News 6/15/16

Top News

American Medical Association EVP/CEO James Madara, MD, speaking at the organization’s annual meeting, lashes out at “digital snake oil” of clinically unproven software and technology products that “impede care, confuse patients, and waste our time,” adding that “interoperability remains a dream.” He says doctors – who mistakenly failed to participate in early digital health projects – need to separate the lame digital tools from the potentially magnificent ones, explaining the present state of “digital dystopia” as:

Direct-to-consumer digital health devices—which only in the fine print say ‘for entertainment purposes only’—to our clunky electronic records, to ICUs that sound like primitive swamps abuzz with a cacophony of  bells, alarms, and whistles.

However, many of the solutions that Madara offers involve products from which AMA benefits – an incubator, an innovation studio, and lobbying efforts.

Meanwhile, John Halamka takes the counterpoint to the “digital snake oil” label, saying that more study rather than politician-like hyperbole is needed to understand that “we’ve achieved exactly the results we designed” in striving to simply replace paper charts with their electronic counterparts and to meet various government mandates. He provides examples in interoperability (e-prescribing, public health reporting, and lab reporting); population health (EHR patient panel queries); and consumer engagement (patient portals), all of which laid the foundation for the next generation of tools that will support team-based workflow, lifetime encounter records, care management workflow support, and family engagement tools. Halamka repeats the same advice he offered for Meaningful Use: focus on a small number of achievable outcomes.

Reader Comments

From Pomp and Circumstance: “Re: vendor press releases. Healthcare institutions are increasingly forbidding them to distribute press releases announcing new sales or contracts. This may distort the perception of success of companies that are compliant with the wishes of their customers.” It’s tough for a vendor to tout their successes when the client asks them not to, going beyond just not naming the client specifically, but prohibiting the sale from being mentioned at all. That practice prevents some much-need visibility into who’s buying what, but I agree that there’s no value to the new customer unless the sale can be crafted into a more self-serving announcement.

From Sticky Wicket: “Re: innovation award winners. You didn’t list those from the attached announcement.” I don’t consider press releases of these types worth mentioning since the average health system CIO would have minimal interest in companies whose enterprise readiness is years away at best even if they manage to avoid being among the 95 percent that will never be successful. Thus I’ve stopped running announcements of the following types, preferring to wait for actual customer success:

• Company funding under $1 million.
• New accelerators forming or companies joining an accelerator.
• Tiny companies winning an app contest or submitting an innovative idea.
• Startups offering a new consumer-facing health app whose outcomes have not been studied.

From Duluth: “Re: Navicure. Sold to Bain.” Unverified. I’ve reached out to the company for a response but haven’t heard back. UPDATE: Navicure confirms that it will receive an undisclosed strategic investment from Bain Capital Private Equity. Founder and CEO Jim Denny and the executive team will remain with the company.

From Gray Sky: “Re: [vendor name omitted]. Has had outages for the past two weeks for all hosted applications. Inside information points to a storage information where customer data has been erased. The company continues to investigate options to restore the data to a reasonable point in time.” Unverified. A company spokesperson responded quickly after hours and is trying to reach one of its executives for a response, so I offered to withhold the company’s name until my next post, which will also include any response the company provides.

From DOSsier: “Re: US Department of State. Issued an RFI for an off-the-shelf EHR for diplomatic missions.” The RFI is here, but note that it covers EHR implementation project management services only – it’s not a RFI for an actual EHR. The original plan was for the Department of State to share the Coast Guard’s Epic system, but the Coast Guard has backed away from that project. Before that, the DoS was planning to roll out the DoD’s AHLTA, so perhaps this RFI involves the DoD’s Cerner rollout. I don’t know the source of the DoS’s existing eMED system. The RFI was posted June 3 with a two-week response date.

From Pickle Entry: “Re: ACA insurance. UnitedHealth Group is pulling out of the exchange in my state. I’ve had to change insurance companies every year since Obamacare was rolled out, paying multiples of the premium prices I paid before the ACA.” The administration touts decreasing levels of uninsured citizens. That’s good, but those newly insured people are spending a lot of insurance company money catching up on their deferred health needs while young, healthy citizens are going without insurance because they are unlikely to get a payback. You can’t blame insurance companies who are stuck with a money-losing risk pool of self-selected patients when they stem their financial bleeding by exercising the only option the government gives them – shutting down their exchange plans. You are fine if you have employer-provided insurance, have a low enough income to qualify for endless government insurance subsidies, are old enough for Medicare, have few assets and therefore little financial exposure to expensive uninsured services, or are rich enough to not care. Otherwise, you’re paying more to keep the insurance-funded profits flowing to providers, drug companies, and the endless bureaucracy of middlemen who make up most of the US healthcare non-system and who are happy that ACA gave them newly insured patients to bill without touching the real problems of unjustified prices, fraud, and the financial incentive to create overutilization.

From Dan Blocker: “Re: data blocking. John Halamka says he’s never seen it. I say he needs to look harder.” Lots of people (including ONC) claim  that providers and EHR vendors intentionally block the flow of patient information, but nobody is serving up real-life examples instead of poorly sourced anecdotes. Such proof can only come from patient complaints and those are rare because: (a) patients don’t know that their interoperability expectations should be higher; (b) the moment of need is when they are unwell; and (c) they don’t have the information or incentive to figure out who to complain to. I bet that if you asked 100 people who were in the process of being seen as inpatients or outpatients to ask those providers to retrieve their history from other providers, nearly all of them would be unsuccessful, but turning that into a data blocking complaint against either of the providers or their respective EHR vendors would require a lot of investigatory legwork. Most of what’s wrong with healthcare is due to indifference or ineptitude, not carefully planned evildoing.

HIStalk Announcements and Requests

Listening: reader-recommended Fantastic Negrito, raw Delta blues from the Oakland,CA solo artist who describes his music as “uncut realness and zero concern for pop anything” and whose background is uplifting. Mark my words: all things (especially musical ones) must pass and eventually audiences will tire of shimmery musical junk food crafted by false-prophet celebrity musicians who possess no life experience and whose primary musical instrument is Auto-Tune. 

Ms. Westover says students in her inaugural high school microbiology course in Georgia are making good use of the lab supplies we provided in funding her DonorsChoose grant request, examining bacteria and analyzing water samples in discovering “a whole new microscopic world.” 

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

Hearst acquires a majority stake in MedHOK, which offers health plan software including case management, utilization management, and medication management. MedHOK will be incorporated into Hearst Health, which includes First Databank, Zynx Health, MCG, and Homecare Homebase.

A federal court dismisses the patent infringement lawsuit brought by telehealth provider American Well against competitor Teladoc, with the court finding that American Well’s patent is too abstract to be enforceable. Teladoc asked the patent office to invalidate American Well’s patients in 2015, after which American Well sued Teladoc just before Teladoc’s IPO. American Well will of course appeal. TDOC shares have dropped 33 percent in the year since its IPO.

Hospital medical device spend management software vendor Procured Health raises $10 million in new funding. The Chicago-based company had raised $5.1 million, with its most recent round being completed in March 2014 with little news since. 

Sunquest acquires patient flow technology from The Royal Liverpool and Broadgreen University Hospitals NHS Trust, which it will market to customers of its Integrated Clinical Environment. 

Patient access and RCM services vendor MedData will acquire RCM services vendor Cardon Outreach for $400 million.

Microsoft inexplicably pays $26.2 billion to buy LinkedIn in its biggest acquisition ever. Microsoft always seems desperate to grab onto whatever is trendy at the moment, wildly overpaying to acquire companies with higher growth potential that it then runs into the ground in repeated and easily predicted examples of failed synergy. MSFT is paying a 50 percent premium to the share price of LinkedIn, whose luster has faded as its revenue stalled and the platform keeps finding new ways to annoy its users in between their rare bursts of job-seeking and self-promotional activities.

Sales

Manati Medical Center (PR) and Mayaguez Medical Center (PR) choose Meditech 6.1, raising the company’s Puerto Rico hospital count to 21. 

Tampa General Hospital (FL) selects records aggregation and referrals management tools from EHealth Technologies.

Mainstreet Health will implement the HealthMedx Vision EHR for its transitional care facilities.

People

Justin Barnes (Justin Barnes Advisors) is named partner and chief growth officer of IHealth.

Extension Healthcare hires Ben Kanter, MD (Sotera Wireless) as CMIO.

Eric Kretzer (Strata Decision Technology) joins SA Ignite as SVP of products.

Announcements and Implementations

Boone Hospital Center (MO) lays off 26 transcriptionists following the decision by parent company BJC HealthCare to outsource transcription services to Madison, WI-based Amphion Medical Solutions, which was acquired by Atlanta-based IMedX in January 2016. 

The American Medical Association adopts ethical standards for telehealth and telemedicine at its annual meeting, noting that technology doesn’t change the ethical requirements for physicians to place the patient’s interests first. The guidelines also urges physicians to be cautious in making treatment decisions based on the limited information available in a telemedicine session and suggests that care coordination is essential.

Government and Politics

The SEIU healthcare employee union tries again to convince California to cap total hospital CEO compensation at $450,000, the same salary earned by the President.

Technology

Microsoft’s new XBox console eliminates the dedicated port for its Kinect motion-based controller, leading to speculation that Kinect is being phased out. Kinect is used by several innovative healthcare applications for pain assessment, physical rehabilitation, and patient-provider communication. My speculation would be that Kinect turned out to be less interesting (and less profitable) for consumer use but it will continue with a non-gamer focus.

Other

The former chief nursing officer of Sonoma West Medical Center (CA) sues the hospital and one of its board members, claiming she was fired after raising concerns about problems with the hospital’s new clinical software that was developed by the board member’s company. She says the hospital allowed the board member to use its patients as his EHR guinea pigs because he has donated $9 million to keep the previously closed hospital afloat, with the resulting buggy product mixing up patient records, providing incorrect medication information, and failing to display the code status of patients. The software in question appears to be from E-Health Records International, which claims that its tablet-based HarmoniMD hospital EHR can be brought live in single day. Its only users appear to be Sonoma West and a single hospital in Africa.

A Commonwealth Fund-sponsored study finds that only 30 percent of behavioral health providers use EHRs, recommending that SNOMED and LOINC terminology be enhanced to address behavioral needs, incorporating IT costs in setting bundled payment policies, adding behavioral-specific clinical decision support and interoperability capabilities to existing EHRs, and requiring EHR vendors to beef up their security capabilities.

A Peer60 report on payers finds that BCBS and Medicare are the ambulatory provider favorites by far, with UnitedHealthcare trailing the pack. Providers like payers that get them paid more quickly with minimal staff involvement, while their least-favorite attributes are time-wasting practices, denials, and poor customer service.

CMS Acting Administrator Andy Slavitt commits at the AMA conference that CMS will simplify its processes, involve physicians in decisions that affect them, focus on patients, support small physician practices, and make “healthcare technology a tool, not an industry.” Some snippets:

Off-the-shelf tools like Certified EHRs and clinical data registries can provide complete capabilities [for quality reporting], but other options exist as well, including most types of reporting that a physician is doing today. If CMS can get data automatically or through another source, we will do so … [CMS will focus on] putting more pressure on technology vendors and less burden on physicians, so physicians can do simple things like track referrals when a patient sees another specialist or visits a hospital … It’s also time to ask a lot more of the technology and technology vendors. This is particularly true in the area of what many call interoperability … the burden needs to be on the technology, not the user. EHR vendors and hospitals that use them will now be required to open their APIs so data can move in and out of an application safely and securely. This will also serve to help eliminate the ‘desktop lock’ that occurred based on early EHR decisions by allowing technology to more easily plug and play. Today’s data silos are more a function of business practices than technology capability and we cannot tolerate it any longer.

Here’s a textbook example of how to write a bad press release. The boring headline contains glaring spelling and capitalization errors, oddly uses the past tense, and reeks of company self-importance in providing a “news item” that would interest no one except the unfortunate author who was charged with getting some company buzz out there despite a lack of buzzworthy events. It randomly capitalizes job titles and other words that are not proper nouns (“EHR Systems”) and uses awkward phrasing that suggests it was crafted by someone whose mother tongue is not English. My mom’s advice remains valid: if you don’t have anything good to say, don’t say anything.

A Virginia hospital blames a misplaced EHR click for sending a sympathy card to the family of a patient who was in fact still alive. Sentara Martha Jefferson Hospital says someone clicked “deceased” instead of “discharged to home” in Epic, triggering the obviously automated condolences. At least the errant checkbox entry didn’t create a medical error that actually killed the patient.

Athenahealth’s Jonathan Bush provides an impassioned video reaction to news that TV host John Oliver formed a fake debt collection company, bought $15 million in overdue medical accounts receivable for $60,000 cash, and then told those patients that he was forgiving their debt. I assume that buying debt at less than a penny on the dollar means it was uncollectible anyway, so it wasn’t really much of a gift.

The Minneapolis newspaper covers the problem in which patient advance directives are not easily located in EHRs. It cites a study in which less than one-third of ED doctors were confident that they could find patient preferences for resuscitation, feeding tubes, or ventilators.

Eastern Maine Healthcare System (ME) offers voluntary early retirement to 43 of the 300 employees in its IT department, which is running $3 million over budget.

The American Diabetes Association is embarrassed when it allows a drug company to present new, sensitive research data to thousands of doctors attending one of its conferences, warning them to hold the information for one hour until the public announcement and the inevitable stock market reaction. The itchy Twitter finger doctors were already blasting out photos of the presentation’s title slide even before the presentation began, after which they tweeted out the presentation’s data slides and charts despite pleas from the ADA to remove them. Novo Nordisk shares dropped 5.6 percent on the modestly positive news.

Here’s the final physician practice vendor overview from Vince and Elise, which includes tips for product selection.

Weird News Andy loves good customer support even if it comes from sophisticated ransomware hackers who now provide live-chat operators to walk victims through the payment process in an effort to differentiate themselves professionally by improving usability. WNA suggests the hacker’s customer support agent be prepared to answer questions such as:

• How do I buy bitcoins?
• How do I know you will actually unlock all our data?
• Do you provide training on how not to click suspicious links?
• How’s the weather in Romania?

Sponsor Updates

• Impact Advisors is named as  one of the 500 largest technology integrators in North America.
• AirWatch announces updates to AirWatch 8.4.
• Bernoulli CNO Jeanne Venella is featured on RN FM Radio.
• Carevive Systems will host a tweet chat on the oncology care model on June 21.
• Cumberland Consulting Group will exhibit at AHIP June 15-17 in Las Vegas.
• Fast Company features CTG Technical Recruiter Kate Orngard in an article on recruiters.
• Extension Healthcare will exhibit at the ONL Annual Conference June 16-17 in Newport, RI.
• FormFast publishes an infographic on the real cost of paper-based informed consent processes.
• Healthfinch will exhibit at the AMDIS Annual Physician Symposium June 21 in Ojai, CA.

Blog Posts

• 4 Reasons Private Physicians Should Be Thankful That They’re Self-Employed (AdvancedMD)
• Making Sense of the Joint Commission’s Change of Heart on Secure Texting (AirStrip)
• The Population Health Jungle (CTG)
• CMO Observations from the 2016 ONC Annual Meeting (Arcadia Healthcare Solutions)
• The MACRA bottom line for IT leaders (The Advisory Board Company)
• New England States Mandate Use of Universal Form; Touch on Script Standard (CoverMyMeds)
• When Data Becomes Strategic (ECG Management Consultants)
• Migrating to 6.1 and other MUSEings from this year’s conference (Galen Healthcare Solutions)
• How do We Level the HIT Playing Field? (Hayes Management Consultants)
• Shift in Prostate Cancer Treatment has Roots in Foundation’s History (Healthwise)

Contacts

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

Curbside Consult with Dr. Jayne 6/13/16

I spent 38 of the last 72 hours seeing patients. Even the full-time physicians in my practice don’t usually work that much in a short stretch, so I’m not surprised that I found it exhausting. Normally, I find our EHR tolerable, but there were times in the last several days where it was unbearable. I experienced instability like I haven’t experienced since being a beta client for another vendor several years ago. I seemed to find more errors in the physician workflow than my co-workers found in the support staff workflows, and I could feel my attention drifting because I was becoming increasingly annoyed.

At one point, I was managing multiple high-acuity patients when I encountered a string of error messages. The one above nearly put me over the edge. End users should never see error messages like the one above. It’s insulting to the users and, although I’m sure it might mean something to a developer, it doesn’t mean anything to a customer who is trying to care for patients. It’s enough to make one want to wish for even more federal regulations – but only if they require vendors to provide mechanisms for graceful error handling.

As an EHR user, I sometimes feel like I’m a research subject in an experiment that hasn’t been approved by any kind of institutional review board. Everyone thinks that Certified EHR Technology is going to make our world a better place but the jury is still out on whether it’s going to truly be effective. And while we as physicians are having to cope with arduous workflows as a result of the regulations, there are advancements that would really benefit us that remain unaddressed.

Over the last decade, I’ve accumulated a wish list of product “enhancements” that would benefit the people in the trenches. Years later, though, they’re mostly unaddressed:

• The NCPDP standard for electronic prescribing limits the “SIG” or prescription instructions field to 140 characters. I’ve been told for years that this will be addressed in a future version of the SCRIPT standard, but it remains unaddressed in any production system I’ve ever used. Physicians who have tried to prescribe triptans or other medications that require unstructured SIGs know exactly what I’m talking about. I bet 140 characters made sense at some point, but it’s time for a change. If we can regulate the picklist selections available for marital status, certainly we can regulate this.
• Standardized lab ordering mechanisms are lacking. One major national reference lab supports electronic directory of services (eDOS) formatting but another doesn’t. This leads to a hodge-podge of strategies for EHR vendors who are trying to manage multiple lab compendia. Some use third parties to try to keep it straight, and others push the work onto the clients. This can result in thousands of physician offices trying to stay in sync with their reference labs, often with a lot of manual work. If we can regulate the use of CPT for lab charges, certainly we can regulate this. (I have to admit that I got a kick out of this reference on eDOS that mentioned that “MU3 proposed rules are anticipated to be published in January 2014 with final rule anticipated to be published in summer 2014.)
• Requirements for lab vendors and the way they deliver results is lacking. Although physicians are required to use LOINC codes for results to meet various quality measures requirements, there is no requirement that lab vendors send LOINC codes with their results. I’m working with a handful of clients right now who are having to do manual recoding to attach LOINC codes to their results, so that they don’t get dinged on their quality reports. If we can regulate the use of SNOMED, certainly we can regulate this.
• Interoperability remains elusive. Even when systems communicate, the mechanisms used to reconcile data from disparate systems can be clunky at best and downright unsafe in certain situations. Although some vendors have robust algorithms to identify potential matches and bring data seamlessly into the patient chart, others deliver a greater cognitive load than I experienced in my third semester calculus class. If we can regulative giving lip service to usability through user-centered design, certainly we can make it a reality.

Unfortunately, my list is growing longer rather than getting shorter. We’re forced to gather loads of information that could be put to good use but isn’t. For example, we collect information on race, ethnicity, religious preference, language preference, sexual orientation, and more. In many cases, it’s not used to further clinical care. It would have been great to have a prompt to ask about religious fasting the other night when I was treating a patient with profound dehydration. Although it occurred to me to ask, it didn’t occur to my patient care technician or to the resident I was supervising.

My state doesn’t have a usable database for identifying potential abuse of controlled substances. That’s not a vendor problem but a failure by our legislators to ensure that what they legislated was actually delivered as promised. It’s sad, because I could benefit from that kind of technology every single day. Other states have had it for years but here I am, calling around to try to confirm my suspicions when I’m concerned about a patient.

I know the industry is going through growing pains. There is a tremendous amount of external pressure and we’re trying to use technology to solve the broader healthcare problem rather than addressing the root causes. We can’t expect that to be easy, and I’m hoping we’ll look back on these times someday and chuckle at our relative naivety. Of course, there’s always the chance we’ll look back on these times fondly, because things will have gotten worse. Let’s hope that doesn’t come to pass.

For now, I’d settle for some friendlier error messages. I’d take “I’m sorry Doctor, I’m afraid I can’t do that” rather than hearing about unhandled exceptions or missing widgets. What’s your most annoying error message? Email me.

Email Dr. Jayne

Monday Morning Update 6/13/16

Top News

In light of voided test results and potential CMS sanctions, Walgreens ends its relationship with Theranos, closing all 40 of its Theranos Wellness Centers in Arizona. Walgreens will redirect lab testing to third-party companies or to the certified Theranos lab in Phoenix.

Webinar

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

• McKesson may sell its health IT business unit to focus efforts on its core drug distribution business.
• Vice President Biden announces formation of the Genomic Data Commons, an open-access cancer database that will help researchers collaborate and share information, as part of the administration’s Cancer Moonshot.
• Theranos says that less than one percent of its blood test results have been voided or corrected, a clarification on earlier reports that it would need to cancel or amend tens of thousands of results.
• Practice Fusion settles FTC charges that it misled consumers by soliciting reviews for their doctors without disclosing that the information would be publicly posted on the Internet, leading to patients unknowingly publishing their own sensitive patient information.
• The House passes the Helping Hospitals Improve Patient Care Act, exempting ambulatory surgical centers from MU and MIPS penalties.

Privacy and Security

UC San Diego (CA) halts plans to post physician reviews and star ratings on its website after realizing the surveys it sent to patients didn’t disclose that their comments could go public, potentially revealing their identities. The two-hospital system has postponed launching the reviews to redistribute surveys with appropriate disclosure language. While one healthcare executive believes the decision is based on physician pushback in the face of potentially damaging reviews, Practice Fusion’s recent settlement with the FTC over a similar situation lends UCSD’s decision some merit.

Twitter locks accounts and issues password resets after reports surface that 32 million passwords were leaked on the dark web. The company denies that its servers were hacked, instead attributing the leak to “combining information from other recent breaches, malware on victim machines that are stealing passwords for all sites, or a combination of both.”

People

The University of Iowa Health Alliance promotes Jennifer Vermeer to CEO.

Innovation and Research

A survey of 750 insured consumers reveals that they aren’t shopping around for healthcare services as much as industry insiders seem to hope they will. Just 30 percent of health plan members comparison shop, and only 30 percent of plans offer comparison-shopping tools. While 42 percent of those surveyed ranked such tools as “very important,” it’s hard to believe that importance would translate to more savvy shopping when a similar percentage believe the "cost is covered by my health plan, so it doesn’t matter."

NewYork-Presbyterian Hospital concludes its 10-week long InnovateNYP Pediatric App Challenge, awarding $40,000 to three finalists:

• FhirStarters pediatric medication administration app, developed by Riley McKenna and Anees Merzi.
• Teen Screen mental health screening and resource app, developed by Vikas Mandadi.
• NYP Care Companion patient engagement app, developed by Ekaterina Chernetsova, Roman Makhnenko, Andrew Gluschenko, Dan Piekarz, Alexander Demura, Margarita Olshanskaya, Egor Kobelev, and Allan Wellenstein.

Government and Politics

Illinois-based Boyd Memorial Hospital, HSHS Holy Family Hospital, and Hillsboro Area Hospital will share a $155,000 USDA Learning and Telemedicine grant to expand stroke treatment, neonatal, and pediatric telemedicine programs.

Other

Stan Larkin lives for 17 months without a heart by wearing a SynCardia Freedom Portable Driver. Powered by compressed air and worn in a backpack, the artificial heart allowed the 25 year-old – the first patient in Michigan to use the device – to live until he received a successful heart transplant in May.

South Australia Health hopes to hire a spin doctor for a six-month stint to convince the public that its highly criticized Enterprise Patient Administration System is worthwhile. The electronic records system is years behind schedule and over budget by over $200 million. Hospital physicians have formally complained that the system cut clinical activity by 50 percent, and have written a letter listing 37 major flaws and pleading for it to be shut down. SA Health named Allscripts as vendor of choice for the 80-hospital, $225 million project in November 2010 and signed the contract a year later.

The local paper looks at the hard time physicians often having locating end-of-life directives within EHRs, attributing the problem to a lack of training and/or intuitive field within the EHR. It holds up Gundersen Lutheran Medical Center (WI) as a forward-thinking organization when it comes to advance care planning documents. The hospital made digitizing such documents a priority when it implemented Epic in 2008.

Sponsor Updates

• Valence Health makes the top 20 of Fastest Growing Companies in 2016 by Crain’s Chicago Business.
• Verisk Health and ZeOmega will exhibit at AHIP June 15-17 in Las Vegas.
• Huron Consulting Group will exhibit at Vital 2016 June 15-17 in Boston.
• Zynx Health will exhibit at the Nurse and Home Care Forum June 15-17 in Foxborough, MA.
• Black Book names E-MDs the top ambulatory EHR for thoracic and vascular surgery specialties.
• The Chartis Group Director Jody Cervenak co-authors a chapter in the new second edition of the Oxford Textbook of Critical Care.
• PokitDok attains Microsoft certification and is inducted into the Microsoft Azure Marketplace.

Blog Posts

• Hybrid IT: The Biggest IT Trend No One’s Paying Attention To (TierPoint)
• Decoding MACRA: Implications and Recommendations for Provider Organizations (Verisk Health)
• Do More with Your Versus Badge: Call for Help, Monitor Rounding & More (Versus Technology)
• Celebrating the Big Wins in Vegas at ANI This Year (VitalWare)
• VUE16: Its’ all About You! (Voalte)
• Go for the Gold: Integrated Text-to-911 for PSAPs (West Corp.)
• Virtual healthcare? Consumers say bring it on (Xerox Healthcare)
• Six Ways to Get Paid Faster and More Fully by Patients (ZirMed)

Contacts

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

News 6/10/16

Top News

Practice Fusion settles with the FTC over charges that it misled consumers by asking for reviews of their physicians without adequately disclosing that those reviews would be posted publicly online. The reviews were published in 2012 as part of the company’s efforts to develop a public-facing healthcare provider directory. “Practice Fusion’s actions led consumers to share incredibly sensitive health information without realizing it would be made public,” says FTC Bureau of Consumer Protection Director Jessica Rich. “Companies that collect personal health information must be clear about how they will use it – especially before posting such information publicly on the Internet.” The settlement, which seems to carry no fine, prompted the FTC to publish six privacy pointers, with perhaps the most relevant being, “Disclosures should reach out and grab consumers,” and “Don’t bury key facts in a hard-to-understand privacy policy.”

Reader Comments

From EMR Expert: “Re: Financial trouble in the Middle East. Like many other vendors in various sectors, Cerner, Epic and InterSystems are having tough times collecting their money from existing clients. One of the executives of those companies stated that their Accounts Receivables of the value of more than $15 million is overdue by more than six months. Support contracts are not being renewed and payments for implementation are not honored. It is a catch 22 situation when all their clients were oil rich and now cash strapped governments/government entities.”

HIStalk Announcements and Requests

This week on HIStalk Practice: AMN Healthcare acquires Peak Health Solutions. CancerLinq announces new collaboration and practice sign-up milestones. North Carolina Medicaid reform will include the development of a statewide HIE. South Carolina lawmakers pass telemedicine-friendly legislation. SingleCare partners with American Well. Closed-door meetings in Texas could lead to more telemedicine-friendly legislation. Medfx and Falcon Physician develop software for nephrology practices. FastMed Urgent Care rolls out TouchCare telemedicine services at 57 clinics. Tandigm Health Medical Director Leslie Saltzman, DO shares the hurdles physician groups face when implementing telemedicine tech.

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

Xerox launches Virtual Health Solutions, a new service line that will offer providers telemedicine consulting, interface design and development, and virtual clinic services.

Connecture, a technology company that builds online health insurance marketplaces, acquires ConnectedHealth, a benefits technology platform that helps employers chose health plans. Financial terms were not disclosed.

Southcoast Health (MA) reports that its $100 million Epic implementation boosted the local economy by $3 million, mainly through hotel room costs, car rentals, gas, and dining. Nearly a third of the health system’s budget for the project went to costs associated with expenses for Epic staff and consultants.

Martin Shkreli jeeringly pleads not guilty to an updated indictment – one that adds a new conspiracy charge to original December allegations that he illegally took stock from a biotechnology firm he launched in 2011 and was fired from three years later. Not surprisingly, the “habitually unavoidable-for-comment Shkreli unloaded as he spoke to customers at a Manhattan Dunkin’ Donuts outlet while live-streaming on Periscope.” In related (and absurd) news, Shkreli blocks presumably reputable reporters from his Twitter stream, and lauds an upcoming satirical musical about his purchase of a $2 million single-copy Wu-Tang Clan album. It will no doubt give Hamilton a run for its money.

Announcements and Implementations

Radiology Associates of Macon (GA) extends its RCM agreement with Zotec Partners.

Meditech develops a sepsis management toolkit for select EHR customers.

St. Vincent’s Medical Center (CT) rolls out telemedicine services from Zipnosis.

The Guam Dept. of Public Health and Social Services partners with Good Samaritan Hospital in Los Angeles to roll out a specialty care telemedicine program for island residents.

Sales

Houston Methodist (TX), Meadows Regional Medical Center (GA), and Shore Medical Center (NJ) sign on for Unified Provider Management software from Phynd Technologies.

People

North Mississippi Medical Center promotes Shannon Fryery to director of telehealth for North Mississippi Health Services.

Callie Shaver (Greenville Regional Hospital) joins Jersey Community Hospital as HIM director.

Ed Mercado joins Crux Quality Solutions as CEO.

Government and Politics

The VA fires three more administrators within the Phoenix VA Health Care System. Lance Robinson, assistant director at the Carl Hayden VA Medical Center; Brad Curry, chief of health administration service; and Darren Deering, DO the hospital’s chief of staff; were all terminated for “negligent performance of duties and failure to provide effective oversight.” The terminations come more than two years after the exposure of the cover up of a huge backlog in medical appointments that severely impacted veteran care.

The House passes the Helping Hospitals Improve Patient Care Act, excluding ambulatory surgical centers from Meaningful Use and MIPS penalties.

Innovation and Research

Cerner launches a one-year pilot study that will help determine whether patient’s genetic data can play a motivating role in promoting behavior change.

A Health Affairs study correlates the use of prescription drug monitoring programs with a 30 percent reduction in the rate of prescribing Schedule II opioids, a change that continued in the second and third years following the launch of the program.

A small Health Catalyst survey of hospital executives finds that 62 percent have between zero and 10 percent of their care tied to the value-based contracts CMS hopes to have hospitals converted to by 2018. Just 3 percent meet the CMS goal of 50 percent value-based reimbursement today, and only 23 percent expect to meet it by 2019.

Technology

Avizia adds the patient-facing MyCare app to its AviziaOne telemedicine and secure messaging solution.

Experian Health’s Coverage Discovery uncompensated-care alert tool can now integrate with Epic’s EHR.

Influence Health develops new digital presence management technologies that include directory listings, reputation, and online provider review ratings tools.

Other

Jennifer Lawrence signs on to play Theranos founder Elizabeth Holmes in an Adam McKay-directed drama about the now-infamous blood-testing startup.

A mother in Australia uses Siri to call emergency services when she discovers that her sleeping baby had stopped breathing. While the digital assistant may have contributed to saving the girl’s life, it likely had more to do with the mom’s administration of CPR, given that the ambulance took 20 minutes to arrive.

Sponsor Updates

• Impact Advisors achieves top overall performance score in the KLAS Healthcare IT Advisory Report.
• InterSystems and PDR will exhibit at AHIP June 15-17 in Las Vegas.
• LiveProcess will exhibit at the SC Hospital Association Hospital Preparedness Summit June 8 in Columbia, SC.
• MedData will exhibit at the Southern Coastal Emergency Medicine Conference June 10-11 in Kiawah Island, SC.
• Medecision signs on as a founding member of the Accountable Care Learning Collaborative.
• Navicure will exhibit at the Arizona NextGen UGM June 10 in Phoenix.
• Nordic and Stella Technology will exhibit at the HIMSS New York State meeting June 16 in the Bronx.
• Millward Brown names NTT Data to its 2016 Brandz Top 100 Most Valuable Global Brands.
• Obix Perinatal Data System will exhibit at the 2016 AWHONN National Convention June 11-15 in Grapevine, TX.
• Experian Health will exhibit at the Georgia Society for Managed Care meeting June 12-14 in Jekyll Island.
• PatientMatters will exhibit at the Ohio Hospital Association Annual Meeting June 13-15 in Columbus.
• The SSI Group will exhibit at the Gulf States ASC Conference June 15-16 in New Orleans.
• Catalyze achieves a second HITRUST CSF Certification.

Blog Posts

• Population Health: Is It Really Working? (Medicity)
• Is It Worth The Effort to Create a Customized Data Breach Response? (ID Experts)
• Maximizing SEO During Your Hospital’s Website Redesign (Influence Health)
• “The Right Side of Healthcare” with David McClellan (Ingenious Med)
• Use Reporting to Diagnose Your Collection Strengths and Weaknesses (InstaMed)
• Pharma Lifecycle Plagued with Integration and Data Management Challenges (Part III – Clinical) (Liaison Technologies)
• Preventing Patient Data Mismatches When Deploying Image Exchange Enterprise Wide (LifeImage)
• Clarity Through Consoles (Netsmart)
• The Future State of Healthcare (Orion Health)
• A Guide to Processing Payments in Your Sleep (Patientco)
• System interoperability in healthcare IT: Why is it important? (Lexmark)
• We Can do Better (PeriGen)
• Recent Regulations Continue Promotion of E-Prescribing (Point-of-Care Partners)
• Modernizing Healthcare Communications (Spok)
• RAC Audits Are Like Most Healthcare Issues: Prevention is Key (Streamline Health)
• Recap of MUSE International in Orlando, Florida! (Summit Healthcare)

Contacts

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

EPtalk by Dr. Jayne 6/9/16

Thanks to everyone who sent well-wishes about my recent hand injury. I’m happy to report that I’m recovering and have traded out the giant dressing for something more sleek – today I sported a Mickey Mouse themed bandage. I’m seeing patients tomorrow and am a bit nervous about hand hygiene, but our infection control nurse is on board with a plan. I’ll also be running with a scribe, so that will help. Laughter is good medicine and I appreciated one reader’s comment that at least I wouldn’t need to buy a foam finger to cheer my team at the ballpark.

From Florida Orange: “I was reading your post and this sentence jumped out at me: “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.” How is satisfaction calculated? HCAHPS scores? Press Ganey? Or Yelp reviews? And what factors make up patient satisfaction?” The methods used vary depending on whether an organization is a hospital or ambulatory group. I’ve actually seen groups use all of the above to assess patient satisfaction, plus other strategies such as anonymous waiting room surveys, online surveys, and more.

In my largely ambulatory world, the factors that come into play include: satisfaction with contacting the office (which may include appointment scheduling and availability); wait time in the office; friendliness and helpfulness of staff; whether patients felt their diagnosis and treatment was explained to their satisfaction; willingness to recommend the office to other patients; and more. My practice uses a third-party survey service that emails a link to the patient and we can see responses via a practice dashboard. They’re not anonymous and we contact anyone who doesn’t give us at least four out of five stars overall or offers narrative comments that are concerning.

Everyone likes getting good reviews, and the percentage of four- and five-star reviews impacts our bonus calculation, as does our ability to care for patients in a timely manner when they arrive. As a member of the executive team, I get an email notification when a patient activates the survey link. Sometimes this happens when I know the patient has to be driving home from the visit, which is amusing. All of our patients are emailed the survey at the time of check-out, even those that we know had less than optimal experiences. The times when we didn’t’ do well are the most important for learning and we really need that feedback.

Different organizations weigh the impact of their results in different ways. I worked with an organization a few years ago that lived and died by their Press Ganey statistics, even when the results didn’t make sense as far as supporting the organization’s overall goals. As organizations evolve along with our changing healthcare system, it’s going to be increasingly important for groups to evaluate their survey strategies on a regular basis. If processes have been improved and responses are flat, maybe it’s time to measure different elements.

Patient engagement is an increasing part of patient satisfaction, and at last week’s ONC Annual Meeting they launched a Patient Engagement Playbook. It’s designed to help organizations improve patient engagement via patient portal usage. The first phase encourages clients through the critical steps of making enrollment easy; activating features that patients want; allowing proxy access for caregivers; and integrating patient-generated health data. Physicians often resist the last item, so if you work with those who might fall into that category, a quick read might be in order.

From Jimmy the Greek: “OK, Dr. Jayne, tell me why this patient portal view of lab results is useless. That’s right, campers, there’s no ‘normal range’ displayed.  Just how the hell is a non-clinician supposed to interpret these values?  Should I turn to Dr. Google?  Should I make a follow-up appointment with my doc to talk through the results?  Should I expect a phone call to discuss them? I have loads of data, but no way to turn the data points into useful information.” This goes right along with my recent post about trends in organizational patient portal release policies. The mere fact of releasing labs to patients doesn’t necessarily empower them, and without the right supporting information can lead to patient frustration or worry. I don’t immediately recognize this vendor, so I can’t tell whether there are other features that would help the patient understand their results such as hovering over them, but from other correspondence, Jimmy seems to be a pretty astute IT guy and would likely have picked up on something like that.

Aprima is hosting its annual User Conference at the Omni Dallas Hotel August 5-7^th. A piece on their blog caught my eye, since it quoted a client from a practice named “Serenity Now Psychiatric and Counseling Services.” That’s probably one of the best practice names I’ve seen in a long time. The write up also caught my eye since they’re offering a service project where attendees can assist with making blankets, gift bags, and other items for patients at Children’s Medical Center in Dallas. I love seeing companies help the community.

Are you a vendor who gives back? Email me.

Email Dr. Jayne

Breaking Down Blockchain’s Healthcare Potential

HIStalk looks at the evolution of blockchain, barriers to adoption in healthcare, and its potential to truly put patients at the center of care.
By @JennHIStalk

The blockchain concept, while not new, certainly suffers from a lack of healthcare-related glitz and glam, a dearth of bells and whistles that seems to have kept the wallets of Silicon Valley insiders tucked tightly in their pockets (or pocketbooks). Like its VC funding, healthcare headlines relating to blockchain are few and far between – a good indication that the concept has some ways to go before reaching critical mass.

Many automatically associate the word with bitcoin – that much ballyhooed digital currency that has tried time and again to take the world by storm. Those more in the know equate it to financial markets, where authentication and security are key. A small but growing number of IT insiders see it as an initially humble solution to healthcare’s many problems (cybersecurity, claims delivery, interoperability, etc.) – one that may mature into a more dazzling and potentially game-changing business process down the road.

Its true potential in healthcare and in any number of other industries will only be realized once stakeholders truly understand its nature, barriers to adoption, and potential, including moonshots and more down-to-earth applications.

Understanding What Blockchain is (and isn’t)

Definitions of blockchain abound, and, depending on the resource, can be either fairly easy to understand or almost too abstract to contemplate. Techopedia defines it as “a critical part of the bitcoin peer-to-peer payment system.” Investopedia goes a bit further, defining it as a “public ledger of all bitcoin transactions that have ever been executed. It is constantly growing as ‘completed’ blocks are added to it with a new set of recordings. The blocks are added to the blockchain in a linear, chronological order.” These summaries are, in fact, too narrow, given that a blockchain does not in fact have to be tied to bitcoin.

“To begin with, blockchain is not equal to bitcoin,” explains PokitDok Chief Scientist Bryan Smith, who is ushering the healthcare transactions technology company into early blockchain adoption. “A blockchain, at its essence, is a distributed database containing records whose contents, authenticity, and security are guaranteed. It drives efficiency, protects rights through immutable records, and establishes a system of accountability – an imperative in the often murky world of healthcare claims and reimbursement.

“With blockchain,” he adds, “engaged participants could opt in to share information that they want to share. That data could be accessible to authorized parties through a variety of front ends – from a mobile device to a sensitive compartmented information facility. There’s no other database that exists with that kind of functionality.”

Smith’s evangelism seems well founded. What provider, patient, or payer wouldn’t want access to a single database that could act as one source of truth for health data? Jerry Cuomo, vice president of blockchain technologies within IBM’s new cloud group, believes blockchain has the potential to consolidate disparate versions of the truth – a concept that would seem to play well with industry efforts around interoperability and a national patient identifier. “In the current world,” Cuomo says, “everyone is keeping their own version of the truth, their own system of record. When something comes in, everyone is working in silos. Each organization has to look at that transaction and determine if it matches their view of the truth. If not, they have to make it match by converting it to their preferred format. Those are all opportunities for things to go wrong. With a blockchain, you’re working across a replicated, encrypted, shared ledger that has an audit trail. It reduces the attack surface because now it’s just one ledger that everyone is sharing.”

Gauging its Potential

Brian Behlendorf, executive director of The Linux Foundation’s Hyperledger blockchain project, says. “Blockchain addresses concerns of security, scalability, and privacy of EHRs.”

Cuomo, whose team is working to develop blockchain pilots across a range of industries, envisions several “moonshot” applications for healthcare, including a patient-centered blockchain that would give providers limited access to a patient’s health record during time of service. “Just imagine a patient who is about to go into the hospital for an overnight stay,” he says. “The patient could set up a contract with the hospital, giving it 24-access to their healthcare records via blockchain. After the 24 hours are up, the hospital can’t add or make changes to that record, which reverts back to patient ownership. The patient sets the terms of who sees the record, for how long, and under what conditions. It becomes a truly patient-centered healthcare record that follows that patient from doctor to doctor.”

Cuomo also believes that new business models around healthcare blockchains are bound to spring up. “Imagine having the ability to advertise your healthcare information via your blockchain – to let organizations know that you’re interested in participating in clinical trials. You could proactively shop out your healthcare information to improve healthcare and better mankind. If those trials offer payment, you could theoretically offset the cost of your healthcare premium for the year. There’s no systematic way to do that today because your healthcare information is all over the place. In a blockchain and a corresponding ecosystem built up around that, patients might be able to more easily – and securely – contribute to medical research.”

From Big Ideas to Practical Applications

Moonshots often trump more practical use cases when a technology is just getting off the ground. While big ideas are essential to generating buzz around an up-and-coming innovation (Tricorder, anyone?), it is the less sexy application that ends up being a springboard for future headline-generating products and services. Where healthcare is concerned, blockchain may be poised to have the most immediate impact on the claims process.

“If you look at the healthcare ecosystem,” Smith explains, “there’s the patient, the insurance companies, and the providers. Sitting between each of them is some kind of intermediary. On average, processing a claim accounts for anywhere between 20 and 40 percent of the total bill. Overhead is significant, and it may be three months after a medical visit that you get an annoying bill that is often impossible to understand. Five years from now, we’ll see blockchain foster dramatic gains in economic productivity and authenticity much like the Internet introduced.”

Cuomo sees immediate potential in the area of dispute resolution. “A lot of these healthcare insurance environments are always dealing with disputes, often in the tens of thousands range,” he says. “It could be innocent things stemming from improper documentation. These things get held up in the system. They take time to resolve, and money isn’t flowing. When money isn’t flowing, it’s bad for everyone. You can’t pay your bill, people aren’t getting paid, etc. A blockchain could be used to enrich claims processing by tracking events. Those events could be used and consented on to be a source of truth – maybe not eliminating disputes, but reducing the time it takes to settle them. A great win-win for everyone.”

Behlendorf, who spent several years helping the White House and HHS use open-source software to drive adoption of shared medical records, also sees potential in blockchain’s ability to drive the sharing of patient records. “While we moved the needle substantially in our work on CONNECT and Direct,” he says, “there are still many who view patient data as their proprietary edge, not something that belongs to the patient. This is not just unfortunate and archaic; it is life-threatening when relevant health data isn’t shared.

“But, there are stakeholders who have a much greater interest in seeing a comprehensive record of patient care, and are in a connective position in the ecosystem. Insurers, for instance, will play a large role here, as well as the new wave of ACOs, and, by proxy, Medicare and the VA. Here, patient care and outcomes are comprehensively consulted, and the blockchain can provide not only a history of care (with permissions managed via keys), but it can also provide proof of authenticity for records shared between such organizations.”

Lessons Learned from Interoperability

Obtaining industry consensus on a common set of standards that levels the competitive playing field has historically been hard to achieve in healthcare. While Behlendorf, Cuomo, and Smith are certainly idealists in their take on the technology’s potential, they are also realists when it comes to calling out barriers to adoption.

“The barriers to adoption of information-sharing standards in the healthcare industry are many and difficult,” Behlendorf explains, “and few have to do with inadequate technology, but instead with alignment of incentives. What blockchain technology might do is introduce new players and new incentives to the market, thus potentially changing that landscape. It also introduces new risks, since we’re talking about widely shared data (even if encrypted), so we can’t be in a rush to implement. We’re very eager to work with the healthcare industry to investigate where we might see some early wins. The challenge, as always, is to find a set of stakeholders with enough of a common interest that they are willing to invest and collaborate. I’ve seen that first-hand in the healthcare industry, so I know it’s possible.”

Cuomo emphasizes the “network effect” necessary to get blockchain off the ground in healthcare. “It starts with a group of companies working together,” he says. “I think the network would be sparked by a set of influencers, like a set of major hospitals coming together, with sponsorships from one or more payers, which would motivate patients to come in and manage their health records via blockchain.

“But,” he adds, “therein lies the rub. That social pact has to be made. There has to be benefit for groups to come together. There’s a social side to it that’s probably more important. The technology facilitates businesses working together with less friction, with a heightened sense of trust and accountability, but you’ve got to agree on those things.”

Moving Ahead with Early Adoption

Smith is confident that every healthcare stakeholder – from providers to banks – will soon be evaluating how blockchain will impact their business processes. PokitDok, which itself is in the process of developing a blockchain system that Smith believes will significantly improve the security of sensitive health data while simultaneously making that data more readily accessible to authorized parties in real time. The company has also founded a Healthcare Blockchain Consortium to further evangelize the technology. While not quite ready to share specifics, Smith says that the consortium will “develop collective efforts to truly effect meaningful change in how healthcare is administered, delivered, and consumed worldwide.”

Cuomo and his team at IBM launched cloud-based blockchain services in April for healthcare, government, and financial services, and are working on internal and external proof-of-concept projects (including collaboration with the Linux Foundation’s Hyperledger Project) that he hopes will further escalate healthcare’s interest.

Behlendorf also takes an early-days approach to moving forward with blockchain in healthcare, stressing that the Hyperledger Project is not a standards effort. “We are here to build software,” he says, “and in doing so, lift the blockchain ecosystem as a whole, across all industries. We would be very excited to see new members from the healthcare industry participate so that we can understand their needs, collaborate, and build the core platform. As open-source software communities have shown, those companies that participate end up with an operational advantage in understanding how this technology can transform their business. They also see their staff develop expertise in a domain that is difficult to simply buy or outsource. This is about building an ecosystem and everyone has new roles to play if they recognize that and invest in transformation.”

News 6/8/16

Top News

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.

Patrick Flynn (Phytel) joins Aventura as COO.

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.

Blog Posts

• Medical Practice Optimization Simplified, Part 3 of 5 (AdvancedMD)
• Developing an End of Life Care Program (Arcadia Healthcare Solutions)
• All Roads Lead to Dallas for Aprima’s 2016 User Conference (Aprima)
• 4 Challenges & Solutions for Big Data Capturing (Catalyze)
• Health Information Exchange: Where Does the Pharmacist Fit? (Wolters Kluwer)
• Where to Focus on Improving Chronic Disease Care (Caradigm)
• CTG Luxembourg Celebrates its 20th Anniversary (CTG)
• 5 Soft Skills Making HIT Professionals More Marketable (Direct Consulting Associates)
• The Scenic Route: One Consultant’s Journey Through Healthcare (ECG Management Consultants)
• MUSE2016 – To Infinity and Beyond! (Galen Healthcare Solutions)
• A Different Kind of Consultant – Leveraging Experience and Personality (HCTec Partners)
• Prescription Drug Monitoring Programs and Mitigation of Opioid Abuse (Wolters Kluwer)

Contacts

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

Curbside Consult with Dr. Jayne 6/6/16

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.

Email Dr. Jayne

Monday Morning Update 6/6/16

Top News

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.”

Blog Posts

• What your CIOs and CEOs learned at our IT Executive Summit (The Advisory Board Company)
• Why Healthcare Providers Should Request Payment Upfront (Patientco)
• Memorial Sloan Kettering’s Charge Capture Success Story (PatientKeeper)
• Improving collaboration and patient care through a single patient identifier (PerfectServe)
• ONC seeks alignment of incentives around free flow of health information (Lexmark)
• Watson and his AI Cousins will Always Need Humans: Is the Converse True? (PeriGen)
• Providing Value while Building the Client Relationship (Phynd Technologies)
• Progress Notes in PMD: Fast, Efficient, Fun (PMD)
• Surescripts at the ONC Annual Meeting: Combatting the Opioid Abuse with Health IT (Surescripts)
• 25 Years, 100 Transfer Centers, 4 Lessons (TeleTracking)
• For Providers, Successful Accountable Care can Start with Employees (Verisk Health)
• Satisfaction isn’t enough. (Voalte)
• The Pharmacist as Provider: Retail Meets the Clinical (West Corp.)
• How can Healthcare Achieve Value-based Care? (Xerox)
• Reducing the Stress of HDHPs and Patient Collections (ZirMed)
• Interoperability and Toppling the Tower of Babel (Aprima)

Contacts

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

News 6/3/16

Top News

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.
• Extension Healthcare, FormFast, and InterSystems will exhibit at the E-Health Annual Conference June 5-8 in Vancouver.
• Glytec highlights studies presented at the AACE Annual Scientific and Clinical Congress in Orlando.
• The HCI Group EVP of Clinical Services Bob Steele is elected to the HIMSS Health IT User Experience Committee.
• Live Process will exhibit at the AAMI 2016 Conference & Expo June 3-6 in Tampa, FL.
• MedData will exhibit at the Advanced Institute for Anesthesia Practice Management meeting June 3-4 in Las Vegas.
• Navicure publishes a new resource guide, “Getting Billing Right.”
• Nordic will host the Qlik Healthcare Wisconsin Users Group Meeting June 9 in Madison, WI.
• Obix Perinatal Data Systems adds two new videos to its “Ask the Experts” series.

Blog Posts

• ICD-10: Are We There Yet? (Medicity)
• Medical Practice Optimization Simplified, Part 2 of 5 (AdvancedMD)
• How Interoperable is Your Brain? (Arcadia Healthcare Solutions)
• 7 Quality Measure Healthcare Organizations Explained (Catalyze)
• Optimizing Medical Device Management (CapsuleTech)
• Current and Future Trends in CCM (CareSync)
• Are Health Plans Heading Towards Data Lakes or Data Swamps? (CitiusTech)
• CoverMyMeds Gives Talk on EPA Best Practices at CBI (CoverMyMeds)
• Patient Wait Times Should be Your Priority (Culbert Healthcare Solutions)
• What Value-Based Reimbursement Really Looks Like (Divurgent)
• End User Training: Three Things to Know Before Your Data Migration (Galen Healthcare Solutions)
• 4 Tips on How to Involve Your Subject Matter Experts in Your EHR Implementation (Hayes Management Consultants)
• Healthcare Organizations and Their Business Associates Play the Blame Game (ID Experts)
• The Positive Impact of Giving! (Impact Advisors)
• Patient Engagement Isn’t as Hard as You Think (Influence Health)
• What is Integration and How Can Providers Benefit? (InstaMed)
• Finland Sets the Stage for Liaison Alloy Health (Liaison Technologies)
• Hospital Billing Contracts – The why, the ROI (hint: very high), and first steps (Nordic)
• Why the Future of Health Looks a Lot Like Your Mobile Phone (Orion Health)

Contacts

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

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.

Morning Headlines 6/2/16

Judge Finds Michael Dell, Silver Lake Underpaid for Dell in 2013

A Delaware judge rules that Michael Dell underpaid shareholders more than $6 billion when he took the company private in 2013.

Transparency Requirements for Health IT Developers Will Help Providers Know More About Their Products

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.

National Solution For Accurate Patient Identification Appears Within Reach

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.

It’s Time to Unbreak Healthcare

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.

News 6/1/16

Top News

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.

Contacts

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

Monday Morning Update 5/30/16

Top News

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.

Blog Posts

• Community Connect versus EpicCare Link: Nordic’s take (Nordic)

Contacts

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

News 5/27/16

Top News

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.

Sponsor Updates

• Iatric Systems, Intelligent Medical Objects, Leidos Health, MedData, and Obix Perinatal Data System will exhibit at the International MUSE 2016 conference May 31-June 2 in Orlando.
• InterSystems will exhibit at the E-health 2016 Conference June 5-8 in Vancouver.
• The National Business Review interviews Orion Health CEO Ian McCrae on NBR Radio.
• ZeOmega launches a consultant certification program for its Jiva population health management system. 
• CloudWave, Experian Health, PatientSafe Solutions, Patient Keeper, Summit Healthcare, and T-System will exhibit at the International MUSE 2016 conference May 31-June 2 in Orlando.
• PatientMatters will exhibit at the Illinois Hospital Association Small & Rural Hospitals Annual Meeting June 8-9 in Springfield.
• Sagacious Consultants releases the May 2016 edition of its Sagacious Pulse newsletter.
• The SSI Group and Streamline Health will exhibit at the SC HFMA Annual Institute 2016 May 31-June 1 in Myrtle Beach.
• Four TransUnion Healthcare solutions receive “Peer Reviewed by HFMA” designations.
• Valence Health will exhibit at the HAP 2016 Leadership Summit June 6-7 in Harrisburg, PA.
• Wellsoft will exhibit at the NAFEC Annual Conference June 6-8 in Houston.

Blog Posts

• Merger and Acquisition in Healthcare – a Solution to a Problem or Problem in Need of a Solution? (Impact Advisors)
• 3 Critical Steps to Become and Remain Relevant on the Web (Influence Health)
• Revolutionary Health IT: A View from Dubai (InterSystems)
• Most fear it, others embrace it … audits! (Hayes Management Consulting)
• Why Secure Text Messaging Is a Misnomer (Spok)
• Where’s the BMT data? My quest to find it. (Liaison Technologies)
• Why I Recommend Integrating Image Exchange with Your EHR (LifeImage)
• QRDA-1 for eCQM to QNet…it’s GREEK to me! (Iatric Systems)
• Bye bye MU – Hello MACRA (MedAptus)
• Tripling Scheduled Payments in Six Months (Navicure)
• Speech Recognition does much more than convert speech to text. (NVoq)
• MUSE 2016 – Sharing Stories (PatientSafe Solutions)
• Common PCI Compliance Mistakes When Processing Patient Payments (Patientco)
• Inaccurate Physician Data Causes Multiple Downstream Problems (Phynd Technologies)
• What’s with Account Managers Managing Accounts? (PMD)
• Aprima Earns Fundamental Building Block for Patient-Centered Medical Homes (Aprima)
• 5 Tips for Managing Employee Health (Verisk Health)
• Choosing the Right Real-time Locating System (Versus Technology)
• Caring for Patients by Investing in Technology (Voalte)
• HITRUST forms a Business Associate Council for Healthcare (West Corp.)
• Healthcare providers prioritize population health, but face challenges (Xerox)
• Keys to High-Performing Clinical Documentation Improvement Initiatives (ZirMed)
• The Alphabet Soup of Healthcare Reform (Zynx Health)

Contacts

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

News 5/25/16

Top News

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.

McKesson acquires Laboratory Supply Company.

Sales

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.
• Elsevier Clinical Solutions and FormFast, Galen Healthcare Solutions, and HealthCast Solutions will exhibit at the 2016 International MUSE Conference May 31-June 3 in Orlando. 
• Extension Healthcare will exhibit at the AAMI Annual Conference June 3-6 in Tampa, FL.
• HCS will exhibit at the ONC Annual Meeting May 31-June 2 in Washington, DC.
• HDS and Healthwise will exhibit at the Cerner Great Lakes RUG May 31 in Chicago.

Blog Posts

• Medical Practice Optimization Simplified, Part 1 of 5 (AdvancedMD)
• Making Technology Work for Nurses (AirStrip)
• A "food insecurity" primer for healthcare providers (Nordic)
• What is Disease Management? (Arcadia Healthcare Solutions)
• Time to Value in Population Health (Caradigm)
• Help with Understanding Medications (CareSync)
• Chris’ One Lap of America: a CoverMyQuest Tale (CoverMyMeds)
• A “food insecurity” primer for healthcare providers (Nordic)
• Think You can Design a Better Medical Bill? (EClinicalWorks)
• Change in Paradigm: Sharing Healthcare Information Outside the Hospital Walls (Hayes Management Consulting)

Contacts

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

Monday Morning Update 5/23/16

Top News

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.
• Experian Health, PatientMatters, and The SSI Group will exhibit at the NAHAM Annual Conference May 24-27 in New Orleans.
• PeriGen offers an update on its go live at Oschner Baptist (LA).
• Streamline Health will exhibit at the 2016 HFMA Western Michigan Spring Institute May 23-25 in Mt. Pleasant.
• Sunquest Information Systems will exhibit at the Pathology Informatics Summit 2016 May 23-26 in Pittsburgh.

Blog Posts

• Taking ‘Access’ on the Road (TeleTracking)
• How CMS’ Medicare Advantage Final Rules Could Impact Your Plan (Verisk Health)
• Remembering an Industry Legend: Dr. Robert Gold, MD (VitalWare)
• Automating clinical processes for the best patient outcomes. (Voalte)
• Three Crucial Considerations for Pharmacists in the Age of Consumerism (West Corp.)
• Why is Medication Difficult? (Xerox Healthcare)
• How healthcare providers could save about $7 billion (ZirMed)
• Checking Out After Your Checkup: Technology Matters (Patientco)
• The Vice President’s Plea (PatientKeeper)
• How Do You Determine the Effectiveness of an IT Solution (Phynd Technologies)
• A Bundle a Day Keeps FFS at Bay (PMD)
• Sage Advice on EHR Adoption – Accenture Doctor Survey 2015 and What it Means in 2016 (Sagacious Consultants)

Contacts

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