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News 11/4/15

November 3, 2015 News 2 Comments

Top News

Pamplona Capital Management will acquire MedAssets for $2.7 billion, announcing plans to divest the company’s group purchasing and performance improvement segments to VHA-UHC and merge its revenue cycle business with another of Pamplona’s recent acquisitions, Precyse. Pamplona says the new, privately company will be a national leader in outsourced revenue cycle, technology, and education, explaining:

Existing and prospective customers of the new, realigned company should expect a business that is dedicated to investing in integrating our technology both internally and with EMR software providers; improving the visualization and utility of our data; scaling our front, middle, and back-end services businesses; and, developing offerings in patient payments and value-based reimbursement. MedAssets and Precyse employees will be part of a growing, focused business that prioritizes long-term value creation

Pamplona will pay a 30 percent premium for shares of MedAssets. MedAssets said this summer that it was exploring strategic alternatives even as an activist investor called for it to replace some of its board members due to questionable acquisitions and undervalued shares. It also lost a key customer and and announced plans to lay off 5 percent of its workforce just a few weeks ago.

Pamplona acquired Precyse in July 2015 for an undisclosed price from Altaris Capital Partners and NewSpring Capital.

HIStalk Announcements and Requests

Want to connect with me on LinkedIn? I’m here, as is Dann’s 3,649-member HIStalk Fan Club.

Mr. Graham in Illinois sent photos of his students using the STEM materials we provided, saying, “The students have shown a great interest in science. They enjoy working with these activities and do the research that goes along with them. They have learned more from these kits than I would have ever been able to teach them using our science textbooks. It is very rewarding for me to see how much they enjoy science now and how engaged they are with these activities. We would like to thank you for supporting our grant and putting these awesome materials into our classroom.”

HIT Geek donated $100 for my DonorsChoose project, which with double matching funded $400 worth of classroom projects:

Eight scientific calculators for Ms. Tyler’s Algebra 2 class in La Mesa, CA.
Green screen broadcasting equipment for Mr. Ventura’s classes in Omaha, NE to allow students to produce morning news broadcasts and video projects.
A field trip to the Wildlife Science center for Ms. B’s Grade 6-8 class of emotionally disabled students in Brooklyn Park, MN.

HIT Geek likes reading about my funding choices. For others who would like to donate, here’s how to do it:

Purchase a gift card in the amount you’d like to donate.
Send the gift card by the email option to mr_histalk@histalk.com (that’s my DonorsChoose account).
I’ll be notified of your donation and you can print your own receipt for tax purposes.
I’ll pool the money, apply the matching funds, and publicly report here (as I always do) which projects I funded, with an emphasis on STEM-related projects.

Webinars

November 11 (Wednesday) 2:00 ET. “Trouble Upstream: The Underinsured and Cash Flow Challenges.” Sponsored by TransUnion. Presenter: Jonathan Wiik, principal consultant, TransUnion Healthcare. The average person spends nearly $15,000 per year on healthcare as deductibles keep rising. Providers must educate their patients on plan costs and benefits while controlling their own collection costs by using estimation tools, propensity-to-pay analytics, and point-of-sale collections. This webinar will highlight industry trends in managing underinsured patients and will describe ways to match patients to appropriate funding.

November 12 (Thursday) 1 :00 ET. “Top Predictions for Population Health Management in 2016 and Beyond.” Sponsored by Medecision. Presenters: Tobias C. Samo, MD, FACP, FHIMSS, CMIO, Medecision; Laura Kanov, BS, RRT, MBA, SVP of care delivery organization solutions, Medecision. With all the noise and hype around population health management, the presenters will share their predictions for 2016 and their insight into meeting the mounting pressures of value-based reimbursement and the tools and technology needed to manage care delivery.

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

Acquisitions, Funding, Business, and Stock

Cerner reports Q3 results: revenue up 34 percent, adjusted EPS $0.54 vs. $0.42, meeting earnings estimates but falling short on revenue expectations. The company projects Q4 revenue and earnings lower than consensus, sending shares down 9 percent in after-hours trading following the announcement.

EClinicalWorks announces the opening of a London office and the signing of its first UK customer, the 1,700-store Specsavers optical chain. ECW says it booked $100 million in international business in the past year.

Teladoc reports Q3 results: revenue up 83 percent, EPS –$0.37 vs. –$2.68, with its loss meeting expectations and its $20 million in revenue beating slightly. From the earnings call:

The company touted future potential given its 60 percent telehealth market share in a market that’s only 1 percent penetrated.
Subscription fees made up 85 percent of the quarter’s revenue, with the remaining $3 million coming from telehealth visits.
The company will raise its visit fee from $40 to $45 on January 1.
Teladoc spent $1.6 million in the quarter on its legal fight with the Texas Medical Board and expects to spend up to $750K more in Q4.
The company emphasizes that customers get what they pay for, with some lower-priced offerings failing to deliver value.
The company says health systems are using its product to acquire patients, while health plans are using it for population health and care management.
Teladoc believes CMS will allow fee-for-service telehealth payments via Medicare and Medicaid.
The company is working with health systems to design a post-discharge program.

Two co-founders and a former executive of travel and expense management system vendor Concur (sold to AP last year for $8.3 billion) join Accolade. The Plymouth Meeting, PA company offer Health Assistants who work with technology and analytics to engage with consumers to reduce utilization and costs. The company claims a 98 percent user satisfaction rate, contacting healthy members an average of five times annually and reaching out to the least-healthy ones 24 times per year.

Referral and access management technology vendor SCI Solutions acquires Clarity Health, which offers authorization and referral management services.

Meditech announces Q3 results: revenue down 3.5 percent, EPS $0.37 vs. $0.50 as product revenue dropped 16 percent year over year due to lower sales. Nine-month net income slid to $51 million vs. $104 million in 2014. Here’s the five-year change:

Product revenue: $60,102,900 (2010) vs. $37,004,099 (2015) – down 38 percent
Service revenue: $58,368,348 (2010) vs.$82,102,999 (2015) – up 41 percent
Total revenue: $118,471,248 (2010) vs. $119,107,098 (2015) – flat
Net income: $31,957,358 (2010) vs. $13,591,077 (2015) – down 57 percent
Earnings per share: $0.89 (2010) vs. $0.37 (2015) – down 58 percent
Shareholder equity: $408,525,252 (2010) vs. $529,738,300 (up 30 percent)

People

Best Doctors names Peter McClennen (Allscripts) as CEO.

HealthMedx founder Charlie Daniels (CS Funding) will return to the company as COO.

Sam Miller, former CIO at Massachusetts General Hospital and University Medical Center (AZ), died last month in Canada. He was 77.

A reader reports that Graham King, former president of Shared Medical Systems and McKessonHBOC’s IT business, passed away this week.

Announcements and Implementations

A two-year Geisinger study finds that patients given online access to their clinical documentation via OpenNotes have a slightly higher rate of adhering to their medication regimens. It’s an unimpressive finding, but perhaps asked the wrong question in the first place since the two observations don’t seem to have much intuitive correlation.

Wheaton Franciscan Healthcare’s southeastern Wisconsin operations will join Ascension Health, which already had 150,000 employees and 131 hospitals. Ascension pays big salaries: the CEO made $8.5 million, the CFO $4 million, the chief medical officer $2.7 million, and quite a few executives at $1.5 million and up.

In England, Addenbrooke’s Hospital is testing an online tool that allows prostate cancer patients to set PSA testing reminders and to track their own PSA levels.

A small study of outpatient diabetic patients finds that use of Glytec’s Glucommander insulin management software reduced the average A1C level from 10.4 percent to 7.4 percent within 30 days.

Middle Park Medical Center (CO) will implement Epic via Centura Health, replacing Healthland.

Government and Politics

The just-announced 2016 work plan for HHS’s Office of the Inspector General includes examining the effectiveness of the FDA’s oversight of medical device security to determine if it adequately protects patients.

The FDA seeks input on how technologies such as apps, telemedicine, and biomedical sensors might be used in performing clinical trials for drugs. FDA wants to know what technologies are being used, how FDA can encourage their use, and what challenges need to be overcome, especially regarding the use of patient-owned devices.

I’m bored with taxpayer trough-lappers biting the hand that feeds them, including the AMA, which announces that the Meaningful Use program is “doomed” unless Congress lowers the bar. It says the market needs new EHRs to support the way doctors practice, not mentioning how many of its members bought whatever a salesperson stuck in front of them in their zeal to pocket a seemingly easy $44,000 taxpayer bribe. AMA blames Meaningful Use for physician data entry time, the requirement to collect pointless information, and for creating interoperability barriers. AMA concludes that physicians embrace new technology, but are stymied by bureaucracy. I hope they are right, actually – it would be just fine with me if Meaningful Use went away.

Medicare will eliminate higher payments for medical practices acquired by hospitals starting in 2017, lowering their payments to be the same as for non-hospital owned practices and saving $9 billion per year. However, the change isn’t retroactive, so it effects only newly acquired practices, meaning hospitals may buy practices even more aggressively to lock in their high Medicare rates. The AHA is predictably lobbying against the change, saying it will reduce access to care. The change may have limited impact anyway depending on how far value-based care has progressed by the time the change kicks in.

Two senators are investigating why 12 of 23 non-profit state co-op insurers funded by $2.3 billion in ACA loans have failed. The senators also express concerns that the surviving co-ops may be using “creative accounting” that may lead to even more failures. A report from a few weeks ago found that all but one co-op is struggling financially, with some of their leaders blaming Republican-led funding cuts. Observers say the co-ops set their premiums too low and had to use their federal loans to pay medical claims.

A national human resources team sent by the VA’s national headquarters to help fix widespread problems (including extended wait times) and massive employee shortages at the Phoenix VA hospital was sent home by the hospital’s acting director, who told them that he “calls the shots.” The team says hospital management was “obstructionist” and “clearly lacked integrity.” The Phoenix VA’s HR department uses paper-based systems with no tracking capability, hampering its hiring efforts. The team observed chronic abseentism that left clueless people in charge and noted that several HR employees refused to learn new IT systems because they would then be held accountable for completing tasks.

Privacy and Security

An unnamed hacker earns a $1 million prize for creating a Web-based exploit for iOS 9, which is mostly interesting because company that sponsored the challenge sells hacks non-exclusively to the highest-bidding world governments and to the NSA. An ACLU technologist referred the earlier company as a “merchant of death” that sold “the bullets for cyberwar.” The new company, Zerodium, will undoubtedly sell the hack many times for far more than $1 million to governments interested in performing electronic surveillance.

Innovation and Research

The Birmingham business paper covers Alabama Eye Bank’s self-development of a FileMaker iPad app for collecting information from cornea donors. The CIO likes that developers only need to learn one tool to deploy to both mobile and to the Web.

Technology

The Glow fertility app comes under scrutiny after the company presents data that claims women who use it to track their fertility cycles are 40 percent more likely to conceive. Researchers immediately pounced on that assertion since the analysis proved correlation but not causation. The study also didn’t control for important variables such as prior fertility treatments. An expert says the results most likely reflect selection bias rather than an app-inspired change in behavior.

Other

The Boise newspaper digs up old news from 2012 saying that the implementation of Epic at St. Luke’s caused provider productivity problems. It appears that the reporter was just playing in some legal databases and decided to throw some factoids together to create a non-story.

Here’s an infuriatingly stupid and insulting comment from an oncology site that also declared the ICD-10 switch to be “much ado about almost nothing.” I suppose the next time an oncology intervention saves someone from dying of cancer we should just say the tumor “blew over” instead of thanking the oncology team for saving them.

A small survey finds that people prefer receiving their lab results via a patient portal rather than by email, traditional mail, or voice mail.

In England, NHS launches its digital maturity self-assessment that trusts are required to complete. NHS England created its own assessment in which trusts will rate themselves on how well they use their systems. NHS declined to use the HIMSS EMR Adoption Model, saying it measures use only within a given organization and NHS wants to focus on interoperability.

A New York business paper delves into the expensive and not universally loved “rebranding” of North-Shore LIJ Health System to Northwell Health, chosen because it’s a neutral name that won’t limit the system as it expands. The system rejected similarly dull, feel-good names such as Laudica Health, Dedication Health, and Northstar. It will spend $20 million to roll out the new name.

Experts debate whether surgeries should be recorded on video as a “surgical black box” that could be used for learning or to defend malpractice lawsuits. Naysayers don’t like the possibility that recordings could be used to prove malpractice, would increase costs, and would expose the sometimes secretive goings-on of a typical OR.

Weirton Medical Center (WV) protests the $1.5 million an arbitrator awarded to a management company the hospital hired to turn its finances around, saying the company miscalculated payment rates and failed to prepare it to earn $1.8 million in Meaningful Use money.

Weird News Andy leans on the bar and starts his story with, “A deer walks into an ER …” An injured deer walks through the automatic doors of Strong Memorial Hospital’s ED and wanders down the corridor. Unlike other ED patients, the deer was taken out to the parking lot, where animal control officers killed it.

Sponsor Updates

Medicity celebrated Halloween with an ICD-10 graveyard titled “You Don’t Want to Die on This Hill.”
Fox Business profiles AirStrip’s integration with Apple Watch and its use at Montefiore Medical Center.
Wellcentive wins the “Emerging Company of the Year” award presented by the Metro Atlanta Chamber of Commerce.
Aprima will exhibit at the American College of Rheumatology Annual Meeting November 8-10 in San Francisco.
Awarepoint will exhibit at the iHT2 Health IT Summit November 3-4 in Beverly Hills, CA.
Bernoulli will exhibit at the American Association for Respiratory Care Congress November 7-9 in Tampa, FL.
Besler Consulting wins a 2015 Bright Bulb B2B Marketing Award for best small team in-house campaign.
CenterX will exhibit at the NCPDP Workgroup Meeting November 4-6 in St. Louis.
Sunquest will exhibit with GeneInsight at AMP 2015 November 5-7 in Austin, TX.
Nordic releases a video titled “After ICD-10: Minimizing pain, increasing gain.”
Direct Consulting Associates sponsors the HIMSS North Ohio Chapter Conference November 5 in Akron.
Connected for Care introduces its telemedicine solution and integrate it with HealthMedx’s LTPAC EHR.
Divurgent will exhibit at the Virginia HIMSS Fall Conference November 5-6 in Williamsburg.
EClinicalWorks and Healthwise will exhibit at the mHealth Summit November 5-6 in National Harbor, MD.
FormFast helps hospitals move away from paper documentation.
The Colorado Technology Association nominates Healthgrades EVP/CIO Douglas Walton for Apex CIO of the Year.

Blog Posts

10 Objectives for EHR Incentive Programs (AdvancedMD)
33 Cyber Security Tips from the Experts (AirWatch)
Technology to Understand the “Pop” in Population Health (Caradigm)
Yes You Can – Put Medicare’s Chronic Care Management Billing Code to Work For You and Your Patients (CareSync)
Lessons Learned – Allscripts PM V14 Upgrade (Culbert Healthcare Solutions)
Enabling Your Integration – IGUANA (Galen Healthcare Solutions)
3 Secrets to Save on Healthcare IT Costs (Hayes Management Consulting)
Butter knives and healthcare delivery – yes, there’s a connection! (Healthfinch)

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us or send news tips online.

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Monday Morning Update 11/2/15

November 1, 2015 News 8 Comments

Top News

Medication management technology vendor Omnicell will acquire Aesynt, which offers pharmacy robotics, for $275 million. As reader WhoKnows points out, McKesson bought the former Automated Healthcare in 1996 for $65 million and then sold it in late 2013 to Francisco Partners for a rumored $52 million. That’s either horrible McKesson mismanagement or a truly spectacular performance by Francisco Partners, which gets a five-bagger in just two years. The only acquisition I recall Aesynt having made was Italy-based Health Robotics, which was having limited success with its IV room robotics technology. FP didn’t even change the CEO when it bought the company – Kraig McEwen came on board in November 2011 and remains to this day.

Reader Comments

From All Hat No Cattle: “Re: John Glaser. I noticed his CV lists his HIStalk Lifetime Achievement Award from 2011. I wonder if any of the other HIStalk award winners list theirs?” Probably not, but someone new will have that chance in around four months when we do it again.

From Over Easy: “Re: Hoag Hospital in Orange County. Rumor is another senior IT leader was released or resigned, which makes the third in the last four months. The hospital has implemented drastic budget cuts in IT and overall in the past two years.” Unverified. I don’t think I know anyone there.

From Wayne Tracy: “Re: VA-DoD interoperability. As a retired Naval Officer having commanded a field hospital (Fleet Hospital 13B) I have come to the conclusion that until Congress holds the Surgeon Generals of the Army, Air Force, and Navy as well as the head of the VA personally responsible, nothing is going to change. Give them a two-year deadline and withhold all medical computer budget funds until they are fully interoperable in real time (say, using HL7’s FHIR) or the budget goes away. It seemed to work when the railway system was not going to meat the end-of-year (2015) deadline — the New York to Washington line miraculously got done in two weeks. Somebody with big brass ones needs to be put in charge. Congressional oversight hasn’t worked to date, just more deadline extensions. Congress, grow some!”

From Wealthy and Wise “Re: Highmark. As patients grovel for care and medications, these guys are raking it in. No wonder they are struggling financially and cutting care and services. Shameful and despicable.” It’s big money in Pittsburgh healthcare, where Highmark Health’s former CEO earned $10 million in 2014 having worked there less than two years before he was paid to go away. Highmark paid its human resources chief $2.7 million and its treasurer $3.3 million. The CEO of arch-rival UPMC made $6.4 million.

From Purple Hay: “Re: UnityPoint Health System, Iowa. VP/CIO Joy Grosser is gone.” Unverified. Her LinkedIn profile is unchanged, but her patch of real estate on the health system’s executive page is now vacant. I searched their site for information and found only that she was paid $591K last year, with other fun information from their Form 990 being that their largest-expense contractors were all IT related: Epic ($7.8 million), McKesson ($4.7 million), and IBM ($4.5 million). Fifth-highest was a “branding agency” that earned $4 million for doing whatever vital, patient care-focused work that branding agencies are known for doing.

From Maven PR: “Re: headlines. You need sexier ones to bring more attention to what you write. I can help you.” I won’t stoop to the level that many or most sites do in shamelessly fooling readers into clicking over to crap stories by using CNN-type click-bait headlines, mind-numbing slide shows, pointless stock photos, and “listicle” articles that start with a number (in the form of “6 Tricks You Won’t Believe that Lame HIT Sites Use to Suck In Readers.”) I would hope that health IT people and advertisers are smart enough to realize that the steak they hear sizzling is usually just cotton candy, but regardless, I would rather have 100 smart, influential, engaged readers than 1,000 who mindlessly click on whatever shiny object is thrust in their face without recognizing that they’ve been had.

From Atom Heart CIO: “Re: DonorsChoose. I think your legacy will be more about the charitable work you have done than with HIStalk, which is amazing given how successful HIStalk has become.” I don’t seek or expect a legacy either way, but it’s exciting thinking about how the donations readers make to DonorsChoose might, through some unlikely chain of events, help some kid become a legacy themselves. One of these days I’ll either decide to quit writing HIStalk or just die in the saddle, in which case I’ll fade away with my planned or unplanned final post being the only artifact of my anonymous existence (and leaving Weird News Andy homeless).

From The PACS Designer: “Re: ICD. With our first month under ICD-10-CM with no major issues, it’s time to focus on the next aspect, ICD-10-PCS (Procedure Codes). Since it will be done first here in the US, it gives us the opportunity to choose where we do it initially. TPD proposes that we do it with the VA and DoD so that a breakdown occurs to the barriers each of them currently have against each other working together to improve healthcare for our military and veterans.”

HIStalk Announcements and Requests

Poll respondents were evenly split on whether they’d want Theranos running their lab tests. I agree with Don, who said that using the company’s services has nothing to do with a pinprick blood sample and everything to do with convenience and pricing. I enjoy visiting LabCorp and Quest about as much dealing with the people at the driver’s license office. New poll to your right or here: if your customers (or patients) knew what you know about your employer, would they be more impressed or less impressed?

Mrs. G sent photos of the printer supplies, reading games, and early literacy books we provided to her Los Angeles pre-kindergarten class via her DonorsChoose grant request, adding, “There are no words to describe the impact this has had on my life. My students and I feel so blessed for your kind donations.” Ms. G from Oklahoma sent photos of her students using the earbuds we provided to her elementary school class for online math intervention work.

I thought sure Facebook would collapse this weekend under the weight of every single parent in America posting pictures of their costumed children. Speaking of which, I was also thinking that people seem to like spending Halloween prowling around old buildings where people have died, making any former hospital an ideal choice since the number of deaths inside any of them must be huge.

Last Week’s Most Interesting News

A diverse group of lawmakers slams the VA and Department of Defense for their expensive and stubborn failure to integrate their electronic medical records systems.
Theranos restructures its board and takes another hit when the FDA labels its proprietary Nanotainer blood draw system as an uncleared medical device.
CMS reports a quiet, non-eventful October following the ICD-10 switchover.
The AMA and MedStar Health rank EHRs on user-centered design without actually doing any research or measuring usability.
Xerox and Lexmark announce poor quarterly results and announce plans to review and possibly restructure their operations.
Athenahealth shares jump sharply after beating quarterly expectations, while those of Huron Consulting tank on lowered guidance due to delays in two academic medical center projects.

Webinars

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

Acquisitions, Funding, Business, and Stock

Quality Systems Inc. will acquire cloud EHR vendor HealthFusion for up to $190 million. QSI announced just over a week ago that it sold its NextGen hospital business to QuadraMed.

CPSI announces Q3 results: revenue down 16 percent, EPS $0.31 vs. $0.83. Shares took a 15 percent dive Friday on the news. The company seems to be struggling now that HITECH-fueled hospital EHR sales are drying up, leaving it to hope that a replacement market emerges. Above is the one-year share price chart of CPSI (blue, down 39 percent) vs. the Nasdaq (up 9 percent).

People

Sarika Aggarwal, MD, MHCM (Fallon Health) joins XG Health Solutions as SVP of population health and chief medical officer.

LifeImage names Matthew Michela (Healthways) as president and CEO. He replaces co-founder Hamid Tabatabaie, who will move to EVP and remain on the board.

Former Siemens Healthcare North America President and CEO Gregory Sorenson, MD takes a minority interest in Deerfield Imaging, which offers image guiding technology, and will become its executive chairman.

Jim Macaleer, co-founder, chairman, and CEO of Shared Medical Systems until he sold the company to Siemens in 2000, died last Thursday.

Announcements and Implementations

Fitch Ratings holds its rating of MetroHealth’s bonds as stable, concluding that the Ohio health system “has demonstrated the ability to be profitable with its challenging payor mix due to its longstanding electronic medical record (Epic), closed medical staff, and care management processes.”

Other

Peer60 publishes “Healthcare IT Trends in England.” NHS hospital executives say their top challenges are physician and nurse shortages, care coordination, and managing and analyzing data. Allscripts, Cerner, and Epic hold high mind share in both EPR (above) and PAS, suggesting they are well positioned to gain business in both clinical and administrative areas.

Greencastle Associates Consulting is named as one of three finalists for the US Chamber of Commerce Foundation’s “Hiring Our Heroes” award for hiring veterans and military spouses. Malvern, PA-based Greencastle was founded by Army Rangers and its three primary executives are all veterans.

Struggling Kinston Hospital (NC) ends its shared services agreement with Novant Health — which included IT improvements — after less than a year,

In Northern Island, Belfast NHS Trust underpays 1,500 employees due to a software error. The union declares the situation to be “totally unacceptable,” apparently finding it even worse than just “unacceptable.”

A healthcare IT entrepreneur says entrenched software vendors are stifling innovation by refusing to open up their systems to startups, causing new companies to burn through their seed rounds without sales to sustain them. He concludes that patients are harmed because “interoperability into the legacy systems of their customers still remains a primary roadblock.” To which I would offer a counterpoint: rightly or wrongly, we’ve defined healthcare (and therefore healthcare IT) as a business. As with any business, it’s irrational to expect competitors to behave in any way that isn’t self-serving, as much as we like to pretend that everybody’s primary motivation is altruistic patient care. Provider or vendor, you are naive and likely to be insolvent if your business plan assumes that your computers will voluntarily lower your barrier to entry.

I asked Vince Ciotti if he would write something about Jim Macaleer in way of tribute for the folks who knew him and who may not have heard that he passed away.

Sponsor Updates

DataMotion publishes an infographic titled “A Brief History of Data Breaches and Security Regulations in Healthcare.”
Ear, Nose and Throat Associates of Texas describes its easy implementation of Talksoft’s RemindMe application.
Vital Images will exhibit at HIMSS Latin America November 4-5 in São Paolo, Brazil.
VitalWare SVP of Operations Doug Picatti is featured in a CNBC report on key issues in the presidential debate.
Huron Consulting Group releases the latest edition of its clinical research management briefing.
ZeOmega will exhibit at the TAHP Managed Care Conference & Trade Show November 2-3 in San Antonio, TX.
Zynx Health will exhibit at the Meditech Physician and CIO Forum November 5-6 in Foxborough, MA.

Blog Posts

T-System’s Dr. Hitchcock Leads Educational Session at ACEP Scientific Assembly (T-System)
TeleTracking Client Conference Offers a Variety of Patient Flow Sessions (TeleTracking)
Post-Acute Care: Strategies and Analytics for ACO Success (Verisk Health)
Texting is Just the Beginning (Voalte)
Empowering Patients, managing denials under ICD-10, and a key to success (ZirMed)

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us or send news tips online.

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News 10/30/15

October 29, 2015 News 7 Comments

Top News

Rep. Tammy Duckworth (D-IL), a former Army helicopter pilot who lost her legs when her Black Hawk took rocket-propelled grenade fire in Iraq, joins several other members of Congress who are fed up that the VA and Department of Defense still haven’t integrated their systems. Lawmakers are reviewing VA-DoD progress in a joint hearing of two House committees this week. Duckworth says that as a former VA employee, she regularly saw the DoD stonewall the VA’s projects in defending its turf. She’s also still mad about her first VA visit where she was asked to take her clothes off to prove that she was still an amputee since the VA wasn’t allowed to accept her DoD medical records, to which she replied to the physician assistant, “I’m not a gecko. They don’t grow back.” Chris Miller, who runs the DoD’s DHMSM project, testified that connecting the VA with DoD is harder than it seems, while the GAO’s IT director observed that her watchdog agency still doesn’t understand why the DoD and VA decided not to build a single system together in the first place. The GAO still wants that answer, but says that neither the VA nor DoD are responding to its inquiries. The GAO suspects that the VA and DoD have spent more than billion dollars in trying and failing to share information, which doesn’t even include the countless mega-billions of taxpayer money that was spent building and supporting their systems.

Speaking of the VA-DoD imbroglio, some members of Congress are convinced that the only way to get the VA and DoD play nicely together is to have the President personally make them. Rep. Dan Benishek (R-MI) says of his peers, “We can’t stand the fact that we’re spending a billion dollars on integrating healthcare and you tell us it can’t be done. We get sick of this.” DHMSM’s Chris Miller says the organizations weren’t ready in 2011 because while the IT part is easy, nobody wanted to address the people and process issues. He opined that interoperability is worse in civilian healthcare, raising the ire of Rep. Gerry Connolly (D-VA), who scolded him by saying that both agencies deal with a specific population but “can’t get their acts together on behalf of the men and women we’re serving.”

Reader Comments

From Don’t Mess with Texas: “Re: vendors pressuring clients. I heard that the day Texas Health Resources issued its press release blaming Epic for its improper treatment of its Ebola patient, Judy and Carl flew to THR that night to pressure the CEO into putting out a retraction, which they did. Epic plays hardball – they’ve done it at our site, too. I don’t blame Epic for being unhappy with the press release, and while veteran CIOs like me knew to take the release with skepticism, flying down in person to get a retraction is pretty heavy handed. I’m sure Epic’s spin is that they care so much for their clients that they wanted to show up in person and offer their help.” That entire process was bungled, although nothing in the THR recap describes a visit by anyone from Epic. THR leadership appears to have thrown Epic under the bus as a knee-jerk reaction without even talking to their own IT folks, who would have been involved with the configuration of the system that was blamed incorrectly (given their quick retraction) for missing their patient’s travel history. Any EHR vendor would have protested and asked for proof of their customer’s claim, although I agree that Epic is among the most vigorous enforcers of its own interests and I’m sure calls were made. THR wasn’t great at managing the Ebola virus, but it was much more aggressive in trying to manage the viral spread of unfavorable publicity.

From Uneasy Detente: “Re: vendor gag clauses. I’ve never seen them pre-loaded into one of my contracts, but I’ve signed a few with a major health IT software vendor as condition of contract settlement, where software doesn’t work and we refuse to go live, for example. The vendor may offer concessions or a refund conditional on signing a number of terms, which generally includes not going out and talking about the problem we’ve discovered. Here’s an example for your eyes only.” I can see why both parties would approve that condition given that they are reaching agreement on either a parting of ways or deciding not to implement a specific application. I’m on the fence about whether that’s a gag clause, but leaning toward no since the customer never actually went live. You would think that customers who did actually implement the application would see and report the same issue, but that’s wishful thinking. That leads us back to the same challenges we have with interoperability – as much as we as patients would like providers to publish and share information that might benefit us, there’s no incentive for those providers to do so and therefore they don’t bother. In fact, going public with software problems introduces the near-certain risk of creating an adversarial relationship with the vendor to which they’ve expensively hitched their wagon. I don’t know of any solution except maybe FDA-type oversight that requires companies to report the patient-endangering defects they discover. Just about any solution that requires providers – competing or otherwise – to voluntarily share information is not likely to succeed. Replace “providers” with “attorneys” or “car dealers” in the previous sentence to put it into a less emotional perspective.

From QM Employee: “Re: NextGen Hospital Solutions. Can anyone explain why QuadraMed acquired it? QuadraMed has not sold their current solution for three years and their product has so many holes (surgery, emergency, scheduling, etc.). There are constant layoffs and some really great employees have left. NextGen customers are in the under-100-bed hospital range and their product is unstable.” The Canada-based parent of QuadraMed (Constellation Software) seems to have broken its own acquisition rules in buying both QuadraMed and NextGen Hospital Solutions since it claims to be interested only in companies that are #1 or #2 in their market, have at least “hundreds” of customers, and face “unimposing” competitors. I can see why QSI wanted rid of its failed hospital business, but agree that it’s puzzling why someone else would want it, although that brings up the strong possibility that it was basically given away just to eliminate distraction and appease torch-wielding QSI shareholders.

From Erstwhile ICD-9er: “Re: Georgia Medicaid’s stance on ICD-10 coding specificity. The CMS leniency was limited to Medicare. Medicaid was given the authority to make the decision for themselves. Georgia is the first to come out with aggressive messaging around their acceptance of ICD-10 specificity. An important distinction is that they related all of their ICD-10 edits for UB claims, but are holding firm on CMS 1500 claims. They have posted notice of this to providers along with a list of codes that will likely be denied. They are accepting feedback from providers about which codes should be accepted.” Thanks for that clarification.

From Kilt Lifter: “Re: ICD-10. Select Health Medicaid in SC refused to do any user testing prior to implementation. They are now telling practices they will not pay any claims until the end of November at the earliest.” The company’s ICD-10 FAQ page brags confidently about their testing, remediation efforts, and overall readiness for October 1.

From Public Health Helpful: “Re: public health. I’m a long-time HIStalk fanboy, but you hit it out of the park with your comment that we ‘irrationally celebrate advancements that are very narrow in scope.’ We should be doing what will benefit the most people in the most significant way – immunizations, blood pressure control, weight loss, cancer screening, following preventive guidelines, and using proven treatments.” The only way to fix “healthcare” is to embrace public health as other countries have done rather than tinkering with how we deliver reactive health-related interventions. We don’t like thinking about that because it requires uncomfortable discussions about social services and the role of government that quickly degrade into political divisiveness. It’s easier and much more profitable to focus on expensive interventions that benefit a small percentage of the population while the far larger population suffers (and drags down economic growth) with chronic conditions whose management standards are well known, just not well practiced by either providers or the patients themselves. We have all the knowledge we need to make the country healthier and therefore more economically competitive, just not the will to use it.

HIStalk Announcements and Requests

I put the $750 raised by Dana Moore’s Epic vs. Centura basketball game to immediate use, applying matching money from my anonymous vendor executive as well as from other charitable organizations to fund these DonorsChoose projects:

A document camera for Mrs. Marler’s third-grade class in Phenix City, AL.
A video camera and accessories for recording advanced placement calculus and physics lessons so that absent students can review them later for Mr. Blachly’s high school class in Indianapolis, IN.
A STEM bundle for Ms. W’s elementary school class in Englewood, NJ.
An iPad Mini to support STEM studies in Mrs. K’s middle school class in Brooklyn, NY.
Four science activity tubs for Mrs. N’s elementary school class in Dothan, AL.
Two tablets for Ms. S’s first grade class in East Haven, CT.
A laptop and accessories for Ms. M’s class of eight emotionally disturbed first grade boys in South Bronx, NY.
Hands-on materials for Ms. M’s advanced placement statistics seniors in Denver, CO.

This week on HIStalk Practice: The wave of physician "Just Say No to Meaningful Use" movements rolls on. American Well digs further into the employer market. AdvantageCare Physicians achieves Stage 6 EHR adoption. ZocDoc and Kareo top the list of US-based deals with Q3 VC funding. A GAO "sting" results in further Healthcare.gov scrutiny. The Interstate Medical Licensure Compact Commission meets for the first time. Maine ups its healthcare price transparency efforts.

This week on HIStalk Connect: the FDA releases its inspection findings from an unannounced visit to Theranos, concluding that their nanotainer technology is an uncleared medical device. IBM Watson will debut on the Apple Watch in 2016 within a patient engagement app being developed by Welltok. Carnegie Mellon University researchers create an app that uses iBeacon technology to provide navigational support for blind users. The team behind the app hopes to add facial recognition features in the coming years. HealthTap launches a suite of new patient engagement apps in a bid to move into the enterprise healthcare space.

Webinars

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

Acquisitions, Funding, Business, and Stock

McKesson announces Q2 earnings: revenue up 10 percent, adjusted EPS $3.31 vs. $2.79, beating Wall Street expectations for both. The company raised guidance and announced an additional $2 billion in share repurchases. Technology Solutions revenue dropped 6 percent, much of that due to “our decision to exit the Horizon hospital software business,” with good performance from payer solutions and RelayHealth.

Theranos continues its fascinating, overly defensive implosion by eliminating seven of its 12 board member positions – including those held by Henry Kissinger and George Shultz – but creating a new board of counselors (which includes all of the old board members) and a medical advisory board. CEO Elizabeth Holmes claims the changes were made in July, although as in the case of the company’s proprietary lab methods, she provides no data to back up that assertion. The company’s new board includes Holmes, her COO, a billionaire who inherited his grandfather’s construction business, a retired general, and a wealthy lawyer who sues big companies. Some speculate that the departed board members wanted to distance themselves from the company and any potential litigation that may result. Meanwhile, Theranos, which has already raised $752 million, authorizes new shares that will value the company at over $10 billion, although that happened right before the critical Wall Street Journal came out.

Leidos reports Q3 results: revenue up 2 percent, adjusted EPS $0.71 vs. $0.65, beating expectations for both.

Sales

Carilion Clinic (VA) chooses Sagacious Consultants, now owned by Accenture, for revenue cycle improvement.

People

Timothy Johnson, DO, MMM (Children’s Mercy Integrated Care Solutions) joins Valence Health as SVP of pediatrics.

Ingenious Med names Scott McClintock (Have Marketing, Will Travel) as chief marketing officer.

Corepoint Health names Dan Simenc (3M HIS) as sales VP.

Announcements and Implementations

Analysis by The Advisory Board Company finds that hospitals are increasingly implementing CDC-recommended antibiotic stewardship programs to reduce inappropriate use, but many of them are too short on staffing and data to be effective. Most organizations have pharmacists rather than the prescriber review orders, most don’t record monitoring overall antibiotic use by prescriber, and few have adequate data to determine whether their programs are improving patient outcomes.

UV Angel announces an ultraviolet-powered patient room IT device disinfection system that automatically runs a cleaning cycle up to 40 times per day when it detects that a targeted device has been used.

Atlantic Medical Imaging (NJ) goes live on patient self-scheduling from OpenDr.

Hackensack University Medical Center (NJ), which self-styles itself with the annoying one-word nonsense of “HackensackUMC,” will integrate Gauss Surgical’s iPad-powered Triton blood loss estimation system with Epic.

Government and Politics

A study finds that the FDA is approving cancer drugs based on short-term patient response rather than their effect on overall survival, with the agency often neglecting to require manufacturers to perform the post-marketing studies that FDA required as a condition of approval. That means many of the most expensive and most important drugs on the market haven’t proven that they actually work, which has been a problem with oncology drugs for decades – drug companies, oncologists, and hospitals make tons of money pumping them into patients with soothing optimism but no guarantee that the patient will live longer or better.

While deaths from overdoses of heroin and prescription narcotics are skyrocketing – the former because addicts are switching from expensive and heavily marketed prescription drugs to cheaper heroin – 80 percent of addicts couldn’t get treatment even if they wanted it because capacity is lacking. I was talking to a first responder the other day who said exactly the same thing – in his tiny, rural town, heroin deaths are common since addicts can buy it on the street for a few dollars per dose vs. the high cost (no pun intended) of oxycodone and other prescription narcotics. The so-called war on drugs has been lost as prisons and morgues fill up and suppliers get even richer as reduced availability drives up prices (a lesson possibly learned from their legal but equally morally challenged pharma counterparts). As usual, these studies are coming from public health experts (Johns Hopkins Bloomberg School of Public Health in this case) since it’s not considered a healthcare or medical issue that provides a business opportunity.

The Department of Justice arrests the former president of drug maker Warner Chilcott, owned by Allergan, for conspiring to pay kickbacks to doctors who prescribed its drugs. The company will also pay $125 million in fines and plead guilty to criminal charges. Meanwhile, Ireland-based Allergan and competitor Pfizer begin merger talks in what would create the world’s biggest drug company with a combined market value of $340 billion, making that $125 million fine look like a valet tip. It would also provide a way for US-based Pfizer to dodge US taxes in declaring the headquarters of the newly created company to be Ireland.

CMS announces that it’s been a quiet October for ICD-10, with the number of claims submitted due to incomplete or invalid information remaining unchanged at 2 percent. The denial rate and percentage of claims rejected due to invalid ICD codes also hasn’t changed much. It a bit early to declare ICD-10 victory, but CMS seems to have defied the naysayers who didn’t believe its optimistic testing status reports.

Other

The AMA and MedStar Health publish their review of EHRs for user-centered design, which instead of looking at actual user usability or testing anything against standards, simply reviewed ONC’s certification test results for use of best practices. The top-scoring products were Allscripts Enterprise, Allscripts Sunrise, McKesson Paragon, McKesson IKnowMed, and Athena Clinicals. Bottom-scoring products are EClinicalWorks Version 1.0, Dr Systems, Greenway PrimeSuite, Epic EpicCare Ambulatory, and NextGen Ambulatory. The analysis used factors such as the vendor’s self-reported UCD process, the involvement of clinicians in testing, and the design of rigorous use cases for testing. It’s a puzzling list when the ancient Meditech Magic finishes one spot behind Cerner in the top 10. I also wonder how meaningful it is to critique user-centered design process by repurposing certification submissions for individual products – you would think a given vendor would use the same design and testing methods for all of their products. The end result will be what it always is in healthcare IT: the top-ranked vendors will brag loudly about the results while glossing over the methodology and applicability, while the low-ranked ones will criticize the methodology and applicability while glossing over the results.

Santosh Mohan, a management fellow at Stanford Health Care and long-time HIStalk reader, sent over this photo if the IT department’s Halloween celebration, in which the three folks above are dressed up as the (a) electronic (b) medical (c) record. I like subtle humor like this because once you get it, you can feel superior in imagining folks who didn’t get the joke.

Meanwhile, PatientSafe Solutions tweeted out this photo of its team. It brings back not-so-fond memories of my hospital’s IT department Halloween celebration, which despite featuring nothing more interesting than pumpkin bowling and orange-iced cupcakes, had to be renamed to the politically correct “fall festival” when a couple of employees complained that it celebrated devil worship.

Weird News Andy cries, “Bring out your dead” as he reads how New York’s health insurance exchange enrolled 354 dead people for health insurance, paying out $325,000 in claims to 230 of them. Design flaws, including people having multiple identification numbers, caused another $3.4 million in overpayments in the program’s first year.

Sponsor Updates

Healthcare Data Solutions publishes a white paper titled “Understanding the Opportunities & Challenges of Telehealth 2015.”
Impact Advisors sponsors an article titled “A Unique Approach to Business Analytics: The Scottsdale Institute Health IT Benchmarking Program.”
Stella Technology and DataMotion will participate in the interoperability showcase at the New Jersey and Delaware Valley HIMSS chapters conference in Atlantic City October 29-30.
InterSystems CEO Terry Ragon is featured in MIT’s Spectrum Magazine.
PDR and Leidos Health will exhibit at the NextGen User Conference November 1-4 in Las Vegas.
LiveProcess will exhibit at the New England Rural Health Round Table November 5-6 in South Bridge, MA.
Wellcentive CEO Tom Zajac will present at the inaugural meeting of The Leader’s Board for Population Health Management November 5 in Dallas.
MedCPU is recognized as one of Entrepreneur’s “Best Entrepreneurial Companies in America.”
Navicure will exhibit at Michigan MGMA October 30 in Mount Pleasant.
Recondo Technology and Sutherland Healthcare Solutions will sell each other’s solutions.
Over 1,000 health and human services leaders attended Netsmart’s Connections 2015 client conference, which featured mental health advocate and former Congressman Patrick J. Kennedy.
NTT Data will exhibit at the 2015 LeadingAge Annual Meeting and Exposition November 1-4 in Boston.
Obix will exhibit at the 14th annual Perinatal Conference November 5 in Dublin, OH.
Epworth Eastern Hospital (Australia) realizes improved outcomes with Oneview interactive patient care technology solutions.
PerfectServe will exhibit at ASN Kidney Week November 3-8 in San Diego.
The SSI Group will exhibit at the Georgia HFMA Fall Institute November 4-6 in Savannah.
Streamline Health will exhibit at the Health IT Leadership Summit November 3 in Atlanta.
Surgical Information Systems will exhibit at HealthAchieve 2015 November 2 in Toronto.
Surescripts will exhibit at the NextGen 2015 user group meeting November 1-4 in Las Vegas.

Blog Posts

Population Health: Not a One-Size-Fits-All Endeavor (Medicity)
Building Your Breach Resistance First Line of Defense (ID Experts)
Three Things Images Need to Do to Be Interoperable (LifeImage)
They Like Us, They Really Like Us (MedAptus)
Growing, Teaching: a Way of Life at Nordic (Nordic)
Population Health: Where the Rubber Meets the Road (Orion Health)
Communicate smarter, not just more often (PatientSafe Solutions)
Four ways to prepare for next year’s price transparency dialogue with patients (Recondo Technology)
Inspiring Newport (PatientKeeper)
Secure Texting Trends: The Benefits of Patients, Physicians & Healthcare Orgs (Practice Unite)
Accurate Provider Information is Essential for Operational Efficiency (Phynd Technologies)
Predictions of Apple Q4 Earnings from Medical Charge Capture and Secure Messaging Users (PMD)
More States Revise ePrescribing Regulations (Point-of-Care Partners)
Three Weeks into ICD-10: Seven Areas to Watch in the New Frontier (Sagacious Consultants)
DV-NJ HIMSS Conference Interoperability Showcase: Quality Control Score for C-CDA Delivery Services (Stella Technology)
GeneInsight Clinic at Brigham and Women’s Hospital (Sunquest Information Systems)

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us or send news tips online.

125x125_2nd_Circle

News 10/28/15

October 27, 2015 News 10 Comments

Top News

FDA declares the proprietary nanotainer blood draw containers used by Theranos to be an “uncleared medical device” following a Wall Street Journal report that the company had voluntarily already stopped using the finger-stick containers for all but one test. A September FDA inspection of the company’s Alameda, CA facility noted a number of deficiencies, including shipping its nanotainer collection tubes across state lines without having them approved by the FDA; not performing quality audits; and documenting required software validation on a shared Excel worksheet. Meanwhile, Theranos says it will now publish data proving the effectiveness and accuracy of its methods.

Reader Comments

From Prostetnic Vogon Jeltz: “Re: ICD-10. Georgia Medicaid is denying claims that use unspecified ICD-10 codes even though CMS said that wouldn’t happen. When I first see a patient with atrial fibrillation, I might not know whether it is paroxysmal, persistent, or chronic – that’s what the unspecified codes are for. I think this is important for HIStalk readers to know about.” The agency didn’t say it wouldn’t be ready for ICD-10, so it appears to have simply made the decision that it will not conform to CMS’s policies.

From Unbridled: “Re: PatientSafe Solutions. They have parted ways with CEO Joe Condurso.” Joe is still listed as president and CEO on the company’s web page, but an internal email sent my way says he resigned last Friday in a mutual decision and that Chief of Staff Si Luo will take over as president. The company announced last Wednesday that it has acquired readmission technology vendor Vree Health.

From Publius: “Re: VA. I predict the VA will go full Epic, forcing Epic and Cerner to get serious about developing interoperability with each other since DoD will be on Cerner. This will benefit all customers. A Cerner-Epic ROI exchange will be as seamless as Care Everywhere (Epic to Epic ROI module).” Politicians seem to be fretting that since VistA uses old technology (just like Epic), it therefore should be replaced with a commercial product despite the VA’s decades-long satisfaction with its internally developed system. The VA and DoD always seem to find reasons to not work together, so perhaps choosing Epic would prolong the hostilities.

From All-Around Good Guy: “Re: Lee Marley, SVP/CIO, Presbyterian Healthcare Services in Albuquerque. She has left and will be missed. The data center was built and Epic was installed during her tenure.” Unverified.

HIStalk Announcements and Requests

A reader who wishes to remain anonymous donated $250 to my DonorsChoose project, to which I applied double matching (from my anonymous vendor executive and from charitable foundations) to purchase materials for Mrs. Sandler’s elementary school class in Aurora, CO (math games), Mrs. Jones’s K-2 class of intellectually and emotionally disabled students in Galivants Fry, SC (math manipulatives), Ms. Sobczak’s Grade 1-3 class of students with communication disorders in South Holland, IL (math games), and the elementary school class of Mrs. Bowers of Oklahoma City, OK (headphones for online math intervention programs).

I’m regularly puzzled when people email me story links that I covered days before, apparently thinking that because other sites ran the news days later that I missed it. I don’t think I’ve ever missed a significant story, so I can only implore you to read all of HIStalk each time I post news on Tuesday and Thursday nights and over the weekend. Reason: other sites keep repeating the same news over and over trying to get more clicks, while I assume readers are smart enough to only need to see it once and therefore I don’t run repeats. Obviously my logic is incorrect if folks are either skimming or skipping certain posts. My other suggestion is to avoid assuming that just because I can summarize a big story in a few sentences doesn’t mean it’s not important – I don’t pad out the content with a lot of filler.

Who should I interview? Tell me someone who: (a) doesn’t work for a for-profit organization; (b) is smarter than most people; (c) is interesting and opinionated; and (d) I haven’t already interviewed recently. I like to expose fresh viewpoints, but those who possess them don’t always volunteer to be interviewed.

I was thinking that what we need to learn in this country that advancing health for a tiny percentage of the population (via precision medicine, expensive celebrity surgeons and surgical gadgets, and dramatic and expensive interventions) is the wrong goal. Our overall health (and health expense) isn’t driven by new developments for the wealthiest and best informed, but rather how well we can move the public health needle for the most people who are involved alongside the medical experts. Research and new medical technology aren’t needed when we can’t even broadly roll out basic services such as prenatal care, end-of-life counseling, mental health treatment, and addressing the social determinants of health. I worry that we irrationally celebrate advancements that are very narrow in scope and outcomes.

Gag Clauses: I Find No Evidence They Exist

Some of the worst and most sensationalistic healthcare IT reporting I’ve seen (and I’ve seen a ton) involves so-called gag clauses, where IT vendors supposedly insert standard contractual terms that prohibit users from openly discussing patient-endangering software errors. That inflammatory topic, like the Loch Ness monster, has generated a lot of rhetoric (some of it political) despite the lack of proof that gag clauses actually exist.

Take the above hype-filled story, in which the reporter not only provides no examples of the gag clauses he claims to have seen, he completely confuses standard intellectual property (IP) terms — like not being allowed to post source code or product documentation on the Internet — with prohibiting EHR-using providers from speaking publicly about product problems via a non-disparagement clause.

The folks at HIMSS Analytics gave me access to its CapSite Database, which contains actual vendor contracts they obtained using Freedom of Information Act requests. I reviewed dozens of contracts from Epic, Cerner, Meditech, Allscripts, EClinicalWorks, Athenahealth, and several other vendors.

I didn’t see a single clause that prohibits customers from speaking out about software problems. I had previously challenged readers to give me a real-life example of a gag clause and I didn’t receive any there, either.

My experience working for providers is that any pressure to keep quiet about software problems is self-imposed. Health system executives don’t want to jeopardize an expensive implementation or annoy their vendor “partner,” so internal policies require that employees obtain approval before making any public comments or publishing articles. The CIO of one of the health systems I’ve worked for said outright that nobody in the IT department (including clinicians) was allowed to publicly comment on anything without his explicit review and approval (“I’ve been burned by that before”) or they would be subject to termination, which may give you insight as to why I remain anonymous.

Epic has raised the most ire by enforcing the intellectual property provision to include screen shots. Customers can’t publish or share Epic screen images – even those involving customizations of Epic they perform themselves – without approval from Epic. The company’s rationale is that screen design exposes IP, where just seeing what fields are captured provides a lot of insight as to what’s happening under the covers such that a competitor could steal the logic. They give permission to publish the screenshots when that isn’t the case.

That doesn’t prevent users from talking about or describing Epic software problems. It just means they can’t publish screen shots, documentation excerpts, or source code (yes, Epic customers receive source code) to make their point without the company’s permission. I saw nothing to prohibit or even discourage that kind of discussion in any of the contracts I reviewed. Perhaps it is included elsewhere, such as in the particulars of Epic’s support fee rebate program where customers get money back for voluntarily following Epic’s suggestions, but I haven’t seen it or heard of a real-life example. I’ve also not heard of a vendor taking formal action against a provider for making unflattering software comments.

I’ll throw out one more challenge and them I’m calling gag clauses a Snopes-like false rumor spread by misinformed people. If you’ve seen an example of a vendor software contract that includes anything resembling a gag clause that prohibits customers and their users from talking about product or company problems, send it my way anonymously and confidentially. I would also like to hear of examples where a provider has spoken unfavorably about a company or product and was pressured to stop, either from the vendor or from their employer, since I suspect that information pressure is far more common.

Webinars

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

Acquisitions, Funding, Business, and Stock

Sunquest owner Roper Technologies acquires CliniSys Group and Atlas Medical, which offer laboratory information systems to 2,000 labs in Europe and lab-customer connectivity in the US, respectively.

Walgreens is rumored to be preparing for a Wednesday announcement that it will buy competitor drugstore chain Rite Aid for up to $10 billion and will take on its $7.4 billion debt load. The deal would give Walgreens 17,800 stores worldwide vs. the 7,800 owned by CVS. Walgreens would also gain Rite Aid’s walk-in clinics, wellness stores, and EnvisionRX pharmacy benefits business. Italian-born businessman Stefano Pessina became the CEO and majority shareholder of Walgreens when it acquired his British pharmacy chain Alliance boots Group in 2012, giving the 74-year-old net worth of $14 billion.

Xerox reports Q3 results: revenue down 10 percent, EPS –$0.04 vs. $0.22 following a $385 million write-down after pulling out of two state Medicaid system contracts. The company says it won’t sell itself, but “a comprehensive review of structural options for the company’s portfolio is the right decision at this time.” Above is the one-year share price chart of XRX (blue, down 28 percent) vs. the Dow (red, up 4 percent). Shares dropped 8.3 percent Tuesday to a 52-week low on 13 times average volume.

Lexmark announces Q3 results: revenue down 7 percent, adjusted EPS $0.57 vs. $0.96. The company’s board has authorized “the exploration of strategic alternatives to enhance shareholder value and unlock the intrinsic value created by the company.” Shares dropped 13 percent following Tuesday’s announcement before the market’s open. Above is the one-year share price chart of LXK (blue, down 25 percent) vs. the Dow (red, up 4 percent).

San Francisco-based, 15-employee medical image analysis vendor Enlitic raises $10 million from an Australian diagnostic imaging company.

HCA announces Q3 results: revenue up 6.9 percent, adjusted EPS $1.17 vs. $1.18. The company blames lower profit on patients who were previously insured but stopped paying their Affordable Care Act premiums. The board authorized the repurchase of up to $3 billion of the company’s shares.

Sales

Emerson Hospital (MA) chooses MedAptus charge capture.

Dialysis Clinic (TN) chooses the EClinicalWorks EHR.

UNC Health Care (NC) and UF Health Shands Hospital (FL) choose Lexmark’s vendor-neutral archive.

Catholic Health Initiatives will expand its agreement with Allscripts to include managed services and its FollowMyHealth patient engagement platform. Mineopie reported as a rumor on October 21 that CHI had signed managed service agreements with both Allscripts (outpatient) and Cerner (inpatient). CHI signed a three-year, $200 million infrastructure outsourcing deal with India-based Wipro in March 2013 with little fanfare since except for IT employees complaining on Glassdoor that outsourcing, layoffs, and marginal management has put IT in shambles. The CEO said in 2010 that the organization would spend $1.5 billion on EHRs and other IT systems.

People

Jyotishman Pathak, PhD (Mayo Clinic) is named chief of health informatics at Weill Cornell Medicine.

Announcements and Implementations

IBM releases Datacap Insight Edition, which can classify and route scanned documents using advanced imaging, natural language processing, and machine learning. It provides an unconvincing healthcare example: “Where doctors and hospitals are transferring hand written notes and images into electronic health records for analysis or filing.”

Truman Medical Centers (MO) and Cerner will work together in piloting healthcare IT and giving Cerner employees on-site experience.

Peer60 publishes “Into the Minds of the C-Suite 2015.”

The American Dental Association’s ADA 2015 conference chooses DataMotion to provide Direct Secure Message and secure e-mail solutions as the technology backbone for secure digital exchange demonstrations.

Privacy and Security

In a remarkable statement, an FBI cyberattack expert says the agency often advises people to just pay cybercriminals the demanded money when a PC is infected with ransomware, which locks their computer information until payment is made to release it. He suggests that the malware is so sophisticated that payment is the best option, with the others being to revert to a backup or pay a security expert to try to remove the malware. Knowing that most people never make backups means they’ll pay either way. It’s a bit surprising that people still store their one single copy of valuable data on their local hard drive, which is a problem we’ve always had in hospitals where employees ignore strong suggestions (or policies) to store everything on the shared drive only. You can easily determine those who didn’t by the volume of their whining when they report a problem that requires immediately replacing or re-imaging their laptop or desktop.

Investigators conclude that China-based hackers breached insurer Anthem because the Chinese government is desperate for ideas on how to care for its aging population. Chinese citizens were promised universal access to healthcare by 2020, but they are not satisfied with the cost, quality, and gaps between the rich and the poor. Somehow the hackers missed the fact that the US has failed equally spectacularly on those same issues despite spending many times more than China and everybody else, so perhaps our cyber-retaliation involves hoping they follow our pitiful example.

Celebrity gossip site TMZ says several employees of Sunrise Hospital (NV) have been fired for trying to take photos and look up the medical records of former NBA star and comatose brothel patron Lamar Odom.

Other

A observational study by Massachusetts General Hospital finds that medication errors were made in half of its surgeries, a third of which caused patient harm. The most common errors involved mislabeled drugs, incorrect doses, failing to treat situations indicated by vital signs, and documentation mistakes.

In Australia, the Queensland government will provide an extra $4.2 million to support the Cerner rollout at the newly opened Lady Cilento Children’s Hospital, which has had many planning-related problems since its opening including an IT budget estimated at $29 million now standing at $67 million.

A state audit finds that South Australia’s Cerner Millennium pathology information system implementation skipped project steps and will fall short of money to complete the project, as additional costs for an unplanned disaster recovery center, legacy system decommissioning, and absence of an electronic ordering module are expected to exceed originally estimated costs of $22 million by several million dollars.

UMass Memorial Health Care (MA) will staff its $700 million Epic implementation by moving its 500-employee IT team to downtown Worcester to create room to house the 250 new hires needed. That’s what the local business paper says, although I would bet a lot of those new IT people are assigned there temporarily for the Epic implementation only. A common Epic implementation model is to choose existing IT team members for the Epic project via interviews and scores on Epic-mandated personality tests, hire new people as needed using the same interviews and tests, bring on temporary resources from clinical and administrative departments to provide subject matter expertise, and move everybody to a sequestered location where they won’t be bothered by unrelated IT work. A lot of those folks are borrowed until after go-live, when they return to their home departments. Hospitals usually hire experienced consultants as well to get them through implementation, after which they go away.

I mentioned previously that I had run into problems using Stride Health to look up available health insurance in various parts of the country to see how many plans involve high deductibles (answer: just about all of them). The company quickly responded with a request for details, then let me know that they had fixed the problems, one of which they hadn’t heard of until my report. It’s working great now.

In bizarre irony, the SXSW festival cancels two panel discussions covering the bullying of females in the online gaming industry after it receives threats of on-site violence. Members of Gamergate, whose members claim a lack of game journalism transparency, have threatened gaming industry women, vowing to publish their personal information or to rape or kill them.

Weird News Andy calls this story “You Don’t Know Squat.” A hospitalized woman in labor passes on the nurse’s recommendation that she perform squats to hasten her delivery, instead choosing to dance down the hall to a rap tune.

Sponsor Updates

Medecision will sponsor the HIMSS Summit of the Southeast 2015 October 29-30 in Nashville and HIMSS Big Data and Analytics Forum November 5-6 in Boston.
AirStrip will exhibit at The Health Management Academy’s CMO and CMIO Forums October 28-30 in Deer Valley, Utah.
Bernoulli becomes a sponsoring partner of the AAMI Foundation’s Coalition for Alarm Management Safety and Coalition to Promote Continuous Monitoring for Patients on Opioids.
Bottomline Technologies sponsors the nonprofit Leadership Seacoast for the fourth consecutive year.
Divurgent wins Business of the Year and Executive of the Year awards from the Business Intelligence Group.
EClinicalWorks will exhibit at the 2015 NJPCA Annual Conference October 28-29 in Las Vegas.
Extension Healthcare receives a 2015 Innovation Award in the Technology category from the Greater Fort Wayne Business Weekly.
FormFast will host a virtual user group meeting November 3 and 4.
HCS will exhibit at the LeadingAge 2015 Annual Meeting November 1-4 in Boston.
HDS will exhibit at Summit of the Southeast 2015 October 28 in Nashville.
Healthcare Growth Partners advises Lavender & Wyatt Systems on its sale to Netsmart.
Zynx Healthcare SVP of Mobile Strategy Siva Subramanian, PhD will participate as a panelist at Partners HealthCare’s Connected Health Symposium October 29-30 in Boston.
Burwood Group becomes one of the first Citrix Solution Advisors to complete three Citrix specializations in virtualization, networking, and mobility.
CitiusTech will exhibit at the NAHC Annual Meeting 2015 October 28-30 in Nashville.

Blog Posts

Optimize Coding Through Partnerships (AdvancedMD)
10 Things Enterprises Need to Know About Cyber Security Month (AirWatch)
The benefits of revenue cycle and compliance coordination (Besler Consulting)
Billian Comes to Boston Event Recap: Update on the Road to Health Data Equity (Billian’s HealthDATA)
The Rise in Electronic Prescription of Controlled Substances (EPCS) (Caradigm)
Final Stage 3 Meaningful Use – Objectives and Measures Summary – Updated (Clinical Architecture)
Baby Monitors for Baby Boomers (Galen Healthcare Solutions)

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us or send news tips online.

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Monday Morning Update 10/26/15

October 25, 2015 News Comments Off

Top News

Athenahealth shares jump 28 percent Friday after the company announces better-than-expected quarterly results. It’s now valued at $6.3 billion, with Jonathan Bush holding $51 million worth.

From the Athenahealth earnings call:

Jonathan Bush says three small hospitals are submitting inpatient claims via AthenaNet using what is basically an interface to the acquired RazorInsights hospital information system.
When asked about the company’s direction as HITECH winds down, Bush said, “The satisfaction and the feeling of being on-mission as opposed to on the tip of an Obama spear is phenomenal for us. No offense, Barack, I know that you’re Mr. President, but that’s just how it feels.”
Bush described telemedicine and the addition of Chiron to its “More Disruption Please” program as, “Imagine a store whose entire inventory rots instantly at the end of each day. That’s a doctor’s office … We’ve tried hammering them too much and that hasn’t been great, e-mailing and texting and auto-calling. We’re working on a partnership with a bunch of different makers of apps. We’ve got a small team that’s toying with a universal Athena app … I imagine someday the store brand of telemedicine for Athena will expand, of course. But right now, I think the right focus is getting those new players with their new energy into the tent.”
When asked to compare the company’s position vs. that of its competitors, Bush said, “We are the only company that’s selling a cloud-based service … No one has even a plan to think about starting to try in the sector that you guys think of as our competitors. I think of them as just a business model from a different era … That you run faster than a three-legged horse is not good enough. We really got to think about what’s emerging in the venture world and what’s possible in our business model and compare ourselves to that. We still feel like we have a long way to go on those results.”
Bush said of the impact of Medicare’s merit-based incentive program, “The thing about the MIPS program is it creeps up on you. This year’s performance is then submitted and the government takes a year to look at the performance. Then in two years, your rates are adjusted according to this year’s performance … It’s trickier to jolt the market with it, but it’s a really big deal. It’s an 11 percent, 12 percent swing in a doctor’s Medicare take-home pay based on how he performs, or she, on this program. So we should be able to sell against it. It’s just harder to explain and to create urgency around.”

Reader Comments

From Dixie Whistlen: “Re: top 25 blogs to read. Why did the magazine list Ed Marx on HIStalk but not the rest of HIStalk? Some of those they mentioned are not even popular.” You would have to ask the magazine. I don’t read those sites or pay attention because, like all such “awards,” it’s just a scheme to get people to click through the endless slide show to fool advertisers with a higher but meaningless metrics. One of the blogs that made the Top 25 hasn’t posted anything new since March 2011 and another winner’s newest post is from December 2013, which suggests a superficial editorial vetting process.

Speaking of junk health IT reporting and meaningless reporting intended to sell ads, I just noticed that US News and World Report is announcing its “Most Connected Hospitals” list, which it has apparently been running for years. That must offer competition to the equally pointless “Most Wired” list from H&HN that achieves little except allow CIOs to pad their resumes and hospital marketing people to place yet another logo on their ads that attempt to convince the locals of their organizational competence.

From Bob Wyer: “Re: cancelled sponsors. You said you would list them each month with the new and renewing ones, but I haven’t seen any.” I did promise to do that but I promptly forgot. Companies decide to stop sponsoring for a variety of reasons: they decide to spend their marketing money elsewhere, they are unreasonably obsessed with ad clicks, I wrote something unflattering but true that made them mad, they don’t have money in the budget, or the decision was made by a marketing person who knows nothing about HIStalk or the industry in general. Anyway, here’s the list of dearly departed sponsors going back several months. I appreciate their previous support, especially those that had sponsored for several years.

From Exotic Delicacy: “Re: Caremark. They won’t allow my prescription to be filled locally, so they ship by next-day air a 12×10 inch carton containing a 9×11 inch Styrofoam cooler packed with five ice packs. The actual meds are about 1×3 inches. Besides the cost, all of that (including the chemicals) goes into the landfill.” I was musing this week of what I call the Amazon Prime effect, where my near-daily Amazon orders create a never-ending mountain of boxes and packing material that I have to scrunch and tear to squeeze them into the large recycling bin that goes to the curb weekly. It reminds me of the department store stock boy job I had while working my way through college, in which the fun chore was feeding heaps of big, flattened boxes into the mall’s paper crusher deep in the bowels of the building. I also learned to hate Christmas gift wrap since it was stored in huge quantities in a truck trailer parked out back, causing me to freeze several times a day in November and December in bringing in more big boxes of it. It wasn’t nearly as fun as my summer job working at a public radio and TV station, which didn’t require me to do a whole lot except download satellite programs like “All Things Considered” to tape for later broadcast and to read the news for our infrequent live programming.

HIStalk Announcements and Requests

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It’s apparently not just me that doesn’t see Dell as a significant healthcare IT player from my extra poll last week. Machete’s comment is an admirably concise interrogatory: “Dell’s in healthcare?”

The results of my regular poll are sobering, in which 6 percent of males and 52 percent of females say they’ve been sexually harassed at work in mostly unreported incidents. Woodstock Generation hopes a lot of the harassment happened in the 1990s when reporting was uncommon, while It’s Everywhere (Unfortunately) adds, “I was harassed by multiple attending physicians in medical school and witnessed them harassing other students and even patients. It was disgusting. As a practicing physician, I have been harassed by peers. Working with software vendor employees and consultants, I have seen entirely too much harassment, mostly fueled by alcohol and testosterone.”

New poll to your right or here: would you be willing to have your lab tests performed by Theranos?

I was interested after running a TV station’s photo of a hospital documentation sheet for a chemo overdose that a couple of readers complained that I had violated HIPAA, which is surprising since we’re supposed to be the HIPAA experts. First, the family took the photos and sent them to the TV station, presumably to bolster public opinion for their lawsuit against the hospital that was involved. Second, only covered entities (health plans, clearinghouses, and providers) are covered by HIPAA. Any other perceived breach of patient privacy can be addressed only through a lawsuit, which has nothing to do with HIPAA.

Reader Derek sent $50 for DonorsChoose, which thanks to the magic of matching funds from my anonymous vendor executive and The NEA Foundation, will provide four tablets that will be shared by three pre-K classrooms in Buffalo, NY, which they will use for math practice. Meanwhile, the photos above are of Mrs. Cole’s Minnesota first graders using the math games we provided and Mr. Burnitt’s Florida elementary school class working with the model rocketry equipment we bought.

Last Week’s Most Interesting News

Quality Systems sells its NextGen Hospital Solutions division to QuadraMed.
Lab upstart Theranos melts down after reports question the validity and limited use of its proprietary methods.
Vendors and providers agree on objective measures of interoperability, although not stating what those measures are or how they will be used.
IBM turns in another unimpressive quarter despite high-profile investments in Watson.
EClinicalWorks announces a cloud services platform, free client interoperability, and an Internet of Things cloud.

Webinars

None in the next few days. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

Lab innovator Theranos continues to unravel as its highest-profile partner, Walgreens, says it won’t open any new Theranos testing centers until the company answers questions about its technology and why nearly all the samples it draws are full-volume ones that are analyzed by traditional lab equipment rather than its proprietary microfluidics machines. In more bad news for CEO Elizabeth Holmes, CMS says its surveyor found nothing innovative in the company’s facilities but did observe quality control problems; some of its claimed partners (Pfizer, GSK, Cleveland Clinic) say they’ve never actually done anything with Theranos; and records show that the company has hired poorly qualified lab directors, including a part-time dermatologist who is not certified by the American Board of Pathology. Questions are also swirling about why the Theranos board is made up of old, politically connected white men without scientific or medical expertise.

Huron Consulting Group shares dropped 24 percent Friday after the company turned in decent Q3 results but also lowered revenue guidance due to expected delays in two big academic medical center projects. The company also says it has “seen a softening in demand for our performance improvement solutions,” which it attributes to stabilized hospital margins due to ACA-insured patients such that “cost reduction work at some hospitals is no longer seen as an urgent concern.”

Fort Lauderdale, FL-based healthcare business services vendor Intermedix will open an operations center, innovation lab, and executive offices in Nashville, TN, creating 116 jobs. The company says the state and city “have welcomed Intermedix with open arms,” not mentioning the open taxpayer wallet that must have influenced its decision.

Announcements and Implementations

Westchester Medical Center Health Network (NY) opens its $7 million, 5,500 square foot eHealth operations center, which contains 20 telehealth monitoring stations that will be staffed around the clock by physicians and nurses.

Government and Politics

CMS goes live with an upgraded Healthcare.gov, saying the site will be 40 percent faster and will include the ability for users to see their estimated yearly costs for each plan. Features not yet ready will eventually allow consumers to filter the list of plans to those that cover a specific doctor, hospital, or drug.

Privacy and Security

A Springfield, MA gynecologist is indicted for accepting drug company bribes for prescribing its drugs and allowing its sales rep to dig through the medical records of her patients. The smoking gun is that as soon as the drug company stopped paying her, she stopped prescribing its products.

Local police in North Carolina speculate that scammers are using data from one of the recent high-profile healthcare data breaches to send unordered diabetic supplies by mail to people who who don’t need them. A recipient whose name, Social Security number, and doctor information was included on the unordered package tried to call the pharmacy number on the invoice, but it was phony.

The Miami-Dade division of Florida’s children’s medical services program mistakenly faxes a clinic roster to four vendors, exposing the information of 150 clients.

Technology

Israel-based MobileODT offers an $1,800 cervical cancer screening tool that connects a mobile colposcope to a cell phone, allowing clinicians to quickly take a cervical image that can also be sent out for a second opinion. The technology, which was trialed at Penn and Scripps, is being used in developing countries that can’t afford a traditional $15,000 colposcope. It will be sold in the US once the company obtains FDA approval.

Other

AMA’s VP of professional satisfaction says EHRs are the biggest driver of physician dissatisfaction. She cites studies that show doctors waste 80 percent of their time performing activities that don’t benefit patients, suggesting that they hire scribes.

A study of nephrology patients finds that patient portals are being used more widely but also more selectively, with less involvement by patients who are poor, black, and elderly.

Like that old Chicago song, nobody really knows what time it is in Turkey, whose government decides to push back the end of daylight saving time until after upcoming elections. The government doesn’t control computers and smartphones, which change time automatically based on rules rather than last-minute political pronouncements, so everybody is confused.

Centura Health SVP/CIO Dana Moore, whose ideas launched my DonorsChoose project during the last HIMSS conference, sent photos of the fundraising basketball game between the tie-dyed Centura team (which eventually won the game) and Epic. He said everybody had a great time and he’s sending me the $620 raised to fund more classroom projects, which will actually fulfill more grants when I apply the matching funds I have available. Good work by Centura, Epic, and Dana.

Weird News Andy deems Sunday’s Dilbert as “HIStalk worthy.” It’s a big panel – click the image to see it full size.

Sponsor Updates

T-System and Wellsoft will exhibit at the ACEP Scientific Assembly October 26-29 in Boston.
TeleTracking will host its client conference October 25-28 in Las Vegas.
Health Catalyst releases a documentary titled “Measured Outcomes: A Future View of Value-Based Healthcare.”
Valence Health will exhibit at the Arkansas HFMA Chapter Fall Conference October 29 in Little Rock.
Versus Technology helps cancer clinics nationwide enhance the patient experience with real-time workflow technology.
Huron Consulting Group will exhibit at the Connected Health Symposium October 29-30 in Boston.

Blog Posts

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us or send news tips online.

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News 10/23/15

October 22, 2015 News 3 Comments

Top News

Quality Systems sells its NextGen Healthcare hospital systems business to QuadraMed, which is part of Canada-based Constellation Software’s N. Harris Computer Corporation. QSI formed its hospital business by acquiring Opus Healthcare Solutions in 2010, ViaTrack Systems in 2011, and the Poseidon Group in 2012. It appears that NextGen will keep its Mirth interoperability product (the announcement didn’t say, but while the hospital solutions web pages are gone, the Mirth ones remain).

Meanwhile, Quality Systems reports Q2 results: revenue up 4 percent, adjusted EPS $0.21 vs. $0.13, beating Wall Street estimates for both.

Reader Comments

From The PACS Designer: “Re: HHD vs. SSD. The need for 500GB or 1TB hard drives for computers will start to diminish with the growth of cloud services. One option that could accelerate the replacement of HHDs is solid state drives (SSD). As the price of SSDs declines they become more attractive to manufacturers who will then shun the HHDs in favor of a 256GB SSD-4GB DRAM system. Western Digital’s acquisition of SanDisk seems to validate the SSD concept of lowering the purchasing costs of systems.”

From So Cal Surf Legend: “Re: Antelope Valley Hospital, Lancaster, CA. Has selected Cerner. Official announcement coming soon.” Unverified, but Cerner was their vendor of choice a few months back. It’s a 420-bed hospital.

HIStalk Announcements and Requests

HIStalkapalooza sponsorships are looking good, meaning I probably won’t have to write a personal (and thus NSF) check for many dozens of thousands of dollars to personally cover the cost. The remaining sponsorship slot is the top-level one I call “Rock Star CEO” that includes:

100 invitations.
A private lounge (capacity 100) with its own bar and food plus two VIP boxes for entertaining prospects, partners, and company executives.
The company CEO introduces the band, gets four all-access passes, and enjoys a meet-and-greet with the band back stage after their performance.
An on-stage banner.
Special recognition from the stage.

Contact Lorre if you enjoy the HIStalkapalooza vibe and want to play a key (and visible) role in producing it for the fun and influential attendees. She would be happy to consider any special needs our Rock Star CEO might have, right down to removing the brown M&Ms.

An anonymous reader donated $50 to my DonorsChoose project, to which I added double matching funds from my anonymous vendor executive and The NEA Foundation to fund a grant for Mrs. Smock’s elementary school class in Buena Park, CA that provides an Apple TV and external hard drive so that students can gain confidence and presentation skills by sharing their ideas with their classmates. Meanwhile, Mrs. Rice sent photos of her Washington third and fourth graders doing programming projects on the laptops we provided, noting particularly an increase in programming interest by the female students.

Early bird registration for the HIMSS conference ($765 for members) ends December 14, just in case you (like I) haven’t signed up yet. I was interested to see in the registration policies that attendee emails aren’t shared with exhibitors, so nobody should get promotional emails, instead having their snail mailbox filled with the usual junk that keeps coming weeks after the conference has concluded. The last policy acknowledges agreement of a condition involving photographic images that isn’t actually listed, so apparently you can take all the pictures you want, not that the old policy stopped anyone anyway. The cheapest hotel still available is Linq at $90. I’m pretty much dreading the conference, especially with the screwy Monday through Friday schedule driven by the overriding desire of casinos and hotels to fleece the weekend tourists.

My Twitter feed has been barraged this week with uninteresting cheerleading updates from Dell’s technology conference. I admit that I don’t think of Dell as a significant, committed healthcare player despite its previous acquisition of companies like Perot Systems and InSite One, any more than I think of other big hardware vendors like IBM and HP as anything more than low-margin vendors dabbling in higher-margin services du jour. I’m interested in whether I’m in the minority and thus created this special poll: how much healthcare influence does Dell have? You can explain what I’m missing in the poll’s comments.

This week on HIStalk Connect: KLAS analyzes interoperability across EHR vendors, naming the best technologies and vendors from a provider perspective. Jawbone wins an injunction against several key Fitbit employees in its suit alleging trade secret theft. Rock Health reports on consumer engagement, outlining which digital health categories are attracting the most attention. Theranos closes out its week of public feuding with the Wall Street Journal with a blog post confirming accusations that has stopped using its finger-stick lab test technology for the time being.

This week on HIStalk Practice: Healthcare.gov bashing ramps up. Virtual tools could be the panacea PCPs have been looking for. Hello Health CEO Nat Findlay explains what physicians need to know about getting paid for CPT 99490. Teladoc celebrates 1 millionth visit. American College of Cardiology members take their EHR usability woes to Washington, DC. Kenneth Iwuji, RN explains what med students really think about healthcare IT. Practice managers weigh in on how the rise in high-deductible health plans has fueled their technology spend. Hologram house calls become a reality.

Webinars

None in the next few days. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

PatientSafe Solutions acquires Vree Health, which offers patient engagement and care management tools. It was owned by drug company Merck.

Post-acute EHR vendor Netsmart acquires behavioral EHR provider Lavender & Wyatt Systems.

Athenahealth reports Q3 results: revenue up 24 percent, adjusted EPS $0.36 vs. $0.27, beating both revenue and earnings estimates. Share price jumped 8 percent in after-hours trading following the announcement.

Microsoft reports Q1 results: revenue down 12 percent, adjusted EPS $0.67 vs. $0.65, beating earnings estimates and sending shares up sharply after the market’s close Thursday.

The Milwaukee business paper covers the launch of Waukesha-based Intellivisit, which offers virtual diagnosis, triage, and appointment scheduling.

Sales

Behavioral Center of Michigan and Samaritan Behavioral Center (MI) will implement Medsphere’s OpenVista.

Jellico Community Hospital (TN) will implement Medhost’s clinical and financial applications.

People

Micky Tripathi, PhD (Massachusetts eHealth Collaborative) joins the board of The Sequoia Project.

Ed Caldwell (MediTract) joins CarePayment as chief revenue officer.

Announcements and Implementations

DrFirst announces myBenefitCheck, which offers prescribers real-time “what will this prescription cost this patient” advice that uses the patient’s drug benefit insurance coverage to display their out-of-pocket cost. It integrates with 300 EHRs via the company’s e-prescribing system.

TransUnion Healthcare’s eScan solution is named the #1 product in collections outsourcing and AR debt by Black Book.

The Delaware Health Information Network forms a joint program with ISpecimen that will allow researchers to search the de-identified medical information of patients whose lab samples are being stored by DHIN members. The researchers then request the samples that look potentially useful and the hospital ships them to the researcher. It’s an interesting funding source for DHIN, which will then discount its fees for participating members. ISpeciment founder and CEO Christopher Ianelli, MD, PhD was a managing director for investment bank Leerink Swann and co-founded Health Insight Technologies, which was renamed Humedica and then acquired by UnitedHealth group for an undisclosed but assuredly large amount.

Healthgrades research finds that one in six Americans received care in a one-star rated hospital, observing that had they chosen a five-star hospital instead, they would have had a 71 percent less chance of dying and a 65 percent risk reduction for complications. It also observes that hospitals may excel only in specific areas, such as the 14 Chicago hospitals that earned a five-star rating for heart attack treatment but had a one-star rating for total knee replacement, hopefully helping consumers understand the “focused factory” concept similar to the idea that you don’t order the steak at a seafood restaurant just because it’s on the menu.

T-System posts a conceptual video that will be presented to the ACEP Scientific Assembly next week that describes how cars equipped with GM’s OnStar system could send details of an accident to a T-System-equipped ED before the patient arrives. The OnStar system can predict severity of injury using vehicle, crash dynamics, and occupant information.

Imprivata Cortext is named in a KLAS secure messaging report as the most-considered product for physician-to-nurse communications.

Qualcomm’s Capsule subsidiary earns FDA 510(k) clearance of its SmartLinx Vitals Plus patient monitoring system.

Cedars-Sinai becomes the zillionth health system to get involved with a health accelerator, which would seem to be late in the game except for the fact that those that preceded them appear to have accomplished basically nothing anyway. It would be interesting to survey all of those eager startups who are seeing firsthand just how monolithic, indecisive, and change-resistant big health systems accelerator operators are.

A CoverMyMeds study finds that 70 percent of EHR vendors are committed to offering electronic prior authorization, up from 54 percent in March 2015.

Park Place International announces an expanded set of high availability solutions for Meditech and 100 other healthcare applications via its OpSus Healthcare Cloud and Microsoft Failover Clustering Services.

Privacy and Security

A Germany-based cybersecurity company says that 27 percent of all website malware attacks targeted healthcare-related sites so far in 2015.

Other

An unfocused article in left-leaning magazine Mother Jones blames left-leaning Judy Faulkner and Epic for lack of interoperability, blasting a blitzkrieg of marginally related facts that seem overly focused on how much money Epic makes and how elaborate its campus is. It observes that HITECH didn’t address interoperability. The reporter misses the fact that EHR vendors deliver what customers demand and few turf-protecting health systems are interested in sharing information with their competitors even if their EHR already supports that capability. The reporter concludes the piece by expressing his frustration that his multiple providers don’t share his information, conveniently not bothering to ask those providers why that’s the case. He also complains about the lack of information sharing by his hospital (George Washington University Hospital), which he fails to note uses Cerner, which he lauds elsewhere in the article for its interoperability as evidenced by the DoD deal and joining CommonWell. Lastly, he misses the point that providers weren’t required to buy anything from Epic, Cerner,or anyone else to collect HITECH bribes – they only had to use them in the prescribed manner. It’s valid that HITECH was mostly a waste of taxpayer money and that interoperability is nearly non-existent, but the market forces that created that situation aren’t nearly as simple as he describes.

The Albuquerque newspaper digs into the tax records of Presbyterian Healthcare Services to find that three of its highest-paid contractors are connected to its EHR. The health system paid Epic $14.5 million, T-Systems North America $9.9 million, and Leidos Health $9 million. Presbyterian has spent over $200 million on Epic. It has $1.5 billion in annual revenue and paid its CIO $429K last year.

Jamie Stockton of Wells Fargo Securities sent over their latest analysis of MU Stage 2 attestation. Epic led the hospital numbers with 97 percent of eligible hospitals attesting, while the lowest-performing vendors (in the 50 percent range) are Medhost, Allscripts, and Healthland. Epic and Athenahealth lead the MU Stage 2 physician attestations at just over 70 percent, while users of systems from Allscripts, NextGen, Greenway, Cerner, McKesson, and GE Healthcare have an extremely low attestation rate. All of this may be more of an indictment of the MU process than whose system they’re on.

Siemens Soarian user SoutheastHealth (MO) will move to Cerner Millennium, although they will stick with Soarian billing.

Prescription compounding firm Imprimis Pharmaceuticals will sell a generic version of Daraprim – the old rare-disease drug whose new owner increased the price 5,000 percent to $750 per dose – for $1 per custom-made capsule. The San Diego-based company says it will start making cheap versions of other one-source generics whose price has skyrocketed, exploiting the fact that compounding pharmacies are not required to submit their products through lengthy and expensive FDA approval. Shares of Imprimis are traded on the Nasdaq, where the company has a market cap of $57 million.

Cherokee Nation’s health services are live on Cerner.

A child at St. Christopher’s Hospital for Children (PA) is given a tenfold overdose of cancer chemotherapy due to a manual dose calculation performed from instructions on a custom roadmap that contained a typographic error.

Weird News Andy codes this story as W20.8XXA, as a man napping under a tree in a San Francisco park is struck on the head by a falling 16-pound pine cone. He’s suing the US Department of the Interior and the park for $5 million, which his attorney says he will need for long-term care.

Sponsor Updates

Experian Health will exhibit at the Healthcare IT Transformation Assembly October 25-27 in Miami.
PDS IT will exhibit at the Midwest 2015 Fall Technology Conference October 25-27 in Detroit.
The SSI Group and Streamline Health will exhibit at The Summit of the Southeast October 28-30 in Nashville.
Surgical Information Systems will exhibit at Anesthesiology 2015 October 24-28 in San Diego.
Iatric Systems, Leidos Health, Nordic, and Obix will exhibit at the Midwest 2015 Fall Technology Conference October 25-27 in Detroit.
Extension Healthcare will receive the Greater Fort Wayne Business Weekly 2015 Innovation Award in the technology category for its alarm safety and event response platform.
The local paper interviews retiring Healthwise founder and CEO Don Kemper and his wife, SVP Molly Mettler.
InterSystems is recognized for the second year in a row as a leader in the Gartner Magic Quadrant for operational database management systems.
Intelligent Medical Objects will exhibit at Netsmart’s Connections 2015 user group meeting October 25-28 in National Harbor, MD.
LiveProcess will exhibit at the 2015 Vermont Healthcare and EMS Preparedness Conference October 22-25 in Jay.
MedData will exhibit at the ACEP Scientific Assembly October 26-28 in Boston.
Phynd Technologies http://welcome.phynd.com/eBookoffers a new e-book, “The Benefits of a Unified Provider Management Platform.”
Navicure will exhibit at MedTrade Fall Conference October 27-29 in Atlanta.
Netsmart will exhibit at the Ohio Council Annual Conference October 22 in Columbus.
Orion Health hosts the 2015 North American Healthcare Collaborative October 26-28 in Scottsdale, AZ.

Blog Posts

Green Eggs and Hippocrates (PatientKeeper)
Inside Secure Texting: Reaching On-Call Physicians & Surgeons (Practice Unite)
A Rising Star is Born (Phynd Technologies)
HHS’ ICD-10 Code is Here to Stay (Porter Research)
ONC’s Interoperability Roadmap: Keeping the Focus Where it Counts (Surescripts)
Are you ready for bundled payments? Increased quality and safety reporting measures? (Nordic)
Here’s why I Heart HIT, as an executive and a mom (Wellcentive)
Before you hire that backfill support team, ask yourself 5 questions (Hayes Management Consulting)
5 Best Practices When Attorneys General Get Involved in Your Data Breach (ID Experts)
The Payment Experience Patients Want (InstaMed)
It’s Out There for the Taking: Time to Saddle Up and Grab Your Data by the Horns (Liaison Technologies)
LifeImage Company Party Photo Album (LifeImage)
It’s the Weekend – Let’s Be Careful Out There (MedAptus)
SayIt Code Fast service helps providers adapt to ICD-10 requirements – at the point of care. (NVoq)
Road Dog’s Top 10 Realities of Healthcare Reform (Forward Health Group)

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us or send news tips online.

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News 10/21/15

October 20, 2015 News 4 Comments

Top News

KLAS rather histrionically reports (placing itself prominently in the story) that vendor CEOs and provider CIOS will “lock arms to make a difference” in supposedly agreeing to unstated objective measures of interoperability as John Halamka reported on his blog October 6. They will then “work closely with Washington to help alleviate the interoperability measurement burden faced by the government.” The obvious problem is that technical standards reflect capability, not reality, and the ultimate test of interoperability is best assessed by patients trying to get all of their providers working from the same basic information. It matters little that a provider’s EHR scores high on interoperability if it isn’t willing or able to share information.

Reader Comments

From Stewart Scrooged: “Re: Ministry Health Care. CEO announces that 500 employees will be RIF’d in what he calls ‘future-sizing.’ Last day for the chosen ones will be 11/28/15. Merry Christmas!” Unverified. Any organization that lays off employees in November or December is desperate, incompetent, or cold. The best thing about layoffs is that while companies jettison their least-valued employees, their best ones get the message and start looking elsewhere, closing the karmic loop.

From Lab Matters: “Re: Jeb Bush’s health plan overhaul. This is not a repeal and replace proposal. This tinkers on the edges of the ACA. And, not to be cynical, but wouldn’t the reduction in the barriers to entry really benefit his cousin Jonathan? He’s another phony crony wanting more giveaways to the private sector at the expense of the public good. Is the ACA perfect? Not by any means. But fix it. Stop with the ‘repeal’ madness that will go nowhere. Playing to his base by saying that is what he is doing and then NOT actually doing it is disingenuous at best. Sorry, Jonathan. Maybe you are the smart Bush people keep referring to since clearly isn’t Jeb.” Jeb Bush’s health plan says Obamacare has made a messed up health system even worse as the federal government took over one-sixth of the country’s economy, concluding that it “embodies the liberal idea that Washington needs to and can solve every problem,” hurting middle-income families in the process as premiums increase and healthcare choices decrease. Bush’s health IT proposals involve eliminating the Meaningful Use program and associated penalties and publicly releasing all raw, de-identified Medicare and Medicaid claims data. I agree with a lot of what he suggests, although I think his emphasis on innovation as a solution is probably misplaced, repealing the ACA is unlikely, and the idea that all of America (including Fortune 100 companies, medical associations, pharma, and their cadre of lobbyists) will obediently line up and scrap a system that made them rich is naive. His main focus seems to be letting the states run healthcare, which isn’t how it was done in those many countries whose citizens enjoy better and cheaper care than we do.

From Pilsner: “Re: Peer60 EHR report. It does not meet the basics to be called credible. Could you please ask for and publish the N value and demographic information?” The report did not cover EHRs in general – it specifically looked at ambulatory “organizations” that are either hospital-owned or independent. It was what Peer60 calls a “First Reaction” report that collects and publishes information quickly rather than exhaustively, which in this case involved 184 respondents, according to the company. It should be noted that Pilsner has a vested interest in Meditech and therefore in questioning the Meditech-unfriendly survey results.

From Follicular Folly: “Re: Cardinal Health. I was bidding for a health IT services contract and was required to take a hair follicle drug test through DC-based Metro Labs. The location was in a tiny hall, the office was beat up, and supplies were thrown all over the shelves as the entire staff conversed in Ethiopian. They said the hair had to be three inches long, and without warning, the manager chopped off two handfuls worth! I reported this to Cardinal Health, who asked what they could do, and I gave them some requests. They removed me from consideration because they couldn’t accommodate those requests. Now I have a chunk of hair missing and can’t get work .” The Yelp reviews for Metro Labs are mostly scathing.

From Mineopie: “Re: Catholic Health Initiatives. Recently entered into a managed services agreement with both Cerner (inpatient EHR) and Allscripts (outpatient EHR), just announced same for Deloitte AMS to manage Epic markets.” CHI announced the Cerner contract in July 2015 and an Allscripts hosting agreement in November 2014. They’ve been working for years with Deloitte, which announced earlier this year that it would turn its CHI Epic work into a service called Evergreen.

From Bilge Water: “Re: tweets. Your social media posts on Facebook and Twitter get good attention from companies. Nice!” Correction – they sometimes get the attention of twenty-something marketing assistants who are assigned the task of making companies look hipper than they really are by tweeting and Facebook posting on their carefully controlling behalf. It’s not as though any big company’s CEO has actually seen what goes out under the company’s Twitter and Facebook accounts, much less that he or she is writing it personally or retweeting it. It’s easy to forget in a Twitter-induced fog of pedantic kindred spirits that that most of the world, including a high proportion of business executives, has zero interest in what’s on Twitter because it’s just people talking to themselves hoping desperately that someone else is listening.

From Yukon Gold: “Re: Medicare Part A hold for outpatient claims due to Local Coverage Determinations needing to be updated in their system. They are targeting an October 23 turnaround, but this is exactly what hospitals worried about — the federal government NOT being ready for ICD-10. This is a big deal for anyone without large cash reserves that has a payer mix that isn’t mostly commercial.” Unverified.

HIStalk Announcements and Requests

Just over half of poll respondents are interested in Meaningful Use news, while the almost-half that includes me has grown weary of the topic. New poll to your right or here: have you ever been sexually harassed at work? I’ll trust your own definition.

Thanks to Jenn for covering the last couple of posts for me. You will agree with me that she did her job well if you didn’t notice anything different.

I’ve been following the Theranos drama, happy that I had long ago already covered all of the now-hot questions about the company in previous HIStalk posts — that only one of its tests is FDA approved, that its microfluidic methods haven’t been independently validated against traditional ones and make up a minority of its tests, and that the still-small company seems secretive and has a weird but high-powered board. Here’s the thing, though – the microfluidic and nanotainer stuff makes the company sexy to Silicon Valley types and hypes its potential valuation as a technology play, but its real innovation is rock-bottom lab test pricing. Patients will get lab work done no matter how their blood is drawn even though they might prefer the Theranos-exclusive finger stick. Investors might like the company less than before, but patients should be happy that Theranos is trying to break the oligopoly of big lab companies and hospital labs whose technology allows them to process most tests for nearly no incremental cost while charging high prices. Theranos is lucky it isn’t publicly traded yet since the stock would otherwise be tanking on the barrage of criticism.

Ms. L says her Indiana kindergartners love using the two Kindle Fires we bought via the DonorsChoose project, enjoying small-group Kindle Station time every day for practicing letters, numbers, and shapes. I have a few weeks left to use the matching funds generously provided by an anonymous vendor executive for donations of $100 or more. Companies or individuals can follow these steps:

Purchase a gift card in the amount you’d like to donate.
Send the gift card by the email option to mr_histalk@histalk.com (that’s my DonorsChoose account).
I’ll be notified of your donation and you can print your own receipt for tax purposes.
I’ll pool the money, apply the matching funds, and publicly report here (as I always do) which projects I funded, with an emphasis on STEM-related projects as the matching funds donor prefers.

Here’s another DonorsChoose photo I received from Ms. Klotz, whose Illinois kindergarten class received math learning centers from us. She says the students love hands-on math work in practicing measurement, geometry, number operations.

Webinars

None in the next few days. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

Former HBOC Chairman Charlie McCall has been paying an army of lawyers for years in trying to have his 2009 criminal conviction for securities fraud and his 10-year prison sentence overturned. He failed again this week as the US Supreme Court rejects his argument that his legal counsel was ineffective.

IBM announces Q3 results: revenue down 1 percent, adjusted EPS $3.34 vs. $3.68, with its sexy product lines like Watson, cloud computing, and mobile computing failing to stop the bleeding. Revenue fell for the 14th straight quarter, missing analyst expectations and sending shares down sharply on Monday. Above is the five-year share price of IBM (blue, down 2 percent) vs. the Dow (red, up 55 percent).

MMRGlobal, a self-proclaimed personal health records vendor whose business focus instead is filing patent infringement lawsuits, will conduct a one-for-five reverse stock split in hoping to strike deals with health IT firms (presumably to buy vague, dormant patents to keep their suit-filing lawyers busy). Maybe they should have gone 1,000-to-one since the OTC market shares are trading at $0.0038, valuing the company at $3 million (the price is so low that the major markets just report it as zero). Both share price and revenue are down 70 percent in the past year and cash flow is negative. Bob Lorsch owns 46 million shares, which sounds like a lot until the calculator shows their value as $175,000.

The Right Place, which connects hospitals with nursing homes for patient placement, raises $2 million.

India-based Attune, which offers a hospital information system and medical device integration, raises $10 million in Series B funding from Qualcomm Ventures and Norwest Venture Partners.

Welltok acquires children’s health gamification platform Zamzee from HopeLab, a non-profit started by eBay founder Pierre Omidyar.

Payments and EDI vendor InMediata raises $4 million

Healthcare API vendor Redox raises $3.5 million.

Sales

West Georgia Health (GA) chooses Agilum Healthcare Intelligence.

Cooper University Health Care (NJ) selects eHealth Technologies for record aggregation and analytics.

Baptist Health Care (FL) chooses Allscripts products Sunrise, Sunrise Revenue Cycle Management, EPSi, FollowMyHealth, and dbMotion, beating out Cerner and Epic. Baptist was running McKesson Horizon for inpatient and NextGen for outpatient.

Hartford HealthCare (CT) will implement Glytec’s eGlycemic Management System in its five hospitals.

People

Cynthia Kilroy (Optum) joins Huron Consulting Group as managing director.

Announcements and Implementations

In England, a doctor on trial for killing a six-year-old boy by ordering a Code Blue team to stop trying to save him after confusing him with another patient who had a DNR order admits that she also missed abnormal blood test results that were read to her over the telephone during hospital computer system downtime.

New Zealand announces plans to implement a single national EHR over the next 3-5 years.

Johns Hopkins University School of Medicine and Microsoft will work together on technology that will collect ICU monitor data to highlight big-picture trends for a given patient. They will revise Project Emerge, a Hopkins ICU redesign project that integrates ICU monitoring data via a tablet app.

Aspen Valley Hospital (CO) will implement Epic with the help of University of Colorado Health. The announcement says the implementation will give UCHealth “expanded opportunities for clinical collaboration with the goal of keeping care close to home,” which sounds a lot like using Epic to lock in referrals.

Beaumont Hospital – Farmington Hills (MI) — the former Botsford Hospital — goes live with Epic. They previously ran McKesson Paragon.

Summit Healthcare announces that four hospitals have implemented its Scripting Toolkit – Wellspan Health, Halifax Health, Nathan Littauer Hospital, and Phoebe Putney Health System. Also announced were upcoming upgrades to the product.

Qpid Health announces GA of Qpid Groupers for Epic, a subscription service of clinical content uploaded via an Epic-provided import tool.

Privacy and Security

Apple removes several hundred apps from its App Store that were found to be using technology developed by a China-based advertising company that collects user information to push targeted ads.

Other

A New York healthcare staffing agency apologizes for running a nurse employment ad in the local Pennysaver that specified, “no Haitians.”

ZDoggMD has turned out some impressive music videos, but now he’s pimped himself out as an Athenahealth spokesperson and is making commercials rather than art. His new one incorrectly blames EHR vendors rather than regulators and bill-payers for the computer work he and his peers are required to perform as a condition of being well compensated, which is like complaining that TurboTax is terrible because it involves paying taxes. He also fails to mention that the employer of those providers (or they themselves) purchased those EHRs voluntarily. Given the functionality requirements of the typical hospital or practice, an innovatively designed new product would look quite a bit like the old ones, excessive clicks and all. We’re the only profession in which the highest-paid workers are expected to peck on computers all day – you would dump your attorney or accountant in a heartbeat if they wasted their expensive time typing while you’re talking. You may also correctly assume that the top-ranking executives of health systems and health IT vendors rarely sit at a keyboard despite their evangelism of the idea for everybody but themselves.

A KLAS interoperability study of minimally described methodology finds that Athenahealth’s EHR is easiest to connect to, followed by Cerner and Epic. That conclusion is pretty much negated by the admission by both vendors and providers that the technology isn’t the problem with lack of interoperability – it’s lack of agreement on standards and the willingness to actually share information.

More drug pricing nonsense and unintended consequences: Congress requires FDA to issue “priority review vouchers” as a reward to companies that develop a drug for underfunded diseases.The vouchers guarantee that FDA will review their next drug in six months instead of its usual 10 months. Drug companies are selling their FDA-issued vouchers on the secondary market, with AbbVie recently buying one from another drug company for $350 million just to cut the FDA’s bureaucratic review time by four months. You can bet that whatever drug they’re developing will be expensive if getting it on the market a few weeks earlier is worth that kind of money.

A study finds the obvious – large health systems are buying up physician practices and then jacking up their prices in using their consumer brand recognition clout to force insurance companies to pay more. What’s unknown is whether those notoriously inefficient health systems will fare better than they did in the 1990s, when they bought a lot of practices only to be shocked by the resulting drop-off in physician productivity.

Weird News Andy says, “I’m not dead yet … well …” in describing a man in India who wakes up as his autopsy begins, only to die later in the ICU.

Sponsor Updates

Direct Consulting Associates and HDS will exhibit at the Midwest 2015 Fall Technology Conference October 25-27 in Detroit.
Divurgent and Cerner Health Conference attendees raise $2,000 for Children’s Mercy Hospital (MO).
Caradigm posts an infographic on clinically integrated networks.
EClinicalWorks recaps its user conference in a series of posts.
Clinical Computer Systems posts an integration video for its Obix perinatal database system.
Extension Healthcare will exhibit at the 2015 CALNOC Conference October 26-27 in Long Beach, CA.
Healthwise will exhibit at the HealthTrio 2015 Users Group Conference October 26-28 in Tucson, AZ.
Aprima will exhibit at the AAP Experience National Conference & Exhibition October 24-27 in Washington, DC.
Aventura and Crossings Healthcare Solutions will exhibit at the 8th Annual Regional DV-NJ Chapters HIMSS Conference October 28-30 in Atlantic City, NJ.
Bernoulli releases a new case study featuring Hospital for Special Care, “Achieving Clinical Clarity from Ventilator Overload.”
Forward Health Group will sponsor the American Heart Association’s Heart Innovation Forum in Chicago on October 29.
CapsuleTech will exhibit at Anesthesiology 2015 October 24-28 in San Diego.
Impact Advisors publishes a white paper titled “Summary and Analysis of the MU Final Rule: Modifications in 2015-18 and Stage 3 Requirements.”
Caradigm and CoverMyMeds will exhibit at the Midwest 2015 Fall Technology Conference October 25-27 in Detroit.
CareTech Solutions launches a new video series, “Women in IT.”
CenterX CEO Joe Reinardy will speak at the 2015 Real-Time Benefit Verification & ePrior Authorization Forum October 22-23 in San Francisco.
CitiusTech will exhibit at IBM Insight 2015 October 25-29 in Las Vegas.
Craneware and its client Parkview Health (OH) will present “Enterprise Pharmacy and Supply Chain Revenue Integrity’ at HFMA’s MAP Event on October 26 in Fort Lauderdale, FL.

Blog Posts

Galen Healthcare Solutions is THE Best Place to Work (Galen Healthcare Solutions)
Orthopedics: Specialists Report Top Challenges (Greenway Health)
Post Go-Live Stabilization: 4 Challenges and Tips for Success (Hayes Management Consulting)
Complex, Inefficient Workflows are a Cyberattacker’s Best Friend (PatientSafe Solutions)
CMS updates to MU Stage 3 and 2015 reporting (AdvancedMD)
An Overview of California’s New Multi-Language Prescription Drug Labels Law (First Databank)
Navigating the Sea of Innovation: Targeting the Right Audience with the Right Tools (AirStrip)
23 Disturbing Statistics about Mobile Security (AirWatch)
Reducing Hospital Readmissions Through Medication Management (Besler Consulting)
How Advanced Micro-Segmentation Can Reduce the Risk of Data Breaches (Burwood Group)

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us or send news tips online.

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Monday Morning Update 10/19/15

October 18, 2015 News 3 Comments

Top News

What seems like fall out from the Wall Street Journal’s exposé continues: Theranos ceases its trademark practice of collecting blood samples from finger pricks after the FDA raised questions about its “nanotainer,” the blood-sample tube company founder Elizabeth Holmes is so often depicted holding. The agency is looking into whether the container needs approval as a medical device, and the company has, as a result, stopped using it for most tests while it waits for approval.

Last Week’s Most Interesting News

Dell will acquire EMC for $67 billion.
23andMe raises $115 million in Series E financing.
Verisk Analytics is rumored to have retained Morgan Stanley to sell its Verisk Health business in what should be a billion-dollar deal.
Accenture predicts that the five-year cost of cyber attacks on US healthcare system will be $305 billion.

Webinars

None in the next few days. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

Sentara Healthcare (VA) enters into an investment partnership with informatics vendor Medstreaming via the 12-hospital system and health plan’s Third Core investment group. Medstreaming will use the financing to ramp up its clinical data management system. Sentara Healthcare SVP Kenneth Krakaur and CFO Robert Broermann will join the Medstreaming board.

Announcements and Implementations

Geisinger Health System (PA) implements Cerner’s HealtheIntent population health management platform.

BluePrint Healthcare IT launches two mobile Care Navigator patient engagement packages for pediatric hospitals.

Billian’s HealthData expands its public data offering to include over 875,000 profiles of provider organizations.

Noble Health Alliance – a collaboration between Pennsylvania-based Aria Health System, Crozer-Keystone Health System, and the Einstein Healthcare Network – joins the HealthShare Exchange of Southeastern Pennsylvania HIE.

Urgent care software and services business Practice Velocity announces that all customer ICD-10 claims have been successfully processed.

Talksoft offers a mobile survey tool to benchmark patient experience and practice performance.

Security and Privacy

North Carolina’s Dept. of Health and Human Services notifies over 1,600 Medicaid patients of an August 19 security breach – an email sent without proper encryption – that may have exposed private health information. Thus far, there has been no sign of nefarious third-party interception.

An Alberta Privacy Commission spokesperson compares the province’s spate of EHR breaches to an “epidemic” after 48 employees at South Health Campus in Calgary inappropriately access a patient’s information. The incident, in which all of the staffers took a look at data on a mother taken into medical custody after the suspicious death of her daughter, follows numerous breach investigations including a conviction for improper access, two charges for the same crime, and the firing of an Alberta Children’s Hospital employee who inappropriately accessed the EHR to snoop into the PHI of nearly 250 people.

Technology

EClinicalWorks launches 10e, a cloud services platform incorporating EHR functionality with population health and patient engagement tools. In addition, the company offers all hospital system clients free interoperability of CDA data using a query-based exchange with Cerner, Epic, McKesson, Meditech, and Siemens.

Healow, an EClinicalWorks subsidiary, launches an IoT cloud, enabling third-party hardware and app developers to collect, store, and analyze patient-shared data through its API.

Other

SAP CEO Bill McDermott addresses the need for more mobile and personalized health data analytics at a company event in Palo Alto, emphasizing the lack of both during his treatment for loss of an eye as the result of an in-home accident:

“In every single meeting, you have to repeat the entire story all over again, because there’s no one electronic medical record that comes before you — or follows you — throughout a case. In my case, I had serious eye injury as probably the primary challenge. And when you work with somebody who’s the retina specialist and something goes wrong with the cornea, you don’t even realize it as a patient, but that’s a whole new medical professional now that has to come into the equation. And then, if something goes wrong with the iris, that’s another medical professional. And then we can go to the lens, so before you’re too far along the process now, you’ve met with five different teams on one eye. It’s not that it’s too many, it’s just that the choreography and the collaboration between individuals is just not there. The system is not organized that way. [I] do think that it’s time for a new architecture, a new approach to managing not just the structured, but also the unstructured information.”

Sponsor Updates

Experian Health will exhibit at HFMA Eastern Michigan October 19-20 in Plymouth.
Impact Advisors publishes a new white paper, “Summary and Analysis of the MU Final Rule: Modifications in 2015-17 and Stage 3 Requirements.”
PatientKeeper will exhibit at HFMA’s Revenue Cycle Conference/MAP Event October 25-27 in Fort Lauderdale, FL.
PDS celebrates the official reopening of its new corporate headquarters.
PerfectServe will exhibit at the Western Section AUA Annual Meeting October 25-29 in Indian Wells, CA.
Sagacious Consultants will exhibit at the Central & Southern Ohio Chapter of HIMSS 2015 Fall Conference October 23 in Dayton.
The SSI Group will exhibit at the 11^th Annual National Association of Healthcare Access Management October 19-20 in Mahwah, NJ.
Surescripts will exhibit at the Healthcare Innovation Expo 2015 October 22 in Washington, DC.
TeleTracking will exhibit at the Pennsylvania Organization of Nurse Leaders Conference October 21-22 in Gettysburg, PA.
Valence Health will exhibit at the AMGA Institute for Quality Leadership October 20-23 in National Harbor, MD.
Verisk Health staff participate in the second annual Verisk Community Service Week.
Kalispell Regional Health shares its ICD-10 success story using VitalWare’s VitalAuditor.
Huron Consulting Group will host Case Management: Navigating the Current Healthcare System Conference October 25-29 in New Orleans.
Wellsoft will exhibit at ACEP 15 October 26-28 in Boston.
XG Health Chair Glen Steele, MD will speak at the 6^th Annual Galien Forum October 27 in New York City.

Blog Posts

Top 10 Hospitals Where Patients Prosper (Billian’s HealthData)
Designing Clinical Communications – Part 1 (PatientSafe Solutions)
After ICD-10: Plotting Your Department’s Next Big Win (Patientco)
At This Pivotal Moment in Healthcare (Lexmark)
Better Communications Between Physicians and Healthcare Organizations can Improve Outcomes (Phynd Technologies)
The Worm in the Apple (PMD)
“It Turned us Into Data Entry Clerks!” (Qpid Health)
Using Non-Clinical Data Can Increase Impact of Analytics (Streamline Health)
Cerner Domain Compare: Summit Team Brings InSync Awareness to Kansas City (Summit Healthcare)
Sunquest Value of the Month: Flawless Execution (Sunquest Information Systems)
RTLS – The ‘Chocolate’ that Energizes Your EMR (Versus)
Introducing Voalte Platform! (Voalte)
Traditional Healthcare BPO Sourcing Will be Tested as Never Before (Xerox)

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us or send news tips online.

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News 10/16/15

October 15, 2015 News 16 Comments

Top News

Personal genome testing vendor 23andMe raises a $115 million Series E on a $1.1 billion valuation. The company nearly shut down in 2013 after the FDA shut down its direct-to-consumer sales and marketing efforts, but has pivoted and now generates its revenue supporting drug discovery. Lt. Dan takes a closer look on HIStalk Connect.

HIStalk Announcements and Requests

This week on HIStalk Connect: Philips partners with Amazon to bring HIPAA-compliant IoT connectivity to its population health platform. Microsoft co-founder Paul Allen invests $500 million in artificial intelligence research. Berlin-based reproductive health app Clue raises a $7 million Series A to grow its user base and expand functionality within its app.

This week on HIStalk Practice: MGMA15 updates from Sunday, Monday, and Tuesday. AdvancedMD launches new interoperability and benchmarking tools. AMA’s new Telehealth Services Group convenes to discuss expanding CPT codes. Heart and Vascular Center of Lake County goes with Allscripts for chronic-care management. AAFP takes ONC to task for its weak interoperability roadmap. Primary care and mental health clinicians discover integrating data can be painful.

Webinars

None in the next few days. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

Glytec’s patent for its mobile diabetes management app, which offers patients real-time insulin-dosing guidance, receives approval from the US Patent and Trademark Office .

DrFirst firms up $25 million in equity financing from Goldman Sachs, bringing its total financing over the last year to $42 million. The company announced last week the integration of its medication management software and secure communications with the Rx30 Pharmacy Management System.

Sunnyvale, CA-based Health Gorilla secures a $2.4 million Series A led by Data Collective. The company has also expanded its diagnostic test automation platform to include electronic ordering and secure messaging.

Theranos fires back after the Wall Street Journal publishes an exposé-like piece by Pulitzer prize-winning investigative journalist John Carreyrou highlighting the fact that company uses its proprietary testing equipment on only 15 of the 200-plus tests it performs, and that many of those tests require large samples rather than the “few drops of blood” the company claims. Theranos asserts that, “Stories like this come along when you threaten to change things, seeded by entrenched interests that will do anything to prevent change, but in the end nothing will deter us from making our tests the best and of the highest integrity for the people we serve, and continuing to fight for transformative change in health care.”

Sales

Seattle Children’s Hospital signs a three-year contract with Wellcentive to implement its population health management and value-based care solutions. The hospital will use the tools within its Seattle Children’s Care Network and Pediatric Partners in Care program.

Steward Health Care System (MA) moves forward with Meditech 6.1. Implementation across its nine hospitals is slated to begin next month, with a go-live date set for 2017.

Technology

Philips partners with Nuance to offer Nuance PowerScribe 360 users the ability to import radiology dosimetry data from its DoseWise Portal.

Medhost implements ExtraHop’s wire data analytics platform to gain insight into how providers use and experience its software. It’s also signed up for the Seattle-based company’s HL7 analytics to improve the troubleshooting process when HL7 interface problems crop up.

People

Validic Chief Marketing Officer Chris Edwards wins the CMO Growth Award from The CMO Club.

Pam Stampen (American Family Insurance) joins Nordic as vice president of human resources.

Eric Topol, MD (Scripps) joins the MyoKardio Board of Directors, and becomes chair of its science and technology committee.

Hackensack University Medical Center (NJ) Vice President and CIO Shafiq Rab, MD receives CHIME’s 2015 Innovator of the Year award.

Miles Snowden, MD (TeamHealth) and Linde Wilson (L.E.K. Consulting) join the Oxehealth advisory board.

Announcements and Implementations

LBJ Tropical Medical Center and 17 outpatient clinics in American Samoa go live on Medsphere’s OpenVista EHR. Four more clinics will roll out the technology in the coming months. Providers in the unincorporated US territory are eligible for Meaningful Use, and are in the process of qualifying for Stage 1.

Hospice Buffalo (NY) implements e-prescribing technology and services from Delta Care Rx.

Baystate Health selects Kyruus ProviderMatch software to streamline and standardize referral processes across its integrated network in Springfield, MA.

Holy Family Memorial (WI) rolls out telemedicine services via the Zipnosis platform. The vendor inked a deal with Michigan-based multispecialty provider group IHA earlier this month.

Mayo Clinic (MN) implements the Viewics Health Insighter analytics platform across several divisions within its Dept. of Laboratory Medicine and Pathology, including Mayo Medical Laboratories.

Government and Politics

The VA and Indian Health Service receive accreditation from EHNAC and DirectTrust, making them the first federal agencies to gain interoperability via the Direct exchange network.

Privacy and Security

Accenture reports that cyberattacks over the next five years will cost US health systems $305 billion in lifetime revenue. Adding insult to injury is the company’s estimate that one in 13 patients will have personal data stolen from technology systems within that same timeframe, leading 6 million people to become victims of medical identity theft.

Innovation and Research

University of Wisconsin-Whitewater researchers determine that Hawaii, Wisconsin, and Iowa have the most efficient healthcare systems based on a five-year look at patient satisfaction scores and access trends, as well as financial and human resource data. The study, sponsored by the Wisconsin Hospital Association, was designed to give employers more insight into employee healthcare ROI across the country.

Other

The Georgia Partnership for Telehealth collaborates with Appling HealthCare System (GA) and WellCare Health Plans to open two new telemedicine-equipped health centers at schools in Appling County.

Epic’s “triple harvest” solar installation in Verona ranks as one of the largest in the area, with two arrays totaling 2.2 megawatts. The company grows alfalfa underneath its largest array, and has installed a network of 2,500 ground-source heat pumps under the alfalfa to heat and cool the campus. It’s somewhat ironic to compare the company’s attempts to go green with the impact its employment boom is taking on Madison’s public transportation system. Ridership on the city’s two routes to the Verona campus has increased by more than 25 percent annually since 2012. The company kicked in $26,000 to help run an extra route starting last month.

Sponsor Updates

Intelligent Medical Objects and Navicure will exhibit at the EClinicalWorks 2015 National Conference October 16-19 in Nashville.
Leidos Health and Obix will exhibit at the Georgia HIMSS annual conference and tradeshow October 23 in Atlanta.
Liaison Technologies covers 100 percent of health insurance premiums for its US-based employees and their dependents.
LifeImage highlights the latest in image-sharing solutions at the 2015 Cerner health conference this week.
Medecision Senior Clinical Content Specialist Lois Morris shares her most memorable case manager story.
Netsmart will exhibit at the Providers Council Conference October 19 in Boston.
Xerox will exhibit at the Midwest Fall Technology Conference October 25-26 in Detroit.

Blog Posts

Horcruxes in Healthcare: Who Owns Your Medical Identity? (ID Experts)
Endless Health IT Capabilities (Impact Advisors)
Unless We Care a Whole Awful Lot (MedData)
Epic MyChart patient engagement strategies: Buy-in, special challenges and Meaningful Use (Nordic)

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us or send news tips online.

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News 10/14/15

October 13, 2015 News 6 Comments

Top News

Verisk Analytics is rumored to have retained Morgan Stanley to sell its Verisk Health business in what should be a billion-dollar deal.

Reader Comments

From Laura: “Re: EHRs. Thanks for highlighting that the problems with EHRs aren’t (just) design and usability. They also relate to the major new spate of inane and arcane, bureaucratic, insane regs and new rules that keep HIT tools from being efficient (or even sufficient). If we could cut loose all of Meaningful Use and all E&M codes, we could open new modes of treatment and care and improve everywhere.” Laura is an informatics-certified physician and professor. I suggest this exercise for those who blame their EHR for excessive clicks and documentation collection. Make a list of every piece of information the EHR requires to inboard and treat a new patient, then map it back to who demands or uses that data element. I’m pretty sure EHR vendors aren’t just adding required fields for their personal enjoyment – the provider has agreed to collect that information for some approved purpose, internal or external, most likely as a condition of getting paid. Usability factors aren’t all that important when your users, by the nature of their jobs, are required several times each day to enter the same 200 codified data elements on the the same screen for each new patient. Clinical employees of EHR vendors dream of a fantasy world in which their products are designed strictly for doctors, nurses, and patients. In the mean time, blaming the vendor for operationalizing the sad current state of healthcare is like blaming fast food restaurants for obesity – those who created the market demand refuse to accept responsibility and instead complain about those they pay to supply their needs.

HIStalk Announcements and Requests

Jenn is filing daily reports from the MGMA conference in Nashville. Want to know how ICD-10 turned out for practices or what’s being discussed in the exhibit hall? Check out her recaps from Sunday and Monday.

Ms. Byrd-Johnson sent photos of her Alabama class using the 10 Android tablets we purchased via the DonorsChoose project. The school district implemented a “bring your own device” policy and we bought the tablets for students who don’t have a device to bring. Also checking in was Mrs. Clark from Tennessee, whose students used the STEM kit we provided to study engineering design and then collaborate to design, discuss, and improve their projects.

Good or bad, the conference season is back. People are endlessly live-tweeting quotes from anyone with a PowerPoint behind them. I don’t get anything (except annoyed) from reading out-of-context, 140-character quotes pulled randomly by tweet-seekers compensated either by ego strokes or paychecks. I’ll be interested to see how conferences handle Periscope and other live video apps whose tech-obsessed users stream low-quality video from presentations and exhibit halls.

I’m also always reminded at this time of year at just how some healthcare people seem to spend every free minute attending conferences at the expense of their employers (and thus patients), reminding me of undergraduates who embrace the undemanding college life so much that they just hang around taking classes forever courtesy of their indulgent parents. I’m also amused that attendees flock to conferences devoted to mobile and tele-anything services, apparently not appreciating the irony of traveling great distances to physically watch someone talking about the huge benefits driven by online collaboration.

Welcome to new HIStalk Platinum Sponsor Clinical Computer Systems, which offers the Obix perinatal data system. The employee-owned, Elgin, IL-based company, which was founded in 1997, has been a labor and delivery technology leader, earning 10 consecutive KLAS rankings. It’s a CommonWell member, a member of the Allscripts developer program, and an Epic collaborator. Obix offers charting modules for intrapartum, recovery, post-partum, strip annotations, care plans, newborn, SCN, and remote provider access. It provides clinical decision support for fetal heart rate assessment and monitoring with automatic charting into the intrapartum charting module. Obix is certified as an EHR module and its products are approved as medical devices by the FDA. Thanks to Clinical Computer Systems for supporting HIStalk.

I found this Obix overview video on YouTube.

Webinars

None in the next few days. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

IT solutions provider UST Global makes a $5 million stock investment in Sandlot Solutions.

I mentioned this weekend that Dell was rumored to be acquiring EMC. The deal was announced Monday, with Dell paying $67 billion for the storage vendor, a 28 percent premium to the share price before word of the acquisition leaked out. Dell will take on another $50 billion in debt and use its VMware equity to finance the deal as it anxiously tries to find something to sell other than low-demand commodity PCs. EMC is lucky that someone with access to capital also is in a business that makes enterprise storage look sexy.

Xerox announces that it has decided not to complete implementation of its overdue Health Enterprise Medicaid processing systems in California and Montana and will write off $385 million in settlement costs in Q3.

Sales

In the UK, University Hospital of South Manchester NHS Foundation Trust chooses Allscripts Sunrise.

People

XG Health Solutions names Mike Bertrand (HealthWyse) as SVP of EHR application development.

ZeOmega hires Chris Brown (Cardinal Health Specialty Solutions) as SVP of sales and marketing.

University of Vermont Health Network promotes CMIO and interim CIO Adam Buckley, MD to the permanent CIO position.

Divurgent promotes Paul Anderson to VP of advisory services.

Announcements and Implementations

Two hospitals of Centegra (IL) go live on T-System’s EV EDIS, with Centegra-McHenry’s LWBS (left without being seen) count dropping to zero on go-live day.

AdvancedMD announces new benchmarking and interoperability solutions at MGMA, where the company is also highlighting its patient engagement and iOS-powered point-of-care solution.

Voalte announces Voalte Platform, which includes collaboration, management, analytics, and integration solutions.

Technology

British Health Secretary Jeremy Hunt says that computers rather than physicians will diagnose medical conditions within 20 years, adding, “You can get 300,000 biomarkers from a single drop of blood, so why would you depend on a human brain to calculate what that means when a computer can do it for you? I think it’s really important that we’re ready in the NHS to harness the power of data to give us more accurate diagnoses, in particular with that example.”

Other

A study finds minimal improvement from the Choosing Wisely program that addresses unnecessary tests and procedures. The authors conclude that the program needs a wider rollout.

Farzad Mostashari, MD tweeted out this photo of a page from Saving Gotham, a just-released book by former NYC Health Commissioner Tom Farley, MD, MPH that describes the public health efforts by former Mayor Michael Bloomberg and former NYHHC Commissioner Tom Frieden, MD, MPH (now CDC director). It sounds like a great read as the rest of the country starts catching on that there’s no such thing as health without public health no matter what intervention-obsessed hospitals and doctors would have you believe.

Peer60’s new standalone ambulatory facility EHR report (not ambulatory EHRs in general as other sites misinterpreted) finds that Epic and Cerner are tied for mind share leadership, with Epic holding a big market share lead. Meditech and Allscripts have decent market share in hospital-owned facilities, but zero mind share, meaning their customers are at risk for defecting. NextGen is also at risk since it has the highest market share among independently owned facilities, but also zero mind share in which Cerner, Epic, and eClinicalWorks dominate. Respondents said vendors should make their product easier to use, improve reporting, and improve practice management capabilities, although 32 percent say it won’t matter since the hospital dictates the EHR used.

The Kansas City paper covers Neal Patterson’s address at the Cerner Health Conference. He called on Epic to join CommonWell’s “open architecture” and announced that Epic-using Geisinger Health System will implement Cerner’s HealtheIntent population health management system. Karen DeSalvo looks like she’s passing Neal a happy stuffed bear in the photo.

Texting-obsessed teens are like compulsive gamblers who can’t stop even as they miss sleep, lose their attention spans, and lie about the time they spend texting, a new study finds. It recommends that parents set screen-free times, which doesn’t give me a lot of hope since many adults are just as phone-zombified as their kids. One opiate of the masses was probably enough.

Weird News Andy finds this story “selfieish,” in which selfie-obsessed millennials, convinced that they are celebrities basking in the exhilarating glow of their own limelight, are flocking to “the shallow end of the value pool” in trying to look better and market themselves more effectively by having plastic surgery.

Sponsor Updates

AirStrip will exhibit at the HMA CEO Forum October 14-18 in Deer Valley, Utah.
Aprima will exhibit at the Oklahoma Primary Care Association event October 14-16 in Oklahoma City.
Wellsoft will exhibit at ACEP15 in Boston October 26-28.
Hospital Sisters Health System writes about their reduction in medication alert fatigue using First Databank’s AlertSpace in Patient Safety & Quality Healthcare.
Cardiopulmonary Corp. (Bernoulli) will host a focus group session October 16 during the CHIME15 Fall CIO Forum October 14-17 in Orlando.
Bottomline Technologies will exhibit at Health Informatics New Zealand October 19-22 in South Island.
PatientKeeper will exhibit at Becker’s ASC 22nd Annual Meeting in Chicago October 22-23 and will sponsor HFMA’s Revenue Cycle Conference in Fort Lauderdale October 25-27.
CapsuleTech will exhibit at Salon Infirmier October 14-16 in Paris.
HealthLoop Chairman Jordan Shlain, MD will present at London Business School’s Driving Innovation in Healthcare Delivery on October 20.
Culbert Healthcare Solutions will partner with ConnexaHealth for consulting.
Verisk Health and ZeOmega will exhibit at AHIP’s National Conference on Medicare and Medicaid & Dual Eligibles Summit October 18-22 in Washington, DC.
Huron Consulting hosts a Coverage Analysis & Billing Compliance Workshop October 16 in Washington, DC.
EClinicalWorks will exhibit at The National Conference on Correctional Healthcare October 17-21 in Dallas.
Fujifilm Medical Systems will exhibit at the Annual Scientific Meeting of the ACG October 16-21 in Honolulu.

Blog Posts

Aventura and Brian Madden Talk Virtualization in Healthcare (Aventura)
Preserving Appeal Rights on Your Cost Report (Besler Consulting)
How New Technologies are Expanding Care (Billian’s HealthData)
Designing Clinical Communications – Part 1 (PatientSafe Solutions)
Big Data? How About Right-Sized Data? (Forward Health Group)
Four Steps to Make Population Health Analytics Actionable (Caradigm)
#IHeartHIT – Proactive Continuity of Care with ChartMaxx (ChartMaxx)
Leading with Passion: There’s No Button for That (T-System)
A Growing Trend: Centralized Referral Management (TeleTracking)
7 Facts About Cyber Security and Phishing (TransUnion)
How can UltraLinq Help with Mobile Imaging? (UltraLinq)
Strategic Thinking. (Voalte)
Opioid Addiction: A Prescription for Disaster (Xerox)
Predictive modeling and the elusive 1-2 percent (ZirMed)
HIT Hiring Managers Want 70% Technical and 30% Traits (Direct Consulting Associates)
Final Ruling is in … Meaningful Use 3 is Upon Us (Divurgent)
Why I Love Health IT (Extension Healthcare)
Final Meaningful Use ruling has arrived! What stays and what goes? (Galen Healthcare Solutions)
ICD-10 Applying Lessons from Implementation (Greenway Health)
A Shift to Service Lines in Hospital Service Delivery (Hayes Management Consulting)
McKesson Horizon: Why Way Now? Part 3 (The HCI Group)
How Will the Final Rules for Meaningful Use Impact You? (HDS)
6 Steps to Building Your Own Plain-Language Glossary (Healthwise)

The following HIStalk sponsors are exhibiting at the Cerner Health Conference October 11-14 in Kansas City, MO:

Access
AirWatch
CoverMyMeds
Crossings Healthcare Solutions
Divurgent
Elsevier
Experian Health/Passport
Fujitsu
Zynx Health
GE Healthcare
Healthwise
Imprivata
Intelligent Medical Objects
Leidos Health
Lexmark Healthcare
LifeImage
MedCPU
Merge Healthcare
Nuance
Summit Healthcare
Surescripts
The SSI Group
Versus Technology
VMware
Wolters Kluwer

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us or send news tips online.

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Morning Headlines 10/12/15

October 11, 2015 News Comments Off

Philips strengthens collaboration with Amazon Web Services to expand digital health solutions in the cloud

Philips announces that it will integrate its HealthSuite platform with Amazon Web Services’ new Internet of Things platform, allowing it to wirelessly and securely exchange data with a variety of medical devices and sensors.

Dell to use VMware to help pay for EMC deal: sources

Dell will acquire EMC Corp for $55 billion in cash and stock options, according to anonymous insiders. An announcement is expected as early as this week.

Time To Implement IOM Health IT Recommendations For Improving Diagnosis

Hardeep Singh, MD, MPH, and Dean Sittig, PhD and professor of biomedical informatics at the University of Texas, publish a Health Affairs post outlining recommended changes that could help EHRs better support diagnosis.

Fitch Rates Banner Health Series 2015A Rev Bonds ‘AA-‘; Outlook Stable

Fitch affirms Banner Health’s AA- bond rating after its $733 million acquisition of University of Arizona Health Network, concluding that integrating UAHN into Banner is already ahead of schedule and under budget, and noting that UAHN will be joining a health system with 21 HIMSS stage 7 facilities, plans of migrating to a value-based reimbursement model, and a solid financial profile.

Monday Morning Update 10/12/15

October 9, 2015 News 3 Comments

Top News

Philips will use the just-announced Amazon Web Services Internet of Things connectivity platform to expand its AWS-powered HealthSuite digital platform in connecting to devices and sensors.

Reader Comments

From Bum Steer: “Re: inpatient EHR vendors. Do you really want a market with only a handful of choices, or even worse, just Epic?” The market itself does that voting with its dollars, not me with my keyboard. The fact that the only vendors with significant market share are Cerner, Epic, and Meditech reflects the fact that they offer customers the broad, integrated, proven systems they want. Other companies fell by the wayside for a variety of reasons: lack of anticipation of the need for a single patient record, corporate bumbling, focusing on the small-hospital market as bigger companies moved down into their customer base, and stubbornly following a best-of-breed product strategy despite ample evidence that it was no longer valid. The next big test, the one where Cerner holds the clear lead, is turnkey systems hosting that frees hospitals from spending capital on hardware and hiring hard-to-find experts willing to relocate. One might hope for new entrants that will challenge the status quo in terms of innovation and value, but imagine the time and money required to design, develop, test, and roll out a full healthcare IT system with zero income until it’s done and then trying to sell it to risk-averse hospitals that have already invested millions in one of the Big Three’s products. The only real question is whether Meditech can challenge Cerner and Epic, who are moving into its market as big health systems offer hosted systems to smaller hospitals or acquire them outright. The health system EHR war has been won and smart companies will focus on how to work with rather than against the victors.

HIStalk Announcements and Requests

It’s a 60-40 poll respondent split on whether consumers should be allowed to order their own lab tests. All Hat No Cattle worries that the general population won’t understand the significant number of false positive results, while Don thinks it’s OK that people will test themselves as an adjunct to medical services or between visits. Bar Code says lab people need to reform reference ranges since many labs simply flag the top and bottom 2.5 percent of the population as abnormal without having any evidence-based cutoff. Mak votes a resounding yes from the personal experience of being denied coverage of certain tests by insurance but confirming his/her suspected diagnosis after paying for the test directly to discover a treatable genetic condition that could affect children and grandchildren as well. DZAMD says with tongue in cheek that while preventing people from practicing medicine without a license is a patronizing vestigial concept, it’s legal to represent oneself in court without a lawyer, to which he says, “expect a similar result.” New poll to your right or here: what is your level of personal interest in the revised Meaningful Use requirements?

Mrs. Beasley from Georgia says her elementary class is intrigued by the Makey Makey kits we provided via DonorsChoose. She will add them to the school-wide “Hour of Code” programming activities that start in December.

Mrs. Eaton, a speech-language pathologist, says she has never received financial assistance to purchase materials for the 50 special education students she serves in her high-poverty, budget-strapped Georgia school, adding that they “were able to begin this school year with great enthusiasm and thankfulness when they saw our recently purchased essentials.”

Last Week’s Most Interesting News

Cerner announces that its SMART on FHIR API is ready for client testing.
CMS releases the pre-publication version of its modified Meaningful Use Stage 2 and Stage rules, with the Stage 3 dates unchanged.
ONC publishes its Interoperability Roadmap.
The US Coast Guard declines to renew its contract with Epic.
Two HELP Committee senators introduce a bill that would require ONC to publish an EHR star rating, fine vendors or providers up to $10,000 for information blocking, and reimburse providers for replacing their EHRs that have been decertified.
John Halamka reports that all the major EHR vendor CEOs have agreed to commissioning an independent third party to publish objective measures of interoperability.
Mercy Health opens a $54 million virtual care center.

Webinars

None in the next few days. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

In a fascinating example of how virtual companies can succeed while using contractors instead of employees, a one-employee, home-based biotechnology research company is acquired by drug manufacturer Roche in a deal worth up to $580 million.

Dell will acquire EMC in a deal that values the storage vendor at $55 billion and will use some of EMC’s majority ownership position in VMware to finance the deal.

Sales

University of Texas MD Anderson Cancer Center engages Santa Rosa Consulting to support its scheduling appointment conversion to Epic early next year.

People

Accreon hires Kimberly Post, CPA (Beacon Partners) as CFO.

Announcements and Implementations

Retail pharmacy software vendor Rx30 will incorporate DrFirst’s secure texting, event notifications, content distribution, and care team collaboration functionality into its software.

Government and Politics

ONC posted the PowerPoint used in its Webinar last week covering the Health IT Certification 2015 Edition Final Rule.

Privacy and Security

Finally a stolen, PHI-containing laptop turns out to have been encrypted. A Humana employee’s vehicle is broken into in Wisconsin and a laptop and paper records for 2,800 Medicare Advantage members were stolen. The 2,500 laptop records should be fine since it was encrypted, but the 250 paper records are obviously freely readable. I was amused by the Milwaukee paper’s coverage, which in describing that the files contained name, date of birth, and clinic name, stated, “… a Humana spokesman would not explain what the term ‘clinic name’ meant.”

Innovation and Research

Microsoft co-founder Paul Allen launches a $500 million project to build an artificial brain that can pass a high school science test.

A study finds that asking a cancer patient’s oncologist “would you be surprised if this patient died within the next year” was more accurate at predicting mortality than other screening methods. It would be interesting to repeat the study but asking the patients themselves that same question.

Other

Blue Cross Blue Shield of Illinois eliminates its most popular medical insurance plan three weeks before the November 1 open enrollment begins, saying medical costs were so high the PPO plan’s price would have been unaffordable. It will automatically switch members to a plan that’s similar but includes only 78 hospitals rather than all 209 Illinois hospitals.

HIMSS is apparently justifying the celebrity-pandering choice of Peyton Manning as a conference keynote presenter because he has something to do with NFL player safety, which I’m sure will resonate with a bunch of hospital IT people.

A Castlight Health study finds, to the surprise of no one, that prices for a given procedure vary wildly even within the same city, with an example being a cholesterol test that is priced from $14 to $1,070 in New York City. I assume it reviewed claims information that reflects prices negotiated by individual payers, which might differ a lot from what a cash-paying, high-deductible insurance patient would find. I still don’t understand why providers shouldn’t be required to offer their lowest prices to everybody.

Bob Wachter tweeted a link to this video of Rachel Pearline, a UCSF hematology-oncology fellow, saying goodbye as she dies of cancer.

Dean Sittig, PhD and Hardeep Singh, MD, MPH pen a Health Affairs Blog post that describes how EHRs could improve diagnosis, as called out by the IOM’s recent report. Their suggestions:

EHRs should provide better support for teamwork and communication.
ONC’s EHR certification criteria should review usability, clinical workflow, clinical decision support, and timely information flow.
EHR screens should be shared among all users, not with separate versions for physicians and nurses as was the case in the Texas Health Resources Ebola patient incident.
EHR vendors should share their documentation templates for emergent situations such as the Ebola case, encouraging users to exchange screen shots and best practices.
The Ebola patient luckily returned to the same THR ED, allowing them to finally recognize his diagnosis, but the authors point out that he could well have gone to a non-THR ED, where lack of interoperability would probably have left his new caregivers working blind.
Congress should fund ONC’s proposed Health IT Safety Collaboratory to discover safety concerns and disseminate best practices.

A Commonwealth Fund study funds that the US spends the most by far among 13 high-income countries — mostly because of expensive technology and high prices – but delivers poor outcomes that include shorter life expectancy and more prevalent chronic conditions. The US also spends a smaller percentage of its economy on social services.

Fitch Ratings likes the $733 million takeover of University of Arizona Health Network by Banner Health, pointing out that Banner has made consistent IT investments that led it to achieve HIMSS EMRAM Stage 7 using Cerner.

Only in Silicon Valley: a self-driving Google car yielding for a pedestrian in a crosswalk is rear-ended by a Tesla.

Weird News Andy summarizes this story as “Hospital cafeteria food … meh.” An 800-pound-man who starred in a series of YouTube videos making fun of his weight is kicked out of a hospital weight loss program for having pizza delivered to his bed. He had hoped to lose 250 pounds so he could get gastric bypass surgery. WNA adds that even without this new quick and easy heart attack detection test, he can predict that the pizza man is at risk.

Sponsor Updates

Experian Health and SSI Solutions will exhibit at AAHAM ANI October 14-16 in Orlando.
PatientSafe Solutions will exhibit at the CHIME15 Fall CIO Forum October 14-17 in Orlando.
The Wall Street Journal features PerfectServe’s latest round of funding in its Venture Capital Dispatch.
PeriGen co-founders Emily Hamilton and Matthew Sappern are featured in the One by One Million blog.
Influence Health will sponsor, exhibit, and present at the AHA’s Society for Healthcare Strategy & Market Development Conference in Washington, DC next week.

Blog Posts

Beyond Best Practices – Accelerate the Hospital’s Revenue Cycle thru Business Process Automation (Recondo Technology)
The Big Day is Finally Here (PatientKeeper)
Vendor Neutral Archive liberates Piedmont Healthcare’s “island of misfit images” (Lexmark)
A Picture is Worth a Thousand Words (Lexmark)
Medicare Creates Experimental Pilot Incentive Program to Boost Medication Adherence (Point-of-Care Partners)
National Health IT Week: Revenue Cycle Supports Mission of Care (Sagacious Consultants)
SMART Label Tip (Sunquest Information Systems)
10 Years of Interoperability in Action: A Historical Look at E-Prescribing (Surescripts)

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us or send news tips online.

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News 10/9/15

October 8, 2015 News 3 Comments

Top News

Cerner opens client testing of its SMART on FHIR standard that has been released to Millennium production. Demonstrating their SMART on FHIR solutions at CHC next week are VisualDX, xG Health, and Boston Children’s Hospital. The company is also calling for interested developers to become part of its ecosystem. This is what the market says it wants – an EHR vendor (one of only three big inpatient ones) that opens its system to third parties to give more choices to its users. It’s a pretty big deal if you ask me.

Reader Comments

From Light Brigade: “Re: Meaningful Use. Do I detect little interest in the new regulations?” You certainly do from me. The Meaningful Use program, not unexpectedly, has turned into just another government program administered by its own well-intentioned but self-preserving bureaucracy. It has wasted an immense amount of industry energy and taxpayer billions with questionable results. We would have been much better off, as I said when it was first announced as a stimulus program, letting the free market dictate the health IT market rather than bribing providers to either use products they already owned a bit differently or to buy EHRs that weren’t selling without Uncle Sam’s subsidy. I just don’t care any more. The government already sets our healthcare agenda as the largest healthcare payer and provider, getting providers to sell out to keep the Medicare and Medicaid payments flowing while complaining constantly, and MU has turned into one more carrot-then-stick distraction and providers unwittingly made possible by taking those early stimulus checks. The government should be involved in setting standards, but not dictating the terms of provider-patient relationships or mandating technology use. I’m not sure all that money and energy made much of a positive difference for patients whose concerns are more about the cost and availability of insurance and care delivery rather than what’s running on the computer in the exam room. We should be talking about how to fix our screwed up healthcare system rather than how to automate the existing mess using old IT systems that chase old incentives.

From Comfortably Numb: “Re: clicks. A nurse told the Health IT Standards Committee recently that it took her more than 500 clicks to admit a patient. That tells you all you need to know about EHR usability.” Actually, that tells you all you need to know about the US administrative requirements for delivering care and accepting insurance company payments. The number of clicks is a reflection rather than a cause of that complexity. Everybody loves shooting the EHR messenger (Epic in this case) instead of the endless requirements by cheap-seaters for clinicians to capture irrelevant, non-medically contributory patient information.

HIStalk Announcements and Requests

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I’ve been playing around with some of the health insurance sites like Healthcare.gov and Stride Health (which seems to be loaded with technical problems related to removing/adding prescription drugs from the user’s profile) under various scenarios. It’s interesting to me that despite their high cost, most of the medical insurance plans those sites suggest don’t kick in at all until the member has paid a $6,000 deductible – the member pays the entire cost of visits, prescriptions, etc. before the plan starts paying 100 percent. The high cost of hospitalization and prescription drugs means that a lot of people will then incur the full $6,000 cost plus the annual premium of around $3,000. I’m not sure all that many Americans have an extra $9,000 lying around. It also strikes me that it’s a leap of faith anyway since you can’t see the fine print when signing up, like which providers are in the network, which ones are accepting new patients, and the cost of any specialty drugs that are covered minimally if at all. It seems to me this means:

People may not bother to buy insurance since it only covers unpredictable catastrophic expenses.
Even people who buy insurance may not be able to pay their high deductibles.
Both of these scenarios, plus higher medical and insurance costs, may make it just as hard for providers to get paid as pre-ACA.
Patients with more financial skin in the game will have incentive to shop around and ask more pointed financial questions of providers.
The ridiculous out-of-network scam is getting worse. ED and hospitalized patients can ask everyone in sight whether they’re in-network providers and still be stuck with huge bill from a provider they didn’t choose. This continues to create hospital trust issues. Imagine if you took your car in for a $30 oil change and later received bills for hundreds of dollars from mechanics the oil change place called in without your knowledge.

Ms. Palmer says her Mississippi third grade students are enjoying the classroom library of 90 books we provided via a DonorsChoose grant, to the point that several students read more than 20 of the new books in the first two months after receiving them.

Listening: new hard rock from Brooklyn’s Highly Suspect, who sounds like Queens of the Stone Age at times. Also: new from Moon Taxi, a polished indie-progressive band from Nashville that’s quickly becoming one of my favorites. They’re on tour playing mostly small venues like the Orange Peel in Asheville and the Majestic Theater in Madison.

I say goodbye and thanks to TriZetto, an HIStalk and HIStalk Practice sponsor since 2011 who, now that they’ve been acquired by Cognizant, demanded brusquely that we cancel their months-overdue sponsorship in asserting that “nobody here has ever heard of HIStalk” (apparently not including the several dozen of its employees are on the email list and whoever manages their Twitter account since they follow me). They were great supporters as Gateway EDI, so-so ones as TriZetto, and non-existent ones as Cognizant. I should offer their spot to competitors like Infosys, Wipro, Tata, and Accenture who might have someone who is familiar with what I do.

This week on HIStalk Practice: Premier dives deeper into ambulatory market with InFlow Health acquisition. Doctors Administrative Solutions buys Spectra Healthcare. Dr. Gregg explains his fondness for ICD-10. Primary care performance metrics are in need of a strategic overhaul. Pulse System acquires Nightingale’s US-based PM business. Brad Boyd offers strategies to mitigate risk during physician practice onboarding. Physician love/hate relationships with technology get even murkier. Flight surgeon and family practice physician gets to the heart of practicing medicine in a time of heightened healthcare IT policy-making. The HIStalk Exhibitor Guide for MGMA 15 goes live.

This week on HIStalk Connect: Startup Health and Rock Health publish digital health funding reports confirming that the industry is maintaining pace with 2014’s investment levels. Mayo Clinic announces the winners of the Think Big Challenge, a developer contest soliciting disease management and general wellness solutions. Dātu Health raises a $10 million Series B invested by St. Joseph Health, an early investor and user of Dātu’s patient engagement platform. Advances in rapid genome sequencing show promise in the NICU.

Webinars

None in the next few days. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

Allscripts promotes CFO Rick Poulton to president and extends CEO Paul Black’s employment agreement for another three years through December 2018. The company has opened a search for a new CFO. Poulton’s pre-Allscripts experience was in the airline industry.

CareSync secures $18 million in series B funding, announcing that its user base has expanded 20-fold in the past four months. The company will hire 500 more employees in the next 18 months. I have to say I never saw that coming – it looked like a great service destined to be lost in a sea of mostly failing competitors who tainted the entire market with their lack of success and focus.

The SSI Group reports that sales for the first three quarters of 2015 exceed its 2014 numbers by 48 percent.

In England, Musgrove Park Hospital goes live on an EHR created as a customized version of open source IMS OpenMaxims software.

UK-based Cambridge Cognition, which offers a dementia detection app, licenses additional tests and a behavioral treatment app that trains people with aggressive behavior on how to better recognize facial cues.

Post-acute EHR vendor Netsmart and KC-based social provider Cornerstones of Care will collaborate on technology innovation.

Sales

WakeMed (NC) chooses Lexmark Accounts Payable Automation.

Hopkins-owned Sibley Memorial Hospital (DC) selects Versus RTLS for its new ED including a personal panic button, staff locator, and asset management.

Intermountain Healthcare chooses American Well to create a $49 video visit service that will launch in early 2016.

People

Barry Volin (Aetna Better Health New Jersey) joins WeiserMazars as healthcare consulting principal.

Valence Health hires W. Roy Smythe, MD (Avia) as chief medical officer.

Aurora Health Care (WI) names Preston Simons (Abbott Laboratories) as CIO.

Culbert Healthcare Solutions hires Randy Jones, DHA (UT Southwestern Medical Center at Dallas) as SVP of consulting services for the Western region.

Zest Health hires Ann Mond Johnson (ConnectedHealth) as CEO.

Announcements and Implementations

The National Association for Trusted Exchange (NATE) turns over administration of its Provider-to-Provider Trust Bundle to the California Association of Health Information Exchanges.

The Social Security Administration joins CommonWell Health Alliance.

Government and Politics

ONC opens a position for a pharmacist to perform policy, advisory, and liaison work.

FDA launches a four-month pilot program seeking to standardize drug company REMS information so that it can be incorporated into electronic systems such as EHRs.

Privacy and Security

In another mail-merge type mistake, Affinity Health Plan (NY) alerts patients that its renewal reminders for the state’s child insurance program contained a different patient’s information on the reverse side.

Valley Children’s Hospital (CA) sues two of its former pulmonologists for downloading records of 164 cystic fibrosis patients from its system in trying to recruit them to a competing practice. Valley Children’s Hospital reported the incident as a HIPAA breach, while the rival practice says doctors have a right to contact former patients to let them know they’ve moved.

Innovation and Research

Boston Scientific announces a remote patient monitoring innovation contest, with winners dividing “up to $25,000 of services in kind.”

Other

The Albany, GA paper shares interesting details of the October 1 Meditech go-live of Phoebe Putney Health System. VP/CIO Jesse Diaz says it was “very challenging” with 1,000 command center calls the first day and a NICU dosing problem, but things are settling down and more orders are being entered electronically than before with a 15-20 percent increase. The health system also opened up a $50 million line of credit to help cover the project’s cost and the potential revenue cycle impact of ICD-10.

St. Luke’s University Health Network (PA) publishes a price list for patients willing and able to pre-pay for bundles of services for common procedures, imaging studies, and ambulatory surgeries. An ACL repair costs $10,270, while most common X-rays run $100. The target market is the consumer I described above who has a high-deductible plan that requires them to pay every penny themselves until their insurance kicks in.

Pathologist Bruce Friedman, MD notes that investor darling lab provider Theranos — whose lobbyists successfully pushed an Arizona law to allow patients to order their own lab tests — now has competition in the state as Sonora Quest Laboratories launches similar cash-only services. I checked out Sonora Quest Laboratories, which turns out to be a Phoenix-based joint venture between Banner Health and Quest Diagnostics that has the largest laboratory testing market share in Arizona with 70 service locations. This is perhaps the first real face-off between Theranos and the established two-company lab market, competing on price in the only state where cash-paying consumers can take full control. Banner had $4.5 billion of revenue in 2013, of which it appears that Sonora Quest Laboratories generated $18 million and parent Laboratory Sciences of Arizona brought in another $80 million if I’m reading their tax forms correctly. The non-profit Banner, which had a $482 million “surplus” that I noticed while perusing their Form 990, paid their HR VP $900K, their CIO an annualized $560K, and their pharmacy director $553K.

Athenahealth’s Jonathan Bush tweeted this selfie with Karen DeSalvo, saying he’s disappointed to lose his perception that all government officials are stiff (maybe DeSalvo lost that same perception about vendor CEOs).

A New York City entrepreneurship site profiles ED wait time system and analytics vendor MedTimers. The company’s founder and CEO is an NYU undergrad.

Weird News Andy calls this story “Recycling Gone Wild.” Dozens of employees of a New Jersey drug company are being tested for HIV and hepatitis after a contract nurse from onsite flu clinic provider TotalWellness who was giving flu shots was caught using the same syringe for everyone.

Sponsor Updates

ZirMed is ranked first for revenue cycle solutions among hospitals under 200 beds in a Black Book survey.
Iatric Systems, Intelligent Medical Objects, Medecision will exhibit at the CHIME Fall CIO Forum 2015 October 14-17 in Orlando.
Impact Advisors and Leidos Health participate in National Health IT Week.
Influence Health will exhibit at SHSMD Connections October 11-14 in Washington, D.C.
PDR wins the 2015 Trailblazer Award for Innovation for EMR/EHR provider-patient engagement.
MedCPU releases a new case study, “Reducing Inappropriate CT Imaging in the ED.”

Blog Posts

Embracing – and Igniting – Change (Medicity)
NHIT Week: Close to the Heart – Electronic Medication Reconciliation (Impact Advisors)
Revolutions in Healthcare Analytic (Part 1 of 6) (Optimum Healthcare IT)
Overcoming Your EHR Optimization Challenges (Iatric systems)
Everyone Sells (Ingenious Med)
The ICD-10 Deadline has Passed! (InstaMed)
Semantic Interoperability, or My Semester Living with an Undocumented Alien (InterSystems)
In Honor of NHIT Week, 5 Trends Advancing the Cause of Health IT (Liaison Technologies)
ICD-9, Finally a Thing of the Past! (MedAptus)
Why We’re Excited to Join the MedData Team (MedData)
Questions to Ask Your SaaS Provider (NTT Data)

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us or send news tips online.

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News 10/7/15

October 6, 2015 News 1 Comment

Top News

CMS’s proposed revised Meaningful Use standards will be published on Friday, October 16 with a 60-day comment period following, but are available now as a pre-publication PDF. It calls for a 90-day reporting period, removes some requirements, expands interoperability-related standards, encourages the use of APIs, and makes Stage 3 optional for 2017 and mandatory for 2018.

Reader Comments

From MHealthcare: “Re: Spectrum Health, Grand Rapids. Announces Project Nexus, which will replace its existing systems (Epic outpatient, Cerner inpatient, and McKesson HealthQuest financials) with Epic.” Unverified.

From Light at the End of the Tunnel: “Re: psychologist-assisted blinding. Is there an ICD-10 code for that?” A clearly disturbed North Carolina woman who says she suffers from body integrity identity disorder (which causes healthy people to want to be disabled) claims in a sensationalistic website’s video that a sympathetic psychologist intentionally blinded her with drain cleaner. I seriously doubt that, especially since she says they used numbing eye drops first and psychologists can’t use medications (only psychiatrists can do that since they are physicians). She also claimed in another attention-seeking video (in which she used a different name) that her blindness was accidental. She’s running a $4,000 fundraising project to buy canes for 35 students of a school for the blind in Indonesia, of which $875 goes for the canes and the rest for a two-week visit to the school by the woman and her fiancé. She concludes, “Don’t think I’m crazy. I just have a disorder.”

From Flamekist: “Re: US Coast Guard. Will not renew its contract with Epic after spending five years and $60 million. Not a single USCG clinic went live. Rumors are it is considering upgrading CHCS instead. This is in direct violation of a federal mandate for EMR compliance.” Unverified. UPDATE: Epic verifies that USCG won’t renew its contract. Leidos was the Coast Guard’s implementation and integration vendor. Implementation delays were due to integration issues and twice the entire system was accidentally overwritten, causing missed dates unrelated to Epic.

From Hootie: “Re: Experian breach. The 15 million people should be provided with free identity theft and credit protection services from Experian. That will make them feel safer, I bet.” An interesting aspect of the huge breach is that even encrypted information was taken, suggesting that the hackers used high-level user credentials. I’d bet it was another phishing attack. It appears that the stolen information is already being offered for sale on the Dark Web.

From Brian Too: “Re: ICD-10 vs. Y2K. Thanks to all who made a positive contribution. The AMA is specifically exempt from thanks. They took a lower-level modernization issue and exploited it for political purposes. The number of absurd statements that came out of there (and from their supporters) was astounding. Some silence from those quarters would be a nice change.” Unless endless whining counts as silence, I wouldn’t bet on it.

HIStalk Announcements and Requests

Mrs. McDermott reports that her New York City fifth and sixth graders are using the four Kindles we provided via a DonorsChoose grant to practice their math fluency skills, including during breakfast and lunch, using the IXL app. She says they think it’s cool because they can write their problems directly onto the screen with their fingers. She’ll use it next for her after-school tutoring groups.

Welcome to new HIStalk Gold Sponsor ID Experts. The Portland, OR-based company has since 2003 provided software and services that help organizations manage cyber risks and data breaches. Software offered includes Radar (managing incident response and flagging notifiable breaches) and MIDAS (detecting medical identity theft by engaging members to securely review their claims). The company also provides cost-effective forensics and breach response services to some of the country’s largest organizations as well as offering consumers identity theft restoration and monitoring solutions that have a 100 percent success rate. The company offers a case study from University of New Mexico Health Sciences Center and Health System, which uses Radar to manage breach incidents and perform risk assessments. Thanks to ID Experts for supporting HIStalk.

I cruised YouTube for ID Experts videos and found this overview of its Radar incident management system.

Grammar and usage peeve: using “drop” to describe something new, as in “CMS dropped the MU rule.” That riles me as much as “went missing” to describe someone whose whereabouts are undetermined.

Webinars

October 7 (Wednesday) 1:00 ET. “Develop Your Analysts and They’ll Pay for Themselves.” Sponsored by Health Catalyst. Presenters: Peter Monaco, senior business intelligence developer, Health Catalyst; Russ Stahli, VP, Health Catalyst. It takes years for analysts to develop the skills they need to build reports and dashboards that turn data into valuable insights. This webinar will describe how to cultivate those analytical skills, including technical prowess and adaptive leadership. Leaders will learn how to develop a culture that fosters improvement, how to encourage analysts to develop the right skills, and ways to remove the barriers that stand in their way.

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

Acquisitions, Funding, Business, and Stock

Cegedim subsidiary Pulse System will acquire the US practice management system business of Canada-based Nightingale Informatix Corporation.

Cureatr opens its Midwest headquarters in Carmel, IN with three employees and three additional hires planned.

Newly formed, Singapore-based AntWorks acquires Lynchburg, VA-based EHR/PM vendor Benchmark Systems for $5 million, expecting a top-line annual revenue of $10-12 million. The company says it will announce a second healthcare acquisition by the end of the year.

Royal Philips acquires 35-employee, Orlando-based ED consulting firm Blue Jay Consulting to expand its enterprise managed services offerings.

Shares in telemedicine provider Teladoc dropped 20 percent Friday on news that insurer Highmark won’t renew its contract. Above is TDOC share price since its July 1 IPO (blue, down 45 percent) vs. the Dow (red, down 6 percent).

Sales

Wilderness Health (MN) chooses eClinicalWorks for population health management.

Rush-Copley Medical Center (IL) will implement Merge PACS, iConnect Access, and iConnect Enterprise Archive.

McLaren Health Care (MI) chooses Cerner for EHR, revenue cycle, and population health management. McLaren selected McKesson Paragon and Allscripts EHR in 2010 and will replace both.

People

Oneview Healthcare hires Monica Lightman (AMC Health) as northeast region VP.

Announcements and Implementations

Orion Health announces its participation in the DoD’s EHR project, which will use its Rhapsody Integration Engine to link Cerner Millennium to civilian facilities. The company’s shares jumped 9 percent on New Zealand’s stock exchange after the announcement since Orion was not originally listed as a Leidos partner in the project.

Premier will accept vendor applications for its Innovation Celebration 2016 product showcase through December 11.

Cerner will integrate the Society for Hospital Medicine’s Project BOOST (Better Outcomes by Optimizing Safe Transitions) toolkit into its Readmission Prevention Solution.

Aprima will incorporate education, gamification, and rewards solutions from HealthPrize Technologies into its patient portal.

Health API vendor PokitDok eliminates fees for several provider-insurer transactions, including enrollment, eligibility, claims processing, authorizations, and referrals.

Divurgent launches RevInsite, a hospital revenue cycle diagnostic and analytic solution.

IBM launches a consulting organization for its Watson and analytics products.

Speakers at the Midwest Fall Technology Conference in Detroit October 25-27 include Carla Smith (HIMSS), Chuck Christian (Indiana HIE), Donna Roach (Via Christi Health), Joe Francis (Detroit Medical Center), Judy Murphy (IBM), Michael Zaroukian (Sparrow Health), Russ Branzell (CHIME), Sue Schade (University of Michigan Hospitals), and Mary Alice Annecharico (Henry Ford Health System). Registration is $295/$395 (HIMSS member and non-member) and rooms at the Detroit Marriott at the Renaissance Center are $159 per night. There’s also the Vikings vs. Lions that Sunday.

Government and Politics

HHS OCR launches a HIPAA page (announced via a tweet) for mobile health app developers. It allows users to submit questions and suggest areas in which HIPAA guidance can be improved. OCR doesn’t say exactly how it will address submitted questions.

As originally reported by reporter Alex Ruoff of BloombergBNA, HELP committee members Senators Bill Cassidy (R-LA) and Sheldon Whitehouse (D-RI) introduce the TRUST IT act that would require ONC to develop an EHR star rating system using stakeholder-developed criteria and user feedback, with automatic decertification of low-rated products. The bill would require EHR vendors to attest to their level of openness as part of certification. Providers or vendors found to be blocking information exchange would be liable for a fine of up to $10,000. The bill also calls for vendors to be fined for failing to participate or for not improving their low-rated products, with the proceeds funding a “revolving user compensation fund” that would reimburse users of decertified EHRs for their costs to replace them.

Mental Health America and Netsmart express support for legislation that would allow providers to share addiction treatment medical records via HIEs and ACOs with the patient’s consent.

DocGraph finds problems with the referral data sets published by CMS and ProPublica, noticing that files inconsistently covered periods ranging from 12 months to 48 months due to misunderstood Freedom of Information Act requests. DocGraph Data Journalist Fred Trotter warns that customers may have used the information to inappropriately sever relationships with specific physicians or even to stop services in certain markets.

Innovation and Research

Israel’s Center for Digital Innovation and Allscripts will create an Israel-based center to connect that country’s startups to the US healthcare market, including access to the developer programs of Allscripts. The non-profit Center for Digital Innovation was launched a few weeks ago in partnership with Allscripts. Ziv Ofek, the founder of Allscripts acquisition dbMotion, is founder and CEO of CDI.

Technology

Microsoft didn’t appear to have much luck selling its Band wearable, so it releases a new version that has a curved display. It also costs $50 more at $249. A vendor gave me one of the original ones at the HIMSS conference, but I reboxed it just an hour after putting it on despite being impressed by its sensors because it was huge, bulky, and rigid. My experience and everything I’ve read suggests that wearables have run their course with little effect on health, just like the millions of closets that hold a dusty, infomercial-pitched healthy juicer.

Other

BIDMC CIO John Halamka, MD says all major EHR vendor CEOs met last week, approving objective measures of interoperability that will be published by an independent entity.

A KLAS report on secure messaging finds over 100 vendors that offer products, many of which KLAS considers as entry-level solutions offered by companies with no other healthcare domain expertise who offer few interfaces. Strategic solutions include rules-driven message prioritization and escalation, alarm management routing, and integration with multiple systems. TigerText leads both market share and mind share, but its price is high for basic functionality, providing opportunity for primary competitors Imprivata, Vocera, Voalte, Spok, Cerner, and Doc Halo.

I speculated a few days ago that Martin Shkreli’s Turing Pharmaceutical must have bribed generic drug manufacturers to not produce an alternative to Daraprim to protect his 5,000 percent price increase for the 62-year-old drug. It turns out he’s smarter than that – the company sells the drug only to company-approved buyers. The FDA requires generic manufacturers to test their drugs against the brand name product, so Shkreli blocks them from obtaining Daraprim, leaving them unable to perform the tests. Meanwhile, Shkreli’s only slightly more restrained drug company peers have been steadily raising prices for years, even for drugs whose demand is slipping, according to a Wall Street Journal report that finds most drug company profits come from price increases. It quotes a former drug company CEO’s statement to investors, “If there’s price increases that can be taken and delivered to shareholders, we’ll go get it, but I do think we got to make sure we take a long enough view and you don’t start to put this thing in a box, where you get the backlash.”

A CNN article seems to blame Google-owned free navigation app Waze for the death of a tourist in Brazil who was killed when the street name she entered took her into a drug gang-controlled neighborhood, where someone fired 20 bullets into her car. The city of Niteroi, it turns out, has two streets with the same name, one in a trendy tourist section and the other in one of the slums where 20 percent of Rio de Janeiro’s citizens live. Perhaps that’s a market opportunity for GPS app vendors – cross reference their directions with police records to avoid dangerous parts of town just like they avoid unpaved roads (or maybe it’s an opportunity for cities to not just turn over known sections of town to criminals).

Weird News Andy says this story is nothing to sternutate at: a 12-year-old girl has been sneezing 12,000 times a day for a month. WNA adds the ICD-10 code of R06.7, also relating that his brother once lost 10 pounds after hiccupping for three weeks. WNA also points out a story describing how a Montefiore Medical Center OR tech who had gone to the ED with a finger injury was found dead in a locked third-floor bathroom three days later.

Sponsor Updates

AirStrip calls for eliminating interoperability barriers as part of the 10th annual National Health IT Week.
Aprima Medical Software will exhibit at the Patient-Centered Medical Home Congress October 9-11 in San Francisco.
Bernoulli releases a new case study, “Beyond Alarm Management,” featuring client Wesley Medical Center.
The local news features Aurora Health Care’s implementation of Clockwise.MD’s online reservation system.
CompuGroup Medical will exhibit at the Symposium for Clinical Laboratories October 7-10 in Las Vegas.
Wellcentive is ranked as the #1 vendor in customer satisfaction and client experience in Black Book’s financial solutions category of “managed care payment / reimbursement solutions.”
Healthfinch CEO and co-founder Jonathan Baran is featured in a video interview on Madison Noteworthy.
Michael Barbouche, CEO of Forward Health Group, is also featured in a Madison Noteworthy interview.
EClinicalWorks exhibits at The Second CAPG Colloquium through October 7 in Washington, DC.
Extension Healthcare and Saint Joseph Hospital will participate in the AAMI Foundation alarm management safety event October 14-15 in Boston.

Blog Posts

Prepared for ICD-10 (AdvancedMD)
CMS Publishes Correction Notice to the FY 2016 IPPS Final Rule (Besler Consulting)
Under the Hood of Medical Devices (CapsuleTech)
Leaning in on Population Health (Part 1): Caradigm Customer Summit 2015 (Caradigm)
Key Takeaways From the Blues IM Symposium 2015 (CitiusTech)
CoverMyMeds Celebrates National Health IT Week (CoverMyMeds)
Employers Want Self-Starters (Direct Consulting Associates)
Interoperability – How Distant is the Future of Data Exchange? (Divurgent)
FormFast Supports National Health IT Week! (FormFast)
#IHeartHIT: Virtually Present (Galen Healthcare Solutions)
The Next Milestone in Provider Payments: Shaping the Substance of MACRA (Greenway Health)
Post Epic Implementation: Now What? Watching Your Watch List (Hayes Management Consulting)
Pharmacies Deliver Satisfaction – Again (Healthcare Data Solutions)
CEO Jonathan Baran and Dr. Frank Byrne Discuss Healthfinch (Healthfinch)
How the Stars Aligned for Healthwise and Health Literacy (Healthwise)
Nordic launches Strategic Affiliate Management training program (Nordic)

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us or send news tips online.

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Monday Morning Update 10/5/15

October 4, 2015 News 4 Comments

Top News

Mercy Health opens a $54 million telemedicine center, where 290 clinical employees will monitor patients in 33 hospitals covering four states. The service, which seems to be marketing itself to other hospitals without actually saying so, offers teleICU, telestroke, nurse on call, electronic visits, specialist consultations, a sepsis monitoring service, skilled nursing facility monitoring, home monitoring, remote hospitalist services, chronic disease management, and analytics services. Consider the implications of offering services like these to small and rural facilities that have physical proximity to patients and a desire to improve their health, but that also don’t have the resources to do so on their own.

Reader Comments

From PM_From_Haities: “Re: Allscripts. Borrowing more money with terms that require it to pay 50 percent of the company’s excess cash flow each fiscal year if it doesn’t meet certain leverage ratios.” The SEC filing is over my head, so anyone with corporate finance expertise is welcome to comment. Above is the one-year price chart of MDRX (blue, down 9 percent) vs. the Nasdaq (red, up 6 percent). Your $10,000 worth of Allscripts shares purchased five years ago would be worth $6,769 today, while the same investment in Nasdaq index funds would be valued at $19,600. Had you bought Cerner shares instead, your $10,000 would be worth $28,450.

From Doctor Mom: “Re: ICD-10. Our doctor’s system combined the correct ‘juvenile dermatomysositis” with the incorrect ‘juvenile polymyositis’ to create a new code for the combined non-existent disease. Otherwise, no issues for us.” I haven’t heard of any significant ICD-10 issues, other than one reader who said his insurance declined a prescription refill because of its existing ICD-9 diagnosis code but approved it when the pharmacist fixed the code. It’s too early to claim victory since ICD-10-based claims haven’t yet been paid, but I’m already feeling sorry for all the vendor and provider people who spent a ton of time preparing for the conversion that everyone is now saying was uneventful, implying in Y2K-like fashion that it all was a false alarm that could have been ignored. It was only a non-event because a lot of people did their best to make it so.

From The PACS Designer: “Re: ICD-10. Now that ICD-10-CM is officially in use worldwide, it will be vitally important that no shortcuts creep into the clinical decision solutions. For instance, if you encounter a present for a ‘burn due to water-skis on fire’ — V91.07XA — you should not enter the present as V9107XA, v91.07xa, or v9107xa.”

From Frank Poggio: “Re: Blue Cross Blue Shield poll question. In 1939, the AMA started Blue Shield and in 1942 AHA created Blue Cross because healthcare costs were too high and volume was down. To drum up business, they both came up with the idea to sell a medical insurance policy. Unions loved it and employers thought of it as a low-cost benefit. One insurance for both was not possible because they didn’t trust each other and physicians wanted to remain as independent as possible. The split was perpetuated when the Feds created Medicare in 1966. The Feds could have forced the two together (a la ACO) but the politics were too tenuous, so the Feds created two separate payment programs — Medicare Part A (hospital) and Medicare Part B (doctor) to mirror BC/BS. Then in 1972 as the health insurance industry matured, the Federal Trade Commission became concerned that doctors and hospitals selling insurance was a conflict of interest. The AMA had to spin off Blue Shield and AHA split with Blue Cross. As time moved on and healthcare costs grew, the Blues saw themselves more as insurance companies than part of the medical establishment. Many of the Blues merged and eventually morphed into today’s UnitedHealth, Anthem, Wellpoint, etc. Not much is different today as providers are trying to protect their revenue, and since the friendly Blues have morphed into nasty enemies, why not create your own more friendly insurance program? Here we go again.”

HIStalk Announcements and Requests

Two-thirds of poll respondents characterize Blue Cross Blue Shield (the association of companies) as a villain vs. the one-third who think they are a hero. Mobile Man explains, “Necessary evil? Absolute power corrupts absolutely? Follow the money? The ‘business of healthcare’ is an oxymoron? You name it …” New poll to your right or here: should consumers be allowed to order their own lab tests?

I received photos from teachers whose DonorsChoose grant projects we funded: Ms. Bruder from New York (electronics kits), Ms. Thomas from Georgia (a math exploration station), and Ms. Lemos from California (two Amazon Fire tablets).

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

Last Week’s Most Interesting News

ICD-10 goes live with few reported problems.
EClinicalWorks will spend $50 million on a new building in preparation for doubling its Westboro, MA headcount to 2,000.
MedAssets announces a restructuring plan that includes laying off 180 employees.
Mayo Clinic-backed Better announces that it will shut down its technology-powered personal health services company on October 30.
Leaders of the Senate’s HELP committee continue pressing HHS to change Meaningful Use Stage 2 and to delay Stage 3.
Patients sue two DC-area health systems for refusing to provide electronic copies of their medical records and charging them thousands of dollars for paper copies.
A study by researchers from England finds that most consumer health apps give bad advice, fail to secure user information, and provide no documented health improvement.

Webinars

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

Acquisitions, Funding, Business, and Stock

This might be a clue that the frothy health IT investor bubble is about to burst: hospital asset tracking vendor Kokicare files its IPO documents even though it has existed for just five months, it has no website, and its official address is the home of its founder, who still works full time as a sales director for another software company. The company, which has no record of previous funding, is hoping to sell $330,000 worth of shares.

People

Falcon Consulting hires Bill Wilson (IBM) as VP of strategic services, Steve Hayter (Providence Health & Services) as VP for technology solutions, Dan Stoke (Medfusion) as VP of client relations, and Paul Tinker (Grant Thornton LLP – not pictured) as executive director of clinical services.

Announcements and Implementations

In Texas, Texas Health Resources and UT Southwestern Medical Center announce plans to create a single cooperative network that will include using a single “compatible interactive IT platform,” which should be made easier since both organizations use Epic.

Privacy and Security

Experian, which offers identity theft and credit protection among its financial and data brokering services, is itself breached, exposing the information of 15 million people who had credit checks performed when requesting service from cell phone provider T-Mobile. Experian was scammed a couple of years ago into selling the in-depth financial information of 200 million Americans to a guy in Vietnam who was reselling their financial identities online to any willing fraud operator.

The August theft of two portable hard drives from the electrophysiology lab of Sentara Heart Hospital (VA) exposes the information of 1,000 patients. The drives were not stored in a secure location and were not encrypted, although the hospital says “we’ve stepped up our procedures.”

Other

A study of primary care practice visits in England finds that 27 percent would have been unnecessary with better use of technology and and coordination with other providers. One in six of the visits could have been handled by pharmacists or nurses.

Walter De Broweur, CEO of Tricorder-aspiring device manufacturer Scanadu, lists concepts he thinks will be important over the next five years:

Mobile health technology impact is lagging because it fails to pass the “toothbrush test” in which users go to several times each day. He says that means letting consumers aggregate their own information and then present it to their doctor with their own point of view.
The “industrial medical complex” will yield to consumer demands only when consumers start to collect their own health-related data such that it adds more value than the EHR contributes.
Big companies will take over preventive care.
Consumers will automatically collect their own data into digital dashboards and contact providers only when needed.
Algorithms will take over medication prescribing, which is the main reason people see doctors, with telemedicine as the first step into avoiding time-wasting appointments just to get prescriptions.
Regular, automatic collection of health data will become more important than the snapshot of health that’s involved in a typical office visit.

Sponsor Updates

Wellcentive will exhibit at the NAACOS Fall Conference, October 8-9 in Washington, DC.
Nordic launches a strategic affiliate management training program.
Valence Health will exhibit at the CAPG Colloquium October 5-7 in Washington, DC.
VisionWare will exhibit at AEHiX15 Fall Forum October 7-9 in Orlando.
Huron Consulting Group closes its acquisition of Cloud62.
ZirMed is featured in a TechRepublic feature on parental leave policies and work-life balance.
Sunquest will participate at CAP October 4-7 in Nashville, TN and at ASHG in Baltimore October 6-10.
Zynx Health will exhibit at the 2015 ANCC National Magnet Conference October 7-9 in Atlanta.
XG Health launches a new website.

Blog Posts

The Concept of ‘Time’ – now an Area of Focus in Healthcare (TeleTracking)
Was Ben Franklin the First Health Choice Architect? (Verisk Health)
Help or hindrance? (Voalte)

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us or send news tips online.

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News 10/2/15

October 1, 2015 News 1 Comment

Top News

ICD-10 goes live with few announced problems, with October 1 marking the beginning of the second, shorter countdown until claims have been submitted and processed. At least we will finally be free of reporters who think they’re being clever in entertaining us with allegedly fun, obscure ICD-10 codes. Above is a photo Cerner tweeted out of its ICD-10 war room, another of Practice Fusion’s support team, and the command center at Ministry Health.

Did anyone have a physician office visit scheduled for Thursday? How did it go?

Reader Comments

From Puerile Excuses: “Re: State of Mississippi RFP. All vendors were required to attend an all-hands call this week or else they would be excluded from the bidding. Despite several rounds of roll calls, nobody from Accenture or Oracle spoke up to verify their attendance. It was a pretty big call to miss given that this is a multi-million dollar award over several years. It will be interesting to see if they talk their way back into the race.”

HIStalk Announcements and Requests

Mrs. Hicks from California reports that the math manipulatives provided by our DonorsChoose project were a big hit, saying her elementary school students wanted to start using them right away and are benefiting from hands-on, high-impact activities.

Mr. Weightman’s Indiana students have already received the 25 sets of headphones we funded just three days ago, using them to tune out noise as they’re working on math and reading skills.

Mrs. Kennedy shared photos of her Virginia elementary school students using the sidewalk chalk and learning games we provided for summer school.

I filed an Office for Civil Rights complaint in early July after my MU-attesting, Epic-using Stage 7 EMRAM hospital refused to give me an electronic copy of my medical records, saying they don’t provide electronic versions to anyone other than doctors. I still haven’t heard back from OCR nearly three months later.

A usage gripe: “breaches” happen when a hacker gets your data, an army breaks through a fortified wall, or a whale surfaces. “Breeches” are what you wear during equestrianism, the part of the cannon that the shell goes through, or in describing babies who are born butt-first.

This week on HIStalk Practice: The Primary Health Care Performance Initiative launches to enhance data quality and sharing globally. Conflicting surveys show that physician spending is up on technology purchases, yet choosing and implementing new technology is of low priority. AAFP delegates discuss EHR irritation, physician burnout at annual congress. HHS awards $685 million to regional and national health networks as part of its Transforming Clinical Practice Initiative. Pennsylvania eHealth Partnership Authority Executive Director Alix Goss stresses the importance of HIE to physician practice success. Physicians vent their frustrations at AMA/Massachusetts Medical Society event.

This week on HIStalk Connect: Two Washington, DC-based hospitals are sued for charging patients hundreds of dollars for access to electronic copies of their medical records. Researchers in England find multiple clinical and data security issues with apps included in the NHS Health App Library. Mount Sinai reports initial results from its Apple ResearchKit-based national asthma study. Online consumer health startup HealthTap unveils a new app aimed at the employee wellness market.

Webinars

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

Acquisitions, Funding, Business, and Stock

EClinicalWorks buys a third office building in Westboro, MA for $21 million, planning to double its headquarters headcount to 2,000 as its annual revenue approaches $400 million. The company will spend another $30 million to renovate the interior.

Premier subsidiary Premier Healthcare Solutions acquires InFlowHealth, which offers physician practice improvement software, for consideration valued at up to $35 million.

PerfectServe raises $21 million in a new financing round.

MedAssets announces a restructuring plan that includes an 180-employee layoff, closing one office, and reducing professional service and vendor fees. It estimates a pre-tax restructuring expense of $11 million, almost all of it in workforce reduction costs, between now and the end of the year.

Mayo Clinic-backed Better, which offers a technology-enabled personal health assistant services for $50 per month for a family, announces that it will shut down on October 30. The company had raised $5 million in a single April 2014 round.

Konica Minolta acquires Viztek, which offers digital software and hardware imaging solutions.

Sales

Children’s Hospital of Philadelphia (PA) chooses PeraHealth’s real-time clinical deterioration surveillance software.

People

A DC-area innovation site profiles Maria Horton, a former Walter Reed ICU nurse and CIO who is founder, president, and CEO of federal security contractor EmeSec.

Aetna hires Gary Loveman, PhD (Caesars Entertainment) as EVP/president of its Healthagen consumer technology business. His primary accomplishment for the struggling Caesars was keeping the company afloat after it took on $22 billion in debt in a leveraged buyout, laying off 12,000 people and earning himself $90 million in share appreciation as the company’s largest business unit filed bankruptcy this past January.

Data management system vendor Flywheel hires Imad Nijim (Lexmark Healthcare) as COO.

Announcements and Implementations

LiveProcess announces its ED Coordinator collaboration solution, which allows ED managers to align resources based on demand to accelerate patient flow.

Princess Margaret Hospital (Bahamas) goes live on Surgical Information Systems.

Leidos and Virginia Tech will collaborate on student-conducted research on the big data challenges of EHRs, with Leidos funding a graduate fellowship in advanced information systems.

Southcoast Health (MA) goes live on Epic.

Six HIMSS chapters will host the Midwest Fall Technology Conference in Detroit October 25-27. Some of the HIStalk sponsors who are sponsoring the event include Airwatch by VMware, Merge Healthcare, Xerox, Caradigm, Orion Health, Leidos Health, Burwood Group, PDS, Fujitsu, and CoverMyMeds.

Government and Politics

Senator Lamar Alexander (R-TN), chairman of the Senate’s HELP committee, gives the administration five reasons that Meaningful Use Stage 3 should be delayed:

Few providers have qualified for Stage 2 and Stage 3 will make it even harder.
Medicare assigns penalties and bonuses based on MU compliance.
Big hospitals are saying the industry needs more time.
A new GAO report found that MU is standing in the way of EHRs talking to each other.
The final MU3 rule should reflect the still-incomplete interoperability work between the committee and the administration.

The White House notes the five-year anniversary of Blue Button, also noting that the next step is widespread implementation of APIs to allow consumers to collect their information from multiple sources into whatever app they want to use.

An HHS OIG report finds that the state of Oklahoma overpaid nearly $900,000 in Meaningful Use payments because it didn’t understand the required timeframes. It also inappropriately received $128,000 in federal reimbursement because it submitted duplicated payments.

Other

UNC Hospitals (NC) quadruples its operating income to $115 million for the year, for which it gives some credit to its Epic implementation.

Forbes names its list of the 400 riches Americans, which includes #35 Patrick Soon-Shiong (NantHealth, $12.9 billion), #121 Elizabeth Holmes (Theranos, $4.5 billion), and #256 Judy Faulkner (Epic, $2.6 billion).

An East Texas judge shuts down the country’s most prolific patent troll by denying its 168 lawsuits for a patent that covers “storage and labeling information,” with 87 of those lawsuits filed in a single April week in an attempt to beat the deadline for tighter filing rules. However, the same Texas lawyer that created eDekka (whose only business is filing patent lawsuits) also represents the country’s #2 and #3 most prolific patent trolls.

Cleveland Clinic Florida offers $49 online doctor video visits.

AAFP President Wanda Filer, MD, MBA, who started her term Thursday, says of EHRs,

I’m now on the fourth EHR of my career. One was such a dismal product that we simply walked away from it. Physicians have heard a lot of good sales pitches, and we’ve seen a lot of people who weren’t involved in clinical care leading us to the health IT "promised land." This has been a difficult journey for many of us, but the Academy is working with stakeholders to turn this situation around and help ensure that EHRs help, rather than hinder, physicians in practice.

The IT team of Centura Health (CO) will play Epic in a fundraising basketball game on October 20, complete with cheerleaders, music, and a concession stand whose sales will be donated to DonorsChoose.

A Florida man is arrested for posing as a doctor in interviewing a woman for a nursing assistant position, which included touching her breasts and attempting to demonstrate (on her) the correct way to take a rectal temperature.

Sponsor Updates

Iatric Systems will exhibit at the Hospital and Healthcare IT Reverse Expo Fall 2015 October 5-7 in Los Angeles.
Influence Health will exhibit at the National Association of ACOs event October 8-9 in Washington, D.C.
Ingenious Med and MedData will exhibit at the MAHAP-MPAA-HFMA Michigan Revenue Cycle Conference October 7-9 in Mt. Pleasant.
InterSystems will exhibit at the iHT2 Health IT Summit October 6-7 in Chicago.
Sunquest and Partners HealthCare announce GA of a new version of the GeneInsight genetic information solution.
Intelligent Medical Objects will exhibit at the MUSE International Medical Users Software Exchange October 7-8 in Liverpool, UK. * Liaison Technologies will exhibit at the Merck Global IT Summit 2015, Americas October 6-7 in Somerset, NJ.
Netsmart will exhibit at the Michigan Premier Public Health Conference October 6 in Thompsonville.
Nordic’s Kevin Dumser and his son’s battled with childhood cancer is featured in the local paper.
Extension Healthcare and its customer Saint Joseph Hospital (CO) will present ideas on clinical alarm improvement at the AAMI Foundation clinical workshop in Boston, MA on October 14-15.
NTT Data will present on health innovation at the Gartner Symposium/ITxpo 2015 October 4-8 in Orlando.
NVoq will exhibit at the American College of Pathologists Annual Meeting October 4-7 in Nashville, TN.
Experian Health will exhibit at the Idaho Hospital Association’s annual meeting October 3-6 in Sun Valley.
Recondo Technology increases scores by over 15 percent in the latest KLAS Mid-Term Report.
Patientco’s partnership with Halifax Regional (NC) is featured in the local paper.
PatientKeeper documents the success Ob Hospitalist Group (SC) has had with the company’s Charge Capture software.
PerfectServe will exhibit at the FSN Renal Reunion October 2-4 in Bonita Springs, FL.
The SSI Group and Stanson Health will exhibit at the 2015 Fall Hospital & Healthcare IT Conference October 5-7 in Los Angeles.
Summit Healthcare will exhibit at the MUSE International Medical Users Software Exchange October 7-8 in Liverpool, UK.
Surgical Information Systems will exhibit at the OR Managers Conference October 7-9 in Nashville.
Surescripts will host its 2015 Customer Forum October 5-7 in Washington, D.C.

Blog Posts

(Healthcare) IT Evolution Revisited (Park Place International)
Why Secure Texting Isn’t Enough (PatientSafe Solutions)
Last Days of Disco (PatientPay)
Live from RSNA 2015 (Lexmark)
Merger Mania Hits Healthcare (Phynd Technologies)
Automation & Empowerment (PMD)
Deaconess Hospital Trains Thousands on Unique Workflows and Scales Back Command Center in One Week (Sagacious Consultants)
7 Ways for Clinical Labs to Stay Relevant (Sunquest Information Systems)

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us or send news tips online.

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Morning Headlines 10/1/15

September 30, 2015 News Comments Off

Electronic Health Records: Nonfederal Efforts to Help Achieve Health Information Interoperability

A GAO report on EHR interoperability concludes that the five major barriers to improved interoperability are cost, inadequate data standards, variation in state privacy rules, poor patient record matching technology, and a lack of trust between sharing entities.

2015 Industry Drill-Down Report – Healthcare

A Raytheon-Websense security report finds that cyberattacks on healthcare entities surged 600 percent in 2014 and the industry now experiences 340 percent more security attacks than the average industry. Researchers explain, “Criminals often move to the easiest targets, and with retail and banking becoming more secure, healthcare networks became a prime target.”

MedAssets to cut 5% of workforce in cost-cutting move

MedAssets, an Alpharetta, GA-based healthcare performance improvement company, will lay off 180 full time employees, or five percent of its total workforce, by the end of 2015.

HealthTap Launches Compass, A Revolutionary New Personal Healthcare Application That Will Give Employees of Flex the Ability to ‘Tap In’ to Intelligent, Efficient World-Class Healthcare 24/7

Online consumer health startup HealthTap announces plans to move into the employer wellness market with an app that offers telehealth consults, treatment planning, and patient reminders.

Going to ask again about HealWell - they are on an acquisition tear and seem to be very AI-focused. Has…

If HIMSS incorporated as a for profit it would have had to register with a Secretary of State in Illinois.…

What I wondered, after reading this? Could a single physician want to shift back and forth, dynamically, between workflows with…

I read about that last week and it was really one of the most evil-on-a-personal-level things I've seen in a…

Thank you sir

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