News 2/19/16

Top News

IBM will buy Truven Health Analytics for $2.6 billion, with Watson Health GM Deborah DiSanzo saying the acquisition makes IBM “the world’s leading health data, analytics, and insights company.”

The Watson Health unit houses previous acquisitions Phytel, Explorys, and Merge Healthcare.

Veritas Capital acquired the healthcare business of Thomson Reuters in June 2012 for $1.25 billion, renaming it Truven Health Analytics. Reports in March 2015 suggested that Truven was preparing for an IPO that would have valued the company at $3 billion.

Reader Comments

From CareCloudian: “Re: former CEO Albert Santalo. He has been fully removed and last Friday was his farewell party. That’s the second company he’s founded and then was fired from.” Unverified. He’s still listed on the company’s executive page and I assume he’s still chairman of the board. Santalo was removed as CareCloud CEO in March 2015. Revenue cycle vendor Avisena fired him as its president and CEO in September 2008 and then sued him and CareCloud, claiming that he had violated his non-compete agreement.

From Seashore: “Re: Sandlot Solutions. I heard they’re going bankrupt.” Unverified. I didn’t hear back from Rich Helppie or anyone from the company after running the rumor that they’ve had big layoffs.

From British Bulldog: “Re: EMIS Health, the former Ascribe. Phasing out operations in Asia Pacific through the end of 2017.” Unverified. The England-based vendor renamed itself in June 2015 to unify products that include EMIS (primary care software with 53 percent of the UK GP market), Rx Systems (retail pharmacy software), Ascribe and Indigo 4 (pharmacy and e-prescribing), and Digital Healthcare (retinopathy screening). EMIS bought Ascribe for $80 million in 2013.

From Dedicated Reader: “Re: Boston Children’s hacker. Caught after trying to flee to Cuba.” The FBI arrests 31-year-old Somerville, MA resident Martin Gottesfeld after he was rescued from his small boat off the coast of Cuba by a passing cruise ship. He is charged with coordinating a week-long denial-of-service attack against the hospital in April 2014 on behalf of the hacker group Anonymous. He faces a five-year sentence for conspiracy.

HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor Catalyze. The Madison, WI company offers “Healthcare’s HIPAA Compliant Cloud,” making healthcare applications and digital health data secure, trustworthy, and interoperable. Developers build their tech stack, then turn things over to Catalyze to provide a HITRUST-certified platform-as-a-service that offers monitoring, dedicated logging, encryption, high availability, and backup and disaster recovery. The company just launched Redpoint, which offers an developer API that provides interface mapping, a RESTful API, a keep-alive VPN connection, and testing. Redpoint offers pre-configured EHR integration scripts (prescribing, encounter or note creation, results alerting, etc.), EHR connectors, and integration workflows. The company offers free reports, open source projects, and an innovator video interview series on its site. HIStalk readers will probably know co-founder, CEO, and privacy officer Travis Good, MD, MBA, who wrote HIStalk Connect for years until Catalyze grew so large (35+ employees) that he ran out of time. Thanks to Catalyze for supporting HIStalk.

Here’s a nice video of Catalyze’s Travis Good talking about compliance.

Ms. M from Colorado says, “I can’t believe someone would be this generous” in noting our funding of her DonorsChoose request for hands-on materials for her advanced placement statistics students.

Also checking in was Mrs. Dickel from her Nebraska kindergarten class, explaining, “The kids are so into these new math tools that they even choose them over Legos during our regular center time! You are truly making a difference in these kids lives. THANK YOU!!!!”

This week on HIStalk Practice: Florida Accountable Care Services and UnitedHealthcare form Central Florida ACO focused on sharing technology and real-time data. Telemedicine market set to surpass the $13 billion mark by 2021. Associates in Dermatology rolls out Iagnosis telemedicine services. CMS introduces new core clinical quality measures. Brad Boyd ponders effective IT governance in the latest Consultant’s Corner. MTBC acquires Gulf Coast Billing. Genesis Medical Associates keeps acquirers at bay by staying tech savvy. Daria Bonner and Phillip Miles outline the importance of physician coder training systems in light of ICD-10.

This week on HIStalk Connect: As apparel companies race to build digital health ecosystems, Asics acquires fitness app Runkeeper for an undisclosed sum. Hackers turn to ransomware to monetize cyber attacks on provider organizations. Microsoft partners with Novartis to create a Kinect-based MS assessment tool. Researchers find little inter-rater agreement in a study designed to evaluate mobile health apps.

Listening: indie rock from Canada-based Wintersleep, whose upcoming release contains “Territory,” featuring a killer bass track by Rush’s Geddy Lee. They sound kind of like Nada Surf, which also has new album out in a couple of weeks. I’m also desk-drumming to a new release from the quirky boys of Weezer.

Webinars

February 23 (Tuesday) 1:00 ET. “Completing your EMR with a Medical Image Sharing Strategy.” Sponsored by LifeImage. Presenters: Don K. Dennison, consultant; Jim Forrester, director of imaging informatics, UR Medicine. Care coordination can suffer without an effective, cost-efficient way to share images across provider networks. Consolidating image management systems into a single platform such as VNA or PACS doesn’t address the need to exchange images with external organizations. This webinar will address incorporating the right image sharing methods into your health IT strategy.

February 24 (Wednesday) 1:00 ET. “Is Big Data a Big Deal … or Not?” Sponsored by Health Catalyst. Presenter: Dale Sanders, EVP of product development, Health Catalyst. Hadoop is the most powerful and popular technology platform for data analysis in the world, but healthcare adoption has been slow. This webinar will cover why healthcare leaders should care about Hadoop, why big data is a bigger deal outside of healthcare, whether we’re missing the IT boat yet again, and how the cloud reduces adoption barriers by commoditizing the skilled labor impact.

February 25 (Thursday) 1:00 ET. “Clinical Analytics for Population Health: Straddling Two Worlds.” Sponsored by HIStalk. Presenters: Brian Murphy, lead analyst, Chilmark Research; Jody Ranck, senior analyst, Chilmark Research. The Chilmark Research clinical analytics team will be sharing some of their key findings from the recently released “2016 Clinical Analytics for Population Health Market Trends” report. This will be followed by a Q&A session to make sure everyone goes to HIMSS16 well informed.

Acquisitions, Funding, Business, and Stock

Healthcare API vendor PokitDok receives an unstated investment from McKesson’s investment arm. The company had previously raised $46 million.

Leidos reports Q4 results: revenue up 10 percent, adjusted EPS $0.78 vs. $0.69.

Bloodbuy, which connects hospitals to blood centers, closes a $3.75 million financing round with Premier and St. Joseph Health (CA) as participants.

Allscripts announces Q4 results: revenue up 1 percent, EPS $0.09 vs. –$0.01, meeting earnings expectations but falling short on revenue.

The local paper profiles 20-physician, western Pennsylvania-based Genesis Medical Associates, which says UPMC and Allegheny Health Network are buying practices everywhere “to secure their patients, their referrals.” The practice says it has turned down “amazing” formal offers to be acquired. It describes its 2007 EHR implementation as “a challenge,” saying it will replace that system (apparently with Athenahealth) and adding that its patient portal isn’t user-friendly. However, the practice’s executive director embraces data-driven quality, seems to approve of the Meaningful Use program, and likes tracking referrals electronically.

From the Cerner earnings call:

• The company says two big deals that didn’t close in Q4 would have allowed it to meet bookings guidance, avoiding the company’s first bookings miss since 2008, but says those deals are still on the table.
• The former Siemens Health Services contributed $930 million in revenue for the full year. Cerner says the acquisition is meeting or exceeding financial expectations. However, Cerner says fuzzy revenue projections on the Siemens side impacted Cerner’s revenue expectations.
• 2015 was Cerner’s best year ever for new footprint business, with 36 percent of Q4 bookings coming from outside.
• President Zane Burke says the marketplace is becoming more aware of Epic’s high cost of ownership, lack of system openness, and lack of cloud-based systems to support population health, saying Cerner expects more success in new sales and selling population health software to Epic users. It says Epic-using Geisinger’s selection of Cerner’s HealtheIntent  validated “the shortcomings of our primary competitor.”
• Forty Siemens customers signed to migrate to Millennium during the year.
• Cerner says the EHR market is changing to what it envisioned in working with Intermountain, explaining, “We believe that EHR will evolve from a transactional system to an intelligent activity-based system that will enable faster adoption of best practices, reduce variance, personalize care, improve outcomes, and the ability to identify unit costs, which will be critical as reimbursement shifts to outcomes-based and bundled payments.”
• EVP Jeff Townsend reports that Neal Patterson’s cancer treatments have gone well and he is progressing as expected.

Sales

Barnabas Health (NJ), East Texas Medical Center (TX), and Stanford Children’s Health (CA) choose Orion Health’s Rhapsody integration engine.

Partners in Care (NJ) chooses Wellcentive’s population health management solution.

AssistRx, Cerner, DrFirst, NextGen, and Practice Fusion subscribe to the ePrescribing State Law Review from Point-of-Care Partners to proactively identify system modifications that may be needed to address ongoing state and federal regulatory changes.

Phelps Memorial Health Center (NE) chooses Interbit Data’s NetRelay secure texting platform.

South Georgia Medical Center (GA) chooses Epic in a $50 million project to replace McKesson Horizon.

People

Divurgent will announce next week that it has hired Steve Eckert (MD Revolution, Encore) to the newly created position of president and COO.

Quality Systems hires Jamie Arnold, Jr. (Kofax) as CFO.

Announcements and Implementations

Nuance announces Dragon Medical One, a cloud-based, voice-driven physician documentation system.

Patientco announces Patientco Payments Hub, which allows RCM vendors to offer patient payment functions to their solutions with processing of all payment types and automated reconciliation. 

Government and Politics

Apple goes public with its refusal to comply with the FBI’s request that it add a security back door to a new iOS release that would allow the FBI to examine the phones used in the San Bernardino terrorist attacks in December. Apple says a security bypass could fall into the wrong hands and would then jeopardize the data of every iPhone user, adding that “the government is asking Apple to hack our own users” and taking the unprecedented step of trying to force an American company to weaken its security.

Privacy and Security

Hollywood Presbyterian Medical Center (CA) pays a $17,000 Bitcoin ransom to an unknown hacker to regain control of its computer systems that had been down for 10 days. The CEO says it was “the quickest and most efficient way to restore our systems,” as registrations had reverted to paper, medical records were unavailable, and the hospital was diverting patients to other facilities. The 434-bed for-profit hospital, which is owned by a Korean fertility specialist, was back up and running Monday. I assume they use a McKesson product since their portal is from RelayHealth. I collected some ransomware prevention tips:

• Keep Windows, browser, browser plug-ins, and antivirus files updated.
• Set the email servicer to block executable attachments such as .exe, .vbs, or .scr.
• Disable Volume Shadow Copy Service (vssaexe), which ransomware sometimes uses to delete volume snapshots that could have otherwise been used to restore compromised files.
• Disable Windows Script Host, Windows PowerShell, remote services such as RDP, and file sharing.
• Store backups off site.
• Don’t plug in USB storage or map network drives unless needed since ransomware often attacks there first. Use read-only folders wherever possible.
• Define Software Restriction Policies to prevent executable files from launching from questionable folders such as /Temp and /AppData.
• Make sure Office macros and ActiveX aren’t set to run automatically.
• Enable “show file extensions” in Windows.
• Install a browser pop-up blocker.
• Deactivate AutoPlay.
• Don’t stay logged on as an administrator unless necessary.
• Install Office viewers so you can see what Word or Excel files look like before opening them.

A Fast Company article warns that while federal law prohibits medical insurers from denying coverage due to genetic testing results, companies that sell other forms of insurance (life, long-term care, and disability) are allowed to deny coverage to applicants with unfavorable genetic test results on file. Life insurance companies haven’t so far mandated that applicants be tested, but may decline to issue a policy if the applicant refuses to answer questions about past testing. The Genetic Information Non-Discrimination Act originally covered all types of insurance, but the legislative sausage-making stripped out everything except medical insurance. Researchers are concerned that more people will drop out of clinical studies for fear that their entire family could be denied life insurance forever.

Other

A New York Times op-ed piece titled “America’s Stacked Deck” points out the influence of money on elected officials, observing that drug companies spent $272,000 per member of Congress to lobby against allowing Medicare to negotiate Medicare drug prices, which it calls “a $50 billion annual gift to pharmaceutical companies.”

Florida deputies charge Malachi Love-Robinson with practicing medicine without a license upon finding that the 18-year-old is running a West Palm Beach holistic medical practice called New Birth New Life Medical Center & Urgent Care. The self-proclaimed doctor examined an undercover officer and provided medical advice, leading to his exit from his practice in handcuffs. He was also charged with stealing checks from an 86-year-old patient during a house call in which he wore a lab coat and a stethoscope, diagnosed her with arthritis, and charged her $3,500 for vitamins, later emptying her bank account by forging checks. Love-Robinson expressed indignation at his arrest, saying he feels “deeply saddened and a little disrespected.”

Sponsor Updates

• Nordic publishes a new white paper, “Finding Your Balance: Applying Supply and Demand to Health IT for Growth and Efficiency.”
• Computerworld profiles Nuance’s speech-to-text offerings.
• Boston Software Systems offers white papers “Eliminate the Chaos: 5 Myths to Avoid in Your EHR Migration” and “Checking Medicare Claims Status: A Vendor Perspective.”
• PatientPay announces the $10,000 Healthcare Billing Challenge.
• Nordic releases a new HIT Breakdown podcast, “Chronic care management from three perspectives.”
• Intelligent Medical Objects will exhibit at HackIllinois February 19-21 in Champaign-Urbana.
• Oneview Healthcare publishes “5 Minutes with Niall O’Neill, COO.”
• Verisk Health announces that its HEDIS solution is ready for the 2015 reporting system with HEDIS Certified Measures.
• The Advisory Board Company announces two case studies in which health systems saved $7 million using its Crimson physician performance analytics software to identify improvement opportunities.
• MModal announces that its Computer-Assisted Physician Documentation is being used at 150 sites.
• Streamline Health will exhibit at the 2016 HFMA WA-AK Annual Conference February 24-26 in Seattle.
• Sunquest Information Systems posts a client testimonial video from Tucson Medical Center (AZ).

Blog Posts

• We’re live! Hey, where are my Reports? (Impact Advisors)
• Blue Men, Best Practices, and Improvisation (InterSystems)
• Pharma Lifecycle Plagued with Integration and Data Management Challenges (Liaison Technologies)
• Journey to HIMSS16: Insights from the 2016 IHE North American Connectathon (LifeImage)
• The Top 10 Things That Will Happen to You During HIMSS (in no particular order) (MedAptus)
• How to Increase Revenue from Your Top Payer: Patients (Navicure)
• Helping Hospitals Get Started on a Unified Communications Strategy (Spok)
• How mobile engages patients and clinicians at the forefront of HIMSS16 (PatientSafe Solutions)
• AWHONN CA Section Conference: What you need to know (PeriGen)
• Back to Basics with Mobile EHR (PMD)
• Meaningful Use – Lost in Translation (Point-of-Care Partners)
• The Value-Based Purchasing Models of Healthcare Reimbursement (Sagacious Consultants)
• Concert by HIMSS: Evolving Standards and the Value Proposition for Interoperability (Stella Technology)

Contacts

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

IBM To Acquire Truven Health Analytics for $2.6 Billion

IBM Watson Health announced this morning that it will acquire Truven Health Analytics for $2.6 billion in its fourth acquisition since Watson Health was formed in April 2015. The acquisition will give Watson Health 8,500 new clients and increase its coverage to 300 million patient lives.

“With this acquisition, IBM will be one of the world’s leading health data, analytics, and insights companies, and the only one that can deliver the unique cognitive capabilities of the Watson platform,” said Deborah DiSanzo, general manager for IBM Watson Health.

The Watson Health unit houses previous acquisitions Phytel, Explorys, and Merge Healthcare.

Veritas Capital acquired the healthcare business of Thomson Reuters in June 2012 for $1.25 billion, renaming it Truven Health Analytics. March 2015 reports suggested that Truven was preparing for an IPO that would have valued the company at $3 billion.

Morning Headlines 2/18/16

Hollywood hospital pays $17,000 in bitcoins to hackers who took control of computers

Hollywood Presbyterian Medical Center caves to the demands of hackers, paying a $17,000 ransom in bitcoin to restore access to its network. Hackers had initially demanded $3.6 million.

CMS and major commercial health plans, in concert with physician groups and other stakeholders, announce alignment and simplification of quality measures

CMS and insurance lobby group America’s Health Insurance Plans agree on seven sets of  clinical quality measures that will standardize quality reporting across multiple payers.

Cerner Downgraded to Hold at Everccore ISI, Price Target Cut to $52

Cerner stock continues to fall, closing 4.8 percent down at the end of trading Wednesday, after lowering its estimate on projected bookings and being downgraded from ‘buy’ to ‘hold’ by analysts.

The NHS’s future is digital – but not if we simply replicate poor paper processes

The Guardian analyzes the potential impact EHRs will have on NHS care delivery, noting that implementing improved business and clinical workflows within the new systems will ultimately dictate the value derived from the investment.

Morning Headlines 2/17/16

Cerner Reports Fourth Quarter and Full Year 2015 Results

Cerner reports Q4 results: revenue was up 27 percent to $1.2 billion compared to $926 million during the same quarter last year, adjusted EPS $0.61 vs. $0.47. Stock prices dropped 14 percent in after hours trading due to downward adjustments to bookings projections.

Under Armour Partners with IBM and SAP to Widen Connected Fitness Potential

Under Armour generated $53 million in revenue from its connected fitness initiative in 2015, up from $19 million in 2014, after acquiring digital health apps MyFitnessPal and Endomondo for a total of $560 million.

What The Flint Water Crisis Reveals About Public Health

Bill Frist and Karen DeSalvo, MD co-author a Forbes opinion piece reflecting on the Flint water crisis and the need for increased public health spending in the US.

Allscripts, Cerner and CPSI Brands Merit the Most Devoted Hospital Clients, Reveals 2016 Black Book HIT Loyalty Index

A Black Book report measures healthcare IT vendor loyalty from “2,077 crowdsourced hospital users” concluding that Allscripts, Cerner, and CPSI have the highest consumer loyalty in the EHR market.

News 2/17/16

Top News

Cerner reports Q4 results: revenue up 27 percent, adjusted EPS $0.61 vs. $0.47, beating expectations for both.  The company adjusted revenue projections slightly downward on lower bookings, with shares dropping 14 percent to below their 52-week low in early after-hours trading Tuesday. CERN shares were already down 21 percent in the past year.

Reader Comments

From Take the Cannoli: “Re: news. Why so little recently? Industry downturn?” We’re in the pre-HIMSS conference quiet period, where companies save their questionably interesting fluff “news” like fall squirrels stashing nuts in their cheeks, misguided into thinking that they’ll get more exposure by expelling their PR flatus during the conference. Nobody will be paying attention as piles of press releases go out all at once on Tuesday and Wednesday, screaming for attention but earning little of it in the self-congratulatory din. Maybe that’s how I could have gotten more sponsor support to expand the HIStalkapalooza invitation list – charge companies for 60 seconds on stage to read their overwrought press releases to the crowd like town criers.

From PointProf: “Re: CHI in Houston. Heard they had 50-hour Epic downtime. Wonder what the root cause was?” I saw some Reddit chatter that said it was a Citrix provisioning problem.

From Scuzi: “Re: ransomware. Breaking news tweeted from [publication name omitted].” They gushed their “story” out as “breaking news” early Tuesday evening, two-plus days after I wrote about it. I linked to the local newspaper that did the actual reporting whereas they didn’t, apparently hoping their readers won’t suspect that they’re just rewording articles from other sites. If you’re not doing actual journalism, at least credit your sources.

HIStalk Announcements and Requests

I’m growing weary of the words “solution,” “platform,” “suite,” and maybe even “system” since those terms don’t really add any value over just “software” except to marketing people trying to tart up their product or salespeople trying to paint a grander image of their zeros and ones. I’m interested in opinions on this.

Susan Newbold, PhD, RN of the Nursing Informatics Boot Camp will be the celebrity guest in our Lilliputian booth (#5069) at HIMSS Tuesday from 10 until 11 a.m.

Mrs. Spell’s North Carolina second graders are using the math stations we provided in funding her DonorsChoose grant request for small-group instruction. She added, “During my morning meeting about two weeks ago, my students were so excited to see the big brown box on the carpet knowing the ‘donors’ thought they were awesome again! I told them how much other people believed in them and that they wanted to share new math games and activities with them for their math rotations.”

This company obviously has a selectively keen eye for detail, spelling HIMSS wrong but doing the “little-i” thing that HIMSS puts on its logo but nowhere else.

I bet HIMSS is glad that keynoter Peyton Manning quarterbacked the Super Bowl winning team, but not so thrilled that he’s simultaneously being dogged by allegations of HGH use and sexual harassment that threaten to tarnish his carefully created public persona. Maybe he’ll exit the HIMSS stage thanking God and Budweiser again.

Webinars

February 17 (Wednesday) noon ET. “Take Me To Your Leader: Catholic Health Initiatives on Executive Buy-In for Enterprise Analytics.” Sponsored by Premier. Presenters: Jim Reichert, MD, PhD, VP of analytics, Catholic Health Initiatives; Rush Shah, product manager analytics factory, Premier. Catholic Health Initiatives, the nation’s second-largest non-profit health system, knew that in order to build an enterprise analytics strategy, they needed a vision, prioritization, and most importantly buy-in from their executives. Dr. Jim Reichert will walk through their approach.

February 23 (Tuesday) 1:00 ET. “Completing your EMR with a Medical Image Sharing Strategy.” Sponsored by LifeImage. Presenters: Don K. Dennison, consultant; Jim Forrester, director of imaging informatics, UR Medicine. Care coordination can suffer without an effective, cost-efficient way to share images across provider networks. Consolidating image management systems into a single platform such as VNA or PACS doesn’t address the need to exchange images with external organizations. This webinar will address incorporating the right image sharing methods into your health IT strategy.

February 24 (Wednesday) 1:00 ET. “Is Big Data a Big Deal … or Not?” Sponsored by Health Catalyst. Presenter: Dale Sanders, EVP of product development, Health Catalyst. Hadoop is the most powerful and popular technology platform for data analysis in the world, but healthcare adoption has been slow. This webinar will cover why healthcare leaders should care about Hadoop, why big data is a bigger deal outside of healthcare, whether we’re missing the IT boat yet again, and how the cloud reduces adoption barriers by commoditizing the skilled labor impact.

Acquisitions, Funding, Business, and Stock

Vizient (the former VHA, UHC, and Novation that were combined in November 2015) completes its acquisition of the MedAssets SCM and Sg2 segments. Pamplona Capital Management announced in November 2015 that it was acquiring MedAssets for $2.7 billion but would keep only its revenue cycle management business, merging it with Pamplona-owned Precyse.

Under Armour says its wearables business brought in $53 million in revenue in 2015, driven by its $560 million acquisitions of fitness apps Endomondo and MyFitness Pal. That company had $4 billion in revenue in 2015, 88 percent of that from clothes and shoe sales and 1.3 percent from Connected Fitness.

Privacy monitoring system vendor Protenus, started in 2014 by two Johns Hopkins medical students, raises $4 million, increasing its total to $5.4 million.

For-profit hospital operator Community Health Systems announces Q4 results: revenue down 2.4 percent, EPS –$0.66 vs. $1.12, sending shares down 22 percent Tuesday. The company blames the results on a weaker flu season in 2015 and lower volume in its former HMA facilities in Florida. Above is the one-year share price chart for CYH (blue, down 72 percent) vs. the Dow (red, down 10 percent).

Imprivata reports Q4 results: revenue up 18 percent, adjusted EPS –$0.09 vs. -$0.04.

Sales

Saint Anthony Hospital (IL) and Cookeville Regional Medical Center (TN, above) renew their IT services contracts with McKesson.

The Jewish Board of Family and Children’s Services (NY) chooses Netsmart’s CareRecord EHR.

People

 
T-System promotes Robert Hitchcock, MD to chief strategy officer and Robin Shannon, RN to chief product officer.

Announcements and Implementations

A Black Book survey finds that hospitals using Allscripts, Cerner, and CPSI are the most loyal to their vendors. Black Book is murky about its methodology, saying only that it surveyed “2,077 crowd-sourced, hospital users” of unspecified job titles using unspecified selection methods. The company unconvincingly claims that it needed to create a loyalty index since metrics for customer affinity, repurchase intent, and client recommendations weren’t good enough to “understand the complexities of EHR customer behavior and underlying motivating forces” and that it “helps hospitals and physicians make better decisions based on customer insights,” not mentioning that dreaming up some new poll gives it something new to sell.

Iatric Systems launches Analytics on Demand, which includes pre-built dashboards for quality measures, Meaningful Use, sepsis, and readmissions that are driven by mapped EHR data.

Wolters Kluwer Health announces the release of Health Language Enterprise Terminology Management Platform that standardizes and normalizes clinical, claims, and administrative data.

HCI Group will provide education and consulting services for organizations that want to improve their HIMSS EMR Adoption Model scores, named as the first EMRAM Global Education provider of HIMSS Analytics.

Government and Politics

A Forbes op-ed piece by Bill Frist and Karen DeSalvo, MD, MPH triggered by the Flint water crisis observes that  the US ranks low in health and well-being despite spending $3 trillion each year on health, calling for Public Health 3.0 in which health professionals take civic leadership roles and business leaders participate in community health. It adds, “Our ZIP codes are a more accurate determinant of health than genetic codes. As a society, we have a collective responsibility to ensure that we are providing the conditions needed to make the healthy choice the easy choice for all members of our communities.”

Privacy and Security

Magnolia Health Corporation (CA) notifies employees that “an unidentified third person impersonated our CEO” in obtaining an Excel worksheet that contained their personal information, including Social Security numbers and salaries.

Other

A PICU medical director in Canada spends the day working as an RN in his unit. He summarizes, “As a physician I think we take for granted that we write an order and the work just gets done … After my day as an RN, I am going to suggest that all the residents who train on our unit do the same. I think there is a huge opportunity to learn how each person on a unit contributes to the care of one patient … RNs spend more time with patients than we as physicians do, having an understanding of how they care for a patient and experiencing a completely different view can only make us better physicians.”

The Tech Museum of Innovation in San Jose, CA opens an exhibit titled “Innovations in Healthcare,” sponsored by El Camino Hospital (CA).

Big companies are mining data about their employees to target health messages, identify those with poor credit scores those who may not take their medications, and even to identify women who may be planning pregnancy by looking at their birth control prescription records or snooping into their search history on employee wellness sites. Prominently mentioned are Castlight Health and Welltok, which aren’t bound by laws that prevent companies from analyzing the personal health information of their employees. Health management company Jiff tailors its wellness programs by employee personality type, deciding which of them will likely require a premium discount to participate in fitness programs. 

Great Lakes Health Connect will provide $250,000 in assistance to connect providers in Flint, MI and Genesee County to its network, earmarking $100,000 to link 40 physician offices, $90,000 for a dedicated implementation consultant, $50,000 for an analytics engine, and $10,000 for training.

Detroit’s Care Bridge care coordination system for patients who are covered by both Medicare and Medicaid isn’t working one year into the program scheduled to run three years, with lack of IT standardization and competitive concerns among its participants blamed as possible roadblocks.

Lightning takes out the fire and alarm systems of Australia’s Robina Hospital, which apparently had no redundancy plan for its Ascom system. The hospital says it has moved the server to another site, thereby scorning the “lightning never strikes twice in the same place” fallacy.

Sponsor Updates

• Besler Consulting publishes the Comprehensive Care for Joint Replacement Special Report.
• The local paper highlights Clockwise.md’s online check-in app in its coverage of a new Carolinas HealthCare Systems urgent care facility.
• CoverMyMeds Director Scott Gaines joins the BioOhio Board of Trustees. 
• Extension Healthcare nominates the winning University of Maryland Medical Center for two Intelligent Health Association awards.
• The HCI Group releases a video on three things to consider during Cerner go-live planning.
• Consulting Magazine interviews Huntzinger Management Group CEO and founding partner Robert Kitts.

Blog Posts

• Collections by Visit Feature Enhancement (AdvancedMD)
• Visit Bernoulli at the HIMSS16 Interoperability Showcase (Bernoulli)
• Opportunities and Challenges with Patient-Centered Care and Outcomes-Driven Care Delivery Models (Carevive Systems)
• Organizational Health Part 1 (Optimum Healthcare IT)
• Patient Access, Patient-Centered Care, and Population Health – Let’s Connect the Dots … (Culbert Healthcare Solutions)
• Big Data – What Does That Even Mean? (Divurgent)
• Mobile Bedside Consents: Promoting Healthcare at the Speed of Now (FormFast)
• TouchWorks 15.1: Allergy Status Enhancements (Galen Healthcare Solutions)
• Understanding and Leveraging the OIG Work Plan (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 2/15/16

Top News

Partners HealthCare (MA) announces that it made $13 million in operating profit on $3 billion in revenue in the most recent quarter and lost $38 million overall including investment losses. The CFO says its Epic implementation will negatively impact profit by $200 million over the next three years. Brigham and Women’s in December said it made $68 million in profit in FY2015 instead of the $121 million it expected, blaming most of the shortfall on unexpected Epic implementation costs. The Boston Globe reported in June 2015 that original cost estimates had been doubled to $1.2 billion.

Reader Comments

From Give Rodney Another Chance: “Re: job hunting tips. You ran something awhile back that I could use for the upcoming conference.”Steer clear of companies with these characteristics:

• The CEO is a well-traveled hack or private equity hired gun whose historical talent is boosting the short-term bottom line to get the company sold before the wheels come off.
• The CEO refuses to move to the city where most of the employees work.
• The position is not located in a primary company office. Out of sight means out of mind, which is great until your ambitious peers conspire to stab your absent back.
• The company demands that you sign a non-compete agreement that will make it tough to land the next job. My favorite strategy is from Dilbert: scan the non-compete into Acrobat, change the wording in your favor, then print it and sign it. Chances are the always-clueless HR department won’t notice that what you signed isn’t what they handed you.
• Management isn’t smart enough to fix problems, so they harm the business with company-wide budget and travel freezes.
• They company has laid people off, meaning executives failed with their hiring choices, strategy, or execution and will almost certainly do so again.
• Executives with reserved parking spots. I loathe big shots who think they are better than everyone else.
• Your interviewer is late, distracted, or someone you wouldn’t hang out with after work. You’re seeing them as good as they’re going to get.
• You get a vague answer when you ask what happened to your predecessor or the company declines to name them for fear you’ll solicit their honest opinion about why they left.
• Your prospective boss talks about himself or herself instead of you.
• The executive team you would be joining has two people who are related or sexually involved. You, Sammy Hagar, serve at the pleasure of the brothers Van Halen.

HIStalk Announcements and Requests

Less than 20 percent of poll respondents are attending the HIMSS conference to attend educational and keynote sessions, with 75 percent of respondents naming networking and the exhibit hall as their primary draw (which explains where you’ll find the crowds). New poll to your right or here: if you had equivalent job offers on the table from the vendors listed, which one would you accept? I asked that poll question back in 2009, so it will be interesting to compare the results.

Northeasterners who are bundling up against wind chills of up to 40 degrees below zero can look forward to better weather in Las Vegas, which so far calls for mid-70s and sun every day.

Mr. R’s Robotics Team 968 from California sent an update on their activities using the laptop we provided in funding their DonorsChoose grant request. The five students been doing technology in-services at the local senior citizen center and are creating their three-hour Saturday “Rookie Training Days” in which students in grades 4-8 will be invited to learn more about STEM and join their team. We also funded a second request from the team for machining tools to help them build their robots, for which they send “a million virtual thanks.” They are working after school and on weekends to finish their robot for an upcoming competition and closed with, “Wish us luck as we will soon embark to Los Angeles for competition, move on to Phoenix, and hopefully compete in the championships in St. Louis.”

Ms. H, a speech-language pathologist in New York, received the USB CD drive we provided. She says, “Thank you so much for your generosity and supporting a low income school. This is a great, especially for these snowy indoor months. You have helped to make a difference in our classroom.”

I donated $100 to DonorsChoose in honor of one of my CIO webinar reviewers, which (with matching funds) provided five voice recorders for Mrs. Hendrickson’s Akron, OH elementary school class. She describes her project as, “They come from the most challenging places, experiencing some of the most heart-wrenching things, and they teach me way more than I teach them. They thrive in love and learn only after they realize someone cares about them. They come unmotivated and leave yearning to learn. They struggle significantly in reading-often 3-4 years below grade level. My students will use the Easi-Speak recorders to analyze their own reading. In order to increase reading skills they need practice figuring out their problem.”

Listening: indie pop from England-based Viola Beach. All four band members and their manager were killed Saturday when their car ran off an open drawbridge after a show in Sweden. 

Last Week’s Most Interesting News

• CommonWell adds several new members, including HIMSS.
• The President’s proposed and rejected $4.1 trillion budget would have given ONC an extra $22 million for interoperability work.
• The Senate health committee  passes the Improving Health Information Technology Act that follows on the HELP committee’s recommendations.
• The Department of Defense gives Leidos and Cerner a $51 million DoD EHR hosting contract over the protests of IBM, CSC, Amazon, and General Dynamics, saying the military needs Cerner’s broad data for managing population health and that Cerner wouldn’t allow them to connect to its systems in any other way.
• Britain’s NHS announces a $6 billion push toward a paperless environment.
• Medical practice operator One Medical Group buys the nine-employee company behind the Rise nutrition app for $20 million.

Webinars

February 17 (Wednesday) noon ET. “Take Me To Your Leader: Catholic Health Initiatives on Executive Buy-In for Enterprise Analytics.” Sponsored by Premier. Presenters: Jim Reichert, MD, PhD, VP of analytics, Catholic Health Initiatives; Rush Shah, product manager analytics factory, Premier. Catholic Health Initiatives, the nation’s second-largest non-profit health system, knew that in order to build an enterprise analytics strategy, they needed a vision, prioritization, and most importantly buy-in from their executives. Dr. Jim Reichert will walk through their approach.

February 23 (Tuesday) 1:00 ET. “Completing your EMR with a Medical Image Sharing Strategy.” Sponsored by LifeImage. Presenters: Don K. Dennison, consultant; Jim Forrester, director of imaging informatics, UR Medicine. Care coordination can suffer without an effective, cost-efficient way to share images across provider networks. Consolidating image management systems into a single platform such as VNA or PACS doesn’t address the need to exchange images with external organizations. This webinar will address incorporating the right image sharing methods into your health IT strategy.

Sales

FamilyCare Health (OR) chooses Wellcentive’s population health quality reporting and care management solutions.

People

Health management software vendor AssureCare names Yousuf Ahmad, DrPH (Mercy Health) as CEO. He had risen from SVP/CIO of Mercy Health to president and CEO, finishing his career there as SVP of system development.

Verge Solutions hires Mark Crockett, MD (Best Doctors) as CEO.

Privacy and Security

Another hospital is hit by ransomware as Hollywood Presbyterian Medical Center (CA) is locked out of its systems by hackers demanding $3 million to unlock its files. LAPD and the FBI are involved in the “internal emergency” that has lasted more than a week so far.

A security researcher shows a conference group how he hacked into a hospital while sitting outside in his car, challenged by the Moscow hospital to test its cyber defenses. He couldn’t initially get past the hospital’s firewall, so instead he sat outside and cracked its Wi-Fi network, stole a poorly chosen network key, and then accessed medical equipment. He concludes that hospitals should make sure their medical equipment isn’t connected to a public network. 

Technology

Chris Evert Children’s Hospital (FL) uses technology from its renovations contractor Skanska to send alerts to the construction crew if noise, dust, or vibration reach disruptive levels.

Other

Professional basketball player Dwight Howard gives pediatric patients at Memorial Hermann Health System a Google Cardboard-powered virtual visit to the home of his Houston Rockets, then surprises them by showing up in person.

A London newspaper profiles the making of autobiographical video exploration game “That Dragon, Cancer,” created by the parents of a five-year-old boy who died of cancer.

Here’s a pretty funny Athenahealth commercial called “What Do You Do for a Living?”

A retired internist and self-proclaimed “dinosaur” says “the art of doctoring is dying” in a Washington Post op-ed piece. He says he would re-invent himself as a “confidentialist” who would take time to know a patient and “stand down the legions of specialists with their scalpels, catheters, and scopes; the backbone to stand up to bottom-line-toeing administrators and self-serving insurance executives and policy wonks.” He adds,

Physicians are now insulated from knowing too much about their patients. It is all about the technology, the testing, the imaging, the electronic health record, the data — once collected by the doctor, but now so regulated and overwhelming that paramedical professionals have been enlisted to record the so-called minutiae, the often rote information in which may lie important clues. Some of these may remain forever buried, the patient not wanting to share sensitive details with just anyone, especially someone who no longer makes eye contact, whose face remains buried behind a computer screen, who seems uninterested or just unskilled in reading body language — that downward glance, that shift in the chair, that half-swallowed response.

A Russian scientist makes 48 million journal articles freely available ok Sci-Hub,  the academic version of Pirate Bay, saying she’s tired of not being able to afford the journal articles she needs for her work. She says, “Payment of $32 is just insane when you need to skim or read tens or hundreds of these papers to do research. I obtained these papers by pirating them. Everyone should have access to knowledge regardless of their income or affiliation. And that’s absolutely legal.” The article notes that she isn’t alone – prestigious universities say they can’t afford expensive journals and 15,000 scientists are boycotting publisher Elsevier, which not surprisingly is suing the researcher who claims Elsevier’s business model is illegal and immoral since it doesn’t pay the authors of articles it publishes.

England’s NHS will monitor Facebook for negative postings about hospitals and will intervene when indicated.

CMS Administrator Andy Slavitt submits a great entry to #HealthPolicyValentines.

Here are others I liked.

Sponsor Updates

• TeleTracking celebrates its 25th anniversary.
• Valence Health will exhibit at The Center for Healthcare Governance Winter Symposium February 14-17 in Phoenix.
• Xerox Healthcare will host Regina Holliday at HIMSS16.
• ZirMed will exhibit at the Healthpac 2016 Users Meeting February 18-20 in Savannah, GA.

Blog Posts

• Interoperability at HIMSS16 (TeraMedica)
• The What and Why of HITRUST CSF Certification (UltraLinq)
• New Factors Impacting HEDIS in 2016 (Verisk Health)
• 5 Tips for Biomeds to Convince Leadership to Invest in RTLS (Versus Technology)
• Making the Business of Healthcare Easier, Online (VitalWare)
• Support Nurses to Promote Patient Safety (Voalte)

Contacts

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

News 2/12/16

Top News

CommonWell Health Alliance announces new members EClinicalWorks, HIMSS, ImageTrend, LifeImage, Mana Health, MediPortal, and Modernizing Medicine. I’m not clear why HIMSS joined or how some of its own high-paying members who haven’t joined CommonWell (like Epic) will feel about its implicit endorsement.

Reader Comments

From Skinny Little B-Word: “Re: Grey Bruce Health Services in Canada. CIO Rob Croft and Manager Peggy Millar are gone.” Unverified. There’s nothing new on their LinkedIn or on Grey Bruce’s executive page.

From Dy-No-Mite: “Re: Mr. H. I don’t understand that name.” I needed an anonymous email address when I first started writing HIStalk in 2003 since my employer at that time was threatening me for writing ill of a vendor who richly deserved it (we were their customer, although I wasn’t writing anything I had learned from that experience). My creativity was limited, as it often is, so I chose mr_histalk@yahoo.com, attaching no particular significance to it. Readers started calling me Mr. HIStalk and that got shortened to Mr. H over the years. I never call myself “Mr.” anything in real life, so the reference was really more like someone who is privately dubbed “Mr. Happy Meal” for frequenting McDonald’s or “Mr. Upbeat” for exuding perpetual grumpiness.

From Identity Thief: “Re: FL Senate bill 1299. It says hospitals must confirm Medicaid patient identities using both biometrics and a positive match with the DMV’s database. Does that mean beneficiaries must have a driver’s license? I also don’t see where funds have been set aside to cover the cost.” The idea probably taps into annoyance taxpayers feel for those who take advantage of Medicaid, a situation that bugs me as well, but medical and insurance fraud isn’t limited to Medicaid patients. Biometrics aren’t perfect and pose security risks of their own (the “stolen electronic fingerprint” scenario) and I don’t get the DMV connection, which must require Medicaid patients who don’t drive to obtain a Florida DMV-issued state ID card. I’m sure this will raise some red-faced debate among people with strong opinions about illegal immigrants and discrimination. It’s a nice idea to positively ID patients for even better reasons (like patient safety) but our lack of political will for something as simple as a national patient identifier makes it unlikely that this bill will withstand the inevitable legal challenges even if it beats the odds of getting that far. 

From Bernie: “Re: Jonathan Bush. It’s ironic that Bush talks down Epic. Try being a vendor that wants to integrate with Athena. They make it very difficult, even when there is customer demand. Bush is no knight in shining armor and their MDP program is a sham.” Unverified.

HIStalk Announcements and Requests

We funded the DonorsChoose grant request from Mrs. Heinrich from California, who asked for headphones, lapboards, privacy petitions, paper, and glue.

Also checking in was Mrs. Sutton from Illinois, who says her fourth grade students had been making their own  fraction strips from paper and colored pencils before receiving the 25 sets of fraction, decimal, and percent tiles we provided. She’s now having the students teach fraction concepts to second graders to “encourage my fourth grade students to be peer leaders as well as master fraction builders.”

Listening: new from Nothing But Thieves, hard-rocking Brit pop that sounds a bit like Muse with guitars instead of keyboards. They’re on a US tour now with upcoming stops in the southern US, including gigs at legendary clubs like Cat’s Cradle, 40 Watt Club, even the Orlando House of Blues where we had HIStalkapalooza not long ago. It’s a refreshing blast of melodic rock surrounded by a sea of formulaic hip-hop, emotive singer-songwriter warblings, and heavily technically augmented songs better suited for dancing than listening.

This week on HIStalk Practice: Some physicians didn’t get the memo about ICD-10. Washington State Medical Association Executive Director and CEO Jennifer Hanscom shares the successes – and frustrations – members have had with health IT. First Stop Health raises $2.1 million. HIEs invest in new patient-matching technology, plus there’s FINALLY a way to summon your Tesla from your Apple Watch. Navicure CEO Jim Denny advises physicians to use ICD-10 momentum to meet 2016 revenue cycle goals. The California Health Care Foundation highlights digital health technologies making a difference in safety net populations. Escape from paperwork and Big Brother become big drivers of direct care.

This week on HIStalk Connect: Concierge provider group One Medical acquires digital health startup Rise for $20 million. Researchers in the UK are  approved to study human embryo genome editing. With a variety of virtual reality devices scheduled to arrive on the market in 2016, VR fitness applications begin to emerge. Withings unveils a new blood pressure tracking feature that it will sell as an in-app purchase to its users. 23andMe partners with fertility startup Celmatix to develop precision medicine fertility treatments and infertility tests.

HIStalkapalooza

I created this page so you can check to see if you should have received an emailed HIStalkapalooza invitation but didn’t because of spam filters. My interest in doing so is self-serving since I’m getting an absurd number of party-related emails that I really don’t have the time to mess with. Please don’t email me or Lorre if you weren’t invited or you’ve decided you want to bring a guest you didn’t previously register – we aren’t inviting anyone else and there’s no wait list. Every year otherwise smart people express righteous indignation that we didn’t invite them even though they didn’t even bother to sign up, apparently relying on our staff psychic to detect their interest (and email address).

Use Twitter hashtag #HIStalkapalooza if you want to get fired up pre-party in the remaining couple of weeks. 

Webinars

February 17 (Wednesday) noon ET. “Take Me To Your Leader: Catholic Health Initiatives on Executive Buy-In for Enterprise Analytics.” Sponsored by Premier. Presenters: Jim Reichert, MD, PhD, VP of analytics, Catholic Health Initiatives; Rush Shah, product manager analytics factory, Premier. Catholic Health Initiatives, the nation’s second-largest non-profit health system, knew that in order to build an enterprise analytics strategy, they needed a vision, prioritization, and most importantly buy-in from their executives. Dr. Jim Reichert will walk through their approach.

February 23 (Tuesday) 1:00 ET. “Completing your EMR with a Medical Image Sharing Strategy.” Sponsored by LifeImage. Presenters: Don K. Dennison, consultant; Jim Forrester, director of imaging informatics, UR Medicine. Care coordination can suffer without an effective, cost-efficient way to share images across provider networks. Consolidating image management systems into a single platform such as VNA or PACS doesn’t address the need to exchange images with external organizations. This webinar will address incorporating the right image sharing methods into your health IT strategy.

Acquisitions, Funding, Business, and Stock

Wipro will acquire Tampa-based insurance company BPO and exchange services vendor HealthPlan Services for $460 million in cash.

The founder of Pristine, which initially offered a healthcare Google Glass app and then changed business models at some point into visual collaboration for field inspectors, sues an Austin-based venture capital firm for stealing his business. Kyle Samani’s suit claims the real goal of S3 Ventures LLC is “to invest in newly formed companies in order to ultimately take the companies from their founders just as the company becomes successful.” He alleges that Pristine, which raised $6.2 million but has not received funding since September 2014, sold 700,000 of his unvested shares. The real lesson learned might be to avoid creating an enterprise-focused business whose platform is a beta-status consumer gadget.

Sales

Health Partners New England chooses Medsphere’s OpenVista EHR.

Cormac contracts with Premier to provide a cloud-based registry to support CMS’s Oncology Care Model.

The American College of Radiology and the University of Florida choose the Visage 7 Enterprise Imaging Platform as enterprise diagnostic viewer for training diagnostic radiology residents.

Announcements and Implementations

McKesson partners with HealthQX, which offers a claims analysis system, to offer software to help payers design and run bundled payment programs.

Bottomline Technologies announces that its Healthcare Privacy and Data Security solution learns normal user behavior and reports exceptions.

First Databank releases OrderKnowledge Canada, a pre-built CPOE drug knowledge base.

A tiny study finds that use of Glytec’s Glucommander IV glycemic control system reduced diabetic ketoacidosis admissions by 45 percent.

Government and Politics

The President’s $4.1 trillion budget, already rejected by Congress, would have boosted ONC’s budget by $22 million for interoperability work. HHS would have received a mind-boggling $1.14 trillion, up 11 percent since 2015, also increasing its FTE headcount to nearly 80,000.

Privacy and Security

The CPA firm of a Nebraska hospital warns it that a laptop stolen from one of its employees had encryption software installed that wasn’t working, exposing the information of 4,200 of the hospital’s patients.

Magazine publisher Time Inc. buys the faded Internet star MySpace to get data on its 1 billion registered users, with Time’s CEO saying the deal “is all about the marriage of first-party data and premium content.” The seller was Viant, which has gone through three names since it bought Myspace in 2011 for $35 million with Justin Timberlake as a partner, hoping to make it a music hub.

Insurance company Centene says it found the six PHI-containing hard drives it reported losing a few weeks ago. They had been placed in a locked storage box awaiting destruction. It’s puzzling why they wouldn’t have looked there first, or why their employee wouldn’t have logged them as being held for disposal. I would bet at least one person will be fired because of the embarrassment caused and cost expended.

Innovation and Research

An AHRQ-funded study finds that higher levels of hospital EHR usage is associated with a lower rate of adverse events for patients with cardiovascular disease, pneumonia, or conditions requiring surgery.

Other

US News withdraws its Best Children’s Hospitals specialty rankings for two hospitals that had submitted erroneous survey data, adding that it “will implement additional data integrity processes to help identify potentially inaccurate data prior to publication.”

University of North Carolina Health Care signs a partnership agreement with Mercy in which Mercy Virtual Care Center will monitor patients in a 28-bed UNCHC ICU.

The Chicago Tribune proudly describes its collaboration with scientists to mine data from the FDA’s adverse event reporting system and Columbia University Medical Center’s EHR to find four new drug-drug interactions that can prolong cardiac QT interval and potentially cause arrhythmias. Thank goodness the actual journal article is concise and factual rather than a crappy Trib attempt at long-form journalism, meaning it’s do long and hammily dramatic that you just want to wring the writer’s neck to make them get to the point. Obviously the study found apparent correlation with one hospital’s information – the real work now begins in proving causation, a challenging project that drug companies aren’t likely to underwrite since the result could reduce sales.

ZDoggMD might be venturing into Weird Al territory with a never-ending barrage of parody videos that threaten overexposure, but here’s his latest that lab people will enjoy, “In Da Lab.”  Watch for the Theranos reference. Pop red tops, homeys.

Sponsor Updates

• Marketing firm Image.works will offer its healthcare clients CRM capabilities from Influence health.
• Rep. Bob Dold (R-IL) visits Intelligent Medical Objects to learn about IMO Terminology.
• The local paper covers LifeImage’s acquisition of Mammosphere.
• Netsmart will exhibit at the MHCA Winter Conference and Annual Meeting February 16 in Clearwater Beach, FL.
• EClinicalWorks releases a new podcast, “What’s Ahead for 2016.”
• Healthfinch co-founder Lyle Berkowitz, MD keynotes the AMA/MGMA Collaborate in Practice Conference March 20-22 in Colorado Springs, CO.
• Park Place International’s Erick Marshall is named a VMware 2016 Vexpert.

Blog Posts

• “New” Words to Watch for in 2016 (ID Experts)
• The EHR Developer Code of Conduct – Next Steps in its Evolution (Impact Advisors)
• Top 5 Reasons I Love HIMSS! (Ingenious Med)
• FHIRside Chat: Two Doctors See New Future Enabled by FHIR, Part 1 (InterSystems)
• Internet of Things and Healthcare (Medecision)
• Precision Medicine and You (Orion Health)
• MACRA 101: Wrapping Our Heads around MU, MACRA, MIPS, and More … (Divurgent)
• Who’s Next? The 3 Ms of HIPAA Compliance Audits (Hayes Management Consulting)
• EHR System Selection – 7 Tips for Transforming Clinical Care (The HCI Group)
• Embracing New Media and Online Resources to Enhance Patient Engagement (Healthwise)
• 2016 – The Year of the Bot (Recondo Technology)
• 3 Major Ways mHealth Apps Improve Hospital HCAHPS Scores (PracticeUnite)
• 3 key learnings from implementing a care team collaboration platform (PerfectServe)
• The making of a vision … of the future of obstetrics (PeriGen)
• Information Management Part 3 – The Information Ecosystem (ClinicalArchitecture)
• PMD by the Numbers (PMD)
• 4 Common Risks for Reporting and Analytics in the Midst of Rapid Expansion (Sagacious Consultants)
• Join us at the HIMSS Interoperability Showcase (Stella Technology)
• The Next Wave of Patient Self Scheduling (Streamline 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.

Morning Headlines 2/11/16

Obama budget would lift HHS spending to $1.1 trillion, entice Medicaid expansion

The President’s 2017 budget includes $82 million for ONC with $5 million earmarked for use on interoperability efforts.

Walgreens Threatens to End Theranos Agreement

As lab vendor Theranos works to resolve inspection issues discovered by CMS auditors, its primary customer, Walgreens, threatens to end the business relationship altogether.

What’s a $4.5B campus look like? Get a sneak peek

Cerner streams a live tour of the Kansas City campus is its currently constructing.  The project will add 4.7 million square feet of new office space at a cost of $4.5 billion.

HIMSS Submits Comments on NIST Cybersecurity Framework RFI

HIMSS responds to NIST’s recently published cybersecurity framework FRI, in which it applauds the effort, but calls for the framework to be a voluntary, private-sector led initiative that could be used as a tool to develop best practices around cybersecurity.

Epic’s Remote Hosting Resurgence

Epic gets back to its roots – and attempts to keep up with the competition – with another foray into remote hosting services.
By @JennHIStalk

Rumors began swirling earlier this year when Epic purchased Mayo Clinic’s data center in Rochester, MN. The reportedly $46 million deal will see Mayo, which is scheduled to go live on Epic in 2017, lease back the 62,000 square-foot facility to Epic for at least the next four years. It’s a somewhat unconventional arrangement that signals that the company is ready to take hold of the remote hosting market.

It’s Identical to Self-Hosting

Epic Senior Vice President Stirling Martin explains that, “In terms of the capability of the hosted systems, it’s identical to what a self-hosted organization would have. Our mission in hosting is to allow organizations to retain all of the same flexibility and configuration they would have if they were running the systems themselves. They still have a highly open platform for interfacing and integrating with third-party systems that they’re running in their own data centers or in third-party data centers.”

Remote hosting is not a new endeavor for Epic, which started out in that very field back in 1979. “About four years ago,” Martin explains, “we embarked on building a data center both for our own purposes and with an eye towards eventually doing hosting. We made the decision about 18 months ago to move forward and get back into remote hosting. Since that point, we’ve been building up infrastructure and working with early customers to get them onto the platform.”

Understanding the Options

Epic offers two hosting options. Full hosting — which includes the production systems, training, testing, and a disaster recovery copy in a geographically separate data center –  has so far been the most common request.

Standalone disaster recovery is another option. Martin notes that, “This is a great opportunity for organizations that may not have a second data center and yet want to ensure that they have a copy of their system up and running in a data center that’s geographically separate enough to be away from a natural disaster.”

He declined to give specific pricing numbers, though he did stress that pricing ultimately comes down to the size of the organization. “The number of concurrent users is the metric we talk about most,” he explains. “We factor lots of data points into the overall sizing equation – the different products they’re going to be using, if they have one hospital and a very large ambulatory practice or many hospitals and a smaller ambulatory practice.”

Clarifying the Customer Base

In making the initial announcement about its re-entry into remote hosting, the company said it would first offer the service to its medical group and small-hospital clients, potentially opening it up to large-hospital users later.

Martin says that the remote hosting service is open to all “members” of the Epic community. “Our mission in doing this was to provide our members with an additional hosting option,” he says. “We’ve probably got a little over 250,000 end users that will be hosted by Epic as these organizations roll out their systems. We have three healthcare organizations that are live in production with a couple more lined up in the coming months. All of the members that had signed up for Epic hosting are live in a non-production way, in that they’re building up the systems as part of their implementation activities. We’re preparing them for go-lives over the next six to 12 months.”

Martin adds that no customer is too small, at least from an Epic hosting standpoint. “The mission here is to provide a very scalable infrastructure that has both the capability to flex up to the very large organizations that we work with, as well as the ability to flex down to the very smaller organizations that we work with.”

He couldn’t comment as to the number of customers that will ultimately switch to Epic for their hosting services, though he did stress that, “feedback from sites that are live on it today is very positive.”

Data Center Details

The data center’s infrastructure includes 100,000 square feet of space, buried under a nondescript hill above the floodplain on Epic’s campus and ready to accommodate added capacity as the need arises. Power generation capabilities are also underground, as is the infrastructure necessary to run critical systems.

The company is currently using a co-location facility as its secondary site until the Mayo data center can be brought up to speed. “With the purchase of that state-of-the-art data center,” says Martin, “we will migrate the existing disaster recovery systems up to the Rochester data center and then start using that as our secondary facility going forward.”

He adds that there is “tremendous redundancy falls in terms of the connectivity in the data centers to the Internet, as well as tremendous redundancy in the connections that we provision from the primary and secondary data centers to an individual health organization. We provision two diverse paths for the connectivity to ensure that there’s redundancy from each of the data centers to the health organization to make sure that no single fiber caught or telecom outage can take out all of the links at once.”

Catching Up with the Competition

Some industry insiders see Epic’s remote hosting resurgence as an attempt to keep up with Cerner, which has offered those services since 1999. Its winning DHMSM bid (with primary contractor Leidos) and the DoD’s $51 million decision to move the project’s hosting to Cerner headquarters makes the notion seem that much more valid.

“Both vendors are investing heavily in this capability,” says Impact Advisors Vice President Lydon Neumann, “which will be difficult for other competitors to match in performance and breadth of service offerings. As for Cerner, they will continue to be a strong competitor and Epic’s entry into this market segment validates Cerner’s value proposition for this increasingly attractive hosting option. Epic and Cerner are creating a significant barrier for the other vendors in the market.”

Neumann adds that remote hosting is already bolstering Epic’s long-term prospects. “The market appears to be responding favorably to Epic’s entry into this segment. As a result, more customers and a broader segment of the market are now likely to consider Epic in order to leverage external capabilities and expertise, while gaining access to more technical services to properly maintain and enhance Epic’s enterprise solutions. Customers and prospects will also be increasingly proactive in aggressively reducing costs and will look to remote hosting to solve long-term challenges of managing and sustaining their technology infrastructure.”

The Customer Perspective

FirstHealth of the Carolinas Vice President of Information Systems David Dillehunt took a look at Epic’s remote hosting service as part of the health system’s overall evaluation of replacement vendors. (The North Carolina-based health system is scheduled to go live on Epic on July 1, 2017.) “It didn’t impact our decision to leave McKesson. We were forced to make a change when McKesson decided to sunset the Horizon platform. Epic had not yet gone live with their first remote-hosting customer, so we elected to do the traditional on premise implementation. However, I would bet that, like most things Epic chooses to do, it will do this well and be able to deliver a solid, reliable hosting platform,” Dillehunt explains.

“I do think this will be very interesting to many potential new clients, and possibly to some older clients as well,” he adds, “particularly where there may be issues with space, power, off-site backup availability, etc. I for one do not feel that remote hosting is the magic answer, but I do believe it is one of many and should be evaluated just like any other major choice.”

News 2/10/16

Top News

The Navy awards Leidos an additional $50.7 million for Cerner-provided hosting services for the DoD’s EHR as I reported here earlier, overriding the objections of IBM, CSC, Amazon, and General Dynamics. The announcement says the Cerner system can operate regardless of who hosts it, but its functionality would have been limited “to utilizing only DoD data, which greatly impacts the accuracy of analytics given the  much smaller population of data which, in turn, could negatively impact patient outcomes” and that Cerner refused to allow connection to its managed services. The document adds that third-party hosting “could adversely impact Cerner’s financial viability and competitive market advantage.” The DoD says the new award won’t increase the overall contract spending limit of $4.3 billion.

Reader Comments

From Ickey Shuffle: “Re: Sandlot Solutions. Massive layoffs and the entire sales team was fired. They barely made payroll. Rumor is that ICW may buy the customer base.” Unverified. I reached out to board chair Rich Helppie but haven’t heard back.

HIStalk Announcements and Requests

We funded Mr. Beeler’s DonorsChoose grant request for 13 environmental and science books for his high school class. He says many of the students at his Texas school go to work immediately after school and don’t get home until their work’s closing time, with only 14 percent of graduates going on to college, so he’s trying to motivate them. Mr. Chen’s class from Massachusetts also checked in to say they’re using the digital drawing tablet we provided to do sketches in Photoshop, then convert their ideas to CAD and then print them using donated 3D printers.

Iatric Systems included a question about my HIMSS exhibit hall pet peeve (booth people playing with their phones) in their employee role-playing training for the upcoming conference In return, they donated $500 to my DonorsChoose project, which funded these requests:

• 3D history and engineering puzzles for the STEM-focused high school class of Ms. Hayes in Charlotte, NC.
• 26 sets of headphones for the elementary school computer lab of Mrs. Schmidt in Vero Beach, FL.
• Three Kindle Fires and cases for the elementary school class of Mrs. Jones in Knoxville, TN.
• Math manipulatives for Ms. VanZanten’s elementary school class in W. Valley City, UT.
• Light experiment kits for Ms. Feeley’s elementary school class in Flushing, NY.

I have zero interest in sports but had the Super Bowl turned on for background noise. It caught my attention when I heard an ad pitching a prescription drug for treating opioid-induced constipation. We must have one heck of a doped-up population if the constipation of long-term narcotics users justifies running a multi-million dollar 60-second Super Bowl ad. The drug industry estimates that it’s a $2 billion market as Americans seek a second pill to fix the problems caused by the first. The commercial didn’t mention the drug Movantik at all, probably to avoid the FDA’s requirements that it rattle off a long list of side effects (third pill, anyone?) Movantik costs $300 for a month’s supply. I wonder how many patients will seek a prescription for it because they’re having side effects from illegally obtained narcotics? A lot of what you need to know about what’s wrong with American healthcare is contained in this one paragraph.

On the jobs board: clinical software project manager, sales executive, interface engineer.

The celebrity guest in our microscopic HIMSS conference booth Tuesday afternoon March 1 will be David Schoolcraft, an attorney with Ogden Murphy Wallace PLLC of Seattle, WA. Our “HIT Lawyer in the House” will be happy to say hello, talk about lawyerly HIT issues, or “just chat about how great HIStalkapalooza was.” Email Lorre if you are unnaturally funny, smart, or famous and want to prove it at our booth — it’s not like we’re drawing for Vespas or running a golf simulator on our $5,000 little patch of carpet, so about all we’ll have is a table to stand behind.

HIStalkapalooza

HIStalkapalooza invitation emails have gone out from Eventbrite. That service provides some nice benefits: you’ll be able to check in quickly via a barcode scan, it will send reminders that you signed up, and it will allow those whose plans change to let me know so I can give House of Blues a better estimated headcount. I’ll also know who took up a spot without attending so I can invite someone else in their place next year (the no-show rate is always at least 40 percent).

I wasn’t able to invite everyone to attend HIStalkapalooza since we needed one more sponsor to cover the cost for all the 1,700 or so people who wanted to come. I’m sorry if you didn’t receive an invitation. As usual, I invited all providers who expressed interest, then did the best I could with the people left on the list.

I had a mini-brainstorm this afternoon – since Eventbrite supports collecting online payment for tickets, next year I should simply charge the incremental price of attendance instead of just shutting down invitations once I hit the number covered by sponsors. Anyone who didn’t bother to sign up themselves or their guest who desperately wants to attend could buy a ticket for $150 or something like that instead of just being told they can’t come. My constraint is sponsor funding, not capacity, so we could handle a lot more people who are willing to pay their own way. I’ll consider that for next time.

Just as a reminder:

• Each attendee must have an emailed ticket to get through security. Walk-up registration will not be available (that’s a screen shot of my own ticket, which I signed up for just like everyone else).
• Attendees cannot bring guests. I explained clearly that any guests needed to be signed up individually, just like when you buy any other kind of ticket.
• I’m not keeping a waitlist since no-show rates were already built into attendance estimates. No additional invitations will be sent.
• I can’t control your company’s spam filters or do the legwork to tell you while your email system didn’t allow the invitation to pass through. I’ll put up a page shortly that works like an airline’s standby list –  the truncated first and last names of each invitee will appears so you’ll know you were invited even though you won’t be easily identifiable to anyone else.

Like last year, the House of Blues doors will open at 6:30 and we’ll close the check-in table by 8:30. The event costs about $200 for each attendee who passes the House of Blues guy with the people-clicker, so swinging by after someone else’s party for a quick beer can wreck the already-stretched budget. Be there on time and you won’t have to listen to a muffled Party on the Moon from the casino outside the HOB’s walls.

You can follow along with whatever it is that people will tweet about the event using #HIStalkapalooza. I’m surprised that nobody has Twitter-bragged about getting an invitation.

Several readers emailed to ask if we’ll have Longo Lemonade at HIStalkapalooza. I hadn’t heard of it, but figured industry long-timer Peter Longo would know (duh) so I asked him. It’s a game where you ask for a Longo Lemonade and then show the bartender how to make it if they’re stumped – apparently word has spread and many will need no further instruction. But for those bartenders who haven’t heard of it, here’s the recipe that will probably result in sugar-sticky bar surfaces all over the House of Blues:

Shake straight vodka with ice and pour into a shot class. Sprinkle a packet of sugar onto a napkin and dip a slice of lemon in the sugar to cover each side. Drink the shot and then eat the lemon slice.

Webinars

February 17 (Wednesday) noon ET. “Take Me To Your Leader: Catholic Health Initiatives on Executive Buy-In for Enterprise Analytics.” Sponsored by Premier. Presenters: Jim Reichert, MD, PhD, VP of analytics, Catholic Health Initiatives; Rush Shah, product manager analytics factory, Premier. Catholic Health Initiatives, the nation’s second-largest non-profit health system, knew that in order to build an enterprise analytics strategy, they needed a vision, prioritization, and most importantly buy-in from their executives. Dr. Jim Reichert will walk through their approach.

February 23 (Tuesday) 1:00 ET. “Completing your EMR with a Medical Image Sharing Strategy.” Sponsored by LifeImage. Presenters: Don K. Dennison, consultant; Jim Forrester, director of imaging informatics, UR Medicine. Care coordination can suffer without an effective, cost-efficient way to share images across provider networks. Consolidating image management systems into a single platform such as VNA or PACS doesn’t address the need to exchange images with external organizations. This webinar will address incorporating the right image sharing methods into your health IT strategy.

Acquisitions, Funding, Business, and Stock

Premier reports Q2 results: revenue up 17 percent, adjusted EPS $0.42 vs. $0.36, beating expectations for both but recording a GAAP loss of $54 million for the quarter.

Mobile consumer payments vendor SwervePay raises $10 million in funding, increasing its total to $11.6 million. The company focuses on healthcare and auto-related services, which for appointment-setting and payments are not all that different now that I think of it.

Cognizant announces Q4 results: revenue up 18 percent, EPS $0.69 vs. $0.59, falling short of revenue expectations but beating on earnings. Shares dropped on lower revenue guidance due to expected reduced technology spending. The company’s healthcare division, its second-largest in contributing 30 percent of total revenue, had a 23 percent revenue increase, still a slowdown from previous quarters. Cognizant acquired TriZetto for $2.7 billion in 2014.

Human resources software vendor Zenefits fires founder and CEO Parker Conrad, informing employees that, “Many of our internal processes, controls, and actions around compliance have been inadequate, and some decisions have just been plain wrong.” Forbes estimates the net worth of 35-year-old Conrad at $900 million. The company, valued at $4.5 billion, has been accused of allowing unlicensed salespeople to sell medical insurance. Zenefits hired as its new CEO David Sacks, who co-founded Yammer (purchased by Microsoft for $1.2 billion) and who used the fortune he made as pre-IPO COO of PayPal to produce the movie “Thank You For Smoking.”

Sales

Spartanburg Regional Healthcare System selects Strata Decision’s StrataJazz financial system.

People

Leidos Health names Chris Freer (SPH Analytics) as sales VP.

Announcements and Implementations

Skagit Regional Health (WA) posts 53 new IT positions with up 20 more coming in 2016 as it implements Epic, on which it expects to spend $72 million over the next five years.

Phynd CEO Tom White attended a recent White House roundtable on technology jobs in rural America, including Phynd’s “Silicon Prairie” home of Kearney, NE. The session with 10 business leaders was hosted by Secretary of Labor Tom Perez and Secretary of Agriculture Tom Vilsack.

Government and Politics

The Senate health committee unanimously passes S.2511, the Improving Health Information Technology Act. Some of what the bill contains:

• Reduce documentation burdens and allow non-physicians to document on their behalf.
• Encourage EHR certification for technology used by specialty providers.
• Create a health IT rating system reflecting security, usability, interoperability, and certification testing results that also incorporates user feedback.
• Empower HHS OIG to investigate and punish data blocking.
• Enlist data sharing networks to develop a voluntary model framework and agreement for information exchange.
• Create a digital provider directory.
• Require certified software to exchange information with registries that follow standards.
• Directs the GAO to conduct a patient matching study within one year.
• Require HHS to defer to standards created by Standards Development Organizations and consensus-based bodies.
• Require HHS OCR to clarify provider misunderstanding about giving patients access to their own information and to publish best practices for patients to request the information. 

More details: the HELP committee’s revised summary and the Senate’s bill.

The President sends Congress a $4.1 trillion 2017 budget that would raise taxes by $2.6 trillion in the next 10 years. It includes HHS funding for the “cancer moonshot” and programs to address opioid addiction, but the big jump in federal red ink would come from Medicare and Social Security entitlement programs that are being overwhelmed with retiring Baby Boomers. The budget includes $19 billion for improving the cybersecurity of government IT systems. It doesn’t address the economic elephant in the room: that even a tiny increase in increase rates could add $1 trillion in annual costs just to service the cost of the existing massive federal debt.

Privacy and Security

A medical school professor says doctors need to stop complaining about EHRs patients shouldn’t obsess over medical records confidentiality because EHR-created databases will change the way medicine is practiced and lead to new cures. He says that simple data mining can find information “lying in plain sight, no invasive procedures or testing required. We could have found it years earlier if we had had the date.”

Technology

Cerner launches the Cerner Open Developer Experience to allow developers to work with Cerner’s sandbox using SMART on FHIR.

Other

The British government will give NHS $6 billion to fund technology projects that will eliminate fax machines and paper, improve cyber security, create a new NHS website, and provide free wi-fi. Patients will gain online tools to schedule appointments, request prescription refills, and communicate electronically with their physicians. NHS hopes to monitor 25 percent of patients with chronic conditions remotely by 2020.

A tiny study finds that pediatricians who remotely evaluate children with fever or respiratory distress using FaceTime on an iPad perform just as well as those who conduct their examination in person.

A well-designed study of discharged heart failure patients finds that telemonitoring combined with health coaching didn’t reduce 180-day readmissions.

Athenahealth’s Jonathan Bush, in a short interview, says that his aunt, Barbara Bush, donated $4 million in Athenahealth profits to the Barbara Bush Children’s Hospital at Maine Medical Center. He says:

The irony is the Barbara Bush Hospital just bought Epic with that money and is building a monopoly to capture referrals that they don’t have the volume to do well. A lot of the stuff they do probably should be done somewhere else. I didn’t say all this to Bar. I said, “That’s just great,” pinching my fingernails under the table.

Weird News Andy says, “I expect it to be in ICD-11” after failing to find an ICD-10 code for the claim that a man in India was killed by a meteorite. WNA codes the encounter as, “W20.8XXA Other cause of strike by thrown, projected or falling object, initial encounter.”

Sponsor Updates

• AdvancedMD makes its patient engagement solution available to users of its AdvancedPM technology.
• The Nashville Post covers Cumberland Consulting Group’s move into performance improvement and revenue cycle.
• Bernoulli participated in the IHE North American Connectathon Week in Cleveland.
• ZeOmega launches a series of whiteboard videos about its population health management software.
• Vital Images offers a zero-cost data migration service.

Blog Posts

• 3 Tips for stopping revenue leaks that are draining your practice profitability (AdvancedMD)
• HIPAA: Helping or Hurting? (AirStrip)
• FY 2017 Wage Index Update (Besler Consulting)
• Lessons Learned from a Medical Trip to Ecuador (Caradigm)
• 3 Key New Hires for the Next Chapter at CareSync (CareSync)
• Completing a PA Request Electronically in 3 Easy Steps (CoverMyMeds)

Contacts

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

Morning Headlines 2/9/16

£4.2 billion investment to bring the NHS into the digital age

NHS Health Secretary Jeremy Hunt announces a new $6 billion initiative to fund the health system’s push toward a paperless care delivery environment.

Theranos has a week to respond to the searing report about its business

Theranos is granted a one week extension to address inspection deficiencies found by CMS auditors during a routine inspection of its California lab.

Give Up Your Data to Cure Disease

A New York Times opinion piece weighs the trade off between patient privacy and  the research value that EHR data sets offer, arguing “We need to get over it. These digital databases offer an incredible opportunity to examine trends that will fundamentally change how doctors treat patients.”

Morning Headlines 2/8/16

One Medical Buys Virtual Nutritionist App Rise

Concierge medicine provider One Medical acquires digital health startup Rise for $20 million. Rise markets an app that provides one-on-one nutrition and diet coaching, and has raised $4 million since its 2013 launch.

Obamacare’s Low Enrollment Numbers Also Show Why Exchange Coverage Will Get Worse

A Forbes opinion piece argues that public insurance exchange coverage options will continue to get worse.

JHU launches new healthcare engineering center

Johns Hopkins University launches The Malone Center for Engineering in Healthcare, a research center focused on data analytics, system design and analysis, and technology and devices.

athenahealth Jonathan S. Bush on Q4 2015 Results – Earnings Call Transcript

On its quarterly earnings call, Athenahealth CEO Jon Bush noted that its recently announced partnership with University of Toledo will help it develop a system suitable for larger academic health systems.

Monday Morning Update 2/8/16

Top News

National medical practice operator One Medical Group pays $20 million to acquire nine-employee Rise, whose app connects users with nutritionists for meal planning and diet advice. The company had raised $4 million. One founder was previously with Groupon while the other worked for Mozilla.

San Francisco-based One Medical Group, which has raised $182 million and runs practices in seven cities, was founded by former Epocrates CMO Tom X. Lee, MD.

Reader Comments

From Lib B Z: “Re: NYU’s Langone Medical Center. Doctors are unhappy with the new EMR added because the changes are confusing and time wasting. The new system supplied by Optum is supposed to work alongside Epic. Langone is reportedly looking at dismantling the recent additions that were hurriedly bolted on.” Unverified.

From Curly Endive: “Re: Epic hosting. We’re also concerned about scanning with McKesson. There seem to be mixed opinions among us whether Epic really gets what a big problem this is. I understand keeping a competitor’s product off their hardware, but my sense is they got caught with their pants down in anticipating that hosting customers would need a solution. They don’t seem to have a fast solution in the works.” Unverified.

From Ex-Epic: “Re: Epic customers in Canada. Children’s Hospital of Eastern Ontario: Beaker (I think), MyChart, Ambulatory and I think inpatient as well.  Women’s College Hospital: scheduling/registration, Ambulatory only. Alberta Health Services: Mychart/Amb and there was rumor when I was at Epic that they were expanding to enterprise (they already have the license). Mackenzie is full enterprise. I think you covered this in the past, but Epic lost out on University Health Network in Toronto, which is the largest hospital network in Canada.”

HIStalk Announcements and Requests

More than 80 percent of poll respondents say their reaction to recent CMS statements about Meaningful Use is negative. New poll to your right or here: if you’re going to the HIMSS conference, what is your primary reason for attending?

Welcome to new HIStalk Gold Sponsor Carevive Systems. The Philadelphia-based company offers an oncology care planning system that combines electronic patient-reported outcomes with clinical data and evidence-based content authored by thousands of oncologists to generate initial, supportive, and survivorship care patient care plans and to link patients to clinical trials. Its rules engine auto-populates the 13 elements of the IOM care management plan required for the Oncology Care Model. As a client reports, “What I really like about the platform is the patient’s ability to report his or her own symptoms, and then we can generate evidence-based practice data to manage those symptoms. Subsequently, we provide an intensive care plan for them … we’re able to see what patients are truly experiencing and help them manage their symptoms more effectively.” Thanks to Carevive Systems for supporting HIStalk.

Mrs. Brunetti says her rural Arkansas students are able to remember math concepts better by using the books and manipulatives we provided in funding her DonorsChoose grant request.

Also checking in is Mr. Garcia, who needed speakers for the six computer workstations he built himself for students of his inner city Dallas school (he’s an Army veteran and computer engineering graduate). We also provided a weatherproof Bluetooth speaker whose use he describes as, “The portable speaker was a hit. We took it to the hallway for the Sphero robotic ball to draw 2D figures. Every time there was a sound it was deep, loud and catchy — our principal came to see us and was very impressed with my students listening to instructions from Sphero. Teaching coordinates X and Y for ordered pairs was very memorable for them. My plan is now to take Sphero, the tablet, and the portable speaker to the basketball court and teach angles, time to distance ratio, problem solving, and critical thinking.”

I’ve been surprised at the number of people who are shocked and indignant at Martin Shkreli’s 50-fold price increase for Daraprim, sputtering that his company should behave “fairly.” That’s the most ridiculous thing I’ve heard lately, that anyone would expect a former hedge fund trader and drug company CEO to take any action that doesn’t best serve him or his shareholders, or for that matter that less-annoying healthcare overlords are working selflessly for the good of their customers in some manner everybody else might consider “fair.” Shkreli is working the system that we all created where we made healthcare a capitalistic, obscenely profitable business, no different than everybody else lapping at the sick people’s trough (McKesson doesn’t pay John Hammergren $150 million per year for being “fair.”) The politicians he refused to answer last week seem to think it’s Shkreli’s job and not their own to fix our healthcare mess. As the New Yorker observes with apparent tongue in cheek,

Nancy Retzlaff, Turing’s chief commercial officer, told the committee about her company’s efforts to get the drug to people who can’t afford it. The arrangement she described sounded like a hodge-podge, an ungainly combination of dizzyingly high prices, mysterious corporate bargaining, and occasional charitable acts—which is to say, it sounded not so much different from the rest of our medical system … True, he has those indictments to worry about. But he is also a self-made celebrity, thanks to a business plan that makes it harder for us to ignore the incoherence and inefficiency of our medical industry. He rolls his eyes at members of Congress, he carries on thoughtful conversations with random Internet commenters, and, unlike most of our public figures, he may never learn the arts of pandering and grovelling. He is the American Dream, a rude reminder of the spirit that makes this country great, or at any rate exceptional.

Meanwhile, a fascinating video interview shows Shkreli casually slurping from a $5,000 bottle of wine while playing chess with the interviewer, describing that he’s a hero among dishonorable drug companies and explaining why hospitals and doctors are healthcare’s real cost problem. We’re still trying to convince him to hang out at our HIMSS booth. I told Lorre to bribe him by offering to buy one full-priced Daraprim tablet.

Last Week’s Most Interesting News

• Practice Fusion lays off 74 employees as it struggles to reach profitability.
• The White House asks Congress to fund a $1 billion “cancer moonshot.”
• Theranos declines to fulfill its promise to allow partner Cleveland Clinic to verify its technology and says it won’t publish FDA testing data until all of its tests are approved.
• A Surescripts survey finds that few New York doctors have the technology required to send all prescriptions electronically by March 27, 2016 as state law requires.
• The Hurley Medical Center pediatrician credits her use of EHR-mined data in proving Flint, Michigan’s water crisis to skeptical state officials.
• A bipartisan Senate bill calls for expanding Medicare coverage of telemedicine.

Webinars

February 23 (Tuesday) 1:00 ET. “Completing your EMR with a Medical Image Sharing Strategy.” Sponsored by LifeImage. Presenters: Don K. Dennison, consultant; Jim Forrester, director of imaging informatics, UR Medicine. Care coordination can suffer without an effective, cost-efficient way to share images across provider networks. Consolidating image management systems into a single platform such as VNA or PACS doesn’t address the need to exchange images with external organizations. This webinar will address incorporating the right image sharing methods into your health IT strategy.

Acquisitions, Funding, Business, and Stock

From Friday’s Athenahealth earnings call:

• The company has 4,600 employees.
• The recently announced development partnership with University of Toledo Medical center will help the company move from its “sub-50 bed hospitals” to larger facilities that need “chemotherapy or more advanced pharmacy and lab or surgery, pre-op, post-op, more sophisticated discharge planning.”
• When pressed on University of Toledo’s  timeline to replace its sunsetting systems, Bush said, “There are a very large number of older inpatient systems that are turning into a pumpkin in 2018. And, yes, we would like to be able to gobble up as much of that as possible. The number one feedback that we get in focus groups with health system executives around Athena is, they don’t do inpatient … they think they need that one throat to choke. So, we’ve got to be there with inpatient and outpatient. And it’s true — 2018 is a bellwether year for us if we’re ready.”
• Jonathan Bush says of practices taking risk, “The awkward truth is that not many doctors, not many lives are truly, truly at risk. They are part of ACOs and other things where the government takes the first two cents and then they spend the year figuring out what the savings might be and then they give you half the savings. Then if you created savings in past years, they rebate you at a later year.”
• The company is working on mapping all providers and AthenaNet patients individually into master directories in creating an instant-on experience so that new clients can instantly receive information about their patients and referral patterns.
• Bush describes the company’s horizontal expansion as, “If you just imagine that the doctor is the guy who launches that pinball up into the pinball machine, the most important guy to get is that ball launcher at the bottom … We are loved more than anyone else. We are the only likeable cafeteria food in all of undergraduate education. That ball is the patient. They shoot up and bounce against labs, pharmacies, clinics, hospitals, surgery centers. We’ve been starting with the most frequent bumpers.”
• Bush says of McKesson Horizon customers who will be forced to make a replacement system decision soon, “We don’t want these beautiful animals to bolt off the cliff in panic and go enter themselves into another 10-year amortization and another nightmare of capital encumberment for their balance sheet and a nightmare of administrative complexity for their IT teams. We want them to believe. Some will bolt, but the partnership with Toledo, the partnership with Beth Israel, the progress through larger and larger hospitals, and the fact that we have a pretty darned good reputation as an entity that delivers in this space, we’re hoping will save some people from unfortunate decisions.”

Above is the one-year share price of ATHN ((blue, down 9 percent) vs. the Nasdaq (red, down 7.7 percent). The company is worth nearly $5 billion.

Meanwhile, Bush weighs in on Turing Pharmaceuticals Founder Martin Shkreli, saying he would “fight and die for Shkreli’s right to be a douche,” adding that drug companies should be able to charge whatever they want for drugs that keep people out of expensive hospitals. 

MMRGlobal, the purported personal health record vendor whose real focus is shaking down EHR vendors by filing nuisance patent infringement lawsuits against them in forcing licensing agreements, conducts a reverse stock split. The company’s one billion plus shares were worth less than a fifth of a penny, valuing it at $2.5 million. The company lost $490,000 on sales of $80,000 in the most recent quarter.

Sales

In Australia, Bendigo Health chooses InterSystems TrakCare as the EHR for its new hospital that opens next year.

Announcements and Implementations

The Ann Arbor, MI VA hospital goes live on LiveData PeriOp Manager in its operating rooms, where it will synchronize perioperative workflow.

Government and Politics

A Forbes editorial says exchange-sold medical insurance will get worse, evidenced not only by enrollment numbers that are 40 percent less than originally estimated, but also by the “adverse selection” of high plan-switching rates indicating that healthy enrollees are trying to minimize the implicit tax in subsidizing sick enrollees who are seeking out the most comprehensive coverage. It concludes that insurance companies that offer the best coverage will be forced out of the marketplaces as federal subsidies run out for their overly sick risk pool.

A proposed Florida bill would require hospitals to verify the identity of Medicaid recipients using biometrics and a link to the state’s driver’s license database.

Privacy and Security

Above is a nice quote from Ministry Health Care CIO Will Weider.

Jackson Memorial Hospital (FL) fires two employees who provided an ESPN reporter with photos of the medical information of NFL player Jason Pierre-Paul, who blew off his right index finger in a July 4 fireworks accident.

Technology

Pebble releases its first health-related smartwatch updates, including a Pebble Health watch face. It’s seems to be purely a step counter and sleep tracker so far. The company’s Valentine’s Day special offers two of its Pebble Time Round Black and Silver for $360, much cheaper than the Apple Watch but equally pointless for me personally. 

Other

Johns Hopkins University launches the Malone Center for Engineering in Healthcare, which will link engineers with clinicians to focus on data analytics, systems design and analysis, and technology and devices. It is funded by cable TV billionaire John Malone, who earned a MS and PhD from Hopkins.

Actress Selma Hayek posts a photo of her posing with the ED doctors who were treating her after an on-set head injury, apologizing for her interesting shirt in saying, “Unfortunately, my wardrobe for the scene was completely inappropriate for the hospital.” She didn’t name the facility, but the doctors appear to work for Northwell Health (the former North Shore-LIJ). I found the Halloween costume shirt she’s wearing for sale here, although I’m torn between that and the company’s mullet wig for my HIMSS attire.

The CEO of Union General Hospital (GA) and four members of his family are arrested for distributing narcotics after an investigation finds that a local doctor had written him 15,000 painkiller prescriptions in three years. The CEO’s brother, who is an ED doctor and former hospital board member, was also arrested, as was their sister, a nurse practitioner. The private practice doctor, who is also a board member of the hospital, was arrested and charged with 41 counts of unauthorized distribution of a controlled substance. It’s fascinating that America’s profitable self-doping has reached such epidemic levels that a hospital’s board apparently conspired to cash in on it. That doesn’t even count the cost of locking up our prisoners of war (on drugs) that has long since been lost in trying to limit supply rather than demand and driving up prices, crime, and overdose deaths as a result.

Yet another study finds that high-deductible medical insurance doesn’t encourage Americans to seek better healthcare services deals – it just causes them to skip getting the care they need. I bet there’s a newly occurring “seasonality” in doctor visits during the first half of the year when patients are paying out of their own pockets again, followed by a surge later once they have – expectedly or unexpectedly – met their deductibles that run nearly $7,000 on exchange-sold plans.

A reader dug up a copy of Epic’s comic book from HIMSS 2000 as produced by “editor in chief Judith R. Faulkner.” The page on the right describes the “unsupported hyperbole decoder ring” that has translated the competitor’s sales pitch as, “We will go public, make gazillions, and retire to an island paradise.” Another page references publicly traded health IT vendors with, “You know what people are saying about the whole Internet stock craze.” That was the year the HIMSS conference in Dallas was pushed back to April to give hospital IT people time to fix unexpected Y2K problems, rocketing attendance to a then-lofty 17,000 (it was 43,000 last year).

Weird News Andy calls the story of the doctor convicted of murder for overprescribing drugs “Rx Wrecks,” with his favorite line being that the perp “sometimes made up medical records” of patients that she described as “druggies.”

Sponsor Updates

• Vital Images employees wear red for National Wear Red Day in support of heart health.
• Reminder and patient engagement service vendor Talksoft announces integration with Greenway Intergy.
• Versus Technology becomes a founding member of the Electronic Hand Hygiene Compliance Organization.
• VitalWare publishes a client success interview with Liz Knisel from ProMedica.
• Huron Consulting Group will exhibit at the Annual AHA Rural Healthcare Leadership Conference February 7-10 in Phoenix.

Blog Posts

• Leading with Passion: the Power of the Human Connection (T-System)
• Patient Flow: A View from Across the Pond (TeleTracking)
• Evaluating Risk with Population Health Analytics (Verisk Health)
• Brand-new buildings, brand-new communication (Voalte)
• Patient Engagement: A Call to Action (West Corp.)
• Beyond the Hippocratic Oath (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 2/5/16

Top News

Free practice EHR vendor Practice Fusion lays off 74 employees – around 25 percent of its workforce – in the face of ongoing losses.

Reader Comments

From Bottled Lightning: “Re: Practice Fusion layoffs. Its IPO has been off the table since Ryan Howard left. I’m not sure why the press keeps propagating that fantasy when the company hasn’t been pitching IPO. They’ve been trying to find a buyer with no luck. Now they’re hunkering down and will try to survive with a much smaller team, filling functionality gaps in the product and trying to make it viable in a real market. You get what you pay for, and since most of its customers pay nothing, the product has some pretty deep gaps.” Unverified. Other readers have said the IPO story was floated as an excuse for dismissing founder and CEO Ryan Howard in August 2015. Investors have poured $155 million into the free EHR vendor in the past seven years. Companies yearning to IPO don’t usually fire the CEO, replace him with someone with no CEO experience, and conduct mass layoffs. It’s a tough time to be in the post-Meaningful Use EHR business.

From Boom Goes the Dynamite: “Re: Practice Fusion layoffs. The CEO is nice but unqualified – the board seems to think he can sell the company so they can get their $300 million (or more) back. Steve Filler quit his Oliver Wyman consulting job to become PF’s COO with much internal fanfare in November 2015 and he’s already gone. The CFO was let go and the chief marketing guy from Google didn’t take long to run away. The company’s 2015 revenue was $15 million, all of it from pharma, and its burn rate is $3 million per month. The board just forked over another $30 million to keep the lights on. Tom the new CEO predicts that they will become revenue positive by Q3 2017, but I don’t see a path to the top of that mountain.” Of the 13 executives listed on Practice Fusion’s website a year ago, only six are still there. If that $15 million annual revenue estimate is accurate, then Practice Fusion is a tiny, struggling company in a shrinking market segment in which it’s not among the top 10 companies (based on Meaningful Use attestation numbers). I don’t see even one attribute that would make me want to buy shares if indeed the company survives long enough to do a Hail Mary IPO.

From Karen Green: “Re: lack of technology vs. lack of adoption. We have plenty of technologies that have begun to interoperate – DSM and HIE messages from acute care partners to post-acute specialists. MU attestation? Check! Not so on the continuum of care, where we are getting care summaries 1-3 days after discharge, rendering them useless for transitions of care. Why? Because the discharge and admissions planners on the front line are still using phone calls and fax to refer the patient. We have to enable the ‘intoperators’ on the front line and within the clinical practice so they can be informed about their patients in a timely way. Gartner suggests that CIOs have to be ‘digital humanists’ to lead the design of systems and technology to ‘enable people to achieve things they never thought possible.’ We must provide solutions that make it easy to give up proven convention for something that goes beyond the automation of processes.” Karen is CIO at Brooks Rehabilitation (FL).

From Brass Ones: “Re: Mackenzie Health in Ontario. Going Epic.” Verified from their job postings. I don’t know of any other hospitals in Canada that run Epic inpatient.

From The PACS Designer: “Re: augmented reality in healthcare. There’s a new term that created a buzz at the recent Consumer Electronics Show and that’s augmented reality. AR works differently than virtual reality (VR) in that the viewing device can be worn while doing other activities like walking or at work.” The mock-up above is from Microsoft’s HoloLens, which will start shipping soon. The company offers a $3,000 developer edition.

HIStalk Announcements and Requests

Ms. Johnson from Oklahoma says her students, many of whom begin school speaking only Spanish, are using the five MP3 players we provided via DonorsChoose to listen to the recordings of books she creates. Meanwhile, Ms. Johnson from Pennsylvania reports that her inner-city third graders are using their new Chromebook and accessories to access online reading and math interventions as well as to perform research – they previously had computer access in just one class three times per week.

This week on HIStalk Connect: Doctor on Demand announces that it will offer psychiatry sessions over its telehealth platform, expanding nationwide by mid-year. Pear Therapeutics raises $20 million in funding to roll out its substance abuse recovery support app. The University of Southern California announces eight strategic partners that will support its Virtual Care Clinic initiative.

HIStalkapalooza

HIStalkapalooza Featured Sponsor – NextGen Healthcare

Visit NextGen Healthcare at HIMSS16 Booth #4421. See for yourself how we help ambulatory organizations achieve real interoperability, improve population health, and transition to value-based care. By focusing less on IT and more on care, our clients are driving the changes you hear about in healthcare. Of course, we’re not all work and no play! We’ll also be taking professional headshot photos in the booth; not to mention Happy Hour the last hour of each day at our booth, #4421!  Stop by after a long day pounding the convention floor for a pick-me-up.

Webinars

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

Acquisitions, Funding, Business, and Stock

Houston-based Decisio Health raises $2 million as it starts marketing its FDA-approved patient dashboard that uses technology licensed from University of Texas Health Science Center of Houston.

Health information vendor IMS Health acquires AlphaImpactRx, which apparently pays doctors to provide feedback about drug salespeople via a mobile app and then sells that information to drug companies. The company also surveys oncologists and pathologists about oncology molecular diagnostic testing, pitching itself to drug companies by, “It’s important to understand how testing is impacting the oncologist’s choice of brand.” I like that doctors want consumer drug advertising to stop, but I also wish they would stop giving or selling their own information to companies like IMS that help drug companies sell drugs that might not be the best option. Drug companies target those doctors using the information they themselves provided.

Athenahealth announces Q4 results: revenue up 21 percent, adjusted EPS $0.45 vs. $0.58, missing revenue estimates but beating on earnings. 

People

David Crutchfield (Maestro Strategies) joins Conway Medical Center (SC) in the newly created position of VP/CIO.

Don Soucy (Orion Health) joins Spok as EVP of global sales.

Leidos names Donald Kosiak, Jr., MD, MBA (Avera Health) as chief medical officer. I’m not sure if he’s trying appear edgy or to hide a bald spot with his head-cropping LinkedIn photo, but kudos for his 18 years of service in the Army National Guard with deployments to Iraq.

E-MDs names Derek Pickell (Convergent Healthcare) as CEO and board director. He replaces David Winn, who retired with the March 2015 announcement of the company’s acquisition by Marlin Equity Partners.

Vocera hires Kathy English, RN (Cisco) as VP of marketing.

Announcements and Implementations

Orchestrate Healthcare launches an information security practice.

KLAS announces members of its Interoperability Measurement Advisory Team. The press release’s headline mentions an inaugural meeting that someone forgot to include in the release itself. 

Philips will use Validic’s technology to integrate consumer health data with its HealthSuite connected health products.

CCSI Distributors, a subsidiary of Clinical Computer Systems, Inc., obtains exclusive US distribution rights to the OB-Tools TrueLabor Maternal Fetal Monitor.

VCU Health (VA) used its Spok communications technology to manage its medical coverage of the nine-day UCI Road World Cycling Championships, which attracted 1,000 cyclists and 640,000 spectators to Richmond, VA.

Healthcare Growth Partners publishes its “2015 Year-End Market Review.” HGP’s reports are brilliant and eloquent and I savor every one of them. Even folks who aren’t interested in business or investing will find them to be concise and insightful, with passages like this:

We urge innovators to approach the market pragmatically and not get carried away by idealism during this transitionary time of policy-based innovation. In health IT, disruption seems to come in increments versus all at once. We find that when health IT companies fail to achieve objectives (or founders get significantly diluted), it’s most often because the product or strategy arrives on the scene too early versus too late.

Government and Politics

A group of senators and representatives introduces the CONNECT for Health Act, which would promote expanded use of telemedicine in Medicare by removing existing restrictions.

Pharma bad boy Martin Shkreli pleads the Fifth Amendment in refusing to answer questions posed to him during a House committee hearing on drug pricing.

A VA care alert warns that its CPRS system rejected an large number of consult/procedure orders, which it discovered while reviewing the system after the October 1, 2015 ICD-10 switch. Clicking the warning’s OK button cancelled the order. The VA says it fixed the problem in a December 29 patch, adding that a few examples were found to have occurred before October 1.

Federal judges reverse the VA’s demotion of two executives who had schemed to force their subordinates to transfer jobs so they could take those lower-level jobs themselves while keeping their executive pay. The judges ruled that the pair’s bosses knew what they were doing and did nothing to stop them. The same two VA executives are being investigated for being reimbursed $400,000 for questionable moving expenses.

The head of California’s insurance marketplace says UnitedHealth Group is “driving me bonkers” for blaming the Affordable Care Act for its losses from selling individual policies. He says the company’s competitors participated and learned from the beginning while UHG initially stayed on the sidelines, then set its rates higher than everyone else and offered broad networks that attract sicker people to sign up.

Privacy and Security

A second former Tampa General Hospital (FL) employee is charged with stealing patient information used to file fraudulent tax forms.

Other

Melissa Memorial Hospital (CO) brings self-pay billing back in house and goes back to separate inpatient and ambulatory statements following problems with First Party Receivable Solutions and its “OK, but not stellar” NextGen billing system.

Glassdoor places Epic as #16 on its list of “Top 20 Employee Benefits & Perks,” scoring the company four spots ahead of Google for offering a paid four-week sabbatical after five years.

The Charlotte newspaper notes that Carolinas HealthCare paid its retiring CEO $6.6 million in 2015, with all of the health system’s top 10 executives earning more than $1 million in total compensation. Even the chief HR officer made $1.3 million.

I like this graphic, available here. The only problem I see is that it seems to be aimed at providers who probably either won’t see it or will ignore what it says. A patient-focused version would be nice if there was a way to blast it to the masses.

OpenNotes sponsor Robert Wood Johnson Foundation lists its three-year goals for the project: (a) expand OpenNotes to 50 million people; (b) conduct pilot projects to see how clinical notes are being used to engage patients and families; and (c) measure the value of sharing notes.

Sponsor Updates

• PharmaPoint incorporates the Surescripts Medication History for Panel Management solution into Xchange Point 5.0.
• InterSystems is listed among the top 25 privately held companies in Massachusetts in the 2016 Boston Business Journal Book of Lists.
• Premier awards Versus Technology a group purchasing agreement for its RTLS/RFID products.
• Leidos Health will exhibit at McKesson Southeast February 10-11 in Charlotte, NC.
• Outsourcing Gazette names MedData one of its Top 25 Most Promising Healthcare Services Providers of 2016.
• Medicomp Systems will host Quipstar at HIMSS16.
• Orion Health will present with CAL Index on March 1 at HIMSS16.
• Sunquest announces UPMC, BSA Health Systems, and Carolinas HealthCare as winners of its client innovation awards.
• PeriGen announces a new online training tool for its Patterns systems.
• Red Hat releases a now viral employee rap video paying homage to its hometown of Raleigh, NC.
• RelayHealth shares a video interview with VP Arien Malec.
• The SSI Group opens registration for its 2016 user group events.
• Streamline Health will exhibit at the 2016 Florida HFMA Regional – Space Coast event on February 5 in Titusville.

Blog Posts

• The Virality of Secure Messaging (pMD)
• Revolutions in Healthcare Analytics (Part 6 of 6, Future Think) (Optimum Healthcare IT)
• Reflections on 2015: Paving the Way to Value-Based Care (Medicity)
• Integration Trends Roundup for 2016 (Liaison Technologies)
• Three Key Tips to Implementing an Imaging Interoperability Platform (LifeImage)
• Insights from a KLAS Category Leader – Integration (MedAptus)
• Finding the Perfect Number of Patients (Nordic)
• Invest in Your Data: How Clinical Mobility Solutions Liberate Data and Drive Cost Savings (PatientSafe Solutions)
• 4 Benefits to Integrating Secure Texting Apps with EMRs (PracticeUnite)
• Investments in Healthcare IT Are Shifting Focus (Phynd Technologies)
• The Virality of Secure Messaging (PMD)
• On the Road to Interoperability, Industry Collaboration Drivers Wanted (Surescripts)

Contacts

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

News 2/3/16

Top News

The White House will ask Congress to approve $1 billion for President Obama’s so-called “cancer moonshot.” Some of the areas to be funded within HHS are early detection via genomics, enhanced data sharing among institutions, and a virtual FDA Oncology Center of Excellence to review new combination products.

Reader Comments

From Judo Chop: “Re: Florida Hospital and Athenahealth. This is part of the December announcement by its parent company Adventist Health System selecting Athenahealth. Florida Hospital will replace a combination of Epic ambulatory EHR that’s used in a handful of clinics, Cerner ambulatory EHR, and Allscripts (the old Misys product) PM. Most of the rest of AHS is using NextGen’s EHR/PM.“ Adventist announced in December that it will be deploying Athenahealth’s PM/EHR to 1,600 employed physicians.

From Polecat: “Re: Meaningful Use hardship exception. The new form doesn’t even ask the EP or EH to submit documentation of their claimed reason.” Correct. I think we can assume that this wink-wink form means CMS will allow anyone to avoid EHR penalties. MU is an embarrassment to everyone involved at this point and even the government is trying to distance itself from it. Just check “EHR Certification/Vendor Issues” and you’re done.

HIStalk Announcements and Requests

Mrs. Haley from Georgia couldn’t wait to send photos of her special education and gifted students using the three tablets we provided in funding her DonorsChoose grant request. She took these photos the day they arrived, where she had already installed reading and testing apps.

Also checking in was Mrs. B from North Carolina, who just got word that we had funded her request for science activity tubs. She says, “I couldn’t believe the email I received with information about my project … I yelled out loud and other staff members came to my classroom to see what was going on … I try to purchase what I can, but it seems as if my money is not going very far these days. Thank you very much from the bottom of my heart. You have made one teacher very happy … You will never know if a future mineralogist, petrologist, or geologist will be inspired by these kits!”

I was thinking today: has anyone actually ever heeded the warning to, “If this is a medical emergency, hang up and dial 911” after hearing those boring, time-wasting phone tree warnings when calling everyone from a dermatologist to a drugstore?

HIStalkapalooza

HIStalkapalooza Sponsor Profile – Fujifilm

With 16 years of industry-leading experience, our TeraMedica division remains independently focused on advancing VNA technology and healthcare interoperability while now leveraging Fujifilm‘s clinical capabilities. As the centerpiece of Fujifilm’s comprehensive medical informatics portfolio, Synapse VNA provides the industry’s leading image management solution. Fujifilm is proud to sponsor HIStalkapalooza. Visit us during HIMSS16 for all your medical informatics requirements, Booth #1024.

HIStalkapalooza Sponsor Profile – PatientSafe Solutions

PatientSafe Solutions has mobilized clinicians and redefined clinical workflows for more than a decade. Meet our team in Booth #4257 to learn how our Clinical Communications platform improves patient care and satisfaction while decreasing costs. Meet us at HIMSS. Our team can’t wait for HIStalkapalooza this year. Look for us at the event to get your picture taken for the 2016 HIStalkapalooza video!

Webinars

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

Acquisitions, Funding, Business, and Stock

Huron Consulting Group acquires 25-employee, Denver-based MyRounding, which offers a mobile rounding and survey tool for hospitals.

Aetna announces that its profit jumped 38 percent in the most recent quarter, mostly due to its Medicare and Medicaid business, but says it lost money on its exchange-issued policies and warns that it has “serious concerns about the sustainability of the public exchanges.”

Alphabet, the recently formed parent company of Google, surpasses Apple as the world’s most valuable company after reporting impressive numbers in its first detailed report. Alphabet made $4.9 billion in profit on $21.3 billion in revenue for the quarter. Share price jumped 8 percent on the news, raising the company’s market capitalization to $559 billion.

Sunquest parent Roper Technologies reports Q4 results: revenue flat, EPS $1.82 vs. $1.85, missing estimates for both and issuing 2016 guidance below expectations. The CEO said in the earnings call, “We think we will have mid-single digit organic growth in Medical throughout 2016 and we think that will get stronger as the year goes on. Sunquest has a number of version changes and software release updates that are rolling out in the second half that will be quite beneficial. And then Strata, Data Innovations, and SoftWriters which are growing rapidly, will become organic in the second half. Verathon and Northern Digital are going to continue to grow at a relatively high rate in 2016. And then we closed on January 7 the CliniSys acquisition in the UK, which is a European hospital laboratory software provider, and it will add to our acquisition sales growth in 2016.”

Machine learning vendor Digital Reasoning, which acquired Shareable on January 8 to create its healthcare business, raises $18.6 million, increasing its total to $53 million.

A New York Times article questions whether it was wise for the struggling Theranos to hire star litigator and company director David Boies as its legal representative, given that he would be representing Theranos management as a lawyer while his responsibility as a director is to the company’s shareholders. It concludes,

The potential for conflict is particularly great. What if Ms. Holmes resists changes that would be in the interest of shareholders? What if the board decides that it is time for her to go — and she stands her ground? The board could do little more than throw up its collective hands under the current governance structure. Mr. Boies and the other outside directors could resign in protest. But why would anyone, particularly Mr. Boies, be a director on a board that lacked the power to make fundamental changes? Indeed, what is Mr. Boies thinking? He may be paid lots of money for his roles, but for someone so successful and savvy to put himself in a position that is bound to be problematic is puzzling.

Meanwhile, Theranos finds another foot to shoot in indefinitely delaying its October promise to allow Cleveland Clinic to validate its technologies and insisting that it won’t publish anything about those technologies in peer-reviewed journals until it receives FDA approval for all 120 of its tests.

Sales

Joseph Brant Hospital (Ontario) chooses FDB MedsTracker MedRec for medication reconciliation.

Craneware signs a $7.5 million contract with an unnamed hospital operator.

People

Seattle Children’s Hospital (WA) names interim SVP/CIO Jeff Brown (Lawrence General Hospital) to the permanent role. He holds three master’s degrees in business administration, executive management, and health informatics.

Allscripts names Melinda Whittington (Kraft Foods Group) as CFO.

CareSync hires Russell Dumas (Napier HealthCare) as VP of clinical operations, David Antle (BobCAD-CAM) as VP of client services, and Teri Spencer (GTE Financial) as VP of human resources.

Cumberland Consulting Group hires Terrell Warnberg (QHR) as partner over its new performance improvement practice.

The Health Information Trust Alliance (HITRUST) appoints Epic President Carl Dvorak to its board and names David Muntz (GetWellNetwork) as senior advisor of public policy.

Athenahealh hires Prakash Khot (Kaseya) as CTO.

Laura Momplet, RN (Dignity Health) joins CTG as chief operations officer and chief clinical officer.

Employee health platform vendor Healthcare Interactive names John Capobianco (KickStart Partners) as president and chief marketing officer.

Announcements and Implementations

Craneware will offer patient payment plan technology from VestaCare with its medical necessity and price estimation products.

Premier announces that it will conduct Innovator Research using Medicare data from CMS’s Virtual Research Data Center. Premier’s research division will analyze episodes of care to identify best clinical practices for care improvement and cost reduction.

A Surescripts study of New York providers finds that 93 percent of pharmacies can receive electronic prescriptions for controlled substances while only 27 percent of prescribers have the technology to issue them. It also finds that 58 percent of prescribers are issuing electronic prescriptions in general. New York’s I-STOP law requires that all prescriptions be transmitted electronically by March 27, 2016, meaning a huge number of prescribers need to take action in the next seven weeks.

Government and Politics

New York Mayor Bill de Blasio hires a consulting firm to figure out what to do about the city’s 11-hospital Health + Hospitals Corporation, which despite extensive city support is expected to run a deficit of $2 billion within the next three years. The health system hopes to convince more patients with commercial insurance to use its facilities than those of its competitors, all of which have similar ambitions.

Privacy and Security

Australia’s Royal Melbourne Hospital says it hasn’t completely eradicated the Qbot malware that infected its Windows XP computers two weeks ago. The hospital says the virus mutated six times in a single day. The keystroke-capturing malware penetrated the hospital’s pathology computers via a Windows XP exploit, managing to evade detection by the hospital’s updated antivirus product.

Other

A study finds that mobile text messaging increases medication adherence rates in chronic disease patients from an assumed baseline of 50 percent to 68 percent, although the sites that are screaming this out as big news failed to note that:

• It’s a meta-analysis, meaning that instead of doing new research it just combines information from previously published studies.
• The studies it reviewed involved fewer than 3,000 patients combined.
• Texting results were measured only for a short duration.
• The studies relied on what patients said they did rather than measuring what they actually did.
• The text messaging in each study was not consistent as to frequency and style.

This is not newsworthy other than the fact that it was published in JAMA Internal Medicine, where it will reach a wide audience. It’s also surprising that the journal misspelled the name of the Johns Hopkins Bloomberg School of Public Health in its author affiliation section.

Duke University Health System (NC) reports making a record profit of $355 million for 2015, explaining that, “For the three or four years leading up to this past year, we had made a series of investments in facilities and information systems that helped to relieve capacity constraints limiting growth … With our new IT capabilities, we are able to better manage care across the spectrum and become more efficient in that way.” The system said it made a lot of money by buying up oncology practices to increase inpatient volume.

I received a survey link from HIMSS about its Learning Center, which sells thinly disguised advertising via its HIMSS Media business. Being a member of HIMSS means being inundated with its vendor-sponsored pitches, in this case disguised as “education,” where high-paying vendor members pay dearly to be hooked up with low-paying provider members in the “ladies drink free” business model. 

The Virginia Tech professor who led the study proving that the water in Flint, MI contains dangerous levels of lead says public science is broken as university faculty members are pressured to get funding and to become famous. He explains, “Where were we as academics for all this time before it became financially in our interest to help? … Science should be about pursuing the truth and helping people. If you’re doing it for any other reason, you really ought to question your motives … Everyone’s invested in just cranking out more crap papers … when you reach out to them, as I did with the Centers for Disease Control and Prevention, and they do not return your phone calls, they do not share data, they do not respond to FOIA … every single rock you turn over, something slimy comes out.”

A Congressional investigation finds that despite the patient-focused claims of since-fired Turing Pharmaceuticals CEO Martin Shkreli, the company was gloating with delight at the profits it would make by jacking up the price of ancient drug Daraprim by 50-fold.

Weird News Andy titles this sad story “Out of the frying pan and into the fryer.” A patient with mental illness jumps out of a moving ambulance while being transported from a hospital and is struck and killed by a driver who then fled the scene.

Sponsor Updates

• Catalyze co-founder and CEO Travis Good, MD will speak on “Excitement in Healthcare Regulation” at the 2016 Hosting Milestone Summit Series on February 4 in Las Vegas.
• Divurgent will attend the South Carolina HIMSS Networking Reception & Dinner February 4 in Columbia.
• FormFast gears up for HIMSS16.

Blog Posts

• Stop Leaking Revenue in your Private Practice; 3 Areas Where You’re Probably Losing Money (AdvancedMD)
• Your Medicare cost report as a source of additional revenue (Besler Consulting)
• New Year, New Security Posture: Top Defenses for 2016 (Burwood Group)
• Building a Culture of Physician Engagement in Population Health (Caradigm)
• CareSync Shares CCM Insights in Letter to Senate’s Chronic Care Working Group (CareSync)
• CodeMash 2016 (CoverMyMeds)
• Leaving No Stones Unturned – Post Live Revenue Challenges & Tools to Help (Culbert Healthcare Solutions)
• Top Ten Reasons Why Good People Quit (Direct Consulting Associates)
• Considering Optimization? Don’t forget about Chart Prep (Galen Healthcare Solutions)
• 11 Pitfalls of a System Conversion and How to Avoid Them (Hayes Management Consulting)
• The Three C’s of the Right Secure Text Messaging Solution (Spok)

Contacts

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

Monday Morning Update 2/1/16

Top News

CMS proposes a rule that would allow qualified entities – of which 13 have been approved so far — to provide or sell Medicare and private claims data to providers to support quality improvement. Only two of the qualified entities report provider performance nationally — Health Care Cost Institute and Amino. Physician practices (or employers paying for their services) would be able to review all-payer data for their patients.

Reader Comments

From Eddie T. Head: “Re: CHIME’s patient identifier challenge. A 100 percent match is unrealistic. Even in countries with a national medical identifier the accuracy is about 95 percent. The 100 percent goal will get in the way of creating a real solution nationwide.”

From AthenaAscending: “Re: Florida Hospital. Is replacing Epic’s PM/EHR with Athenahealth.” Unverified.

From Unintended Consequences: “Re: AGH in Pittsburgh. Its Epic acute go-live has created medical care havoc in peripheral LTAC and SNF facilities that had relied on Allscripts Sunrise for order entry and results retrieval. They are not on Epic and have resorted to a 1980s paper requisition and lab retrieval system. Doctors cannot see a list of their patients. AGH’s command team has informed doctors that stat orders must be called in and cases ordered as consultations won’t appear on the consultant’s patient list.” Unverified. 

HIStalk Announcements and Requests

A reader asked me to post a single summary of my unsuccessful quest to obtain an electronic copy of my hospital stay information, which I’ve done here.

A surprising 80 percent of poll respondents aren’t fans of the idea of the ONC-published EHR star rating that Congress is considering. Jacob Reider commented that it’s a terrible idea and is outside of the government’s role. Ross Koppel says summarizing complex systems with a single star rating is simplistic. Barbara Hillock thinks such ratings would be misleading since they would be driven by the expectations of customers who don’t always follow the vendor’s implementation recommendations. Meltoots commented that ONC and CMS need to stop getting in the way of patient care with new programs.

New poll to your right or here: how have recent statements from CMS affected your perception of HHS/CMS/ONC?

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

Mrs. Johnson from Illinois sent photos of her kindergarten class using the math tools we providing in funding her DonorsChoose grant request. She says, “It was so generous of you to help us succeed in getting some of the tools we need to make learning math engaging and fun! The look in these kids’ eyes when I tell them we have something new that will help us learn is motivation for me. I couldn’t have provided these materials on my own and appreciate the support you have given.”

Epic consulting firm BlueTree Network donated $1,000 to secure a spot at my CIO lunch at the HIMSS conference, which allowed me to fully fund these DonorsChoose teacher grant requests with the help of matching funds:

• Science activity tubs for Mrs. B’s first grade class in Richfield, NC.
• Three iPad Minis, cases, and a document camera for the second grade class of Mrs. Mann of West Newton, PA.
• Electricity and magnetism activity tubs for Ms. Anderson’s fourth grade class in Phoenix, AZ.
• Two Osmo gaming systems for Mrs. Boyd’s elementary school class in Chocowinity, NC.
• Three programmable robots and engineering components for the new middle school robotics club started by Mr. Rector in Beebe, AR.
• STEM challenge kits and for Mrs. May’s special education classes in Edgewater, FL.

HIStalkapalooza

I have received over 1,200 requests to attend HIStalkapalooza, so I’m closing signups Monday. Sign up now or never. I’ll be able to invite most of the people who signed up. We’ll be handling invitations, RSVPs, reminders, and electronic check-in through Eventbrite this time and I expect the invitation emails will go out this week. This is where the annoying part of throwing a free party begins as it does every year when I vow that this year’s event will be the last because of the time and energy it requires:

• People will email me asking if they can bring a guest. If you didn’t sign up your guest like the form clearly states, then they can’t come – it’s like going to an Adele concert or traveling on American Airlines –everybody needs a ticket, with the only difference being that HIStalkapalooza tickets are free.
• I’ll hear from folks who claim to be the most loyal and careful readers who swear they mysteriously missed the dozens of times I’ve provided signup instructions and wanted to be added after the fact. Sorry, no, it’s only a party and your life won’t be ruined if you miss it because you couldn’t follow the rules everybody else figured out.
• Vendor administrative assistants who don’t read HIStalk and who signed up bunches of their executives (who rarely actually show up) will start bugging us about why they haven’t received invitations. That’s actually already happened as the admin of one company keeps asking why her 23 executives haven’t been invited yet. This isn’t a company outing and we have more important things to do than swap party-related emails, so I’m hitting “delete” on those.

Last Week’s Most Interesting News

• CMS warns Theranos that its California lab practices are dangerous to patients and that it has 10 days to fix the problems or face suspension from Medicare.
• Leidos announces that it will acquire the IT business of Lockheed Martin for $5 billion.
• Cerner Chairman and CEO Neal Patterson notifies shareholders that he is being treated for soft tissue cancer.
• A Texas hospital regains access to its EHR after being locked out for more than a week by ransomware.
• Flint, MI-based Hurley Medical Center says it was hit by a cyberattack by hacker group Anonymous, which is protesting the city’s water crisis.
• Big Bucks Equals Big Interest in CHIME’s National Patient ID Challenge.
• McKesson’s Paragon Dilemma.

Webinars

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

Acquisitions, Funding, Business, and Stock

Capital BlueCross orders Theranos to stop performing blood draws in Capital’s storefront in Hampden Township, PA following a CMS investigation that found deficiencies in the California lab of Theranos that “pose immediate jeopardy to patient health and safety.”

Xerox will split itself into two companies, responding to pressure from activist investor Carl Icahn to separate its $11 billion document imaging business from its $7 billion business process outsourcing. Xerox, which acquired Affiliated Computer Services for $5.6 billion in 2010 and will now basically spin it back off, has 104,000 employees who will be part of the new BPO company. Xerox announced Q4 results with the announcement: revenue down 8 percent (its 15th consecutive quarter of declining sales), adjusted EPS $0.32 vs. $0.31, beating earnings expectations.

WeiserMazars acquires Lion & Company CPAs, which includes healthcare consulting among its offerings.

Quality Systems (NextGen) announces Q3 results: revenue down 1.7 percent, EPS $0.16 vs. $0.16, missing on revenue but beating on earnings. Shares dropped nearly 20 percent Friday on the news. Above is the one-year share price of QSII (blue, down 20.7 percent) vs. the Nasdaq (red, down 1.34 percent). Five-year performance looks a lot worse, as Quality Systems shares dropped 67 percent as the Nasdaq gained 67 percent.

The HCI Group acquires Houston-based Expert Technical Advisors.

Philadelphia-based orthopedic practice The Rothman Institute and the University of Virginia Health System participate in a $4 million funding round for Locus Health, a remote care management company of which both organizations are customers.

Meditech publishes its FY2015 annual report. Revenue was down 8 percent for the year (“primarily due to lower product bookings”) and net income dropped from $124 million to $70 million. Neil Pappalardo owns about $450 million worth of shares.  

Announcements and Implementations

Recondo Technology launches MySurePayHealth, which allows patients to estimate their out-of-pocket cost for a given procedure.

An emerging technology site profiles Valdic co-founder and CTO Drew Schiller as part of its “Today’s Entrepreneur” series, in which he lists his top three lessons learned:  (a) if someone isn’t interested in paying for your product, ask them what they would pay for; (b) reputations follow you, so treat everyone well; and (c) we are so fortunate to be living in an era where it is this easy to start a new company and iterate on ideas.

Government and Politics

Ashkan Soltani, senior advisor to White House CTO Megan Smith on loan from the Federal Trade Commission, announces that he has effectively been fired after just six weeks on the job when the Office of Personnel Security denies his security clearance. Soltani, whose White House assignment involved privacy, data ethics, and recruiting technologists for government service, previously won a Pulitzer prize as part of the Washington Post investigative team that revealed the extent to which the National Security Agency spies on American citizens.

This might be the highest-profile bungling of the HIMSS acronym. Pedantic grammarians such as myself smugly note that HIMSS and HIPAA are “acronyms” as opposed to “initialisms” (acronyms are sounded out as words, while initialisms are pronounced as their individual letters, as in “CIA” or “IBM”).

Privacy and Security

Scientific American’s “How Data Brokers Make Money Off Your Medical Records” contains no new information, but gives the public a glimpse at how companies are buying and selling their de-identified medical information. It mentions IMS Health, which takes in $2.6 billion per year by combining and repackaging information on 500 million people worldwide and then selling insights to drug companies and other to help them target sales. It repeats the now-obvious concept that it’s not hard to re-identify people by linking multiple databases. Drug company Pfizer spends $12 million per year to buy health data, but even its own analytics director says patients own their data, should be told how it’s being used, and should be given the ability to opt out of data that’s being collected for purely commercial purposes.

Technology

A Fast Company article describes the use of robots in long-term care, giving as an example Luvozo’s SAM “robotic concierge” that uses remote care staff. 

Other

A good interview with WebMD’s dethroned founder Jeff Arnold, now CEO of Atlanta-based Sharecare, describes how the company uses individual results from its acquired RealAge health questionnaire to push content to users. Sharecare also offers personal health consultations via its AskMD app and publishes a voice-analyzing app to detect stress. On the downside, the company’s co-founder is the pseudo-medical huckster Dr. Oz.

Kaiser Health News describes the enthusiasm patients of Newport Orthopedic Institute are expressing for the empathetic, automated post-surgery daily emails they receive from the practice’s HealthLoop system. The article provides an example of a knee surgery patient who responded to a system-generated, emailed question about calf pain, which triggered his doctor to see him immediately and diagnosis his dangerous blood clot.

The Hurley Medical Center pediatrician who uncovered the human effects of the Flint, MI water crisis credits the hospital’s Epic system and EHRs in general for allowing her to quickly discover the increasing number of children with high levels of lead in their bloodstream. “If we did not have Epic, if we did not have (electronic medical records), if we were still on paper, it would have taken forever to get these results,” says Mona Hanna-Attisha, MD, MPH. She cross-referenced the abnormal blood levels to home addresses using geographic information system software to prove what was happening despite the denials of state officials. She is also adding an Epic flag to allow doctors to track those children for lead poisoning symptoms that can take years to emerge. Note once again the key involvement of a doctor trained in public health when discovering and responding to a regional crisis.

Chester County, PA commissioners proclaim January 29 as R. James Macaleer Day, honoring the recently deceased local charitable benefactor and founder of Shared Medical Systems on his birthday.

The US Army Reserve highlights the actions of three members of the 345th Combat Support Hospital of Jacksonville, FL who are deployed to Kosovo and who saved the life of a motorcycle accident victim while on leave in Greece. Those involved were Major David Whaley, who is a doctor of pharmacy; Colonel Edward Perez-Conde, brigade surgeon; and Major Kirk Shimamoto, a doctor of dental surgery. Perez-Conde says he considered using a pocketknife and ball point pen to relieve the victim’s pneumothorax, but, “we didn’t know how the police would react to a medical procedure using a pocketknife and we certainly didn’t want to go to jail.”

Flint-based McLaren Health Care (MI) will centralize its 13 billing and collections offices, saying it lags in standardizing its revenue cycle processes but hopes it can increase revenue by $30 million by reducing denials and increasing collections. The health system also says it is working on integrating Cerner’s EHR and patient billing systems.

An article describing how ad-supported publishers are “freaking out” over their readers using ad-blocking software provides an example in Modern Healthcare. The Interactive Advertising Bureau calls AdBlock Plus, which has been downloaded 500 million times, “unethical” and “immoral,” declining to note that publishers are producing content that few people are willing to pay for in any form, including by the viewing of ads.

A New Hampshire jury awards $32 million to a former Walmart pharmacist who claims she suffered gender discrimination in being wrongfully terminated for notifying the state’s board of pharmacy about the large number of errors the pharmacy was making, some of which the store manager inappropriately blamed on her. Mauren McPadden, who had worked for the company for 18 years, also says Walmart violated her HIPAA rights by accessing her PHI and telling co-workers that she had suffered a nervous breakdown. Walmart claims it fired her because she lost her pharmacy keys.

Sponsor Updates

• T-System offers free tool to providers for documentation and diagnosis of influenza patients.
• Valence Health will exhibit at the HFMA First Illinois Managed Care Meeting February 4 in Chicago.
• Huron Consulting Group releases a new clinical research management briefing.
• ZirMed will exhibit at the AAPAN Annual Forum February 1-2 in Laguna Niguel, CA.
• Aprima launches its redesigned website. 
• Caradigm completes the ConCert by HIMSS interoperability testing and certification program.
• Sandlot Solutions will exhibit at the Louisiana Hospital Association’s Winter Leadership Symposium February 2-3 in Baton Rouge.
• Surescripts will exhibit at the EHealth Initiative 2016 Annual Conference February 3-4 in Washington, DC.

Blog Posts

• Best-of-Breed Solutions (Voalte)
• 3 Places to Find Patientco at HIMSS16 (Patientco)
• A Luxury Beyond Belief (PatientKeeper)
• How Secure Texting Apps Improve Physician-Physician Communication (PracticeUnite)
• Education Minimizes the Impact of Healthcare Hackers (PerfectServe)
• Predictions of Apple Q1 Earnings from Medical Charge Capture and Secure Messaging Users (PMD)
• Why our expansion at Partners matters (QPID Health)
• Content Interoperability: Achieving Clinical Data Quality Success (Stella Technology)
• 2016 IHE Connectathon in Full Swing! (Summit Healthcare)

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Lt. Dan.
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Why I Still Don’t Have an Electronic Copy of My Medical Records Six Months After Asking

I decided in June 2015 to go through the exercise of requesting an electronic copy of my medical records. They’re from an Epic-using, Most Wired-winning, EMRAM Stage 7 academic medical center at which my only encounter was an unplanned, uneventful one-night stay while traveling. I wanted to see how the records request process might work for the average patient.

I also tried using the hospital’s MyChart portal to look up my own records as a second experiment. That’s a different process managed by the hospital’s MyChart support team. I was not successful since my visit was not listed and the polite but baffled technician couldn’t figure out why. The technician did not offer to research the problem further.

Day 1

The records request page on the hospital’s website offers two options: dropping by personally to the hospital’s health information management department (which they clearly prefer) or downloading, completing, and faxing a form. Scanning and emailing the signed form was not possible, they said – it has to be faxed. Requests for images must be made separately by calling a different telephone number.

The form is complicated since it was primarily designed for patients who want to give someone else access to their records, such as for a workers compensation claim. The hospital really should create separate forms to avoid awkward references to “the patient” when it’s the patient making the request. It also asked for “patient medical record number or other identifiers” which hospitals frustratingly and somewhat arrogantly expect patients to learn and remember.

I completed the paper form as best I could, but it was not easy to figure out what they were looking for. Then I had to scan the signed form and find an online fax service to send it to the HIM department’s release of information fax machine.

The paper form did not provide an option for how I wanted to receive the information, stating flatly that paper copies would be mailed and that an unstated per-page fee would be charged by its contracted release of information vendor (it’s scary to agree to pay the fee upfront without knowing how many pages are involved or what the per-page charge is). It didn’t ask how I preferred to be contacted (not that it mattered since they never contacted me), but it did ask for a telephone number and physical address, again oddly worded since the multi-purpose form isn’t intended for patients only, with fields such as, “Phone (if known)” as though the patient might not know their own telephone number.

Day 11

I called the hospital’s HIM department since I hadn’t heard back from my request. They said they hadn’t taken any action because I hadn’t provided dates of service for my one and only encounter with the health system (since I couldn’t remember the date – it was more than a year before). They looked it up and said they would mail the records. I told them I wanted them in electronic form.

The HIM person said they don’t provide electronic information to patients, only to physicians. I said they were obligated to give me an electronic copy if I wanted it. She said she would get back with me after she talked to her supervisor.

Day 13

I hadn’t heard back from HIM, so I called them again. The supervisor repeated that they are not obligated to give patients electronic copies of their records and would provide only mailed paper copies. I repeated that they are indeed obligated to provide electronic copies. I said I would file a Office for Civil Rights complaint if they refused. Which they did, again.

I filed the OCR complaint. It was an easy online form to complete and I received quick email confirmation that it had been received.

Day 39

A letter-sized envelope arrived in the mail from the hospital. My name and address were scrawled nearly illegibly on the front with no indication of what was inside. I opened it up and there was my visit summary, contained on two pages front and back as printed off from the hospital’s Epic system. The hospital didn’t include a greeting or explanation or anything to indicate why they had sent the copies – it was just two Epic-generated pages that I finally figured out. I can’t imagine the average patient receiving the same document and making sense of it. At least they didn’t charge me for the two pages.

Day 211

I received a letter from the Office for Civil Rights informing me that my complaint was being closed without formal investigation. Instead, OCR said it had decided to “resolve this matter informally through the provision of technical assistance to the hospital.”

I haven’t heard from the hospital. I still don’t have an electronic copy of my records. My visit still doesn’t display in MyChart.

I invite readers to try this same process with their hospital or physician practice and let me know how it goes.