Solutions business unit in the face of drug pricing pressures. (As MCK Auto Pilot commented in March, laid off McKesson employees were already pontificating upon the likelihood of a near-term sell-off.) The Atlanta-based company cut 1,600 jobs – nearly 4 percent of its US workforce – that same month in an effort to cut costs after losing key pharma customers. MTS had $2.9 billion in sales in the last fiscal year, and an operating profit of $519 million. McKesson’s drug business had $188 billion in sales in the fiscal year and a profit of $3.6 billion.
HIStalk Announcements and Requests
Welcome to new HIStalk Platinum Sponsor Meditech. The Westwood, MA-based company basically created the healthcare IT industry in the 1960s and continues to provide its customers with "One Patient, One Record, One Bill, One Portal" systems at a sustainable cost. Clinicians designed the company’s shared, mobile, patient-centered Web EHR to deliver usability, with just-in-time relevant information displayed on easy-to-use personalized screens and a fast-track implementation plan that accelerates the time to value. Meditech is used by 250,000 doctors who are safely and effectively treating 100 million patients across all care settings with 100 percent utilization and high levels of productivity, paying attention to their patients rather than to their EHR. Meditech-using health systems have earned awards such as HIMSS EMRAM Stage 7, Magnet, Davies, Baldrige, and various "top hospitals" lists. Thanks to Meditech for supporting HIStalk.
Webinars
June 28 (Tuesday) 2:00 ET. “Your Call Is Very Important.” Sponsored by West Healthcare Practice. Presenters: Cyndy Orrys, contact center director, Henry Ford Health System; Brian Cooper, SVP, West Interactive. The contact center is a key hub of patient engagement and a strategic lever for driving competitive advantage. Cyndy will share how her organization’s call center is using technologies and approaches that create effortless patient experiences in connecting them to the right information or resource. Brian will describe five key characteristics of a modern call center and suggest how to get started.
Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.
Last Week’s Most Interesting News
Billionaire Patrick Soon-Shiong, MD takes NantHealth public in a $91 million offering.
A federal appeals court rules against Epic, deciding that companies cannot force their employees to sign arbitration agreements that prevent them from filing lawsuits against their employer.
ONC reports that 84 percent of US hospitals had adopted a basic EHR by 2015, up from just 9.4 percent in 2008.
Forbes lowers its estimate of Theranos founder Elizabeth Holmes’ net worth to zero, down from $4.5 billion.
The Washington Redskins confirms that the medical records of thousands of NFL players have been compromised after a laptop belonging to one of the team’s trainers was stolen in April.
Acquisitions, Funding, Business, and Stock
TrueVation sells the Canadian rights to PatientPrep to Canadian EHR vendor QHR for $500,000. TrueVation, which has headquarters in the US and Canada, will continue to own and market the patient onboarding software in the US.
Fortune contributor Dan Primack challenges the magazine’s revised estimate of the net worth of Theranos founder Elizabeth Holmes (from $4.5 billion to $0), pointing out that its original estimate was way off the mark. “Like other founders of privately-held startups,” he says, “Holmes did not hold any liquid securities in her company. It’s possible that she sold some shares along the way ― as small secondary transactions alongside broader company fundraises ― to pay the mortgage or buy a car (even a nice car), but the vast majority of her holdings had little more than theoretical value. Elizabeth Holmes has plenty to worry about. Losing $4.5 billion that she never really had shouldn’t be one of them.”
Announcements and Implementations
Glendora Community Hospital (CA) implements an e-forms solution from Access in its ER and admissions departments.
Validic adds Finland-based Polar wearables to its digital health ecosystem of devices, wearables, and apps for corporate wellness programs and remote monitoring programs.
Intermountain Healthcare (UT), Providence Health & Services (WA), Stanford Cancer Institute (CA), and precision medicine software company Syapse form the Oncology Precision Network to share aggregated cancer genomics data and increase access to clinical trials, particularly for patients in underserved communities.
Cloud solutions and health IT consulting firm CloudWave (fka Park Place International) partners with Commvault to offer Meditech users data backup, archiving, and disaster recovery solutions.
St. Luke’s Hospital (MN) implements SIS perioperative IT solutions to complement its Meditech EHR.
RCM vendor Rev-Ignition will offer its clients paperless billing solutions from PatientPay.
People
Joel Sangerman (Option Care) joins Zillion Health as vice president of sales, managed markets. (You can read my May 2016 interview with Zillion President Bill Van Wyck here.)
Jennifer Dangar (The Weather Company) joins Jackson Healthcare in the new role of chief of corporate operations.
Technology
Rennova Health adds electronic medication management software to its Medical Mime M2Select EHR for substance abuse treatment and behavioral health providers.
Baltimore-based ICmed develops software to help families coordinate, document, and share health data and care plans.
Privacy and Security
ProMedica Bixby and Herrick hospitals (MI) alert 3,500 patients that their medical records were inappropriately accessed by seven employees – three of whom have been fired. The hospitals have launched an internal investigation into the breach and implemented an auditing program that includes EHR monitoring tools.
Other
The universe nearly implodes when Apple’s App store and several other services including ITunes goes down for seven hours on Friday. The company offered no explanation for the outage, leading several message boards to proclaim it had been hacked.
Sponsor Updates
First DataBank publishes FDB MedKnowledge Canada in Canadian French.
PatientMatters will exhibit at the Illinois Hospital Association Small & Rural Hospitals Annual Meeting June 8-9 in Springfield, IL.
Streamline Health and T-System will exhibit at the 2016 CHIA Convention & Exhibit June 5-8 in Long Beach, CA.
The local paper profiles the expansion of TierPoint’s data center in Milwaukee.
Valence Health will exhibit at the National Bundled Payment Summit June 7-9 in Washington, DC.
VitalWare publishes a client success story featuring a Chicago-based health system.
Wellsoft will exhibit at the NAFEC Annual Conference June 6-8 in Houston.
ZeOmega posts a new video, “The Future of Population Health Management and Value-based Care: The ZeOmega Perspective.”
Forbes revises the estimated net worth of Theranos founder Elizabeth Holmes from $4.5 billion to $0. The magazine named her the youngest self-made female billionaire in 2015. (Judy took the number-three spot this year.) Its estimate of her wealth is based on her 50-percent stake in Theranos, which Forbes values at $800 million. As Lorre mentions in her latest HIStalk Connect post, Holmes owns common stock, so there won’t be much left by the time investors cash out on preferred shares of the $724 million they invested.
HIStalk Announcements and Requests
This week on HIStalk Practice: CMS opens up the CPC+ program to eligible primary care practices enrolled in Medicare ACOs. MGMA’s latest physician compensation survey shows continued uptick in primary care pay. ONC develops transparency dashboard to help providers comparison shop for healthcare IT. Care Management Solutions of Louisiana implements EQHealth Solutions population health management tech. Curmudgeonly bookstore owner gives Mr. H a run for his pet peeve money. Direct Urgent Care founder Caesar Djavaherian, MD offers thoughts on price transparency and the benefits of EHR-integrated digital stethoscopes.
This week on HIStalk Connect: Nokia completes its acquisition of Withings. CB Insights reports 2016 is on track for a record year in digital health deals and funding. Lorre reviews Paul Kalanithi’s memoir, “When Breath Becomes Air.” Houlihan Lokey’s Dmitry Krasnik shares his growth predictions for healthcare IT. Proskriptive’s Michael Hollenbeck shares his journey from sales leadership to startup founder.
Here is video from HIStalk Connect’s first meetup, held last week in Pasadena, CA. The event featured Stacy Bamberg, CEO of Veristride, who shared the journey of a young startup in developing a healthcare data analytics platform leveraging IoT via an insole wearable. Email Lorre if you’re interested in having HIStalk Connect sponsor your next meetup.
Webinars
June 28 (Tuesday) 2:00 ET. “Your Call Is Very Important.” Sponsored by West Healthcare Practice. Presenters: Cyndy Orrys, contact center director, Henry Ford Health System; Brian Cooper, SVP, West Interactive. The contact center is a key hub of patient engagement and a strategic lever for driving competitive advantage. Cyndy will share how her organization’s call center is using technologies and approaches that create effortless patient experiences in connecting them to the right information or resource. Brian will describe five key characteristics of a modern call center and suggest how to get started.
Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.
Acquisitions, Funding, Business, and Stock
MedAssets-Precyse acquires Salt Lake City-based analytics and consulting firm Equation for an undisclosed sum. MedAssets and Precyse were acquired by Pamplona Capital Management last year; full integration of the companies is expected to wrap up this year.
EarlySense secures a $25 million funding round led by Israel-based Bank Hapoalim. The company, which has offices in Israel and Massachusetts, has raised $100 million so far. Its under-the-bed monitoring sensors are used in healthcare settings and as part of consumer health products like Samsung’s SleepSense tracker.
Patient rehab tech firm Moving Analytics raises $1.1 million in funding led by Launchpad Digital Health. The Los Angeles-based company will use the money to further develop its home-based cardiac rehab tool and to develop a complementary COPD product.
Sales
Presbyterian Healthcare Services (NM) signs a three-year contract with MedeAnalytics for enterprise analytics services. PHS consists of eight hospitals, a statewide health plan, and multispecialty physician group,
Announcements and Implementations
DirectTrust gives consumers secure-messaging access to its network of 58,000 healthcare organizations and 1.2 million email addresses.
Texas Tech University Health Sciences Center reports positive results from its Delivery System Reform Incentive Payment (DSRIP) program, which included adoption of population health management software from Enli Health Intelligence. Outcomes included a 60-percent increase in foot exams and a 100-percent increase in Pneumovax screenings over a 12-month period.
Medical University of South Carolina deploys Epic’s integration of Vidyo virtual visit software into Hyperspace and MyChart Web and mobile apps.
St. Joseph Medical Center joins the Greater Houston Healthconnect HIE.
People
Dave Jansen (Sagacious Consultants) joins The Wilshire Group as senior consultant.
Noel Allender (Jacobus Consulting) joins Leidos Health as Epic practice managing director.
Bobby Tuli (Healthgrades) joins Geneia as head of product management.
Government and Politics
ONC launches a new website focused on improving health IT vendor transparency that gives providers an opportunity to review mandatory cost and system limitation disclosure statements on products in the marketplace.
ONC awards Boston Children’s Hospital $275,000 as part of a $625,000 cooperative agreement announced at HIMSS that will help create a FHIR App Ecosystem. Boston Children’s will be tasked with developing an online app discovery site, which ONC hopes will simplify the process of publishing health IT apps, and the ability to discover and compare them.
Privacy and Security
The paper and digital medical records of thousands of NFL players are stolen from a Washington Redskins trainer’s car during an April break-in. The thief absconded with a backpack containing a password-protected but unencrypted laptop that had copies of player medical records and medical exam results for NFL Scouting Combine attendees dating back to 2004. The bag also contained a zip drive and hard copy records of similar documents. According to the NFL, its electronic monitoring system prevented medical records in its EClinicalWorks EHR from being downloaded. No foul play seems to have occurred thus far as a result of the breach.
Innovation and Research
CHIME concludes the Concept Blitz Round of its Healthcare Innovation Trust National Patient ID Challenge, and names two winning submissions that will each receive $30,000. The contest will now move on to the final round, which will award a $1 million prize to the winning team.
Researchers at Geisinger Health System (PA) analyze the EHRs of over 2,000 patients admitted to the hospital for overdoses during a 10-year period to look for patterns that may indicate a likelihood of death or complications. Not surprisingly, predictors of the most dire outcomes included higher prescription opioid use, concurrent chronic diseases and mental disorders, and use of other psychotropic medications.
Technology
TigerText adds Honeywell scanning and bot technology to its messaging platform, enabling care teams to verify patient identity and pull data directly from the EHR.
Clinical Computer Systems will integrate its Obix Perinatal Data System with Meditech versions 6.15, 6.16, and beyond.
Seniorlink develops care coordination and communications technology that connects ACOs, managed care organizations, and providers with caregivers.
Best Computer Systems adds DrFirst’s Backline communication and care collaboration technology to its BestRx pharmacy management system.
Sponsor Updates
AirWatch releases the latest episode of its Echo One podcast.
Bernoulli publishes a poster on alarm reduction it presented during the annual NPSF Patient Safety Congress last week in Scottsdale, AZ.
Besler Consulting renews its HFMA Peer Review designation for its transfer DRG Revenue Recovery service.
Bottomline Technologies announces new board members.
Crain’s Cleveland Business features Direct Consulting Associates.
EClinicalWorks will exhibit at the AAOE 2016 Annual Conference June 9-12 in San Francisco.
June 2, 2016NewsComments Off on EPtalk by Dr. Jayne 6/2/16
I was talking to one of my colleagues today, who reminded me that June 1 was the registration deadline for the Clinical Informatics Board Exam. The so-called “practice pathway” for clinical informaticists who haven’t completed fellowship training closes in 2017. I would encourage anyone who thinks they might want to be Board Certified and who falls under the grandfather provisions to give it a shot. Although we’re past the cutoff, you can still register (although the late fees climb from $400 to $1,600 over the next several months). AMIA is offering their Clinical Informatics Board Review Course live in August and September.
CMS held a webinar on Wednesday to talk about the Quality Performance category, which will account for 50 percent of the MIPS score in the first year of the new program. This will replace the Physician Quality Reporting System (PQRS) for Medicare physicians. The blurb advertising the session talked about the goals for the category of simplifying administrative and reporting burdens for physicians. Frankly, whenever I see anything from CMS talking about so-called “administrative simplification” I have to laugh. The complexity of getting paid in our current environment has just become absurd. I’d like to see those in power truly consider what it would take to create a simple program that actually helps physicians deliver better care rather than creating more hoops to jump through. Whatever it might be, it’s certainly not 800+ pages long.
The ONC Annual Meeting also took place this week. Sessions were to focus on “three core commitments” of improving consumer access to health information, combating information blocking, and implementing national standards. They did live stream the sessions but I decided to instead spend my free time working on a project that actually made me feel fulfilled rather than just generally frustrated. I’ve taken up a new craft and it was great to engage my brain in something completely different from what I do most of the time. In addition to a finished project, I also walked away with some great new ideas for work – powerful evidence that getting away is a good thing.
Most of my Memorial Day weekend was spent seeing patients. I never know what my travel schedule will bring, so I often schedule myself for the holiday weekends so that my clinical work doesn’t interfere with consulting engagements. My partners don’t mind me working the holidays, that’s for sure. I was pleasantly surprised on Monday when our executive responsible for physician satisfaction showed up with barbecue. Although my team definitely appreciated it since we were extremely busy, the real tone of the day was set by the fact that most of my support team members were veterans with fallen comrades on their minds.
For the fifth or sixth time in the last several months, I had a patient ask me what I thought about concierge medicine. This particular patient was in her 80s and said she was tired of “getting the run around” from her doctor’s office and never being able to get in. She has been seeing us fairly often for various acute illnesses, so her care is already a bit fragmented. I know her physician and know that their practice certainly has struggles with staffing and capacity. For patients of means, concierge or other direct care models are definitely attractive. As much as people talk about not wanting to move to a two-tier health system like Canada and the UK, every time I have one of these conversations I feel like we’re moving in that direction.
It was in that frame of mind that I came across this NPR piece in which a young physician longs for the time “when physicians were ‘artisans.’” The interviewer mentions that the physician “must have known at the outset that wasn’t the way medicine worked anymore.” I’m not that much older than the physician in the story, and I can say without a doubt that when I went to medical school, I had no idea that clinical practice looked more like a hamster wheel than anything else. Fast forward and students have tens (if not hundreds) of thousands of dollars in student loans, which makes some students drawn to higher-paying specialties for fear they won’t be able to get by in primary care.
The interviewer likens the pull of concierge or direct practices to the slow food movement. I do enjoy an heirloom tomato, but I think the analogy is a difficult one. The costs and complexity of healthcare have gotten so out of control, it’s nearly impossible for the average patient to be able to choose rationally between providers, facilities, and procedures. I know my practice leans heavily towards patient satisfaction scores for determining provider compensation, and the idea that giving patients what they need (rather than what they want) can impact me negatively is always a consideration. Sometimes we have to send people away unhappy, and I did have one of those situations this weekend. Fortunately, our physician leadership handles patient dissatisfaction with compassion and tries to help the patient understand why we advised a course of care different than what they wanted, but it’s never easy.
What’s your favorite artisanal or heirloom food? Email me.
ONC launches a new website focused on improving health IT vendor transparency that gives providers an opportunity to review mandatory cost and system limitation disclosure statements on products in the marketplace.
CHIME concludes the Concept Blitz Round of its Healthcare Innovation Trust National Patient ID Challenge, and names two winning teams that will each receive $30,000. The contest will now move on to the final round which will award a $1 million prize to the winning team.
Athenahealth launches its Unbreak Healthcare marketing campaign, designed to “jolt the industry into experiencing what is broken in healthcare,” through a series of short films, social media conversations, and a new web publication called athenaInsight.
An ONC survey finds that 84 percent of US hospitals were using at least a Basic EHR at the end of 2015, a nine-fold increase since HITECH was adopted in 2009, although adoption by psychiatric and children’s hospitals lags. A Basic EHR must have the capability (even if the physician doesn’t actually use it) of accepting physician orders, recording meds and allergies, documenting encounters, recording problem lists, and viewing lab and imaging results.
Someone tweeted out what an inarguably great thing this is, but for the $31 billion in taxpayer bribes that were required to make providers use the same EHRs they were otherwise avoiding like the plague, maybe we should expect a bit more than just market penetration and instead look at outcomes, access, and data portability. I’m not so sure that I as a patient feel any safer, better cared for, or more appreciated as a customer just because I’ve seen some spotty, half-hearted technology use amidst the still-mountainous piles of provider paper.
Reader Comments
From Burnt Steak: “Re: Epic’s mandatory employee arbitration clause. Whose side would you take?” I really dislike the idea of mandatory arbitration, especially when it’s buried (as it is with most retail contracts, like for credit cards and cell phone service) in small print. However, a lack of willingness to walk away means those employees or customers accept the terms offered. I have limited respect for employees who complain about their jobs, go on strike, or file employer lawsuits – they should prove their point by finding a better job elsewhere. The market will quickly tell them if they are underappreciated, and if it turns out nobody else is willing to give them more money or benefits, that should be a clue that they are sitting precisely at the intersection of supply and demand for their services and shouldn’t embarrass themselves further by complaining. You’re not going to make yourself look better by griping about the employer (or your spouse or the city that you live in, for that matter) that you freely chose.
HIStalk Announcements and Requests
Mrs. McCullough says her Georgia kindergartners are using the six Kindle Fires we provided in funding her DonorsChoose grant request to engage with reading and math apps and to participate in a weekly learning center, where they listen to stories and play phonics games.
It’s hard to accept rampant healthcare inefficiencies and indifference when people in many US cities can place an Amazon order by noon and receive it by bedtime that same day. Although maybe there’s hope from companies like Capsule, a just-launched New York startup that delivers prescriptions by bicycle at no extra charge and that uses technology for refill requests, medication instructions, and patient communication, although the founders wisely decline to label the company as the inevitable “Uber for drugs.”
I finally had my appointment with a new doctor (actually, her PA) last week for my annual physical, following the miscue from a few weeks back where I showed up for my appointment, filled out a mountain of paperwork, and waited for some time before being told that the doctor was out of the office for previously scheduled surgery (they said they tried to call me earlier, but had incorrectly entered my phone number). This time wasn’t perfect, either – all of the paperwork I had completed previously (medical history, insurance information, NPP, etc.) had been mysteriously lost, meaning I had to fill out the clipboard full of forms all over again. To add insult to injury, the PA either didn’t see or didn’t use the information, repeating questions about allergies, meds, smoking status, and other topics that I had already documented minutes before but that hadn’t yet been entered into their Practice Fusion free EHR. At least the EHR wasn’t intrusive during the visit (since she mostly documented on paper) and the e-prescribing worked OK.
My latest linguistic peeve: the use of “unpack” as a synonym for “explain,” which doesn’t save syllables or add nuance and is therefore pointless other than to make self-aware authors feel smugly clever.
Thanks to the following sponsors, new and renewing, that recently support HIStalk, HIStalk Practice, and HIStalk Connect. Click a logo for more information.
Webinars
June 28 (Tuesday) 2:00 ET. “Your Call Is Very Important.” Sponsored by West Healthcare Practice. Presenters: Cyndy Orrys, contact center director, Henry Ford Health System; Brian Cooper, SVP, West Interactive. The contact center is a key hub of patient engagement and a strategic lever for driving competitive advantage. Cyndy will share how her organization’s call center is using technologies and approaches that create effortless patient experiences in connecting them to the right information or resource. Brian will describe five key characteristics of a modern call center and suggest how to get started.
Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.
Acquisitions, Funding, Business, and Stock
DrFirst acquires Meditech consulting firm The IN Group, saying the acquisition will allow DrFirst to help its customers make the most of their healthcare IT investments.
Sales
MD Anderson selects Nuance’s Dragon Medical and PowerScribe 360 for physician documentation as part of its Epic rollout. MDA will also use services from Epic consulting firm Physician Technology Partners, which the announcement says is now owned by Nuance.
Pontiac General Hospital (MI) chooses Medsphere’s OpenVistA EHR. The financial turnaround of the hospital, which has filed bankruptcy twice as Doctors Hospital of Michigan, is being led by 25-year-old Sanyam Sharma, whose computer scientist parents started eligibility software vendor Infrahealth and put him on the payroll when he was 14. He’s now EVP of the company and heads up Sant Partners, a company his parents created to buy Pontiac following his father’s discovery as a consultant that the hospital had extensive revenue cycle problems.
Ohio State University Wexner Medical Center chooses Strata Decision’s StrataJazz for decision support, cost accounting, and contract analytics.
People
Home monitoring technology vendor Sentrian hires Bryan Ness (Wellcentive) as chief revenue officer and Molly Cogan (Wireless Life Sciences Alliance) as VP of marketing and communications.
Announcements and Implementations
Liaison Technologies will launch its Alloy Health cloud-based integration service in Europe.
Peer60 publishes “Hottest Trends in Medical Imaging IT (UK).”
UPMC (PA) signs its third agreement with organizations in China, collaborating with for-profit First Chengmei Medical Industry Group to offer clinician training and to advise the hospitals on hospital operations, including IT.
Cincinnati Children’s Hospital Medical Center (OH) will use the Curelator Headache app to study the factors that precede migraine headaches in children and adolescents. The study’s 60 participants will use visual data entry tools to document emotional, dietary, physical, and environmental factors in 2-3minutes per day to show them their associated migraine triggers so they can make lifestyle changes. The app is commercially available in a limited-functionality free version and as a $50, six-month subscription that includes trigger tracking.
Government and Politics
A Congressional stalemate forces the CDC to cut emergency public health funding in many cities—including lab services, mosquito control, and disease surveillance — to free up money to address the Zika virus. It’s amazing given the amount of federal money that is wasted on low-quality, unneeded, and sometimes questionably billed hospital care that CDC has to choose which outbreak to fund with a fixed few million dollars.
China’s FDA reverses its push toward making non-prescription drugs available online, ordering e-commerce provider Alibaba to tell its vendors – include drug store chains — to immediately stop selling OTC drugs on its online marketplace.
In other Alibaba news, Hong Kong regulators say the company violated takeover rules in its 2014 investment in pharma data and barcode tracking company CITIC 21CN (now known as Alibaba Health Information Technology) because the deal included buying a medical technology company from a shareholder who was also the brother of the company’s vice chairman, giving the company an unfair advantage. The acquisition raised some eyebrows at the time because Citic 21CN’s small amount of revenue came from sales to the Chinese government and both companies have Communist Party and military leaders as investors. The acquisition and subsequent rise in Alibaba’s share price made Chen Xiaoying, wife of a former general, a billionaire. She bought a $68 million home two days before the deal was announced.
Privacy and Security
The ED physician staffing service used by two Carondelet hospitals in Arizona notifies 1,000 patients that their information was disclosed when an ED logbook was stolen from the car of one of its doctors.
Technology
USA Today summarizes a report indicating that telehealth usage would increase if it was more affordable to hospitals and if medical studies prove that it works. I think it’s time to separate vendor-provided telehealth (online services that connect cash-paying patients with whatever doctor the vendor has available in the belief that patients think all doctors are equal) versus using the technology to interact with the patient’s trusted ongoing provider in a more convenient way. Some patients and conditions can be treated by a doctor in a speed-dating type of consultation where they don’t know anything about the patient except what they can learn by asking a few quick questions, but few would argue that an encounter of that type will be as successful as having a virtual visit with their regular provider who is armed with their medical records (although “successful” to most patients means, “I got the prescription I wanted.”)
Other
A man presenting to the ED with atrial fibrillation is successfully treated after the team notices his heart rate-recording Fitbit and determines that his AF was triggered by a seizure, therefore making him a candidate for electrical cardioversion. The case was described in a journal article that is mildly entertaining while not being all that medically useful since AF is treated all the time without consulting the patient’s wearable and instead asking them their history.
A London newspaper profiles a hepatitis C patient whose only hope for survival is the new drug Harvoni, which has a 95 percent cure rate at an astonishingly high price. The man finds a doctor in Australia who imports a cheaper version of the drug from India and China, where drug company Gilead Sciences was forced to license the manufacture of local versions since those governments say Harvoni is almost identical to older, cheaper drugs and therefore won’t pay for it. The doctor tests the imported drug’s purity and mails it to patients who pay his consultation fee. Some NHS doctors will work with such “buyer’s club” patients since NHS can’t afford to provide the drug to everyone who needs it and buying prescription drugs from other countries isn’t illegal in England. However, the British pharma trade group says patients who buy drugs offshore are stifling innovation and taking away treatments intended for poor countries. US insurers and governments are struggling to pay for Harvoni, which costs $1,125 per pill and $95,000 per treatment. The same pill in India costs $10.
Here’s a pretty funny “EHR in the exam room” video from Athenahealth that I ran across while looking for something else.
The Wall Street Journal profiles the use by Northwell Health (NY) of an evidence-based calculator that assesses the likelihood of strep throat, respiratory infection, and deep-vein thrombosis based on physician answers to questions popped up in the EHR and then guides appropriate ordering of medications and tests. A medical school professor overseeing testing of the software in Wisconsin primary care clinics says physician participation in the optional program is low, however, because “there is a big backlash against clinical decision support.”
The speaker at a Memorial Day ceremony in Anthem, AZ is Bill Krissoff, MD, a since-retired orthopedic surgeon who shuttered his practice following the 2006 death of his Marine son in Iraq. He joined a Marine Corps medical battalion at age 60, deploying to Iraq and Afghanistan “to finish Nathan’s unfinished tasks” in serving on the resuscitative surgical team as primary or assisting surgeon for 225 serious casualties.
Weird News Andy finds it ironic that “smart” tampons double as a blood collection tool that allows women to track their reproductive health via an iPad (WNA snickers right about there). I can’t decide if this is a great use of technology or the moment where we collectively jumped the quantified-self shark.
NantHealth’s previously postponed IPO will happen this holiday-shortened week, with insiders taking the majority of the $91 million offering. The company’s IPO documents don’t specify how it will spend the money, saying only that it will be used for “general corporate purposes.” NantHealth’s filings indicate that the company lost $72 million on $58 million in revenue in 2015, with $291 million in liabilities.
Meanwhile, shares of Patrick Soon-Shiong’s cancer therapy company NantKwest have dropped 79 percent since its July 2015 IPO, erasing $3.1 billion of the company’s $3.7 billion first-day valuation and creating a legal boom as law firms line up offering to represent shareholders in class action lawsuits. Above is the share price of NK (blue) vs. the Nasdaq (red).
Reader Comments
From Mutton Dipper: “Re: the ‘Women in Health IT’ section of that industry rag. I don’t think they’re doing women any favors by carving them out as a special interest curiosity.” We’ve talked about this previously, but perhaps it’s time to see the content they think women in health IT need that isn’t available elsewhere. Stories on the site are: (a) the Gates Foundation donates money to study gender inequality, which has zero to do with health IT; (b) HIMSS celebrates nursing informatics, apparently in the gender-biased belief that it’s a female-only profession; and (c) two women took new jobs, something us menfolk apparently wouldn’t care about. Every story was just a padded out rehash of a press release (without crediting the press release).
HIStalk Announcements and Requests
It is Memorial Day, created not as a nonchalant summer kickoff, but rather to set aside time to remember those who died while serving in the armed forces (unfortunately, people usually forget to observe the latter in celebrating the former).
In Flanders Fields By John McCrae
In Flanders Fields the poppies blow Between the crosses row on row That mark our place; and in the sky The larks, still bravely singing, fly Scarce heard amid the guns below.
We are the Dead. Short days ago We lived, felt dawn, saw sunset glow, Loved and were loved, and now we lie In Flanders fields.
Take up our quarrel with the foe: To you from failing hands we throw The torch; be yours to hold it high. If ye break faith with us who die We shall not sleep, though poppies grow In Flanders fields.
More than half of poll respondents say exposure of their financial and contact information would be the worst part of a medical records breach, while 22 percent say they would be most upset about having their mental health history made available. The results don’t surprise MobileMan, who says he’s always believed that people worry more about their money than their health. JaneOrJohnDoe just lies when clinicians ask about potentially embarrassing behavior, avowing that he or she never has sex, smokes, drinks, or uses drugs because co-workers and the HR department don’t need to know. Missy C22 takes the opposite approach, saying people can get any information they want, so she doesn’t worry about breaches.
New poll to your right or here: what level of unexpected medical expense would you struggle to pay?
My insurance company told me my travel-related malaria prevention medication was covered and would cost $80. The Walgreens pharmacist said no, actually it’s not covered, so he offered me the cash price of $268. I looked online while standing at the Walgreens counter and found a coupon on GoodRX that Walmart accepts. I called Walmart from the Walgreens parking lot and asked them to call for a copy of my prescription, which they priced at $140 for cash-paying customers. It was ready when I arrived – I just showed them the coupon on my phone to make my final price $70, saving me nearly $200 for just a couple of minutes of effort since I was going to Walmart anyway. This is a great example of screwy American healthcare for several reasons:
The old drug is unreasonably expensive and going up all the time.
The insurance company would apparently prefer to treat me for malaria than to pay upfront to prevent it (the same lack of logic that leads them to decline to pay for birth control pills).
Prices are all over the place – how can Walmart sell the same drug for half the Walgreens price?
A less-persistent customer would have wasted a lot of money by not shopping the drug price and not being aware of GoodRx.
Sometimes a discounted cash price is cheaper than using insurance.
GoodRx makes money by using an unspecified PBM’s negotiated discounts, passing the savings along to their customers while taking a transaction fee for themselves and giving the PBM big volume. That’s a brilliant business model in which everybody wins.
The price varies wildly even when using the GoodRX coupon – Walgreens actually accepts the same coupon but charges $127, while the PillPack online pharmacy tops the price curve at $275 (the first two examples lead me to assume that the PBM’s discount on this drug is 50 percent since it cut the price in half at both Walmart and Walgreens).
Maintenance drugs offer even more savings. A month’s supply of generic Lipitor whose cash price ranges from $90 to over $400 depending on the pharmacy is just $19 using a GoodRX coupon.
Healthcare is the only example I can think of where paying cash carries a penalty rather than a discount. I remain unconvinced by arguments saying it’s not reasonable to force providers to give cash-paying patients the lowest price they’re willing to accept from any other payer.
We providing kits and equipment for the inaugural robotics team of Ms. Sobosan’s Nevada high school in funding her DonorsChoose grant request. Team member Bryan concludes, “The robotics resources changed the way I looked at programming. I’m not very good, but it has inspired me to learn even more when I program apps, robots, and games. Although it won’t be easy, I will push myself to keep learning. The robot we are building is taking a while to assemble, but so far it is going very well and I expect to have fun with the projects you have sent.”
I was thinking about CMS Acting Administrator Andy Slavitt’s comment that interoperability isn’t like sending a man to the moon. Actually, it is — if you told the 1960s-era US and Soviet Union that it would be optional but nice if they shared information for the good of their respective space travelers even while they are desperately trying to beat the other in getting there first.
Last Week’s Most Interesting News
A federal appeals court finds that Epic’s mandatory employee arbitration clause violates federal labor law.
A renowned cognitive science expert says IBM Watson Health should stop “making up nonsense” about analyzing cancer and admit that its technology doesn’t really use cognitive computing.
Apple CEO Tim Cook says health use of the Apple Watch is a major company priority.
Kansas Heart Hospital pays ransomware demand but declines to make further payments as the hackers demand to release its files.
The ACLU sues a genetic testing company to force it to give patients their complete results rather than just a subset.
Webinars
June 28 (Tuesday) 2:00 ET. “Your Call Is Very Important.” Sponsored by West Healthcare Practice. Presenters: Cyndy Orrys, contact center director, Henry Ford Health System; Brian Cooper, SVP, West Interactive. The contact center is a key hub of patient engagement and a strategic lever for driving competitive advantage. Cyndy will share how her organization’s call center is using technologies and approaches that create effortless patient experiences in connecting them to the right information or resource. Brian will describe five key characteristics of a modern call center and suggest how to get started.
Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.
Acquisitions, Funding, Business, and Stock
Cerner says in its annual shareholder meeting that:
More hospitals run its systems than anyone else’s.
The company has 22,000 employees who are paid an average annual salary of $80,000, with an average age in the mid-30s.
Cerner will spend $750 million on population health management R&D.
Last Thursday’s Chicago federal appeals court ruling that Epic violated federal labor laws in requiring its employees to agree to arbitration clauses is reverberating throughout the country. The three-judge panel ruled that the National Labor Relations Act gives employees the right to band together even if they aren’t represented by a union. Conflicting previous rulings in other cases may take the issue back to the US Supreme Court. Studies have found that mandatory arbitration clauses often result in employees simply giving up their complaints, while federal and state officials worry that forced arbitration allows companies to hide employment wrongdoing. Cerner is certainly watching closely since it told employees in December 2015 that they had to choose between signing arbitration clauses or giving up future salary increases.
Announcements and Implementations
The board of ETMC-Tyler (TX) approves the purchase of MedHost, Athenahealth, and Novarad.
Privacy and Security
A dozen FBI agents, one of them armed with an assault weapon, raid the home of a Texas software security researcher and take him away in handcuffs after he reports to dental software vendor Eaglesoft that the information of 22,000 patients on their servers is freely visible over the Internet. The company, instead of thanking him, notifies the FBI that he illegally accessed its server and thus violated the Computer Fraud and Abuse Act, leading the FBI to haul him away from his family in his underwear. The same researcher previously alerted the FTC that Henry Schein Dental was misleading customers by claiming it encrypts their data. He had also alerted a Pennsylvania dental practice in December 2013 that their patient information was visible online, only to receive a cease and desist letter from the practice demanding that he never mention their practice or doctors again.
A ProPublica study finds thousands of examples where doctors, dentists, or their employees responded to negative Yelp patient reviews with information that included PHI. The HIPAA violations ranged from the simple (acknowledging that the Yelper was indeed treated, for example) to posting extensive medical, dental, and family information.
Other
An 87-year-old senior living resident choking on a hamburger is saved by a fellow resident who springs to her side to perform the Heimlich maneuver. That fellow resident was 96-year-old Henry Heimlich, MD, the surgeon who created the technique in the 1970s, who had never actually performed it on an actual choking victim. On a less-upbeat note, Heimlich’s son has bitterly renounced his father for years as a fraud and claims he stole the idea from peers, adding that he has advocated bizarre therapies for AIDS and cancer. Back on the upbeat side of the story, Heimlich’s nephew is 66-year-old Anson “Potsie” Williams from “Happy Days,” whose affected, white-bread musical warblings on the show also caused Heimlich-like projectile vomiting.
In Vancouver, ED and ICU doctors at Nanaimo Regional General Hospital refuse to continue using its nine-week-old Cerner EHR and instead go back to paper due to patient safety concerns. The doctors say Cerner calculates drug doses incorrectly and is causing meds and lab tests to be delayed, adding that it takes them twice as long to enter orders and that serious patient errors are happening every day. Island Health will spend $134 million on the project, which will be rolled out to hospitals in Victoria next year.
In Australia, Cairns Hospital’s budget crisis is so significant that it’s telling doctors to stop using pens and to turn off unused lights. The medical staff says the real problem is its new Cerner EHR, described as slow and impeding accurate documentation for payment.
Blue Shield of California, pressured to review the salaries of its executives as non-profits always do, issues a report showing that its CEO made $3.5 million in 2015, while SVP/CIO Mike Mathias was paid $1.2 million.
Vince and Elise recap the top physician practice systems vendors in their latest installment. Feel free to add comments if you agree or disagree with their conclusions.
Sponsor Updates
For the Record magazine features a story about clinical process measurement by LogicStream Health’s Dan Rubin, MD, MHI.
A federal judge grants Epic’s request to dismiss a patent infringement lawsuit brought by patent troll (or “non-practicing entity” in legal terms) Preservation Wellness Technologies, which sued Epic, Allscripts, Athenahealth, and NextGen for violating its 2009 patent covering the idea of giving patients and doctors access to electronic medical records with different levels of authorization. Apparently the US Patent and Trademark Office thought this was something new since they granted the patent.
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. Kudos to Epic for not just paying off the troll, although you have to wonder how much it had to spend to prove that it did nothing wrong.
Meanwhile, Epic didn’t fare as well in a federal appeals court where it had asked to have an unpaid overtime lawsuit brought by its technical writers dismissed. Epic argued that the arbitration terms that it forced all of its employees to accept to keep their jobs precludes employee class action lawsuits like the overtime one. The judge sides with the employees, ruling that Epic’s mandatory arbitration clause violates the National Labor Relations Act because it prevents employees from acting together on employment issues, which they are allowed to do even if they aren’t union members.
Reader Comments
From Pumice Stone: “Re: vendor agnostic. Pet peeve time! Agnostic means someone who claims neither faith nor disbelief in God.” I agree. “Vendor-neutral” is a better way to convey a lack of bias, although the grammatical horse has left the barn and dictionaries that strive to reflect rather than define usage will no doubt be adding “vendor-agnostic” along with other recently added non-words like “WTF,” “beer o’clock,” and “awesomesauce” as lexicographers use the “everybody gets a trophy” model in rewarding those who create cutesy new words despite their obvious lack of mastery of the perfectly fine choices already available.
From Maple: “Re: Evariant. They just took Series C money this month but apparently laid off 30+ folks. No jobs are listed on their jobs board. A new CFO was announced this week, too.” Evariant, which has received $69 million in funding, sells a patient marketing system. I checked their executive page from a year ago and seven of the 10 people listed then aren’t on the current version of the page.
HIStalk Announcements and Requests
Mrs. Steele says her Tennessee kindergarten class is using the headphones and wireless mice we provided in funding her DonorsChoose grant request to listen to level-tailored stories to help them read better.
This week on HIStalk Practice: Compulink debuts an EHR for gastroenterologists. Pavlovian wearable helps curb user behaviors. Direct Urgent Care sends heart and lung sounds to its EHR via connected stethoscope. Duke University physicians share advice for PCPs in need of MACRA help. Connecticut passes telemedicine-friendly Medicaid legislation. Ohio physicians will soon have real-time access to controlled substances prescriptions.
Webinars
June 28 (Tuesday) 2:00 ET. “Your Call Is Very Important.” Sponsored by West Healthcare Practice. Presenters: Cyndy Orrys, contact center director, Henry Ford Health System; Brian Cooper, SVP, West Interactive. The contact center is a key hub of patient engagement and a strategic lever for driving competitive advantage. Cyndy will share how her organization’s call center is using technologies and approaches that create effortless patient experiences in connecting them to the right information or resource. Brian will describe five key characteristics of a modern call center and suggest how to get started.
Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.
Acquisitions, Funding, Business, and Stock
The software half of HP’s November 2015 split into two publicly traded businesses will spin off its enterprise services business in a tax-free merger with CSC that will create “a pure-play global IT services leader.” CEO Meg Whitman, who predicts industry consolidation, said on the earnings call related to corporate spinoffs, “We have this thing down to a science” in “unlocking the value of these two companies.”
Wellth, which rewards high-risk patients for taking their meds or testing their glucose correctly, raises $2 million in a seed round.
IMS Health acquires Privacy Analytics, which offers data de-identification tools.
Zebra Medical Vision, which sells a medical imaging analytics engine that supports diagnosis, raises $12 million in a round led by Intermountain Healthcare, increasing its total to $20 million.
Sales
Shore Medical Center (NJ) chooses Phynd to manage the information of its 5,000 providers within Cerner and other systems.
People
WEDI gives interim CEO Charles Stellar (AHIP) the permanent position.
Paul Tang, MD (Palo Alto Medical Foundation) joins IBM Watson Health as VP/chief health transformation officer.
Government and Politics
ONC publishes a list of health IT products and vendors that have not complied with its certification program.
The FDA will collaborate with Flatiron Health to explore how the de-identified treatment data of patients who aren’t enrolled in clinical trials could be used to investigate the safety and effectiveness of immunotherapy.
Health insurers stung by Affordable Care Act losses follow through on warnings of premium increases as a sicker-than-expected insured pool drives up their costs. The highest increase requested so far is in Western Pennsylvania, where Highmark wants to hike premiums by 38 percent. The administration continues to downplay the high premium costs, saying that most people will get federal premium subsidies.
A House committee wants the Justice Department and the state attorney general to investigate former Oregon Governor John Kitzhaber and CMS for the botched rollout of the Cover Oregon insurance exchange, which spent $305 million in federal money and never enrolled a single person before shutting it down and moving to Healthcare.gov at no cost.
CMS Acting Administrator Andy Slavitt — about whom I’ll editorialize is the most transparent, visionary, patient-focused executive in federal healthcare (I’m even placing him ahead of Karen DeSalvo because he gave up a huge income to work for CMS and he took a thankless job) — speaks to the Massachusetts Medical Society:
[User-driven policy] is actually not that radical a concept in the real world. In the real world it might be called “talking to your customers about what they want.” Perhaps in Washington, though, it is a bit of a new concept … Interoperability in some respects needs to just be as simple as this: how can we collaborate for the best outcomes when a patient is going to experience different parts of our fragmented healthcare system? What we want out of interoperability is simple: having a patient referred for other care and understanding what happens at that visit; or communicating with the physician when a patient is discharged from the hospital to make sure they are taken care of and are healing at home … We are not talking sending a man to the moon. We are actually expecting technology to do the things that it already does for us every day. So there must be other reasons why technology and information aren’t flowing in ways that match patient care. Partly, I believe some of the reasons are actually due to bad business practices. But, I think some of the technology will improve through the better use of standards and compliance. And I think we’ll make significant progress through the implementation of APIs in the next version of EHRs which will spur innovation by allowing for plug and play capability. But the reason that the pledge is important is because the private sector has to essentially change or evolve their business practices so that they don’t subvert this intent.
Privacy and Security
Apple posts a job opening for a HIPAA-focused privacy lawyer.
Innovation and Research
Cognitive science expert Roger Schank, PhD, says IBM Watson is “not doing ‘cognitive computing’ no matter how many times they say they are,” adding that “Watson can’t draw real conclusions by counting words in 800 million pages of text.” He concludes, “It would be nice if IBM would tone down the hype and let people know what Watson can actually do and stop making up nonsense about love fading and out thinking cancer. IBM is simply lying now and they need to stop. AI winter is coming soon.”
Technology
Citrix announces the HDX Ready Pi, a Raspberry Pi-powered thin client that will cost under $90 when it reaches the market in a few weeks. The device configures itself automatically when plugged into an available display; can be simply thrown into the recycle bin if it fails since its cost is negligible and there’s nothing to re-image; and it can be given to remote workers since it doesn’t store data.
Other
A JAMIA-published study by consultants from Wolters Kluwer Health describes how Huntsville Hospital (AL) reduced sepsis-related deaths by 53 percent following implementation of a program that included change management, electronic surveillance, and sepsis detection algorithms.
Surveyed single ACOs spend an average of $2 million per year to participate, with $563,000 of that going toward health IT technology, population analytics, and reporting. More than half say they won’t stay in the Medicare Shared Savings Program if they don’t earn the 5 percent MACRA Advanced APM bonus.
A Federal Reserve Board survey finds that nearly half of Americans would struggle to pay an unexpected $400 expense, which might explain why people whose exchange-issued health insurance policies carry a $6,800 annual deductible before insurance starts paying anything aren’t necessarily going to actually seek care (or renew their policies for 2017).
In China, scalpers are tying up Beijing’s ATMs, which allow scheduling hospital appointments, to book hospital and doctor appointments that they then sell to buyers from $50 to $500.
NantHealth’s Patrick Soon-Shiong invests $70.5 million in newspaper publisher Tribune Publishing in a transaction arranged by another health IT billionaire. Tribune chairman Michael Ferro, who sold Merge Healthcare to IBM for $1 billion last fall, enlisted Soon-Shiong’s financial help in fighting off a hostile takeover bid from USA Today publisher Gannett.
Chicago-based Tribune, which publishes newspapers in Chicago, Los Angeles, Orlando, South Florida, San Diego, and other cities, named former Merge CEO Justin Dearborn as CEO in February 2016.
Soon-Shiong says he will use healthcare-developed artificial intelligence to “bring together editors and reporters and create a completely new news network … where you integrate through fiber infrastructure and through cloud computing and you centralize a news network but actually take local news and bring it in on a daily real-time basis.”
Reader Comments
From Turkish Taffy: “Re: Tampa General Hospital. They’re live on American Well in offering $49 virtual visits. It’s interesting that they decided to outsource instead of using local physicians.” It probably makes sense to scale up quickly with an established provider rather than trying to organize local physicians to respond to instant-on video visits as part of their workday, not to mention the malpractice and billing considerations. They can always insource the service later. I don’t know how the revenue split works, but it’s probably not going to be a big money-maker for the hospital anyway unless it drives referrals.
From Hans Morefield: “Re: Fred Morefield. It’s with sadness but also appreciation that I share the May 22 passing of my father. He was an HIT veteran who established and led SMS’s international business starting in 1978, conceived of and led Healthcare Data Exchange (HDX) in 1990, and contributed to Denver Health’s turnaround during six years there. He was responsible for key industry innovations, and as I hear all the time, for launching many careers, including my own.”
From Clinically Insignificant: “Re: HIT news. What topics interest you least?” I gloss over at press releases about:
Newly announced partnerships. Nobody cares when one company “partners” with another except customers who will be told directly of what is usually just cross-selling.
Appointments to advisory boards. If the company really respected that person’s value, they would put them on their real board.
Launch of yet another innovation fund. All the good companies have long since found a financial dance partner.
Company funding of less than $1 million. I’ll pay more attention when success generates larger investments and Darwinism has weeded out the pretenders.
The results of vendor surveys whose methodology is either unstated or indefensible.
Companies and publications hoping to milk exposure by giving some other company a questionably devised award. The only award that counts is being awarded business from customers.
HIStalk Announcements and Requests
We funded the DonorsChoose grant request of Ms. Garris in providing headphones so that her students can focus on their learning station laptop exercises while she’s working with small groups. One of the students says the group learning has changed from “chaos” to “peaceful” as a result.
Listening: new from Mudcrutch, Tom Petty’s pre-Heartbreakers band from the early 1970s, which regrouped with Petty to make a 2008 album and has now done so again prior to a US tour that kicks off this week. I don’t particularly like the past music of 65-year-old Tom Petty or even Southern rock in general with its obligatory pedal steel and harmonica all that much, but Mudcrutch has a clean, strong sound with catchy touches of Dylan, the Byrds, and occasional 1960s-sounding throaty organ and fuzz guitar. It’s a good choice for a summer soundtrack.
Webinars
None scheduled soon. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.
Acquisitions, Funding, Business, and Stock
Orion Health announces FY2016 results: revenue up 26 percent, EPS –$0.23 vs. –$0.28.
Unstructured data analytics vendor Apixio raises $19 million in a Series D funding round.
Fired Practice Fusion founder and CEO Ryan Howard launches iBeat, which will offer a heart monitor and emergency notification watch.
Varian Medical Systems will spin off its imaging hardware and software business into a publicly traded company.
Forbes says Keith Dunleavy, MD, who founded data analytics firm Inovalon, is now a billionaire due to rising share price.
Adventist Health (CA) chooses VitalWare for pricing intelligence, coding compliance, and charge master analytics.
People
Columbus Regional Health (IN) hires Steve Baker (Indiana University Health System) as VP/CTO/CIO. He was CRH’s IS director for 11 years through 2010, seeing the IT department through the June 2008 flood that destroyed the hospital’s data center and closed the hospital for several months. He replaces CIO Diana Boyer, who will retire after 31 years of service.
Care coordination software vendor PingMD names Susan Driscoll (Wolters Kluwer Health) as president and CEO. She replaces co-founder Gopal Chopra, who will remain board chair.
SPH Analytics hires Bill O’Connor, MD (Orion Health) as chief medical officer.
Announcements and Implementations
SSM Health goes live with Surescripts National Record Locator Service to allow clinicians to retrieve the records of patients seen elsewhere and review them within Epic.
A Nuance study finds that its clinical documentation improvement customers improved their financial performance metrics quarter-over-quarter after implementing ICD-10.
Government and Politics
HHS clarifies an earlier statement involving a $6.50 flat charge for providing an individual with a copy of their medical records, saying that providers are allowed to charge a flat fee of up to $6.50 per request, but otherwise can still calculate their fees based on the allowable labor costs for either a specific request or for an average request.
Innovation and Research
Apple CEO Tim Cook says the company is focused on health and its entry point is Apple Watch, to which new sensors will be added.
Technology
Chromebooks (of which I have one) outsold Apple Mac desktops and laptops (of which I have none) for the first time in Q1, with sales of at least 2 million units. I’m very happy with my recently purchased Asus that cost around $200 – it’s like a tablet with a really nice keyboard built in since it’s instant-on, instant-off with a battery life of around 10-12 hours, no need for antivirus or other add-ons, and software that is automatically updated from the cloud. It’s perfect for travel and doing keyboard-intensive tasks (like ordering stuff) while relaxing on the couch with a small, lightweight device with a decent-sized screen in your lap. Just about the only negative is the maddeningly clunky Google apps (like Docs) that it uses by default, even to make a simple list or to edit an emailed Word document. It only works when connected to the Internet, although most parts of the country have adequate cell phone coverage to tether anyway. I’m taking both the Chromebook and my iPad Mini next time I travel to see which one I find more useful – I would bet on the former.
Other
Mike Lynch, the billionaire who sold big data company Autonomy to HP for $10 billion during the latter’s disastrous Leo Apotheker years (not to be confused with the company’s only slightly disastrous Carly Fiorina years a bit earlier), says Google mishandled its patient data deal with England’s NHS. On the other hand, Lynch is an investor in DeepMind competitor Sophia Genetics, which offers hospitals genomics-powered diagnoses.
I’ve written several times about the phenomenon in India of friends and family members forming an angry mob to attack doctors and hospital officials following the death of their hospitalized loved one. The Washington Post says it’s getting worse as medical residents at underfunded government-run hospitals, who work up to 20 hours per day, are requesting permission to carry guns to defend themselves from people who blame them for poor care or long delays.
Iatric Systems President Frank Fortner creates a song parody about virtual visits in which he channels Daughtry in declaring “I’m staying home in the place where I belong, where telehealth is often good enough for me.” For my money, Frank’s version is better than the original.
Sponsor Updates
Aprima will exhibit at the Practice Management Institute June 2-3 in New Orleans.
Catalyze launches Change Agent, a new publication on Medium.
Besler Consulting’s latest podcast focuses on comprehensive care for join replacement quality measures.
CapsuleTech will exhibit at the 2016 International MUSE Conference May 31-June 3 in Orlando.
Frost & Sullivan recognizes Validic with its 2106 visionary innovation leadership award, calling the company “an industry leader and de facto standard in health data interoperability.”
Forbes names The Chartis Group as one of America’s best management consulting firms, with “best firm” distinction in healthcare, data analytics, and digital transformation.
CitiusTech founder and CEO Rizwan Koita authors an article about healthcare technology in India for LiveMint.com.
ZeOmega will integrate its Jiva population health management solution with McKesson’s InterQual Connect.
Crossings Healthcare Solutions will exhibit at the Cerner Great Lakes RUG May 31-June 2 in Chicago.
CTG receives a marketing excellence award from its partner, Dynatrace.
DrFirst presents “What good is secure text messaging if no one uses it?” at MUSE 2016.
Direct Consulting Associates will exhibit at the Northern Ohio Chapter of HIMSS Regional Conference May 26 in Cleveland.
Kansas Heart Hospital (KS) is hit with ransomware, pays the ransom that it calls a “small amount,” and is still denied access to unspecified systems when the hackers demand further payments. The hospital says it won’t pay again.
The hospital didn’t announce which systems were affected or whether they have been restored, only saying that patient information wasn’t placed at risk.
Reader Comments
From Danbury Whaler: “Re: Western Connecticut Health Network. Laying off significant management, including the president. They blame it on state funding declines. IMO, they are way over budget in the construction of a new building and way over budget in IT.” EVP Dan DeBarba just resigned from the three-hospital network, which confirms that it has laid off several managers because of the $1 million it had to pay in a newly implemented state tax on non-profit hospitals. The system chose Cerner in September 2015.
HIStalk Announcements and Requests
The vast majority of poll respondents would recommend their most recently experienced hospital or practice. New poll to your right or here: what part of your medical record would you be most upset to have exposed in a breach?
I was looking back through my old polls to see what topics were hot long ago. These caught my eye:
NAHIT paid consultants to define five common acronyms such as EMR and RHIO, saying consensus will increase HIT adoption. Do you agree? (May 2008 — 86 percent said no.)
The HIMSS “Taking HIT to the Streets” program will pay attendees to attend EHR vendor demos. Is that an acceptable practice? (November 2009 – 80 percent said no).
What impact will the iPad have on healthcare? (April 2010 — 42 percent said little or none, 29 percent said some, 29 percent said a good bit).
What’s the best way to encourage better usability? (May 2010 — it was an even division among just letting the market decide, adding usability criteria to EHR certification, having an independent organization rank and announce usability test results, and educating providers better).
What credential earns the title of “informaticist?” (November 2010 — 35 percent said a clinical degree plus work experience, 22 percent said clinical degree plus certification, 23 percent said non-clinical experience, and 20 percent said a graduate degree in informatics).
Will state HIEs be viable once they’ve spent their stimulus money? (July 2010 — 81 percent said no).
Do KLAS ratings accurately represent product performance? (September 2010 — 61 percent said no).
What will HITECH’s legacy be? (July 2011 — 42 percent said increased EHR adoption, while 31 percent said waste of taxpayer money).
Are Regional Extension Centers worth the $650 million taxpayers are paying for them? (November 2011 — 84 percent said no).
Do you agree with Neal Patterson that Cerner and Epic will be the only surviving hospital information system vendors? (May 2012 — 75 percent said no).
Ms. Hayes in North Carolina says students in her STEM-focused high school are using the six 3D puzzles we provided in funding her DonorsChoose grant request to work as teams and have fun learning about engineering and history.
Last Week’s Most Interesting News
Theranos admits that the results of all of the lab tests it ran on its proprietary Edison analyzer in 2014-2015 are unreliable.
The VA says its new Web front end for VistA will be rolled out by the end of summer.
Two Missouri HIEs continue their bickering and political maneuvering.
John Halamka clarifies his MACRA thinking in suggesting that HHS pare the program down to focusing on just three specialty-specific outcomes at a time, also recommending that EHR certification be stripped down to include only the interoperability required for basic care coordination.
Webinars
None scheduled soon. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.
Acquisitions, Funding, Business, and Stock
My Coverage Plan Inc., a Madison, WI-based for-profit subsidiary of a non-profit public interest law firm, is awarded a five-year, $1.6 million NIH grant to develop software to train hospitals to determine patient eligibility for public health programs. The company also sells a patented decision support software that helps hospital financial counselors qualify patients for Medicaid and other programs.
Cambia Health Solutions-owned diagnostic software vendor Enigma Health apparently shuts down. Another Cambia investment, point-of-service patient technology vendor Wellero, closed in January.
The year-old health Internet subsidiary of China-based insurer Ping An Group raises $500 million in Series A funding, valuing the company at $3 billion.The Ping An Good Doctor app offers video visits, appointment scheduling, disease management, sale of over-the counter medications and medical devices, and insurance coordination. It claims 77 million registered users and up to 250,000 daily consultations.
People
UConn Health (CT) hires Dirk Stanley, MD, MPH (Cooley Dickinson Hospital) to the newly created position of CMIO, where he will help lead its Epic implementation.
Athenahealth promotes Karl Stubelis to SVP/CFO following the resignation of Chief Financial and Administrative Kristi Matus, who had held the position for less than two years. The company says she’s leaving because her job will be split into the CFO position and an SVP of talent and culture, for which a search has been initiated. Jonathan Bush seemed nervously defensive and uncharacteristically inarticulate on the call announcing the change, sounding like he’s imitating other companies in trying to aggressively manage company culture, hiring consultants and placing great value on what he heard at Microsoft’s CEO conference as Athenahealth nears its goal of $1 billion in annual revenue. He mentioned several times that things change at that $1 billion mark and he seemed worried about employee comments left on GlassDoor.
Announcements and Implementations
Six-hospital St. Luke’s University Health Network (PA) says its January 2016 Epic go-live was a success, giving a nod to VP/CIO Chad Brisendine. The health system will go live on Epic ambulatory by January 2018.
Government and Politics
The ACLU files an OCR HIPAA complaint against genetic testing company Myriad Genetics, claiming the company denied four consumers access to their full genetic test results. Myriad released the information to the consumers as soon as the ACLU announced a press conference about their complaints. HHS regulations give individuals a right to receive the full genetic test results, not just those genetic characteristics known to be associated with disease. Myriad says it didn’t know about the regulation since it was announced only in an HHS blog post that clarified provider responsibilities for information release under HIPAA. One of the consumers wants to donate her genetic information to the NIH-run ClinVar research database, but Myriad won’t submit its breast cancer genetic information to ClinVar even though other testing companies do so.
Privacy and Security
Lawrence General Hospital (MA) tests employees by sending faux phishing emails with subject lines like “Prince’s last words on video” and “Banking statement: your transaction failed” to see how many employees click the link. The hospital publishes the number of links clicks and disciplines employees who open three or more attachments.
Innovation and Research
An Israel-based startup is working on eyeglasses that work like smartphone cameras in focusing on whatever the wearer is looking at, potentially eliminating the need for vision testing and having new glasses made to deal with age-related nearsightedness.
Technology
Microsoft releases Skype for Business App SDK Preview, which allows iOS and Android developers to add instant messaging, audio, and video to their apps. Virtual visit company MDLive is using it.
Other
A local TV station reports that Effingham Health System (GA) has fired CIO Mary Pizzino as the 25-bed critical access hospital converts to non-profit.
The CEO of Wake Forest Baptist Medical Center (NC) steps down to become executive director of the hospital’s venture arm, where he will focus on commercializing healthcare technologies that include analytics and digital health.
Vince and Elise post their Physician Practice Vendor Review, which he notes with amusement is often called “ambulatory.” Technically, that would mean that those patients arriving at an ambulatory care center in a wheelchair should not be allowed in since they are not in fact ambulant. The word “ambulance” is a variant, although it refers to the ambulating horses that pulled medical wagons in 1800s France. One might also quibble with the word “clinic,” which originally defined doctors who visited patients at their location rather than the modern-day opposite where the sick person is expected to make their way to where the doctor is sitting.
Sponsor Updates
T-System will exhibit at the 2016 PHIMA Annual Meeting May 23-25 in Lancaster, PA.
Validic will present at the Digital Health Summer Summit June 7 in San Francisco.
Vital Images will exhibit at the HIMSS Minnesota Spring Conference May 24 in Plymouth.
Hamad Medical will showcase Zynx Health at the Cerner Middle East Regional User Group May 31 in Dubai.
Theranos cancels or corrects the results of tens of thousands of lab tests it ran in 2014-2015 on its proprietary Edison analyzer. Basically, the company says none of those results can be trusted even though the medical decisions made from them have long since happened.
One doctor who sent a patient to the ED in 2014 because of abnormal lab results recently received a revised report in which the corrected results were actually normal. In addition, an insider says Theranos regularly reported inaccurate coagulation results because it incorrectly programmed its Siemens analyzer.
This admission by Theranos is ample cause for the company’s doors to close even before CMS metes out its likely punishment. The privately held (and therefore minimally transparent) company hyped its technology without medical evidence; claimed as its niche a questionably advantageous (except in pretending to be a high-multiple technology company) finger-stick sampling method that turned out not to work; loaded its board and management team with people who know nothing about healthcare; expended extraordinary effort to avoid participating in the mainstream medical community; advocated that consumers order their own lab tests even though the clinical and financial impact of that practice has not been studied; and now admits to a remarkable level of incompetence in not even being able to correctly program another company’s analyzer. Selling cheaper lab tests isn’t much of a draw (no pun intended) if the results are untrustworthy. Theranos needs to give back the tiny bit of volume it took from Quest and LabCorp and find something less critical for its college dropout founder to pursue while waiting for the inevitable patient class action lawsuits to gather steam.
Reader Comments
From Damascus Sword: “Re: MD Anderson. Encore did the selection, Santa Rosa did the go-live, but whoever ran the implementation (Deloitte, I think) would have been paid fees far exceeding the other two.” Unverified.
HIStalk Announcements and Requests
I’ve figured out how to filter out the 99 percent of political “news” (especially of the emotional Facebook and Twitter variety) that is really just zealots spewing intolerant invective: skip anything that uses a carefully chosen unflattering photo of a political figure or that refers to that person by last name only. I apply similar criteria for scientific or technical articles in which the author pretends to be informative while actually editorializing – I move on immediately if I see the words “fortunately” or “unfortunately.”
Mrs. Boyd says students in her North Carolina class have “taken ownership of their learning and celebrate each other’s success” by using the two Osmo gaming systems we provided in funding her DonorsChoose grant request. Most interesting to me is that she reports — as have other teachers for whom we have provided group learning technology – that it has brought some shy students out of their comfort zone as they participate more actively, which will probably benefit them long after they’ve forgotten the specific lessons.
This week on HIStalk Practice: Keizer Solutions acquires Colonial Valley Software. PatientPop raises a $20 million Series A. The Midwest Independent Physicians Practice Association gets into telemedicine. The Center for Rheumatology’s expansion strategy highlights the tough choices physicians must make to remain independent. Medical Association of Georgia plans to launch private HIE. Consortium of Independent Physician Associations opens for business in Ohio. CityMD CMO David Shih, MD shares the challenges urgent care facilities face when it comes to adopting healthcare IT.
Webinars
None scheduled soon. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.
Acquisitions, Funding, Business, and Stock
EHR hosting and support vendor ITelagen acquires competitor Planet Logic.
Onex Corp. again places medical imaging vendor Carestream Health on the market, considering separating its medical imaging and dental imaging business in raising up to $3 billion. The buyout firm acquired Eastman Kodak’s healthcare business for $2.35 billion in 2007 and failed to attract a buyer in 2013 at the $3.5 billion price it sought. The company made $360 million EBIDTA on revenue of $2.1 billion in 2015.
Quality Systems (NextGen) reports Q4 results: revenue flat, adjusted EPS $0.19 vs. $0.21, meeting revenue expectations and beating on earnings.
Sales
England’s Sandwell and West Birmingham Hospitals NHS Trust chooses Cerner pending financial approval.
Lake Health (OH) chooses Cerner Millennium and HealthIntent, replacing Soarian.
Houston Methodist (TX) selects Phynd to manage and share the data of its 21,000 providers.
Decatur Morgan Hospital (AL) chooses InfoPartners for its Meditech 6.0 to 6.1 upgrade.
People
Stratus Video hires Brad Blakey (CareCloud) as VP of sales and marketing.
Announcements and Implementations
SAP announces its Connected Health ecosystem and its most recently announced partners CancerLinQ, Castlight Health, and Dharma Platform.
Health IT startup Vericred announces availability of API-driven drug formulary datasets for health plans in all 50 states. The API returns information on drug formulary tiers, prior authorization, step therapies, and quantity limits.
InterSystems releases its TrakCare Enterprise laboratory business management system, with initial implementation in two NHS trusts.
Government and Politics
CHIME and the Association for Executives in Healthcare Information Security send comments to a Senate hearing on ransomware, suggesting that Congress remove the HHS restriction on pursuing a national patient identifier (which it says will make health records less attractive to hackers since they won’t have otherwise identifiable information such as SSN) and to “encourage investment through positive incentives for those who demonstrate a minimum level of cyberattack readiness and mature information risk management programs.” I can’t imagine any industry other than healthcare that could keep a straight face while asking Congress to pay its members for keeping their own business information secure.
Privacy and Security
A hacker claiming to be part of the Anonymous group leaks a database from two hospitals in Turkey in retaliation for a previously rumored Turkish hacker’s attack on two US hospitals. Anonymous denies any involvement.
The hackers behind the TeslaCrypt ransomware sunset their product and post the master decryption key on their support site.
Technology
UC Irvine’s medical school posts a video showing the use of smartphone-powered digital health technologies.
Other
FHIR architect Grahame Grieve says FHIR is being hyped as the solution for interoperability, adding that groups like HL7 can’t impose prescriptive information models or force vendors and providers to standardize processes – it can only provide a common way for them to do it if they’re so inclined. He adds that conforming to FHIR doesn’t accomplish anything unless it’s supported by cultural changes.
A prenatal imaging clinic in Canada blames a computer virus after it gives a dozen parents-to-be identical ultrasound images that also match the sample image featured on the company’s website.
Australian Computer Society profiles the year-old, non-profit CancerLinQ, an American Society of Clinical Oncology project that is analyzing the information of 1 million US cancer patients to identify treatment patterns and to allow doctors to search symptoms and treatments. Its CEO says that only three percent of cancer patients qualify for clinical trials, but the automated collection of EHR information for the other 97 percent creates a rapid learning system in which any doctor who contributes de-identified information can use the entire database.
Weird News Andy sings happily along to his just-created TV jingle, “Cleaner, Fresher, Softer Arteries!” Scientists find that a sugar that’s the active ingredient in the Febreze air freshener can remove plaque from hardened arteries. WNA cynically notes that the article’s last line should really be its first – the sugar can’t be patented, so drug companies aren’t interested in sponsoring the clinical trials that would allow it to reach the human market.
Sponsor Updates
Valence Health opens registration for its Further 2016 value-based care conference September 14-16 in Chicago.
HDS will exhibit at the Cerner Great Lakes RUG May 31 – June 2 in Chicago.
Influence Health will exhibit at the Healthcare Marketing & Physician Strategies Summit May 23-25 in Chicago.
InterSystems will exhibit at the Midas+/Xerox Annual Symposium May 23-25 in Tucson, AZ.
National Decision Support Company adds support for ACR’s Radiology-TEACHES and R-SCAN initiatives to its platform.
Frost & Sullivan recognizes Intelligent Medical Object’s medical terminology platform for enabling the clearest patient narrative.
LiveProcess will exhibit at the Mississippi Preparedness Summit May 24-26 in Biloxi, MS.
Obix Perinatal Data System will exhibit at the HIMSS Northern Ohio Trade Faire & Conference May 26 in Cleveland.
May 18, 2016NewsComments Off on Paging Dr. Facebook
HIStalk looks at how healthcare use of social networks is changing in light of consumer expectations and provider comfort levels. By @JennHIStalk
The rise of social media usage in healthcare settings has increased over the last several years as the entire industry has moved to a more digital-centric way of doing business. Whether it’s patient portals, online bill pay, way-finding apps, or online appoint check-in, patients — and providers, to some degree — have become used to conducting the business of healthcare via convenient, easily accessible, Web-based tools.
While patients in the US may never log in to patient portals with Facebook credentials, their providers are inching their way ever closer to incorporating social networking tools into relationship-building aspects of care.
Twitter Consults Take Off
Will social networks ever be used as bona fide care tools? With HIPAA’s tight hold on patient data and the love/hate relationship consumers have with privacy, the role of said networks as diagnostic tools remains a pipe dream at best. Not so in India, however, where Practo has added Twitter-based healthcare consults to its ecosystem of digital tools for providers and patients.
The startup, which claims to be Asia’s number one physician search engine, launched the @AskPracto Twitter account in early April, giving users in India, the Philippines, and Singapore the ability to tweet their health questions to the handle and receive responses back from Practo-affiliated physicians in near real time.
“We are excited about our partnership with Practo, as this addresses a fundamental need for users and opens up the benefit of real-time healthcare information access to millions of users,” said Ravi Bhaskaran, Twitter’s head of business development for India and South Asia, leading up to the launch.
Bhaskaran’s comment highlights the need for Web-based tools that make it easier for people to access care. With a population of over 1.25 billion, India has more Internet users than the US has people. Healthcare access, especially in rural areas, is — at the risk of understating a nationwide problem — a challenge for those looking to connect with physicians at brick-and-mortar facilities. Thus, mobile, Web-based communication tools seem like the go-to answer for issues of access and provider availability.
“We believe that healthcare issues can be addressed and awareness can be raised by social networks like Twitter,” says Practo Assistant Vice President of Marketing Varun Dubey. “With this partnership, we are making it super easy for people to get access to healthcare information right from Twitter. This collaboration will enable millions of consumers to get quick access to relevant healthcare information and make better, more informed decisions about their health.”
Response to the collaboration has been overwhelmingly positive. “We saw impressive traction on the first day of the campaign,” says Dubey, “with over 5,000 questions being tweeted by consumers with answers sent from @AskPracto. More than 8 million people have participated so far on the social media platform, and this number is growing every day. We’ve actually received questions from many more countries including the US, Australia, and even parts of Africa and Latin America.”
Such collaborations may offer citizens in less developed countries an easy, albeit extremely high-level, answer to issues of access. Their ability to succeed in the US remains doubtful, especially when it comes to the inevitable questions of privacy and physician reimbursement. Dubey is quick to note that Practo takes patient privacy “extremely seriously. Consumers can always come straight to Practo Consult and ask their questions anonymously.”
He is slightly more evasive when it comes to how Practo physicians are reimbursed for their time on Twitter, moving the conversation back to the company’s proprietary physician-patient consulting platform. “All healthcare specialists on the Practo Consult platform respond to questions in order to generate more awareness and enable consumers to make more informed decisions about their health,” he explains. “This in turn helps them build their value as a qualified, experienced, and trusted doctor. If you think about it, a patient who gets the right answer on Practo Consult from a verified doctor will trust that doctor and is likely to visit him or her in the future for any healthcare problem that needs to be assessed in person.”
While the @AskPracto handle is likely part of a larger marketing push to drive users to the company’s private consulting platform, it can’t be denied that opening up healthcare expertise by way of social media will likely offer underserved patients an easy, affordable way to have their high-level healthcare questions answered.
Messaging Apps Make Provider Wish Lists
The concept of healthcare diagnoses via social media seems to be taking a different turn here in the US, with secure messaging apps piquing the most provider interest and vendors responding accordingly. Remote consulting startup HealthTap launched its service via Facebook’s Messenger app last month, offering users the ability to submit questions and receive answers from the company’s physicians covering 141 specialties.
“HealthTap is a really cool platform,” says Piedmont Healthcare (GA) Chief Consumer Officer Matt Gove, “and them getting into Messenger makes all the sense in the world. But when you’re a healthcare provider, you have a different cost structure. We have a different way of interacting with people. We have a different goal in terms of increasing the health of our communities and building long-term relationships with individuals. It’s a bit different than the app that allows you to quickly ask a question and keep moving.”
“We’re certainly interested in how to use digital technology to provide alternative models of care,” he adds, “but I haven’t seen the use of social networks to diagnose people. Where I am most excited is not doing it inside social networks, but doing it inside messaging apps. That’s what has the most potential – inside Facebook Messenger where you can have a secure conversation with people about their medical issues.”
“We occasionally use messenger apps to engage with folks about their specific experience with us,” Gove continues. “It’s not as much about the clinical side as it is about the experience side. To be fair, in many ways, I think the customer’s perception of quality is really about the experience they have with us. The average person doesn’t understand clinical quality, but they do understand if you smile and say hello and ask them if they need something. Did you provide them with an easy to understand bill? That’s where the experience breaks down for most people. It’s not in the direct interaction with the caregiver. That’s where we’ve been focusing on — how to better use secure messaging apps to have conversations with people.”
Gove adds that a HealthTap-type messenger app would be nice to have, but it’s not likely to happen until the service is seen as more than a novelty, a sentiment based on Piedmont’s rollout of virtual visits. “We’re getting extraordinarily good reception for it,” he explains. “There’s a hurdle to get people over the novelty piece and see this as just as good as what they’re used to. I would put HealthTap getting into Messenger into that same category. I think messenger apps are an important part of the future. We are not there yet, and if Piedmont isn’t there yet, there won’t be many systems that are.”
The Future Role of Social
Gove, who has gained a well-earned reputation for pushing the boundaries of social media marketing within healthcare organizations like Piedmont and Grady Health System (GA), continues to look for innovative ways to use social media within the healthcare setting. Looking ahead, he hopes to get a better handle on using the social networks that have the most user traction and growth.
“I’ve yet to meet a health system that does Snapchat very well,” he says. “Most of my colleagues describe it as a cesspool. That may or may not be correct. It certainly made me laugh when they said it. It reinforces the fact that Facebook will always be a very powerful place for us to be. Twitter isn’t there and isn’t going to get there. Instagram is okay, but I don’t see it evolving to something that becomes a great tool for engagement. I think you’ve got to look at where people are aggregating and excited and engaged right now and figure out how to best leverage that.”
For now and the foreseeable future, provider use of social media seems to be about building relationships with patients and prospective customers. Gove believes that health systems are just getting to the point where they can use social media in an effective way to have conversations and build those relationships. Making the leap to using Twitter as a clinical tool is not in their near futures.
“I think most providers are looking at social as a way to maintain relationships, which again gets into the messenger space,” he says. “Facebook is their mobile strategy. There’s no denying that as everybody continues to get on Facebook, and as the average age of the Facebook user trends older, that something else takes its place on the young end. Don’t forget that so many of the patients that we need to maintain relationships with everyday are older. Them getting on Facebook is a wonderful thing.”
The VA says it will have its Enterprise Health Management Platform (EHMP) running by the end of summer. It’s a graphical front end for VistA that I’m guessing is the Facebook- and Google-like “prototype” that was mentioned a couple of months ago.
VA Chief Information Strategy Officer David Waltman said during a demonstration that, “The interoperability between the VA and the [DOD] record system exceeds any electronic health record systems that are anywhere in the non-government environment.” EHMP builds on previous development work for the VA-DoD Joint Legacy Viewer and will replace CPRS as part of the VistA Evolution program.
The VA has released a software development kit for the open source EHMP, hoping that companies will extend or commercialize it.
Reader Comments
From Dutch Loaf: “Re: ransomware webinar. That had to be the best-attended of those you have had and it was very useful.” John Gomez’s ransomware webinar was indeed excellent, and while it did very well with 115 live attendees and 700 YouTube views afterward so far, the leader is still Vince and Frank’s November 2014 “Cerner Takeover of Siemens, Are You Ready?,” the YouTube recording of which has been viewed an astounding 7,750 times.
From Boots on the Ground: “Re: MD Anderson’s Epic project. The reader comment referring to Encore Health Resources should have noted that Santa Rosa Consulting ran the successful go-live, providing 1,100 associates in the largest, single-sourced go-live.” Verified. Encore got a $50 million contract for selection and other services, as the reader pointed out, but Santa Rosa ran the go-live.
HIStalk Announcements and Requests
I was interviewing Hayes Management Consulting President and CEO Pete Butler the other day when he mentioned how long he has been reading HIStalk, going back to his days as the company’s western region director when he recommend to founder Paul Hayes that they sponsor. I checked my old emails and can thank Hayes Management Consulting for supporting my work for 10 years – they signed up in July 2006. Which also reminds me that HIStalk itself turns 13 years old on June 3, entering that awkward, insufferable teenager phase.
Ms. Stuckeman from Texas reports that her after-school science and math club “embarked on a journey of exploration and invention” when they received the machine-building kits we provided in funding her DonorsChoose grant request. She adds, “They were so excited to have these shiny new building materials. Students came across problems and had to solve them. This made them stronger as it challenged them to think critically through trial and error. Team members rejoiced with confidence as they were proud of what they had accomplished.”
Listening: hard horror punk rock from Wednesday 13, which sounds like Alice Cooper mixed with Iron Maiden and Dixie Dead. The band is really just Joseph Poole from North Carolina’s barbeque capital of Lexington along with some backing musicians in tribute to 1980s horror films.
Webinars
None scheduled soon. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.
Acquisitions, Funding, Business, and Stock
Financial Times has fun with the rock concert / party rally launch of the Siemens Healthineers name, calling it “a writhing, Spandex-clad horror” and noting that at the end, “A few arms were raised bearing phones to capture what was possibly the most embarrassing corporate rebranding event ever.” The article notes that the launch violated three rules:
Don’t try to put your corporate values to music since that always creates mass humiliation.
Don’t create eye-rolling names by cutting and pasting parts of other words.
Claiming to be one team with one dream doesn’t make it so. It just makes you look stupid.
Healthcare-only technology and consulting firm CitiusTech will hire up to 1,200 new employees this fiscal year, increasing its headcount by nearly 50 percent. CEO Rizwan Koita says the company is hunting for acquisitions.
Decisio Health launches its FDA-cleared Decisio Clinical Intelligence Platform, which formats patient monitor information into an electronic triage system, and closes a $4.5 million second round of funding.
Experian Health signs 276 new deals and 479 existing client contracts in Q4.
People
The Indiana HIE hires Valita Fredland, JD (Indiana University Health) as VP, general counsel, and privacy officer.
Jason Griffin (Encore, A Quintiles Company) joins Orchestrate Healthcare as AVP South.
Parallon Technology Solutions names Charles Bell, DO, RPh (HCA) as chief medical officer.
Mercy Health (OH) hires Jeff Carr (Cintrifuse) as its first chief innovation officer.
Announcements and Implementations
PokitDok releases its Pharmacy Benefits Solution, a set of three APIs (pharmacy plan, pharmacy formulary, and in-net work pharmacy) that allow EHR users to check a member’s prescription insurance and send prescriptions to in-network pharmacies.
American Well creates an online marketplace that will allow its customers to exchange services, such as providers who can create and market condition-specific telehealth programs to insurance companies and employers. Consumers seeking telehealth services can choose doctors from provider organizations that market their services.
DSS will incorporate First Databank’s medication reconciliation and e-prescribing solutions in its open source EHR.
Government and Politics
The Missouri Health Connection HIE supports the governor’s veto of funding that would have helped the state’s Department of Social Services connect to it. MHC says unnamed special interests (Cerner?) “are working to hinder and fragment the adoption of HIE in Missouri.” MHC claims the proposed budget would have prevented hospitals from freely choosing an HIE and would have forced MHC to share patient information with competitors without having privacy and cost structures in place. The counterpoint might be that federally funded MHC wanted to connect with DSS and then charge competing HIEs for connecting to it. The governor said he vetoed the line item funding because it would have allowed some providers to participate without paying. Missouri HIEs have been fighting for control for years. Perhaps ONC should launch its data blocking investigations in Missouri, starting with organizations that have received HHS/CMS/ONC grant funding specifically to facilitate data exchange.
FTC Chair Edith Ramirez says she’s worried about hospital mergers that are creating expensive health system monopolies, adding that competition is also vital for maintaining hospital quality. The president of the American Hospital Association disagrees, saying the creation of a modern healthcare system requires such mergers.
The state of Arizona spent millions (it isn’t sure exactly how many) to develop a tissue and organ specimen database that has been abandoned. The system was used by only three hospitals and did not have a sustainable business model, leading to its shutdown in September 2014. Hospitals are trying to resurrect the system, hoping to rebuild it using a different contractor since the original one has since left the state. That company’s founder says the real challenge is that hospitals don’t necessarily want to share their research information in a competitive environment. It’s a lot like hospitals not willing to financially support HIEs or share their information on them.
The National Cancer Institute solicits research ideas for the National Cancer Moonshot Initiative, with already-submitted ideas being publicly visible on the site.
Privacy and Security
Dekalb Health (IN) says a ransomware attack last week forced it to take its systems down, transfer patients out, and initiate ambulance diversion. The health system did not say in the announcement whether it paid the ransom demanded.
The government of Kuwait will require all citizens and visitors to undergo DNA testing to create a national database for use in criminal cases and paternity claims. Visitor samples will be taken upon arrival at Kuwait International Airport.
Technology
A Florida business paper profiles Medical Tracking Solutions, which offers medical device companies a supply chain system for tracking the devices they stock on consignment in hospitals. The COO says the system replaces “really old school” hospital methods that involve forms that are hand-filled and faxed.
Other
Cerner help desk employees file a class action lawsuit against the company, claiming they were expected to work at least 48 hours per week without being paid overtime because their positions were misclassified as exempt. Four other overtime lawsuits are pending against Cerner.
A Navicure survey of 300 provider executives finds that the most significant patient payment challenges are patients who can’t pay, the need to educate patients about their financial responsibility, and patients who don’t pay on time. Patient payments make up a significant portion of revenue for most organizations, with one-fourth of respondents saying it’s 31 percent or greater. The majority of respondents acknowledge that they don’t store patient credit card information, send electronic statements, or offer automated payment plans.
Patients of a Virginia lab company that was acquired by a competitor following its bankruptcy filing to settle kickback charges are being sent bills for tests done as far back as 2009. Bankruptcy lawyers for former high-flyer Health Diagnostic Laboratory, which had $375 million in revenue in 2013, were ordered by the court to try to collect its $50 million in unpaid bills to pay off its remaining debt. The competitor who bought the company is receiving complaints and threats about the collection practices even though it didn’t buy the overdue accounts along with the business and thus isn’t involved with the collection efforts.
The Boston Globe reports EHR employee complaints at Partners Healthcare (MA), whose $1.2 billion Epic project is the largest ever undertaken by Partners. A maternity nurse says she speaks for others like her in complaining that the system has come between her and her patients, calling it “tedious, labor intensive, and you feel like you can’t do what you want to do.” One doctor, annoyed at having to work at a wall-attached monitor with her back to her patients, retired early. On the other hand, the article is hardly a shining example of thorough investigative reporting, with the newspaper chatting with just 24 of 68,000 Partners employees. One might also note that the “you can’t do what you want to do” comment is exactly why hospitals implement EHRs.
Weird News Andy says a man was “saved by the pizza.” Employees of a Domino’s Pizza in Oregon become concerned when a customer who has ordered delivery almost every day for seven years fails to place an order for 11 days. They sent a delivery driver to check on him, but the man didn’t answer the door or answer his phone. The driver called 911 and deputies found him on the floor suffering from an apparent stroke. He’s in stable condition.
Sponsor Updates
Impact Advisors posts a white paper, “The MACRA Proposed Rule on MIPS and APMs: Summary and Key Takeaways.”
LogicStream posts a recording of its webinar, “Reduce CAUTI Through Clinical Process Measurement.”
AirStrip CEO Alan Portela will speak at the Medical World Americas conference May 19 in Houston.
John Halamka revisits his criticism of the proposed MACRA requirements, specifically suggesting that HHS focus on rewarding three specialty-specific outcomes at a time, allowing each specialty to choose those three outcomes and giving doctors free rein to use whatever technology they need to achieve them.
Halamka also suggests limiting EHR certification to basic care coordination interoperability functions:
Sending a summary of care to a recipient listed in a national provider directory.
Querying a record locator service and retrieving a common data set.
Sending a care summary to a patient-provided address.
Populating a relevant registry.
Interacting with a prescription drug monitoring program.
Reader Comments
From Mister F: “Re: MD Anderson / Encore’s $50 million contract. Trace the relationships of current MDACC leadership > Encore leadership > Healthlink. It’s fraternity-based procurement behavior. If someone had the time to create the map of Healthlink alums in provider leadership roles, those in services (vendor) roles, and the subsequent contract awards, it would look pretty interesting.”
From Mark: “Re: Qardio’s real-time blood pressure and scale monitor that was just launched. Do MDs really want this ‘continuous’ information? Is this a billable service? How will MDs replace lost income with fewer patient visits?” Technology companies anxious to get a foothold in the lucrative healthcare market often confuse their limited sensor and analytics capabilities with what will work in real life to improve oucomes. Doctors don’t have the time or interest to monitor a patient’s self-measured vital signs, which have minimal diagnostic or therapeutic value (ask any nurse how often they ignore inpatient vital signs monitors without clinical consequence). It’s a situation similar to companies convinced that the biggest problem in medicine is lack of accurate diagnosis and offer technology to assist where assistance usually isn’t needed, not to mention that diagnosing from data alone ignores that art of medicine. It’s rarely healthcare professionals that come up with these ideas, and when it is, they’re usually ignoring the practical practice of medicine hoping nobody will notice and buy their product anyway.
HIStalk Announcements and Requests
Poll respondents say it’s the federal government and doctors themselves who are most responsible for physician dissatisfaction. Some respondent thoughts:
Ann Farrell says MACRA is crazily complex, but adds that doctors have been self-centered for decades in denying their quality statistics and failing to lead the charge on patient safety. She welcomes income-focused doctors to the world in which RNs and other employed professionals live — KPI games, stagnant wages, job loss, unrealistic productivity goals, and dwindling respect.
Frank Poggio says doctors have been their own worse enemy since the start of Medicare, first fighting the concept but then jumping on the bandwagon when Part B was introduced, making many specialty doctors millionaires but not helping PCP who found that, “When you go to the bed with the devil, you wake up in hell.” He adds that doctors have an image problem both with patients and with payers because of the way they practice.
Meltoots (who is a doctor) says the profession may be seen as whiny, but physicians are being beaten senseless with constantly changing regulations, fighting with insurance companies, patients who can’t pay their large deductibles, board certification headaches, and RAC audits. He says everybody should be paying attention if it’s so bad that John Halamka is on the ropes. He or she adds, “It takes 14 years of training just to make a fresh new me and another 17 of practice experience that is truly invaluable to my abilities as a surgeon. With my low costs and my quality numbers, CMS and ONC should be begging me to stay on board and not be penalizing me 2 percent because I cannot do MU. And with MACRA, it looks like they want to ratchet me down 9 percent. Look at my costs per patient, co-morbidities, and readmit rate and tell me I’m a bad deal for CMS. No chance.”
New poll to your right or here: would you recommend the hospital or medical practice where you had your most recent medical experience as a patient? Overachievers are welcome to click the Comments link on the poll after voting to explain.
I’m annoyed that Yelp, Tripadvisor, and LinkedIn are forcing website readers on mobile devices to open their proprietary app to continue reading. Not only do I resent being forced into their walled gardens, they often launch the App Store instead of handing off smoothly to their app that I’ve already installed.
Ms. Hardy and her Pennsylvania class of 18 elementary school students are “incredibly grateful” for the document camera, dry erase lapboards, and computer speakers we provided in funding her DonorsChoose grant request. She has students show their math answers on the whiteboard so she can easily see which ones need extra help. She reports that the document camera makes the students more eager to share their work and allows the visual learners to see lessons and materials modeled for them in their preferred learning style.
Last Week’s Most Interesting News
Theranos shuffles its board and its president steps down.
MD Anderson attributes its $160 million year-over-year drop in net income to its Epic implementation.
NantHealth files for an initial public offering.
McKesson loses a Horizon hospital to Cerner and a 14-hospital Star and Horizon group to Epic.
HHS Secretary Burwell acknowledges to the ACP that Meaningful Use has been “burdensome” and “inflexible” for doctors and reinforces HHS’s interoperability agenda.
ProPublic’s online narcotics prescribing database that was intended to call out questionable prescribers has the unintended consequence of being used to identify those prescribers by drug-seekers.
Webinars
None scheduled soon. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.
Sales
Doctors Community Hospital (MD) chooses the Summit Express Connect interface engine to manage all EHR connections.
Lincoln Surgical Hospital (NE) selects Access Passport for Web-based electronic forms integrated with Meditech.
Announcements and Implementations
ZeOmega releases Clinical Assessment Protocols for its Jiva population health management platform.
Penn State Health (PA) signs up for virtual ICU monitoring from Mercy Virtual.
Privacy and Security
The creator of the Tor anonymous Web browser (which powers the “dark Web” hacker haven) warns that medical identity theft is fast becoming the primary form of identity theft. He mentions that an unnamed healthcare organization is developing anonymous online drug tests, health services, health chat, and research questionnaires. He defends anonymous browsing as being similar to encryption in initially being used by people trying to hide something, but eventually becoming mandatory for secure, Web-powered commerce.
Children’s National Health System (DC) warns that its outsourced transcription provider, Ascend Healthcare Systems, misconfigured a server and thus allowed access by FTP to the information of 4,000 patients over a one-week period in February 2016. The health system stopped doing business with Ascend in mid-2014 and notes that Ascend failed to meet its contractual obligation to delete its data.
New Scientist magazine, which exposed England’s NHS data sharing agreement with Google two weeks ago, finds that neither Google nor the Royal Free London NHS Foundation Trust have requested ethical approval. It also notes that Google’s recently acquired DeepMind app has not been registered as a medical device. Royal Free defends sending Google the fully identifiable information of 1.6 million patients each year, saying that patients give their implied consent when their information is used by IT companies related to direct patient care.
Technology
Entrepreneur profiles India-based ICliniq, which offers an online doctor consultation app that uses a bot running on the WhatsApp-like messaging program Telegram. The company also offers a standard Android version.
A LinkedIn article by Cyrus Maaghul describes out-of-hospital use cases for blockchain technology that include tracking drug development, clinical credentialing, population heath data analysis, insurance risk pooling, telemedicine, and remote device monitoring. He’s head of product and technology for Phoenix-based PointNurse, which offers virtual visits with nurses for patient navigation, referral, consultations, disease management, and remote monitoring.
A Memphis man’s LifeVest wearable heart monitor and defibrillator saves his life when his heart stops beating in his sleep. The device has a 98 percent first-shock success rate for patients at risk for sudden cardiac arrest. The device first earned FDA approval in 2001, although I don’t recall hearing about it until now.
Other
Scripps Health’s Q2 financial report shows that its Epic project will cost $309 million in capital and $361 million in 10-year operating cost, although it expects to save $211 million of that by retiring applications that Epic will replace.
The New York Times notes that people who buy medical insurance via Healthcare.gov or state exchanges are often treated as second-class citizens even though their policies are issued by the same big insurers as employer-provided plans. Many providers don’t accept exchange-issued policies, provider networks are narrower and geographically limited, and some policies offer no out-of-network coverage at any price. The article notes that exchange-issued policies often omit high-priced providers that have local clout to set high prices, such as Memorial Sloan Kettering being left out of every exchange-sold plan even though New York employers would not find that acceptable for their employees. The article also observes that many of the doctors listed in insurance company directories aren’t accepting new patients even though federal law requires insurance companies to keep their provider directories current.
Direct-to-consumer teledermatology websites made a lot of mistakes when diagnosing and treating fake patients. In 62 encounters with 16 websites:
None of the doctors asked for the patient’s ID.
Two-thirds of the sites assigned a doctor without giving the patient a choice, mostly without disclosing the doctor’s licensure status. Some of them used offshore doctors who aren’t licensed in California where the study was performed.
Only one-fourth of the doctors asked who the patient’s PCP was, and only 10 percent offered to send them records.
Patients were rarely offered warnings about the risks of the drugs prescribed during the encounter.
Clinicians diagnosed correctly most of the time when shown a photo in which the condition was obvious, but failed to ask good questions otherwise.
The doctors missed significant diagnoses such as secondary syphilis and gram-negative folliculitis.
The treatments ordered didn’t always follow guidelines.
The study’s authors note, however, that those same doctors might have performed equally poorly during in-person sessions, so maybe it’s not teledermatology itself that’s the problem. They suggest that while direct-to-consumer medicine can be be effective, the clinicians should be part of the practice or health system the patient already uses rather than randomly selected contractors of third-party sites.
UPMC reports that it paid six of its executives at least $2 million in its most recent fiscal year, including $6.43 million to President and CEO Jeffrey Romoff. CIO Dan Drawbaugh made $1.57 million.
TV consumer reporter John Stossel complained about poor customer service while he was hospitalized for lung cancer, but now he offers his solution: high-deductible insurance that forces consumers to shop carefully. Maybe he missed the recent research that found that what actually happens is that people just skip getting care rather than shopping more carefully for it. He also takes a logical leap in assuming that people paying more out of their own pockets will create an environment he describes as: “When patients shop, doctors strive to please patients rather than distant bureaucrats. More doctors give out their email addresses and cellphone numbers, and shorten waiting times. Their bills are easier to read because the providers want customers to pay them!” A lot of Americans now have high-deductible plans, so he as an investigative reporter should be able to fund examples where his idea has actually worked.
Sixteen VPs/SVPs of Wheaton Franciscan Healthcare will lose their jobs in its merger with Ascension Health, among them SVP/CIO Greg Smith.
The family of comedian Joan Rivers settles the medical malpractice lawsuit they brought against the New York city clinic where she died during a routine endoscopy. The suit claimed that the gastroenterologist performed a laryngoscopy despite the concerns of the anesthesiologist, while a CMS investigation found that the clinic failed to keep proper medication records, didn’t record the patient’s weight, failed to obtain informed consent, and allowed staff to take selfies with Rivers before she died.
Vince and Susan move along with their 2016 vendor review, covering small vendors in Part 4.
Weird News Andy says this man’s heart’s in the right place, even if it’s the wrong place. A patient’s complaint of right-side chest pain radiating to his right shoulder is found to have situs inversus, a rare condition in which all of the major visceral organs are on the opposite side of normal.
Sponsor Updates
Huron Consulting Group employees lead nearly 100 events during its annual day of service.
ESD offers a discount on automated testing solutions to CHIME members.
T-System will exhibit at the MIHIMA 2016 Annual Meeting May 18-20 Bay City, MI.
Talksoft is chosen as Greenway’s Intergy Partner of the Month.
Visage Imaging will exhibit at ACR 2016 May 16-17 in Washington, DC.
Zynx Health announces the winners of its 2016 Clinical Improvement Through Evidence Award.
Experian Health and PatientMatters will exhibit at the HFMA Florida Spring Conference May 15-18 in St. Petersburg, FL.
Red Hat announces the agenda and keynote speakers for Red Hat Summit 2016, June 27-30 in San Francisco.
The SSI Group will exhibit at the Rural Hospital Alliance of Mississippi meeting May 18-20 in Orange Beach, AL.
Streamline Health will exhibit at the 2016 Michigan HIMA Annual Meeting May 18-20 in Bay City, MI.
Theranos President and COO Sunny Balwani will retire, which Theranos says is part of a broader reorganization that involves creating three new positions – chief medical officer, head of research, and COO. The company has also added three board members, two of whom were already on the board until Theranos replaced them in a hasty October 2015 reaction to media coverage questioning its technology claims and a CMS investigation of its clinical practices.
Balwani was a technology executive with no medical or science experience when he was put in charge of the company’s California lab in 2009, which CMS later cited as posing “immediate jeopardy” to patients.
Reader Comments
From Frank Poggio: “Re: HHS challenge to design a simpler patient bill. This is the height of hypocrisy. Does CMS think providers on their own created the insane billing requirements and processes? It started with Medicare Part A, then B, then D. Co-payments, deductibles, out of network, referral approvals, contractual allowances, UC charges, and on and on. Next, billing systems will have to deal with VBP, P4P, bundled payments, MACRs, and more. Providers never asked or suggested any of these — they just have to figure out how to carve up charges /costs and services and put it all on a one-page bill. A 1995 analysis found that the Federal Register contains 11,000 pages dealing with an IRS 1040 submission, but hospital billing required 55,000 pages to describe. If CMS really wants to simplify the patient bill, they need to go to a single-payer system. Until they do that (not likely), the patient bill will continue to be the mess it has been for the last 50 years. Who do I call to collect my $5k?” I had the same reaction. Not only is billing too complicated for even providers and payers (much less patients) to understand, the bill is constantly amended over months as the parties involved negotiate who will pay what. It’s absurd to think that patients will assume financial responsibility when nobody can tell them what they owe at the time they owe it, not even accounting for the fact that bills are full of errors and questionable practices that patients aren’t equipped to analyze and report no matter how well presented the information might be. In comparison, IRS forms and tax policies are a consumer-friendly delight.
From Wonky Warrior: “Re: George Washington Medical. Appears to be switching back to Allscripts from Epic at six of their sites.” Unverified, although a recruiter’s email sent my way says that six recently acquired sites (four urgent care centers and two OB/GYN practices) were on different EHRs, they moved to Epic, and now they’re going back to Allscripts EMR, which is what the medical faculty plan uses.
From Jenson: “Re: MD Anderson. Encore did indeed run the selection process. It’s a great business model – Encore runs the procurement, chooses the vendor that requires the most third-party integration support (Epic), and then gets nearly $50 million to support the Epic project. I would pick Epic every time.” The internal document is here. The same regent’s meeting agenda from late 2013 also included a nearly $5 million contract with Cognizant for ICD-10 implementation services.
From Pithy Patti: “Re: MACRA. HHS is out of touch if it expects providers to understand 962 pages of legislation.” Here’s an important point that a lot of self-proclaimed experts are missing: nobody expects providers to individually read and understand those 962 pages. We all follow a lot of laws and rules that are mired in endless pages of legalese somewhere in the government, but that doesn’t mean we’re expected to read and interpret those documents on our own. The government’s job is to pass laws that pass legal muster and convey legislative intent, not to create breezy, easily digested summaries of what they mean so that laypeople can use the Congressional Record as their personal policy manual. That’s a job for non-government experts (consultants and associations, for example) who turn those dense documents into rules their constituencies can follow, just like they do for payment rules that providers follow. The Affordable Care Act had a couple of thousand pages that nobody read (including the politicians who voted for or against it), but it has spawned dozens of thousands of pages of regulations that spell out the specifics.
From Kellan Ashby: “Re: Siemens Healthineers video on YouTube. It’s been pulled. Siemens Embarrassedineers?” Fear not – someone reposted a copy of the corporate atrocity-filled video. Sing and air-guitar with me, “Oho, oho …” Just in case it accidentally gets removed from YouTube again, I’ve downloaded a copy.
HIStalk Announcements and Requests
Ms. Mills from Texas says the electric circuit kits we provided in funding her DonorsChoose grant request have had a great impact on her fifth graders, who have gained confidence in progressing from the easy projects to those that required all the kit’s parts.
I had an appointment with a new doctor this week, having taken the first available slot (mid-May) when I made the appointment (early January). I was encouraged when the practice sent me a link to its Practice Fusion portal to provide basic information. I arrived 30 minutes early to complete the inevitable pile of paperwork, which was just as I expected (entering my name and date of birth maybe a dozen times on a clipboard full of forms for medical history, insurance, notice of privacy practices, release of information, and so on). I returned the forms and waited for 15 minutes before I was called to the desk, only to be told that the doctor was out sick for the day (which they didn’t mention when I checked in) and that I should have received a call the previous to reschedule (they had transposed the digits of my phone number). The next available appointment was three more weeks out. I’m not sure which worries me more, the inefficiency of the staff or the fact that they use a free EHR and lots of paper to run the practice. We’ll see how it turns out.
This Week on HIStalk Practice: St. Thomas East End Medical Center goes live on Greenway. ReGroup Therapy raises $1.8 million for virtual mental health consults. Pediatric Medical Associates makes the leap to electronic records. British researchers take the first steps in developing a diagnostic video game. Retailers rate their top challenges when it comes to jumping into healthcare. Healthix President and CEO Tom Check offers insight into the challenges of bringing physician practices into the HIE fold.
Webinars
None scheduled soon. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.
Acquisitions, Funding, Business, and Stock
Teladoc reports Q1 results: revenue up 63 percent, EPS –$0.40 vs. –$5.87, meeting revenue expectations but falling short on earnings. The company reported big increases in telemedicine visits and membership and touted high satisfaction rates, with President and CEO Jason Gorevic saying in the earnings call that telehealth has a higher barrier to entry than many people believe and that its competitors are stumbling in trying to achieve scale. The company spent an unbudgeted $1 million in legal expenses, including $700,000 in its fight with the Texas Medical Board, and will spend another $4 million in legal fees in the remainder of 2016. Teladoc expects to lose around $42 million in the fiscal year. TDOC shares are down 40 percent since their June 2015 IPO, valuing the company at $440 million.
The 14-year-old CEO of a company that sells first-aid vending machines claims he turned down a $30 million acquisition offer from an unnamed healthcare company. He started the company last year after winning a business plan contest in his high school’s entrepreneurship class. The Six Flags theme park has ordered 100 of the machines, which dispense kits of Band-Aids and other supplies for up to $20. One of the four revenue sources he offers is “selling opt-out data.” The machine also requires the purchaser to acknowledge a form that releases the organization that installs it from liability. I’m not sure I’m really buying the success story since the alleged acquisition offer and product sales are hearsay and since then he has raised his unsubstantiated asking price to $50 million, but I’ll try to suppress my cynicism that the world doesn’t really need a Redbox stuffed with overpriced Band-Aids.
Sales
Freeman Health System (MO) chooses the Empower patient portal from Influence Health.
British Columbia’s Interior Health Authority chooses FormFast for enterprise forms standardization and automation in its 22 facilities, integrating with Meditech.
Hospital for Special Surgery (NY) chooses Strata Decision’s StrataJazz for cost accounting and continuous improvement.
People
The NIH names Patti Brennan, RN, PhD (University of Wisconsin – Madison) as director of the National Library of Medicine.
Lee Horner (CareCloud) is named president of telemedicine at remote interpretation services vendor Stratus Video.
Announcements and Implementations
Health Catalyst eliminates its non-compete agreements, no longer restricting for whom employees can work after leaving the company.
ZocDoc will integrate its appointment-finding and patient self-scheduling marketplace with Epic using APIs.
CMS, responding to small medical practice concerns about MACRA, publishes a fact sheet and reminds that it will accept comments about the proposed legislation through June 27. I’m not sure that “flexibilities” is an actual word (sort of like “implementations”), but it does seem that CMS is listening and they (along with ONC) have been pretty good about soliciting and using stakeholder feedback.
A federal judge rules that the US government can’t subsidize the cost of health insurance for lower-income Americans by reimbursing insurance companies for income-based premium reduction, saying that the administration overstepped its bounds since Congress did not approve that expense. Insurers were reimbursed for more than half of the exchange-issued policies, and if appeals fail and the payments are stopped, insurance companies will be stuck with paying several billion dollars per year themselves, giving them strong incentive to stop selling policies on the exchanges. It’s a complex issue that is beyond my understanding, but Tim Jost at Health Affairs provides expert opinion.
Privacy and Security
Allen Hospital (IA) notifies 1,600 patients that their information was accessed by a former employee whose EHR login credentials had not been deactivated despite having apparently left the organization seven years ago.
Ponemon Institutes’s annual healthcare privacy and security study, sponsored by ID Experts, finds that 90 percent of the 91 covered entities have had a breach in the past two years, although most involved fewer than 500 records. It calculates the cost of a provider breach as $2.2 million. Half of the reported breaches involved criminal activity, with an additional 13 percent caused by a malicious insider. Providers continue to worry most about careless employees, but a significant number also worry about cyberattacks and the use of unsecured mobile devices. One-third of providers say they’ve bought cybersecurity insurance.
Technology
@drnic1 tweeted about Luxe, an Uber-like service that will meet you wherever you are, park your car securely, and return it to wherever you want for $5 per hour or a flat rate of around $15 per day (the price varies by city, but that includes both the parking car and the service). They’ll even wash your car or fill it up with gas for a bit extra. It’s available now in San Francisco, LA, Chicago, Seattle, Austin, and New York. That would be cool when you’re driving into the city for meeting, heading off to the airport, or attending an event that might charge $20 or more to park in an uncovered and unsecured lot. I would enjoy not only the cost savings, but the lack of stress and time required to find a spot and then hunt down the car afterward.
Other
Doctors in England are told to review patients for whom they had prescribed statins after experts find a seven-year-old error in the QRISK calculator provided in the SystmOne EHR sold by UK-based TPP. QRISK is a short questionnaire that determines the disk of cardiovascular disease.
ProPublica notices from Web traffic to its 2013 Prescriber Checkup — a database that shows heavy opioid prescribers based on Medicare Part D data – that drug seekers are apparently using it to find doctors who are most likely to write them narcotics prescriptions.
Minnesota’s health department cites a nursing home operator for two deaths involving mistakes in transcribing medication orders, one involving a blood thinner transcribed to the wrong resident’s chart and the second due to a 10-fold morphine dose transcription error.
US Army Sgt. Elizabeth Marks, the combat medic who won four swimming events this week at the Invictus Games — for injured military personnel and veterans — and received her medals from the competition’s organizer Prince Harry asks him to instead take her medal to the medical team at England’s Papworth Hospital that saved her life from respiratory distress in 2014. The 25-year-old Arizona swimmer joined the Army at 17 and suffered a serious hip injury while deployed to Iraq in 2010 that left her with no sensation in her left leg.
The ratings agency of Gulfport, MS downgrades the city’s bonds issued on behalf of Memorial Hospital at Gulfport, noting a sharp decline in liquidity that the agency partially attributes to an increase in AR days following the hospital’s Cerner implementation.
This is a great graphic making the social media rounds, although like most graphics, it’s nearly impossible to determine the source.
A Washington Post reporter touring a hospital in North Korea with government handlers is ushered out for asking too many questions in the staged situations that tried to put the country in a positive light. She apparently insulted her hosts in noting ancient diagnostic equipment, staff who aren’t allowed to access the Internet, supposedly frequently used PCs for which nobody knew the password, and a photo op with a perfectly made up patient who strangely had no personal effects or chart in her room. I assume “The Interview” wasn’t available on the patient entertainment system.
Weird News Andy has Hollywood gold in mind with his script for “Snakes in the Ceiling,” inspired by the story of a live python falling from the ceiling at Tacoma General Hospital (WA). WNA wonders if the reptile subsisted on hospital food during its stay. A visitor brought the snake into the hospital a month ago in a cat carrier filled with stuffed animals (any one of those elements might suggest a need for mandatory psychiatric observation), then called the hospital to report that he had lost his slithery friend. The hospital, to its credit, called him back so he could take his wayward pet back home to do whatever it is that people do with pet reptiles in the privacy of their homes. I’ll stand by my long-held assertion that hospitals are the one place where you see a random and often disturbing cross-section of the citizenry that you would ordinarily avoid.
Sponsor Updates
Medicity CEO Nancy Ham is named one of the most powerful women in healthcare IT. Also named is Vyne President and CEO Lindy Benton.
Bernoulli will present a poster on alarm reduction during the 18th Annual NPSF Patient Safety Congress, May 23-26 in Scottsdale, AZ.
ID Experts sponsors the Fifth Annual Benchmark Study on Privacy & Security of Healthcare Data.
Influence Health announces the 2016 eHealth Excellence Award Winners.
Orion Health announces that its software manages 102 million patient health records globally.
AdvancedMD launches patient-centric solutions for independent OB/GYN practices with a limited-time promotion at the ACOG conference.
GetWellNetwork will host its user conference May 23-25 in Philadelphia.
InterSystems will exhibit at VA Healthcare 2016 May 16-18 in Arlington, VA.
Early bird registration for Health Catalyst’s September 6-8 HAS16 ends May 27.
Nordic releases a white paper titled “Value-based care: How’d we get here and how do we go forward?”
I spend a lot of time hearing physician complaints about EHR usability. It’s certainly sensitized me to the issue of usability in general.
Let’s face it – there is some pretty poor software out there, in all spaces. There are some websites I visit that just want to make me scream, especially ones that use technology reminiscent of Geocities circa 1990-something. No matter what industry one works in, if you have to use something day-in and day-out that makes your life harder, you’re not going to be happy.
I was grateful today that I only have to renew my state controlled substance number once every couple of years. It’s bad enough that I have to register with both the federal Drug Enforcement Agency and also with my state, but their website put me over the edge.
I knew it was going to be a pain when the login screen told you to make sure you had enough time to finish the renewal because the system might time out on you. Then, it told me to turn off my pop-up blocker, but not until I had been through multiple screens that had to be resubmitted when I arrived at the pop-up step. They also introduced new fields that had to be completed for each practice location — fields detailing the number of hours per week spent in various activities such as patient care, ambulatory administration, inpatient administration, research, etc. Since I work a varied schedule at more than a dozen sites, this meant pulling numbers out of the air to populate more than 72 fields.
Additionally, when you save each location, it fires a popup that tells you that you need to complete the fax number for the location if it has one, despite it not being a required field. That was another 12 clicks and 12 screen refreshes that I didn’t need to do.
The final usability flaw was when I arrived at the credit card payment screen. Although it leaves the card number and CVV fields blank, it pre-populates the expiration date. If you’re like me and either multitasking or simply get distracted, you look back and the expiration field has numbers in it, so you move on. Unfortunately it then pops up that your card is expired, and sends you back three screens for you to re-key the information.
It felt like an exercise in futility, but what’s a girl to do? Complaining to the board that regulates your ability to prescribe certain drugs feels like you’re just asking for an audit. There’s no competition and no choice, so you just have to pay your fee (which feels like a cash grab, since we’re already regulated by the DEA) and be happy about it. Or if not happy, at least resigned.
On the opposite side of the usability chasm, there are plenty of vendors who are actually getting it done. One of the things I enjoy most about HIMSS is checking out emerging solutions and looking at vendors that are trying to break into the market with something novel. It doesn’t always have to be a “gee whiz” product. but it might be just someone who is doing things better or slightly different than the people who are already in the market.
I recently had a chance to look at iScribeHealth and learn about their journey to market. Their mobile app solution is an adjunct for EHR documentation. It allows providers to enter key data elements such as medications, problem list updates, histories, and more without using the EHR. It also supports dictation and charge entry.
They recently took their first batch of clients live. It’s quite different moving from the development phase to the real world and I’ll be interested to see how things go over the coming months. They’ve got some good hooks in their marketing material – encouraging users to “free yourself from late nights spent updating patient charts and wishing you had chosen a different career path.”
They’re also pushing the patient engagement aspect, allowing physicians to focus on the patient at the point of care and not on the technology. They also have automated reminders and surveys to connect with patients outside of the visit. Personally, they had me with their martini glass icon. Who doesn’t like a cosmopolitan in their daily workflow?
Just when you thought you had recovered from HIMSS16, it’s time to start planning your submissions for HIMSS17. The call for proposals opened last week and runs through June 13. They’re also looking for reviewers to take a look at all the content submissions during the summer months. I’ll let you do the math on how many months it is from the time the submissions are due until the actual presentation and determine for yourself whether it’s easy to keep things fresh with that kind of lead time.
I’ve previously been somewhat down on the American Academy of Family Physicians and other organizations for enabling some of the negative forces impacting physicians today. They have posted some introductory modules covering MACRA and the shift to value-based care. I appreciate their taking it down to the basic level that many physicians need to try to understand what’s about to happen to them.
In people news, today the National Institutes of Health announced the appointment of Patricia Flatley Brennan, RN, PhD as the new director of the National Library of Medicine. She has a long history in the informatics community. I find it most interesting that her doctorate is in industrial engineering and she has worked to leverage that knowledge in health care. The best implementation director I ever worked with was a ceramics engineer by training, so I appreciate what that background and mindset can bring to the table.
Regarding the 99% drop in AmWell stock -- True fact--I mad a profit buying AmWell on a dip once, and…