News 12/30/15

Top News

ProPublica launches HIPAA Helper, which allows searching government data to see if a given provider or insurer was named in privacy complaints, breaches, or violations. The organization calls out frequent offenders , none of which have been assessed penalties by the Office for Civil Rights. 

Reader Comments

From The PACS Designer: “Re: fluorescent camera pills. As we get smaller technology in the form of camera pills, the innovations become exciting. Florescent technologies are now so small that they can be inserted into a swallowed form that includes a camera that can now detect cancer without using an endoscope. The sensor used is called the single photon avalanche detector (SPAD) and it can detect single light photons given off by the molecules in human tissue.”

From Dorm Fridge: “Re: saying ‘no problem.’ I say it to indicate that whatever I did wasn’t a burden. It makes just as much sense as ‘you’re welcome.’” “You’re welcome” indeed doesn’t make much sense (nor does “thank you,” for that matter – why not “I thank you?”) but at least it’s traditional. Just about everybody I’ve heard say “no problem” — or its even more annoying variant, “not a problem” — is under 30, so I certainly wouldn’t use the phrase when trying to sell something to curmudgeonly older executives. I’ve also noticed that younger folks have unnecessarily raised the gratitude gamesmanship by embracing “thank you SO MUCH,” oddly pronouncing the “so” more like “soul.” Here’s a compromise: expressions of gratitude don’t require a reply, especially the call-and-raise response of thanking that person back, so just let it ride unchallenged or give a slight smile or nod. It’s all weird, of course, just like saying “goodbye” or “bye,” which originated as a shortened version of “God be with you,” which technically a non-believer shouldn’t be saying. I’m also intrigued that non-Texans are using “howdy” for some reason.

HIStalk Announcements and Requests

RIP Motorhead and Hawkwind singer Lemmy, who has died of cancer at 70.

A reader who wishes to remain anonymous donated $250 to my DonorsChoose project, which was matched by the Bill & Melinda Gates Foundation and then again by my anonymous vendor executive. That allowed me to fund $1,000 worth of teacher grant requests, all of which carried additional matching funds to stretch the donation value to fund $2,000 worth of projects:

• Three sets of ear buds and wireless mice for Mrs. Steele’s kindergarten class in Huntland, TN.
• Two programmable robots for Mr. Willet’s elementary school digital lab in Asheville, NC.
• Five MP3 players to form a listening center so that Ms. Johnson can read books for her first grade class in Oklahoma City, OK, in which the student poverty rate is 100 percent and 98 percent are English Language Learners.
• A Chromebook, case, six sets of headphones, and a wireless mouse for Ms. Johnson’s third grade class in Philadelphia, PA.
• An iPad Mini, Apple TV, case, and display adapter for Mrs. Robles’ middle school math class in Phoenix, AZ. She replied almost immediately, “Oh my God! Because of you, all my underprivileged students will be beaming with smiles and their brains full of knowledge that they will be eager to engage in and learn. It is because of wonderful people like you that our children have equal access to success and in becoming someone in this world! The kids have had to deal with the lack of the proper tools to learn. This will definitely be a game changer. They will not feel left out in the technological world and will be super proud to come and learn in my room. Over 150 students will now feel part of a new era of learning.”
• A laptop and Ethernet switch for a student-led project in which the West Covina, CA school’s robotic team will recruit new members by demonstrating their robots to fellow students and parents on Saturdays. As the students who made the request summarized, “This year, our robotics team won the 2015 Chezy Champs Competition and we are ready to win it again! Just like a football team, after high school seniors graduate, we have to rebuild the team. Without enough team players and support, we are at risk of losing our robotics program … With a new notebook and Ethernet switch, we will be able to showcase our previously built robots! We want to be able to show how exciting robotics is, and be able to present this without having any embarrassing hiccups.”

Webinars

January 13 (Wednesday) 1:00 ET. “Top 5 Benefits of Data as a Service: How Peace Health Is Breathing New Life Into Their Analytics Strategy.” Sponsored by Premier. Presenter: Erez Gordin, director of information management systems, Peace Health. Finding, acquiring, and linking data consumes 50 to 80 percent of an analyst’s time. Peace Health reduced the time analysts were spending on data wrangling, freeing them up to create new actionable insights.

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

Acquisitions, Funding, Business, and Stock

I took a look at how publicly traded health IT-related stocks fared in 2015 from best to worst. For the year to date, the S&P 500 was up less than 1 percent, Nasdaq around 7.5 percent, and the Dow down less than 1 percent.

1. MedAssets: up 56 percent
2. Nuance: up 43 percent
3. Aetna: up 38 percent
4. Leidos: up 34 percent
5. Allscripts: up 21 percent
6. UnitedHealth Group: up 19 percent
7. Vocera: up 18 percent
8. Cognizant: up 17 percent
9. Athenahealth: up 13 percent
10. Teladoc: down 8 percent (since its June IPO)
11. Premier: up 4 percent
12. Quality Systems: up 4 percent
13. McKesson: down 3 percent
14. The Advisory Board Company: up 3 percent
15. Cerner: down 5 percent
16. Imprivata: down 14 percent
17. CPSI: down 17 percent
18. Evolent Health: down 34 percent (since its June IPO)
19. Castlight Health: down 64 percent
20. Streamline Health: down 68 percent

Government and Politics

A new law that goes into effect this week allows CMS to fine insurance companies whose provider directories contain mistakes that can cause patients to inadvertently receive out-of-network care. California fined Anthem Blue Cross and Blue Shield of California last month after discovering that 25 percent of the doctors in their directories either didn’t accept their insurance or had moved, while Blue Shield has paid $38 million to cover out-of-network bills that were caused by its inaccurate doctor listings. Critics say the provider directories are full of doctors who are dead, moved, retired, no longer accepting insurance, or not accepting new patients. Insurance companies say directory management is a nightmare since doctors often don’t return their calls and 30 percent of them change affiliations in a given year. CMS originally required insurance companies to call every doctor monthly to verify their listings, but changed that to quarterly since as MGMA says, “The last thing physicians want is for hundreds of health plans to call them every month.”

Privacy and Security

This won’t help the argument for a national patient identifier: the TSA may stop accepting driver’s licenses issued by several states that refuse to comply with federal standards. Federal law requires states to check documents that verify the identity of applicants, equip the license with a chip or magnetic stripe containing the information collected, and to share information with other states and the federal government. The Department of Homeland Security wants to implement the $3.9 billion program to more carefully check travelers and to prevent identity theft, while critics say it’s the equivalent of a national ID card and the recent hack of the Office of Personnel Management raises concerns about storing too much personal information in one location.

Mainstream media have picked up on a Financial Times report that simply added up the number of hacked US medical record records for 2015 and reached the unsurprising total of 100 million, nearly 80 million of which resulted from the Anthem breach alone. FT repeats the hacker motivation in which a credit card record fetches only $1 on the black market, while a complete medical record is worth $2,000.

Technology

The first non-beta release of Google Glass will occur in mid-2016, says a newspaper that ran purportedly leaked photos of the device obtained from FCC filings. It will now be sold only to businesses under the name Google Glass Enterprise Edition, available only from companies that will pre-load their software on it. Features include a sturdier hinged design, an external battery pack, a larger screen but at least one model that won’t include a screen at all, and eventually a clip-on model for people who wear glasses. Excited Glassholes who paid $1,500 for the previous version – most of whom abandoned it quickly due to limited functionality and unlimited public scorn — probably aren’t thrilled that the Glass development team now refers to their premature technology investment as “little more than a scuba mask attached to a laptop.”

St. Jude Children’s Research Hospital scientists develop ProteinPaint, a free Web application and dataset that allows scientists to analyze and contribute information on genetic mutations that cause pediatric cancer.

Other

An interesting article questions the AMA’s interest in requiring competency testing for aging physicians. Some experts say evidence is scant that older doctors are less competent or less likely to follow modern standards and therefore any new competency testing should be applied to all doctors. This is a brilliant quote: “It’s a growing concern now that 26 percent of active physicians in the US — about a quarter million docs — are over 60. Fears they will soon go running for the exits and create a physician shortage are competing with fears that they will stick around forever and create a quality performance gap.”

In Pakistan, a government official angry at the IT department of a local hospital gives it until February 15 to go live with its computer system after the project was delayed for five years.

The $1,000 per pill hepatitis C drug Sovaldi costs only $4 in India after Gilead Sciences licenses 11 India-based companies to produce generic versions that aren’t available here. You’re welcome, India (or should that be “no problem?”) That nicely illustrates how product pricing that would be entirely reasonable in every other industry (charge whatever people are willing and able to pay) is infuriating when being an un-wealthy citizen of a purportedly wealthy (but deeply in debt) country means you can’t afford to get something that would make you healthier.

Researchers find that contrary to perception, Britons have better teeth than Americans, mostly because they have access to publicly funded medical and dental care and we don’t. We’re mid-pack in global dental health, which is a lot better than we fare in overall health in every category other than spending.

A senior manager at a company that specializes in “changing health behavior” (meaning being paid to push paid advertising at doctors) urges colleagues that “we must rely in EHR technology to capture data and use it to target our messages effectively … Our promotion can be just as successful as [wrestling promoter] WWE.” You can bet that sort of nonsense will neither raise physician EHR satisfaction nor lower US healthcare costs, but the fact is, it works, because doctors aren’t nearly as smart as they think in resisting the siren song of billion-dollar industries willing to do anything to wrest control of their prescribing pen or keyboard.

It’s puzzling to me why some experts – doctors, CIOs, and health IT people – seem to structure their entire professional lives around Twitter and Facebook as though whatever they do there constitutes a professional accomplishment worth including on their LinkedIn profile. As evidence, note the unconvincing “7 Social Media Platforms Every Urologist Should Use,” which suggests that “it’s becoming essential for every healthcare professional to cultivate an online presence” and adds that following lame conference tweets is as good as actually attending. The author says every urologist should use Facebook, LinkedIn, Doximity, Twitter, Figure1, Instagram, and Periscope. I think it’s probably an uncommon urologist whose social bleatings would prove entertaining or informative, so perhaps the blanket recommendation that all of them take to the airwaves should be tempered with the reality that not all of them are well suited for it. Self-proclaimed “King of the Urology Twitter World” Ben Davies, MD  (@daviesbj) is an obvious exception, although he shares stuff that patients might not need or want to see.

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.

20 Top Stories of 2015, 20 Predictions for 2016

It’s not too hard to choose 2015’s big stories, but I’m annoyed by people who make obvious “predictions” that are intentionally vague enough to evade accountability, like psychics who boldly proclaim that their client will have “a change in fortune” or “family developments, some good and some bad” in hoping desperately not to lose business by being proved clearly wrong. My predictions will be specific and I’ll publicly recap them this time next year even if they make me look silly.

What are your predictions for 2016? Send them my way and I’ll list them here.

Stories

1. The Department of Defense chooses the team of Leidos, Cerner, Accenture, and Henry Schein for its $4.3 billion EHR project.
2. High-flying Theranos and Turing Pharmaceuticals go down in flames, at least temporarily.
3. NantHealth continues its acquisition streak and PR push, but temporarily shelves its IPO plans.
4. ICD-10 finally goes live with barely a ripple thanks to the in-the-trenches folks who modified systems to accommodate it.
5. The Supreme Court upholds the Affordable Care Act, but poor-performing state exchanges, increased insurance company costs, and increasingly higher deductible and narrower networks leave the middle class footing the bill for a bold experiment that has mostly helped providers gain paying patients without improving overall health.
6. Just about everybody pushes back on Meaningful Use Stage 3, either by complaining to Congress or exiting the program, and doctors increasingly say their EHRs are the top source of their dissatisfaction.
7. Industry mergers increase dramatically at all levels – health systems, health IT vendors, drug companies, and insurance companies.
8. Epic CEO Judy Faulkner pledges to donate her multi-billion dollar fortune to a charitable foundation upon her death or direction.
9. Epic and Cerner continue to dominate the inpatient systems market at the expense of their only significant competitor, Meditech.
10. Data breaches become commonplace, including hackers who accessed the identities of 80 million people associated with Anthem.
11. Cerner completes its acquisition of the former Siemens Health Services, but sees its financial results tarnish slightly immediately following.
12. Athenahealth acquires software from RazorInsights and Beth Israel Deaconess Medical Center as it increases its push into the inpatient market.
13. CVS and Walgreens continue to lead health IT with innovative apps and services.
14. Epic wins several impressive customers, but struggles in the UK, loses the DoD contract, and will be displaced with Cerner following Banner Health’s acquisition of financially strapped University of Arizona Health Network.
15. The OpenNotes project to allow patients to review clinician documentation gains ground with positive study findings and new funding.
16. Expectations increase for the FHIR standard as the best way to integrate EHR information with other systems.
17. ONC releases its Interoperability Roadmap that calls for EHR vendors to expand their API support and for the government to streamline privacy and security policies.
18. Mobile apps show considerable promise for diagnosing and monitoring mental health conditions, especially depression.
19. Apple announces ResearchKit for clinical study enrollment.
20. Major healthcare systems and payers pledge to migrate most of their business to value-based payments by 2020.

Predictions

1. The cooled-off IPO and funding markets will leave nearly all of the unprofitable startups that graduated from the overabundance of accelerators and incubators in the past few years struggling to gain or maintain momentum and customers. Companies with IPO intentions will postpone their plans due to market conditions, but Health Catalyst will do so anyway with decent but comparatively unspectacular initial share price results as wary investors wait for a couple of good quarters to convince them.
2. Healthcare costs will become a contentious topic in the 2016 presidential elections as the millions of Americans who purchased health insurance are stung by low utilization and high costs due to high deductibles and co-insurance, leaving them both poorer and less healthy than before. Medical bankruptcies will increase significantly and hospitals in particular will find it difficult to collect the money owed by under-insured patients. At least one presidential candidate will timidly suggest cost controls – both provider and pharma – as the only remaining option in trying to manage the increasingly damaging costs of healthcare in the US. Provider mergers will continue and national brands such as Kaiser Permanente that combine insurance and care delivery will gain prominence.
3. Consumers will lose interest in fitness trackers and wearables as 2015’s Christmas presents gather January dust just like they did last year.
4. The CEOs of Epic, Cerner, and Meditech will start to pull back from day-to-day company involvement as they approach retirement.
5. ONC and Meaningful Use will become increasingly less relevant and more contested as ONC replaces Karen DeSalvo with a new National Coordinator who lacks her experience and bipartisan support.
6. Several mid-tier consulting firms will be downsized or acquired as their implementation and advisory business dries up.
7. At least three big health systems will experience a data breach that results in exposure of the information of 100,000 or more their patients. The industry will realize that collaboration to identify and mitigate breach threats is essential and of mutual benefit. The government and organizations such as HIMSS will attempt to create and manage an information sharing and risk assessment platform.
8. The VA will announce plans to eventually replace VistA with a commercial product. Congress will push Cerner since the Department of Defense will be implementing it, but the VA will favor Epic just to be different.
9. At least one Epic and Cerner customer will switch to the other company’s product in trying to get a better deal on crippling software maintenance fees. Epic will also expand its hosting service to compete with Cerner’s successful offering.
10. The terms “telemedicine” and “mobile health” will become antiquated as they simply become another accepted aspect of care delivery. “Information blocking” will also fade away as a hot term when everybody realizes the concept involves speculation without proof, but consumers will increasingly demand that their providers share their information – both with their other providers and with themselves – without charging per-page fees for information that exists in electronic form.
11. IBM Watson will continue to produce mostly hype. No convincing studies will demonstrate its value, but newly announced, high-profile partnerships will keep IBM shareholders hopeful.
12. The dark horse publicly traded company best positioned to succeed in health IT and related areas without a lot of fanfare will be Premier.
13. Athenahealth won’t get much inpatient traction with the former RazorInsights and BIDMC’s WebOMR.
14. McKesson will consider packaging and divesting its many health IT offerings as non-core business.
15. Epic will not join CommonWell, but will leapfrog its competitors in offering APIs and slowly building a carefully controlled third-party ecosystem.
16. Software for population health management and analytics will enter Gartner’s Trough of Disillusionment as providers implement it poorly and without a commitment to truly change their profitable business models.
17. Cerner and Epic will continue to poach the business of Meditech, CPSI, and best-of-breed vendors whose small-hospital customer bases are being acquired by larger health systems.
18. “Big data” will support a few meaningful clinical studies performed using only aggregated electronic information, but “little data” will provide more impressive but less-publicized results as doctors design the treatments of individual patients by reviewing the outcomes of similar patients.
19. Consumer healthcare apps will continue to be plagued by inconsistent use, questionable design, and an unremarkable impact on health or outcomes.
20. CHIME and AMIA will follow the HIMSS model of increasing conference attendance and revenue by catering to high-paying vendors willing to buy access to prospects.

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.

Monday Morning Update 12/28/15

Top News

AMA President Steven Stack, MD says EHRs are the #1 frustration of doctors, explaining,

We live in a world where a 2- or 3-year-old can pick up a smartphone and use it with no instructions. If you’re not careful, they’ll order from Amazon and have something delivered to your house two days later. But we have graduate-educated physicians who are being forced to use software that looks like it’s on an old-fashioned, DOS-based system, a Tandy, an Atari, the kind of software you can only see in a museum. And that’s the software we’ve been given to manage patients’ health and well-being. So you have physicians whose efficiency is decimated. Their ability to communicate with each other is completely crippled. And then they’re told you’re not doing a good job.

Reader Comments

From Coal-Bearing Santa: “Re: Marshfield Clinic. I’ve heard that CareCloud has made a deal for its Cattails system and will white label it as an additional CareCloud product.” I forgot that the organizations announced a deal in April 2015 to sell software and services to large physician groups.

From Frisbee Golfer: “Re: Claritas Mindsciences. The three-person firm (everybody is a consultant), which makes the Craving to Quit app, has asked consultants to work for half their normal rates and is struggling to pay vendors after they failed to raise funds for operations in December.” Unverified. Their executive page still lists four people, but what drew my attention is that the company spelled its own name incorrectly on the exec page and sometimes uses “Mindscience” instead of “Mindsciences.”

From John: “Re: NHS. They have the top Christmas song!” In England, the Lewisham and Greenwich NHS Choir beats out Justin Bieber for the top Christmas song. Bieber encouraged his Twitter followers to buy the record instead of his own, which sent it to the top of the sales chart. Proceeds will be donated to charities.

HIStalk Announcements and Requests

Three-fourths of poll respondents say they had at least as good a year in 2015 as they did in 2014. Pablo says he left the health IT staffing market because business is dying due to EHR vendors expanding their own internal consulting teams, a saturated and commoditized market, and staffing companies that failed to transition into advisory services.

New poll to your right or here: which company did you lose the most respect for in 2015? Vote and then click the poll’s Comment link to explain.

I’ll be closing my reader survey shortly, so you’ll have done your good deed for the next year if you take two minutes to complete it. I’m already contemplating one change as suggested by a reader who would like to see more in-depth reporting in particular areas.

My latest pet peeves: (a) people who say, “I get that” in subtly but indignantly correcting someone who they perceive believes otherwise;  (b) those folks, mostly younger, who respond to a thank you with, “No problem,” thereby devaluing the act that triggered my gratitude by suggesting it wasn’t much effort for them; and (c) Facebook users who excitedly “like” obviously phony stories without bothering to check Snopes.com first, like photos of the Egyptian pyramids covered by snow after a freak storm.

We funded four tablets for three pre-K classrooms in New York via DonorsChoose. Mrs. Martin says many of her students had never seen a tablet. They watch videos on them, trace on-screen letters with their fingers to learn to write, and play educational games. That’s a pretty strong ROI for tablets that cost only $41 each.

An anonymous donor sent $500 for my DonorsChoose project, which was matched by the Bill & Melinda Gates Foundation in a one-day funding special and then the $1,000 total was matched again by my anonymous vendor executive, allowing me to fund these projects (some of these had additional matching funds applied as well):

• 10 sets of headphones for Mr. Ohlinger’s middle school science class, Canton, OH
• A Bluetooth robotic arm, a solar powered robot, and a BoeBot robot kit to create a robotics team at Ms. Sobosan’s high school in Las Vegas, NV
• 15 scientific calculators for Mr. Cho’s Bureau of Indian Affairs high school class in Lower Brule, SD
• Math story books for Ms. Livingston’s third grade class in Las Cruces, NM
• Headphones, whiteboards, privacy partitions, and paper supplies for Mrs. Heinrich’s elementary school class in San Jose, CA
• Three tablets for Ms. W’s second grade class in Oakland, CA

Anonymous Epic QA donated $100, with multiplied into $400 due to Gates Foundation and my vendor exec matching money to buy these items:

• Engineering toys and team building sets for Ms. Medina’s first grade class in Los Angeles, CA
• 25 sets of headphones for Mrs. Riley’s second grade class in Baltimore, MD
• An iPad Mini for Mrs. Ulhaque’s first grade class in Houston, TX

I had a little bit of extra money in the account, so I decided to buy a Chromebook, wireless printer, and supplies for Mrs. Hamilton’s fourth grade class in Carson, CA. I also realized that when I announced that donations had funded $22,000 worth of projects in 2015 that I was off considerably – all of the recent donations were via gift cards and those show on the donor’s totals, not mine. The actual total is a lot higher and even that doesn’t take into account matching funds from foundations.

Last Week’s Most Interesting News

• The Department of Defense expands the scope of the DHMSM project in giving Leidos/Cerner a no-bid hosting contract, saying Cerner’s systems won’t work properly unless the company hosts them itself.
• Medicare releases a dashboard showing its drug-specific spending.
• Martin Shkreli is arrested on securities fraud charges and fired as CEO of the two drug companies in which he holds substantial ownership.
• Congress passes a blanket Meaningful Use hardship exemption.
• Vanderbilt University Medical Center announces that it will replace McKesson’s Horizon Expert Orders, which VUMC originally developed as WizOrder, with Epic.

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

A watchdog’s report finds that McKesson paid the most money in misconduct penalties of all Department of Defense contractors since 1995. McKesson paid $2.05 billion in penalties for 24 instances of misconduct while earning $6.2 billion of the Pentagon’s business.

The Greenville, SC paper profiles local personal health records startup ChartSpan, which says it will grow from 20 employees to more than 200 within the next two years.

People

Eric Alper (Lifespan) is named VP/chief clinical informatics officer at UMass Memorial Health Care.

Firelands Regional Medical Center (OH) promotes Denao Ruttino to AVP of operations.

Other

New York-based non-profit United Rescue is spending $2 million to train and equip volunteer first responders in Jersey City, NJ who will be notified via a smartphone app when someone nearby calls 911 with a medical emergency, allowing them to render aid to the victim before paramedics arrive. The program is modeled after one in Israel where 3,000 volunteers respond to 700 emergencies each day for a program cost of $7 million per year.

Impact Advisors sent over photos from their holiday employee gatherings across the country, including this one from Chicago.

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.

News 12/23/15

Top News

ONC releases its 2016 Interoperability Standards Advisory that lists federally recognized interoperability standards and guidance.

Reader Comments

From Ambient Occlusion: “Re: homegrown EHRs. Regenstrief/Eskanazi signed up for Epic earlier this year.” Somehow I was thinking Marshfield Clinic and my fingers typed Regenstrief instead when I was trying to think of the last few health systems that are using homegrown EHRs (BIDMC is the other) now that Vanderbilt is moving away from WizOrder/Horizon Expert Orders in favor of Epic. I replied as such to Ambient Occlusion, who then pondered what Marshfield will do after pumping so much money into Cattails. He added a theory that they’ve probably capitalized some of their software development costs and would therefore not only need to spend big money to replace their self-developed product, but even more to write down whatever of its depreciated costs that remain on the books. Marshfield has tried to commercialize Cattails, but given that the newest press release on their site is from 2010, I’m guessing it’s not burning up the EHR charts.

From Benign Growth: “Re: HIStalk. I’m new here and I can’t figure out who’s writing what.” That’s easy – every word you read in an HIStalk news post is mine (Mr. HIStalk, aka Mr. H) unless I’m taking a rare day off and Jenn is covering for me. It always amuses me when people refer to the HIStalk “team” as through there’s a bunch of us working full time in an office. I write HIStalk, Jenn writes HIStalk Practice, Lt. Dan writes the HIStalk headlines and HIStalk Connect, and Lorre handles the webinars and sponsor activities. We each do our own thing with minimal contact with each other since we’re spread out and don’t need much supervision. Our past and present day jobs didn’t often support the creativity and fun we enjoy here. It will be 13 years in June since I started HIStalk and I still can’t wait to start filling the blank page every day.

From Rough Taxpayer Sex: “Re: DHMSM. SPAWAR has added a sole-source hosting agreement to Leidos/Cerner. This looks like a total scam. Either they lied in the RFP about what they could provide or they’re lying now.” DoD awards Leidos a no-bid Cerner hosting contract that it claims won’t cost more than $5 million per year, explaining the need to modify the scope of the $4.3 billion award as follows below. Note that it’s nobody’s fault according to the wording – Leidos didn’t suggest that service and the government people involved could not have anticipated the need for it (I expect this excuse to be re-used for future expensive scope changes):

While Leidos solution meets the contract requirements, many of the capabilities of the DHMSM EHR cannot be fully realized unless they are hosted in the Cerner environment. In order to fully enable these functionalities, the DHMSM EHR requires direct access to proprietary Cerner data, which is only available within Cerner-owned and operated data centers. The proprietary data consists of quantitative models and strategies which are the result of extensive Cerner-funded research and development efforts conducted over 15 years. The models are based on analysis of clinical, operational, and financial data associated and incorporate vast amounts of actual longitudinal patient data and information collected through other Cerner applications. Forward deploying the DHMSM EHR into any other hosting solution would prevent access to these models and data. Significant functionality exists within the required system that utilizes machine learning and computational statistics to enable predictive analysis and decision support that directly impact patient outcomes. Therefore, no other contractor can satisfy the requirement. Prior to awarding this performance-based contract, the Government could not have anticipated this solution-specific need, which is why this scope was not included in the original RFP.

HIStalk Announcements and Requests

I use the responses from my once-yearly reader survey figure out what I’m doing well and not so well. I would appreciate two minutes of your time to complete it. That will also place you in the running as the randomly chosen recipient of a $50 Amazon gift card. I used previous survey results to make changes that became into some of the most important attributes of HIStalk, so your time will not be wasted. I get a lot of great ideas from the survey, although I have to be careful not to: (a) fix something that isn’t broken; (b) do something that isn’t true to my personality or passions; (c) take on more work than I can handle effectively; or (d) do something that would make writing HIStalk less fun so that I would be tempted to quit doing it.

An anonymous Epic developer donated $200 for my DonorsChoose project, to which I applied matching funds from my anonymous vendor executive as well as from private foundations to purchase these items:

• Fraction, decimal, and percent learning tools for Mrs. Sutton’s third grade class in Herrin, IL
• A Chromebook for Ms. Marlowe’s kindergarten class in Charlotte, NC
• Math games and learning materials for Ms. Osborne’s elementary school class in Columbia, SC
• Math games and a learning center rug for Mrs. Begg’s middle school class of learning and emotionally disabled students in Baltimore, MD

Ms. Osborn’s Florida second graders, many of whom are children of immigrants and frequently-moving military families, are working in teams using the STEM materials we provided via DonorsChoose to solve real-world engineering problems.

Also checking in is Ms. C from South Carolina, who teaches a class of severely intellectually disabled seventh and eighth graders for whom our DonorsChoose donation provided a library of around 100 high-interest, low-readability books. She provides background on the student in the photo above as an example: “The picture of the boy reading a book with my Dr. Seuss hat on is a child from a low-income family. He will come to school hungry and is usually very sleepy because he can’t sleep at night. He is very capable of reading better than he does right now. He loves to go over to my little classroom library and pick out a book to read. The other day he told us that he is actually leaning something this year. Until this project was funded, I really didn’t have enough books for a classroom library, but now I do.”

It’s that time of year where we’ve now gotten past the shortest day (December 21) and spring and the HIMSS conference aren’t far away. I’ll probably take this Friday and next off since I doubt many folks will be reading on Christmas and New Year’s eve and day. I expected to be mostly loafing around for most of December since it’s usually slow, but I’ve been pretty busy with fresh news and lots of companies are signing up as HIStalk and HIStalkapalooza sponsors. It’s good to keep busy, for which I thank every person who reads HIStalk and every company that supports it.

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

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

Invoice Cloud acquires Imagevision.net, which offers the HealthPay24 point-of-service payment product used by 100 hospitals.

The professional regulator in England bars two former finance directors of one-time NHS software supplier iSoft (now owned by CSC) from practicing accounting for eight years for their involvement in the company’s financial irregularities nearly 10 years ago. Four company executives were acquitted in 2013 of securities charges.

Sales

Northern Arizona Healthcare chooses Cerner Business Office Services for its ambulatory clinics and ACO, apparently replacing Athenahealth.

Announcements and Implementations

Summit Healthcare releases a Cerner-specific version of its domain compare-and-sync platform that supports data extraction, analysis, regression, and testing.

Halifax Health (FL) goes live with Wolters Kluwer Health’s POC Advisor for real-time, data-driven sepsis alerts and advice.

Government and Politics

CMS releases the Medicare Drug Spending Dashboard that includes the top 15 drugs by overall annual cost and per Medicare user as well as the drugs whose price jumped the most in 2014. The $1,000 per tablet hepatitis C drug Sovaldi topped the list as Medicare spent $3.1 billion on it at an average per-patient cost of $94,000. The most expensive drug per patient was Remodulin, used to treat pulmonary arterial hypertension, which cost an average of $134,000 per patient per year. You will recall that the Affordable Care Act prohibits Medicare from negotiating drug prices, a carrot added by the White House to appease drug companies who otherwise would have used their political clout to kill its administration-defining initiative.

Kansas state auditors say the state’s delayed Medicaid system rollout was due to unrealistic timelines and unmet functionality promises from contractor Accenture. Federal taxpayers are footing most of the cost of the Accenture contract that is worth $135 million upfront and $50 million for ongoing maintenance. Auditors predict that the project will run $46 million over budget, with nearly all of that bill also being passed along to federal taxpayers.

CMS is investigating complaints filed by two former Theranos employees who claim that the lab company instructed its employees to continue using its proprietary testing technology despite “major stability, precision, and accuracy” problems. The former employees said results varied widely and that quality control checks of the testing method often failed. Theranos says the former employees are just disgruntled. The company continues to claim that it will publish peer-reviewed data proving its claims, but says they aren’t yet ready.

Other

Baseball data analysis expert and Harvard-trained statistician Paul DePodesta, played as a composite character by Jonah Hill in the movie “Moneyball,” joins Scripps Translational Science Institute in a part-time, unspecified role. He says in an interview conducted by his new co-worker Eric Topol, MD:

If there’s a player who has been in the Major League for say five years, we have an awful lot of data on that player. So when we’re making a decision on that player, we may largely be using data to make that decision. Go to the total opposite end of the spectrum – a 15 year old playing in Maracaibo, Venezuela – we don’t have a whole lot of data on him. We have some, what I would call sort of outside data. We know about players form that area, we know players of his size, his strength, his age, his position. Not necessarily specific things about him, but we can create general conceptions about what that player could be expected to do based on all these other players have done who are similar to him in same fashion … people are trying to get their arms around uncertainty and trying to make better decisions for the future and realizing that data can really help them do that. Whether it’s financial services or trucking or farming, I mean there are all sorts of different industries that I never even dreamed of back when the book first came out and even when the movie came out that have reached out to us — to me or to Billy or to others — and have said, “We’re doing this now and it’s really helping — do you have other ideas about what we might be able to do?

Speaking of “Moneyball,” I’ll say again that of the many conference speakers I’ve seen, the best was Billy Beane of the Oakland Athletics. If you haven’t seen the movie, here’s a recap. Beane’s team didn’t have the money to sign or retain big-name players who made occasional crowd-pleasing plays yet failed to achieve consistency, so he measured and analyzed available player performance data to choose lesser-known and therefore less-expensive players who produced consistent but unspectacular results, like getting on base a high percentage of the time, and then managed using those specific strengths to produce team wins. I thought it was bizarre that Health Catalyst chose Beane as a keynote speaker for its first Healthcare Analytics Summit in the fall of 2014 until I heard him.

A USC report predicts that Medicare spending will double to $1.2 trillion by 2030 as per-beneficiary costs rise 50 percent, caused by aging baby boomers who — much more than in previous generations — are overweight, disabled, and suffering from chronic conditions. In other words, people who might have died from now-preventable heart disease will live longer and more expensively in requiring treatment of cancer and Alzheimer’s disease.

CMS identifies at least five drugs whose cost doubled in 2014 from the new Medicare Drug Spending Dashboard that I mentioned above, with the ridiculously unoriginal Vimovo (two old generic drugs combined, naproxen and esomeprazole, the first for pain and the second to reduce side effects caused by the first) leading the list after a new company bought the drug and raised its price 500 percent. Ancient drugs captopril and digoxin were among the leaders, which cries out for some sort of action to stop companies from buying the rights to old drugs and then jacking up their prices to yield pure profit without the inconvenience of performing research studies or creating something new that might benefit patients rather than shareholders.

I also note that Vimovo maker Horizon Pharma is using a now-common drug company trick to increase patient demand while raising societal costs overall – its “support card” promises that patients will pay little or nothing as co-pays even while the company is sticking their insurance company for the inflated cost. Medicare spent $39 million on this lame drug in 2014, which of course means doctors prescribed it quite a bit for reasons that probably aren’t entirely rational.

It hasn’t been a great week for Martin Shkreli, who in addition to being arrested on securities fraud charges and then fired as CEO of Turing Pharmaceticals, has now been fired as CEO and board member of KaloBios, the drug company he bought just a few weeks ago. Meanwhile, Shkreli tells the Wall Street Journal that the government trumped up securities charges in desperately trying to find something to arrest him for. He also claims that his over-the-top behavior is “a social experiment” that makes him an undeserving target. He would make an ideal HIStalk interview, although I’m not holding my breath.

This image has been used so many times without attribution that I can’t tell where it came from, but I saw it on LinkedIn and liked it.

Gallup’s annual poll of most honest and ethical professions finds nurses, pharmacists, and physicians taking the top three spots. The last-place finishers are members of Congress, telemarketers, and lobbyists.

Sponsor Updates

Blog Posts

• Start with Why (Iatric Systems)
• Unified Care Teams Need a Unified Communications Strategy (PatientSafe Solutions)
• Information Management #2 – Bad Data (Clinical Architecture)

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.

Monday Morning Update 12/21/15

Top News

Vanderbilt University Medical Center will implement Epic, replacing the sunsetted McKesson Horizon Expert Orders. VUMC developed WizOrder and sold it to McKesson in 2001, which commercialized it as HEO. VUMC announced in April 2015 that it would choose between Epic and Cerner. It says none of the functionality it self-developed in WizOrder will be lost. I can’t think of any other homegrown systems still in use other than at Beth Israel Deaconess Medical Center and perhaps at Regenstrief.

Reader Comments

From Below the Beltway: “Re: Meaningful Use. A blanket hardship exemption was not included in either the omnibus or the extenders package passed and the matter seemed settled for this year. Surprisingly, the Legislature came to an agreement on a bill with several Medicare reforms, including a change to the hardship exemption on a bill with several other Medicare reforms. The bill, S. 2425, passed the Senate Friday morning and the House Friday afternoon by voice vote and unanimous consent, respectively.” The full text of the bill is here.

From The PACS Designer: “Re: EDWs. TPD isn’t a vendor neutral archive advocate. More VNAs only complicate the storage issues and can result in arguments about what can be put in a VNA. A better idea is the electronic data warehouse (EDW), which encompasses not only using internal data sources, but also can include external ones and can bring more value to the decision-making processes. EDWs are also a better way to communicate with an HIE. What do you think?”

From Spiffy Tie: “Re: Cerner. My organization is a Cerner client and my perception of the company has fluctuated widely over the past 10 years. I’ve been especially disgusted by Cerner’s business plan. Their software has improved in many respects, but to make it functional requires a lot of customization. Cerner will gladly sell consulting time to multiple organizations to make the same changes rather than building it into the base product. Issues that would be bugs or defects in other software is typically said to be WAD (working as designed). If you want it fixed, you can pay for the customization yourself or submit an ‘idea,’ which is almost always rejected as ‘not aligned with current priorities.’ Other new features that are essential (to correct prior defects, safety issues, or gaps in content) are incorporated into new packages that have to be purchased separately rather than being a part of already-purchased upgrades. Despite my disgust with Cerner’s overall approach, I also have very positive feelings about Cerner in terms of their employees. Virtually everyone I’ve worked with is knowledgeable, professional, and willing to go the extra mile to make things work for our staff and our patients. I have very high regard for them and enjoy working with them very much. I think it’s especially egregious that Cerner would turn on its best asset, their employees, with this forced arbitration clause. If other companies and our judicial system have engaged in or supported such abusive extortion of hard-working individuals, then shame on them too.”

HIStalk Announcements and Requests

The vast majority of poll respondents see Cerner’s requirement that employees sign arbitration clauses to continue eligibility for merit increases as negative. Some readers say it’s not just Cerner doing it and perhaps adding the $500 in stock options as a legal “consideration” was required to make the unilateral contract change legal. Several respondents predict that the company will lose good employees who will resent the strong-arm tactics and whose talent gives them career options elsewhere. New poll to your right or here: how was your 2015 compared to 2014? Click the Comments link after voting and explain why.

Readers always enjoy the HCIT Family Tree that shows the acquisition history of all the health IT vendors. Creator Constantine Davides, senior healthcare analyst with AlphaOne Capital Partners, has updated it. Here’s a trivia question I randomly chose from Constantine’s chart: which company owns the former Medifor?

I’ve been using a third-party Rumor Report form for years, never quite getting around to making the easy switch to the form design tool I already own that would have saved me $20 per year. The choice was made for me, which you may have noticed if you tried to use the form recently – the tiny company that hosted it lost their server and didn’t have a backup, so they shut the service down without letting users know. Try the new form instead.

My latest pet peeve: software companies that claim to be “population health management” vendors instead of “population health management software” vendors.

Mrs. Schmidt’s California fourth graders can’t wait to start using the STEM lab kits and library we provided via her DonorsChoose grant request. Also checking in was Mrs. Marler of Alabama, whose third graders are using their new wireless document camera to explain their thought process to the class.

Not much will be happening over the next couple of weeks, so I’ll have less to write about. Then it will get crazy as it always does between New Year’s Day and the HIMSS conference, a frantic 10 weeks.

It’s time for my annual reader survey. Take a couple of minutes to fill it out and you’ll be: (a) helping me, and (b) entering yourself into a random drawing for a $50 Amazon gift card.

Last Week’s Most Interesting News

• Cerner requires its employees to sign away their rights to sue the company in return for remaining eligible for merit increases.
• Robert Wood Johnson Foundation releases a dataset containing details of all marketplace-offered insurance plans for 2015 and 2015.
• CMS gives doctor selection website Amino access to provider-level quality and cost data.
• Five foundations donate $10 million to the OpenNotes initiative.
• National Coordinator Karen DeSalvo, MD, MPH calls for health IT stakeholders to commit to providing consumer access, avoiding information blocking, and following standards
• Dell is again rumored to be trying to sell the former Perot Systems for $5 billion to help pay for its EMC acquisition.

Webinars

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

Here’s the video of Wednesday’s webinar, “A Sepsis Solution: Reducing Mortality by 50 Percent Using Advanced Decision Support,” sponsored by Wolters Kluwer Health and featuring guest presenter Rick Corn, VP/CIO of Huntsville Hospital (AL).

Acquisitions, Funding, Business, and Stock

Columbus, OH-based Aver, which offers software that allows providers to calculate bundled prices based on past claims, raises $11 million, increasing its total to $22 million.

New York’s Capital Region loses its bid for $500 million in state money that would have supported an investment of $100 million to $200 million to create a population health technology hub, but IBM Watson Health and other participants say they will continue their efforts without the state funds.

Sales

China-based Luye Medical Group chooses the InterSystems TrakCare EMR.

University Hospital Southampton NHS Foundation Trust chooses Hyland OnBase for enterprise content management.

Other

Pharma bad boy Martin Shkreli, who was arrested Thursday on securities fraud charges and then resigned (or was fired) as CEO of Turing Pharmaceuticals on Friday, spent Friday just like any other day: vainly live-streaming himself on YouTube as he exchanged messages with fans and critics, played his electric guitar, looked for women on dating sites, and played online chess. Magazines such as Vanity Fair are digging deeper beyond his cartoonish villain personality to acknowledge his brilliance, bluntness, and seldom-mentioned charitable side. Meanwhile, shares in biotech company KaloBios Pharmaceuticals, which Shkreli acquired a few weeks back via shrewd Wall Street betting, were halted on the news of his arrest, having shed half their value in pre-market trading. They had jumped from under $1.00 per share to as high as $40 after Shkreli’s involvement was revealed, all in less than four weeks. His stake in the company, once worth $80 million, is now valued at around $50 million, at least until trading resumes. He is apparently still serving as CEO of KaloBios. A UCSF medical school professor and author reminds those who expressed glee at seeing Shkreli perp walked that his infamous Daraprim price hike wasn’t illegal and in fact still stands:

It easy to demonize him. But if you’re going to let the market drive the pharmaceutical industry, it shouldn’t surprise anyone that he wants to maximize profits. There’s no law that he has to be ethical. His job is not to make drugs available and save patients. His responsibility is to make a profit for his shareholders.

Colorado puts single-payer coverage on the ballot, where the state would pay the medical bills of all citizens not covered by Medicare or military programs. Wage earners would pay 3 percent of their net income with their employers kicking in another 7 percent, with the new taxes covering the program’s estimated cost of $25 billion per year. Critics point out that Vermont already abandoned a similar plan because the state couldn’t afford it.

A California nursing home with a history of quality problems stops the IV antibiotic of a patient transferred from a local hospital after three days instead of the ordered four weeks due to a nurse’s order entry error.

France tackles anorexia head on by requiring models to obtain a doctor’s certification that their weight is healthy. The new law also requires magazines to clearly indicate when photos of a model have been Photoshopped to suggest a larger or smaller waistline, with fines of up to $40,000 for failing to do so.

Sponsor Updates

• Forward Health Group’s PopulationManager earns the highest preliminary rating scores in the KLAS population health management technology report.
• KLAS names Wellcentive among its top five population health management platform vendors.

Blog Posts

• As We Celebrate This Season (TeleTracking)
• 10 Tips for Choosing the Right RTLS for Your Hospital (Versus Technology)
• Happy holidays! (Voalte)
• Imaging Clinical Decision Support (Zynx Health)
• 5 questions with Nordic CEO Bruce Cerullo (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.

News 12/18/15

Top News

ONC’s Health IT Policy Committee issues its congressionally-mandated interoperability report that includes these recommendations:

• Create outcomes measures that reward well-coordinated and affordable care, such as not paying for performing duplicate lab tests.
• Publish EHR vendor interoperability scores based on actual customer use.
• Add Medicare payment incentives for technology-driven care coordination.
• Convene a summit meeting to start the operationalization of ONC’s Interoperability Roadmap and the recommendations in the document.

Reader Comments

From Fair and Balanced: “Re: Epic. Our support rep has been asking questions about one of our projects, saying Epic recently started an intra-company contest for writing news stories about positive client developments. She and I both speculate that Epic is looking for stories to feed to actual media outlets. If that’s the case, I’m uneasy that Epic is going to this length to promote itself in relying on its own employees for good news rather than for it to come about via independent parties noticing it.” Unverified. I’m not sure I would find that practice objectionable other than it seems to violate Epic’s unconvincing insistence that it doesn’t practice sales and marketing. Industry magazines and sites will cover anything that a vendor or provider hands them on a silver platter regardless of news value, but it’s a tougher sell to newspapers. I was once approached by the local big-city newspaper about a story that their highly visible technology reporter was writing about mobile devices. As I was taking him around to interview people at our hospital, I was surprised at how clueless and generally weird he was (he carried what looked like a purse and stopped every five minutes to squirt drops into his eyes, plus he didn’t seem to know much about technology). The resulting piece was superficial and not insightful since he simply regurgitated selective quotes from our folks, which is probably why I’m disdainful of former reporters who proclaim themselves health IT experts simply because they’ve spent a few years working at that superficial level.

HIStalk Announcements and Requests

This week on HIStalk Practice: AMA opens up its Physician Innovation Network to beta testers. Connecticut physicians detail their telemedicine challenges. Wisconsin joins the Interstate Medical Licensure Compact. Clinicians don’t seem convinced when it comes to HIE ROI. Stericycle VP Lyn Triffletti offers physicians tips to get a handle on HIPAA. Kaiser Permanente Northwest offers members urgent care video visits. Telemedicine keeps operations running smoothly at the North Pole. Dr. Gregg describes his user experience of e-prescribing in the dark.

This week on HIStalk Connect: Rock Health publishes its annual VC funding report which says that digital health startups raised $4.3 billion in investment capital this year, matching 2014’s total. Google partners with Johnson & Johnson to launch a new surgical robot solutions business. Medtronic partners with Samsung to develop smartphone apps for patients receiving neuromodulation therapy. Four foundations invest $10 million to fund the expansion of the OpenNotes program nationally, with a goal of reaching 50 million patients within the next three years.

Listening: Intronaut, LA-based jazzy progressive rock whose sound ranges from a jamming Alice in Chains to a heavier Tool. Also, one of my favorite bands, Zip Tang, masters of complex progressive rock now evolved to a power trio with the departure of the amazing Marcus Padgett (saxophone, keyboards, vocals, and most relevant to health IT, SVP of Experian Health).

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

Insurance company/PPO Clover Health, which analyzes insurance claims to target high-risk patients with specific care manager interventions, raises $35 million in Series B funding led by Sequoia Capital, increasing its total to $135 million.

Data-driven physician performance website MD Insider raises $12 million, increasing its total to $24 million. The round was led by Summation Health Ventures, an investment fund started by Cedars-Sinai and MemorialCare Health Systems, with Cedars-Sinai CIO Darren Dworkin joining the company’s board.

California startup Kumba Health launches a marketplace for consumers willing to pay cash to choose physicians, labs, and imaging centers.

Oration, which offers prescription buying tools for the employees of large, self-insured companies, releases its first app and announces $11.2 million in Series A funding.

Toronto-based customer management software vendor NexJ Systems spins off its population health management software business into a new company, NexJ Health Holdings.

WellDoc, which offers a prescription-only diabetes management app, raises $22 million in Series B funding, increasing its total to $27 million.

Cerner says 93 percent of its 17,000 US employees have  signed away their right to sue the company in return for $500 in stock options and ongoing eligibility for merit increases. An expert says it’s the only example he’s seen where a company will limit future merit increases to employees who decline to sign its arbitration clause.

Sales

King’s College Hospital NHS Foundation Trust chooses Allscripts Sunrise.

The VA contracts with Cogito Corporation, which sells voice guidance technology for telephone salespeople, for software that can assess the mental health of participating veterans by analyzing their telephone conversations.

People

Paul Kleeberg,MD (Stratis Health) joins Aledade as medical director. He served on the HIMSS board from 2011 through 2015 and was its chair through June 2015.

Practice Fusion hires Steve Filler (Oliver Wyman) as COO and promotes Octavia Petrovici to SVP of product management.

Dan Orenstein (Athenahealth) joins Health Catalyst as general counsel.

Divurgent promotes Shane Danaher to national partner of client services.

Announcements and Implementations

Robert Wood Johnson Foundation releases a dataset of all insurance plans offered on health insurance marketplaces in 2015 and 2016, supporting state-by-state analysis of premiums, deductibles, and other plan attributes. For example, the dataset shows that prices increased an average of 10 percent for all tiers in 2016, while silver plans in Alaska saw the largest jump at 35 percent to an average premium of $643.

LauraLynn, Ireland’s children’s hospice, goes live on Oneview Healthcare’s patient engagement solutions in providing entertainment for patients and bedside access to clinical applications for clinicians.

Health information service provider MedAllies will use IBM-owned Merge Healthcare’s iConnect Network Services for image ordering and results delivery for its members. 

Columbus, OH-based CrossChx launches its Queue fingerprint-based check-in kiosk for hospitals that it says reduces wait times by 80 percent. The company says it links a fingerprint to hospital EHR data to provide interoperability when its customers check in somewhere else. Founder and CEO Sean Lane is a former Air Force intelligence officer and NSA fellow who served five tours in Afghanistan and Iraq before founding Battlefield Telecommunications Systems.

Government and Politics

CMS names Amino as its second national Qualified Entity, giving the doctor selection website access to Medicare’s provider-level quality and cost data. Amino has raised $20 million in three funding rounds.

HHS says few states have accepted available federal money to support data-driven Medicaid fraud detection even as improper payments have nearly doubled to 10 percent. The states that were contacted by Modern Healthcare gave several reasons: they have their own data mining efforts, they are trying to figure out if it would help, or they’re waiting to see what other states do before jumping in.

Privacy and Security

LifeLock will pay $100 million to settle FTC charges that it overstated its data protection capabilities and engaged in deceptive advertising.

Innovation and Research

Researchers at NYU Langone Medical Center release a free app that uses Apple’s ResearchKit to track the symptoms of concussion patients.

Other

Madison magazine reviews the impact of Epic on Wisconsin, observing that it attracts huge numbers of liberal arts degreed young professionals who often leave the company after a few years but remain in the Madison area, giving Wisconsin an enviable population of high-achieving Millennials.

Turing Pharmaceutics CEO Martin Shkreli, the most-hated man on the Internet for hiking the price of old but important drug Daraprim by 5,000 percent after acquiring it, is arrested by federal agents and charged with securities fraud. Prosecutors claim Shkreli played a Ponzi-like financial shell game while with Retrophin, a drug company he started before Turing that eventually fired and sued him. Shkreli had previously mocked the lawsuit, saying, “The $65 million Retrophin wants from me would not dent me. I feel great. I’m licking my chops over the suits I’m going to file against them.” A wag observed that Shkreli was arrested only after he bought a rap album and started wearing hoodies, another dubbed him “Karma Bro,” while The New Yorker’s satirical piece was headlined, “Lawyer for Martin Shkreli Hikes Fees Five Thousand Per Cent.”

Former BIDMC CEO Paul Levy writes that news media misreported details about President Jimmy Carter’s cancer, running click-baiting headlines that gave credit to a “miracle drug” (which has actually performed poorly in clinical trials) while downplaying the likely impact of surgery and radiation therapy. Levy quotes a freelance health reporter’s comments at a medical summit in 2009 that sums up the state of medical and health IT journalism pretty well:

It is not our job to satisfy you [physicians], but to keep our readers reading and our viewers viewing. The more responsible the press becomes, the less readers seem to like it.

A fourth co-conspirator pleads guilty to impersonating a Cerner employee in selling medical equipment and $6 million in investments from 50 physicians.

Kaiser Permanente will start its own medical school that will train students on its integrated style of care. The California-based Kaiser Permanente School of Medicine will admit its first class of 48 students in 2019.

Another medical helicopter goes down as two crew members die in an Arizona crash. It was operated by the publicly traded, Colorado-based Air Methods, the self-styled “defenders of tomorrow” that operates medical transport services as well as its 60-aircraft helicopter tourism operation (the recently acquired Blue Hawaiian in Hawaii and Sundance Helicopters in Las Vegas). It also runs a billing company for other medical transport companies, including EMS agencies and ambulance services. The company earned $741 million in revenue where it staffs its own aircraft with medical personnel and bills the patient directly, as well as $162 million from hospital contracts. It earns an average of $12,000 in net revenue per patient transported. As the pie chart above illustrates, federal taxpayers provide 60 percent of the company’s patient revenue. Air Methods likes healthcare reform, predicting that more widespread insurance to pay for its transport services will increase its annual revenue by $31 million. The company’s investor presentation lists its #1 operational challenge as “accidents.” The Glassdoor reviews of Air Methods are pretty bad, with a common theme being that it isn’t really focused on the safety of patients and staff. It has a commendably obtuse and high-falutin’ but questionably punctuated mission statement: “To be the dominant global expert of comprehensive, vertically-integrated, critical care access solutions supporting patient logistics—the movement of patients and their medical analytics.”

Sponsor Updates

• Medicity is positioned in the Leaders category in the 2015 IDC MarketScape.
• LiveProcess is selected as one of 50 Most Promising Healthcare Solution Providers for 2015.
• Medication management solutions vendor HighFive will replace manual mapping of data with SyTrue’s natural language processing and terminology tools.
• CareSync founder and CEO Travis Bond will speak at an SXSW Interactive Festival session titled “Apps and Better Medical Outcomes: Real Solutions.”
• Orion Health launches version 6.2 of its Rhapsody integration engine.
• T-System names five of its ED customers as winners of its client excellence award.
• MedData celebrates its 35th anniversary.
• Inc. Magazine names Lexmark as a new corporate logo that went viral in 2015.
• RedHat makes Glassdoor’s list of companies with the happiest employees.

Blog Posts

• IoT Security: Is Your Fitbit a Key for Criminals? (ID Experts)
• A View through the ICD-10 Looking Glass (Impact Advisors)
• The Data Awakens (Forward Health Group)
• Why SEO is a Must for Hospitals (Influence Health)
• So long spreadsheets! Your transplant data deserves better (Liaison Technologies)
• The Top 10 Elf ICD-10 Moments (MedAptus)
• What do cross-country skis have to do with your EHR running more efficiently? (Nordic)
• Revolutions in Healthcare Analytics Part 4 of 6 – Organizational Readiness (Optimum Healthcare IT)
• Mobile Activates and Engages Patients in their Care (PatientSafe Solutions)
• 3 Reasons Why Healthcare Providers Should Take EMV Seriously (Patientco)
•  Med Wreck (PatientKeeper)
• Painting the Future of OB (PeriGen)
• Inaccurate Provider Data is Causing Problems for Patients and Healthcare Providers (Phynd Technologies)
• A Radiologists, a Pathologist … and a Pigeon? (PMD)
• Why the CFO should care about health IT as much as the CIO (Qpid Health)
• Meaningful Use 3: Patient Access (Sagacious Consultants)
• The Business Case for Interoperability: A Q&A with Salim Kizaraly, Founder and SVP, Stella Technology (Stella Technology)
• HDHPs: Patient Engagement for the Checkbook (Streamline Health)
• Sunquest Value of the Month – Agility (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.

News 12/16/15

Top News

Five foundations, including the Gordon and Betty Moore Foundation and Robert Wood Johnson Foundation, provide $10 million to expand the reach of the OpenNotes initiative to give patients access to their visit notes.

Reader Comments

From Mutual Arbitration: “Re: arbitration clauses. Now Uber is doing them, only they are blasting them to the smartphones of their drives who have to tap ‘agree’ to keep driving. Leave it to Uber to get 400,000 agreements signed almost instantly.”

From Petal Pusher: “Re: another outrageous hospital billing practice. A friend who was admitted to a major NYC hospital says a clinical psychologist came to his bedside, introduced herself, and asked if he wanted to talk about how he was feeling. Sure, he said, so they spoke for 20-30 minutes. She came back a few days later. Surprise – this was charged to his bill even though it wasn’t told it would be billable, he didn’t ask for it, and it was never ordered for him. He thought it was part of the hospital service, for which they billed $7,700 per day.” I suppose the message here is that when you’re hospitalized, just answering the “how are you doing” question from some stranger who wanders into your room could trigger a bill.

HIStalk Announcements and Requests

Mrs. Shaw reports that not only were her fourth graders named the top math class in her Pennsylvania school, two of her students were among the top individual scorers as well thanks to the Chromebook and accessories we provided for math practice via DonorsChoose.

I sent the email blast and tweet on my interview with Gerry McCarthy late Monday afternoon. Gerry emailed me four hours later to let me know that he had already received over 300 emails, calls, and LinkedIn messages in response. I appreciate knowing that since, as I told Gerry in reply, HIStalk is to me just an empty room in which I sit while attempting to fill an empty screen each day in a quite personal way, so I don’t have a good view of what it looks like on the other side of that screen even though I’ve been doing it for nearly 13 years.

Webinars

December 16 (Wednesday) 1:00 ET. “Need for Integrated Data Enhancement and Analytics – Unifying Management of Healthcare Business Processes.” Sponsored by CitiusTech. Presenters: Jeffrey Springer, VP of product management, CitiusTech; John Gonsalves, VP of healthcare provider market, CitiusTech. Providers are driving consumer-centric care with guided analytic solutions that answer specific questions, but each new tool adds complexity. It’s also important to tap real-time data from sources such as social platforms, mobile apps, and wearables to support delivery of personalized and proactive care. This webinar will discuss key use cases that drive patient outcomes, the need for consolidated analytics to realize value-based care, scenarios to maximize efficiency, and an overview of CitiusTech’s integrated healthcare data enhancement and analytics platform.

December 16 (Wednesday) 2:00 ET. “A Sepsis Solution: Reducing Mortality by 50 Percent Using Advanced Decision Support.” Sponsored by Wolters Kluwer Health. Presenters: Rick Corn, VP/CIO, Huntsville Hospital; Stephen Claypool, MD, medical director of the innovation lab, Wolters Kluwer Health. Sepsis claims 258,000 lives and costs $20 billion annually in the US, but early identification and treatment remains elusive, emphasizing the need for intelligent, prompt, and patient-specific clinical decision support. Huntsville Hospital reduced sepsis mortality by 53 percent and related readmissions by 30 percent using real-time surveillance of EHR data and evidence-based decision support to generate highly sensitive and specific alerts.

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

Here’s the inimitable Vince Ciotti and Frank Poggio doing Tuesday’s webinar, “CPSI Takeover of Healthland, Are You Ready?” You will no doubt be entertained by their wry humor even if you have no horse in that particular race.

Acquisitions, Funding, Business, and Stock

Telehealth and videoconferencing platform vendor Vidyo receives a $10 million investment from the venture capital arm of Kaiser Permanente, increasing its total to $163 million.

Telemedicine platform vendor Chiron Health raises $2.3 million in a seed round and releases its patient-facing app. The company allows practices to conduct video visits with guaranteed reimbursement.

Dell is reported to be trying to sell the former Perot Systems for more than $5 billion to help pay for its EMC acquisition, which was previously rumored in early November and reported here. Dell acquired Perot for $3.9 billion in 2009 and is rumored to be talking to Tata, Atos, Genpact, and CGI about buying it.

In a stellar example of how American healthcare is an ugly mix of compassion and profit-seeking, Daughters of Charity Health System (CA) receives a $260 million investment from a hedge fund that also has the option to buy the six-hospital system outright after three years.

Sales

SPH Analytics chooses Clinical Architecture’s Symedical platform for management of clinical and administrative terminologies as well as its SIFT free text semantic interpretation tool.

People

Bill Howard (Caradigm) joins Audacious Inquiry as senior director.

MedSys Group promotes Ann Bartnik to VP of client services.

Lisa Gallagher (HIMSS) and Arien Malec (RelayHealth) will replace John Halamka as co-chairs of the Health IT Standards Committee upon expiration of Halamka’s term in January.

Drug company marketing software vendor OptimizeRX names James Brooks (iCare) as SVP of business development.

Announcements and Implementations

Allscripts adds self-pay capability to its FollowMyHealth patient portal by integrating functionality of its Payerpath products.

Bethesda Hospital (MN) goes live hospital-wide with Epic’s MyChart Bedside tablet app for patients and families.

GetWellNetwork announces several recent new sales of its Marbella patient rounding data collection system.

Southwestern Vermont Medical Center goes live on the NetRelay secure messaging tool from Interbit Data.

Technology

Microsoft will end support and updates for Internet Explorer 8 on January 12 but is selling custom support agreements for customers unable to upgrade their browser, many of which I would guess are in health systems. IE8 was released in March 2009, replaced by IE9 in March 2011.

FDA approves the tricorder-like Checkme Pro health monitor from China-based Viatom Technology. It performs one-lead EKGs, pulse oximetry, temperature measurement, movement sensing, and cuffless blood pressure measurement.

Other

A federal judge denies a motion brought by the Texas Medical Board that sought to dismiss Teladoc’s lawsuit against it, allowing the lawsuit to proceed. Teladoc successfully argued that the board’s rule that allows telemedicine sessions only after an initial face-to-face visit unfairly limits competition.

Eric Topol, MD lists his top developments from 2015 that will change medicine.

In England, dating app Tinder helps the NHS raise organ donation awareness among its younger users by suggesting they sign up as donors when they swipe a supporter’s photo.

A Wall Street Journal article recaps recent studies showing that patients resent doctors who spend a significant portion of their encounter working on a computer instead of making eye contact, suggesting that computers aren’t the problem but rather how they are physically positioned and how the doctors choose to use them. It will be interesting to see what happens as medicine shifts to newer graduates unaccustomed to looking up from their phones to see the actual world around them, or perhaps newer patients will be perfectly happy receiving their medical care from the equivalent of a Facebook post and reply.

An interesting New York Times article by Abigail Zuger, MD describes the common situation in which she uses around 10 information systems that each have their own password composition rules and expiration dates, forcing her to keep an index card listing them all in her pocket at all times. She adds, as the subject of the article suggests, that she’s seeing a “retro explosion of paper” as non-interoperable systems force reliance on hand-delivered paper or faxes. She describes what it’s like: “Who knows what the biblical stonemasons sang to themselves during work hours at their Tower of Babel? This is the soundtrack at ours: ‘What exactly did the kidney guy tell you to do?’ ‘Are you sure?’ ‘How did the ER explain that?’ ‘Could you just bring in the new pills next time?’”

ProPublica digs into significant problems at the American Red Cross in an article called “The Corporate Takeover of the Red Cross” as the charity struggles in the fifth year under a leadership team that was mostly brought over from AT&T. The article says Red Cross has cut its payroll by a third, eliminated jobs, closed chapters in reducing their number from 700 to 250, alienated volunteers, and bungled several emergency response efforts to the point that some emergency planners have decided not to use its services. Surprisingly, its business of selling donated blood to hospitals lost $100 million in the most recent fiscal year because of revised clinical guidelines that reduced blood demand and its failure to adopt industry standard scannable labels. It plans to increase sales of its CPR training programs from $150 million per year to $700 million fizzled as actual revenue instead dropped. An internal survey found that only 35 percent of employees trust the organization’s executives — many employees call the charity “the AT&T retirement plan” — and volunteer satisfaction dropped 20 percent in one year to 32 percent. The CEO of the Center of Volunteer and Nonprofit Leadership, in observing the inept response by Red Cross after a California wildfire while running billboards using the event to solicit donations, concludes, “I view them more as a fundraising and marketing organization than a disaster relief or charity group.”

Sponsor Updates

• Perigen wins an innovation award in clinical information management.
• Black Book ranks Nuance as the leading vendor for clinical documentation improvement solutions.
• DataMotion releases a free Dr. Seuss-like electronic book titled “A Healthcare Holiday Tale: Horace & the Messaging Miracle.”
• Medicat will integrate terminology management software and patient education content from Wolters Kluwer Health with its college health service software.
• PatientPay customer Kids First Pediatrics Group in the Atlanta area reports that it is successfully using the company’s solutions to address the shift from 90 percent insurance-paid claims to 50-percent patient responsibility due to more widespread high-deductible health plans. 
• KLAS names Divurgent as the top-rated vendor in go-live support delivery.
• EClinicalWorks client HealthNet is awarded the 2015 HIMSS Ambulatory Davies Award of Excellence.
• Healthwise’s Catherine Serio publishes “Alone, Adrift, and Hoping for Health.”

Blog Posts

• Meaningful Use Modified Stage 2 (AdvancedMD)
• Innovating at the Intersection of IT and Care (AirStrip)
• The role of patients in readmissions (Besler Consulting)
• Ready or Not? How to gauge your organization’s readiness for new patient engagement technology (Burwood Group)
• Prior Authorization Renewals in CoverMyMeds (CoverMyMeds)
• Please Get Rid of That Superbill (Galen Healthcare Solutions)
• Best Practices for Documentation during Rapid Change (Hayes Management Consulting)

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.

Monday Morning Update 12/14/15

Top News

Alphabet’s Verily – the just-renamed Google Life Sciences – launches Verb Surgical, which will develop surgical robots in conjunction with Johnson & Johnson.

Reader Comments

From Dickey Ascot: “Re: CareTech Solutions. COO Pat Milostan resigned last week. He follows the resignations of CFO Rob Johnson and Controller Dan Lincoln. Karl Graham, formerly in charge of its service desk, has been reassigned. Since the company was acquired by HCT Global Services of Chennai, india, six executives have resigned as its operation focus has been cost cutting and relocating customer services offshore.” Unverified. The company’s executive page still lists Milostan, Johnson, and Graham in the same roles, as do their individual LinkedIn profiles.

From Bill Duck: “Re: occupations. What would you have been if not a hospital IT person?” I wish I had the skill and personality to be a band manager like Shep Gordon, but since I don’t (and besides, I don’t tolerate prima donnas well), I would probably fall back on some solo endeavor that involves creativity, working mostly alone, a lack of convention, and not working for people or causes I don’t respect. My early days as a clinical analyst hit all of those except the last one, which was a partial match. Actually I guess I have that with HIStalk, which is maybe why I’ve stuck with it for so long. I would probably be a pretty good book editor, especially for non-fiction books.

From All R. Base: “Re: mHealth News. HIMSS Media is shutting it down in favor of recently acquired MobiHealthNews.” I don’t have a reaction since I don’t read either site. As far as I can tell, none of the folks involved have any healthcare or technology background, which is fine when they’re just rewording press releases to sound like expert reporting, but not so fine when they forget that they’re just watching the actual athletes perform as nacho-eating fans.

From Schmarbitration: “Re: arbitration clauses. There was a great series of articles several weeks ago in the NY Times diving into arbitration agreements. The main reason companies do this is to make class actions go away and that has been upheld in pretty much all courts. Sounds like Cerner did this in response to associates being classified as exempt. Epic did the same a few years ago, but with no carrot and a very large stick. People mock frivolous class action suits, but ultimately, they are one of the only tools to keep companies in line when a small amount of damage is spread over large numbers of people.” The article says big companies are eliminating their lawsuit risk by adding a one-sentence arbitration clause (so-called “get out of jail free” cards for corporations) to their agreements, with examples being cable companies, cell phone providers, and online stores. Their customers are unlikely to have the money to pursue arbitration individually rather than signing up with an existing class, so the company gets its way, just like the Wall Street-led credit card companies and retailers intended when they masterminded their protective loophole. A federal judge concludes, “Ominously, business has a good chance of opting out of the legal system altogether and misbehaving without reproach.” An example is Cerner’s Kansas City neighbor Sprint, which charged $20 roaming fees to customers who never left home, but pocketed the millions because each customer would have been required to hire an expert witness at up to $1 million just to get back their $20. The Supreme Court upheld arbitration clauses starting in 2011, led by Chief Justice John Roberts, who as a private attorney for Discover Bank had been involved in creating them in the first place.

HIStalk Announcements and Requests

It was just about a 70-30 poll respondent split as to whether their job is a significant part of their identity vs. just a way to pay the bills. Two percent said the most important part of their life is their employment. Furydelabongo would love to become a patient advocate but keeps working as a “disruptive innovator” after realizing that his/her employers in care delivery and healthcare IT don’t keep patient interests foremost. Mobile Man says his need to support the most important thing in his life – his family – has overemphasized his work as part of his self identity. Cassie admits that she associates the majority of her personal value with her work, but wishes she could stop and move into the “it just pays the bills” group.

New poll to your right or here: What is your reaction to Cerner employees becoming ineligible for future pay raises if they refuse to sign an arbitration agreement? Answer and then click the poll’s Comments link to explain, especially if your employer already has such an employment clause in effect. Tick, tock.

Ms. Catoire sent photos from her urban Virginia high school earth sciences class, for which we provided a Chromebook and printer supplies via her DonorsChoose grant request. Her school can’t earn accreditation because it lacks supplies for interactive and hands-on learning, with our donation allowing her to improve individual learning by supporting individual learning styles. She adds, “Just a few of the activities that I use in my class include having the students create animated presentations, movies, mock assessments, and virtual labs, all which have been made possible by your donation … it is because of your generosity that both the students and myself find the teaching and learning process to be so exciting and fulfilling.”

I was thinking about the ridiculous situation where a patient’s in-network hospital has all kinds of out-of-network people running around sending them bills their insurance doesn’t cover. Instead of those “not this one” markings surgeons make to ensure that they don’t amputate the wrong leg, patients need to write in Sharpie on their foreheads, “no out-of-network providers.” Or, perhaps bring their own single form (vs. the mountain of them the hospital requires them to sign) in which the hospital agrees to provide no out-of-network services without prior authorization. It’s pathetic that hospitals take no responsibility for using providers who bill separately without accepting the same insurance. It’s like paying for a pricey restaurant meal and later finding your credit hard hit for charges from the chef, florist, and exterminator.

The Meaningful Love Program

I hereby propose that the federal government turn over responsibility for managing the IRS’s “married filing jointly” tax break. Couples can expect these changes.

• Couples who want to file jointly will be required to participate in the Meaningful Love program, in which they will document the quality of their relationship using  government-certified software called Electronic Marital Records (EMRs).
• Conversations and other intimate encounters must be documented via a series of EMR checkboxes and predefined text strings as entered on ever-present computers positioned between them at all times, with the administrative burden estimated at eight distracted minutes of the average 12-minute encounter.
• Heartfelt handwritten cards and murmuring phone calls will be eliminated in favor of email templates (CPOE, or Computerized Partner Outlook Entry) composed by choosing from a series of government-approved drop-down phrases to improve legibility and standardization.
• Marital decision support will be used to provide evidence-based recommendations such as anniversary reminders, suggested behavioral changes based on menstrual cycle tracking, and time-since-last-sex alerts.
• Each couple must maintain a marital problem list that they reconcile during each encounter.
• EMR records must be sent electronically upon request to anyone with whom either partner might wish to arrange an outside dalliance or in the case of divorce where the new partner would benefit from having the old partner’s EMR data. This will improve the urgent “unconscious person in my bed – what do I do without a history?” scenario as long as all US couples participate despite a lack of incentive for doing so. Future program enhancements will provide the other partner a real-time alert when the tryst has been scheduled.
• The amount of the tax break will be pro-rated based on mutual attestation that the relationship is loving, the surveyed satisfaction of both people, and their romantic performance as benchmarked against other couples.
• The Eligible Pair (EP) must submit their EMR-generated marriage quality data to the appropriate state and federal agencies and for the benefit of unmarried researchers who are trying to understand how relationships work.

These requirements are being protested by the American Marital Association and the EMR vendor-sponsored social media campaign #LetLoversBeLovers, but in the mean time, couples who are unwilling to share their marital bed with Uncle Sam just to avoid a few dollars in penalties can opt out by filing individual tax returns.

Last Week’s Most Interesting News

• Cerner tells employees to sign away their right to sue the company or else they will never be given pay increases.
• Ascension Health buys almost half of Accretive Health and signs a 10-year revenue cycle agreement with the company.
• UL acquires IT accreditor InfoGard, which certifies EHR and EPCS systems.
• National Coordinator Karen DeSalvo, MD tells a group that public health receives only 3 percent of federal health expenditures vs. 97 percent paid to deliver medical services even though 80 percent of health doesn’t involve doctors and hospitals.

Webinars

December 15 (Tuesday) 1:00 ET. “CPSI’s Takeover of Healthland.” Sponsored by HIStalk. Presenters: Frank Poggio, CEO, The Kelzon Group; Vince Ciotti, principal, H.I.S. Professionals. Frank and Vince are back with their brutally honest (and often humorous) opinions about the acquisition. They will review industry precedents (such as Cerner-Siemens), the possible fate of each Healthland product, the available alternatives, and steps Healthland customers should take now. Their previous webinar that covered Cerner’s takeover of Siemens has drawn nearly 7,000 views and this one promises to be equally informative and entertaining.

December 16 (Wednesday) 1:00 ET. “Need for Integrated Data Enhancement and Analytics – Unifying Management of Healthcare Business Processes.” Sponsored by CitiusTech. Presenters: Jeffrey Springer, VP of product management, CitiusTech; John Gonsalves, VP of healthcare provider market, CitiusTech. Providers are driving consumer-centric care with guided analytic solutions that answer specific questions, but each new tool adds complexity. It’s also important to tap real-time data from sources such as social platforms, mobile apps, and wearables to support delivery of personalized and proactive care. This webinar will discuss key use cases that drive patient outcomes, the need for consolidated analytics to realize value-based care, scenarios to maximize efficiency, and an overview of CitiusTech’s integrated healthcare data enhancement and analytics platform.

December 16 (Wednesday) 2:00 ET. “A Sepsis Solution: Reducing Mortality by 50 Percent Using Advanced Decision Support.” Sponsored by Wolters Kluwer Health. Presenters: Rick Corn, VP/CIO, Huntsville Hospital; Stephen Claypool, MD, medical director of the innovation lab, Wolters Kluwer Health. Sepsis claims 258,000 lives and costs $20 billion annually in the US, but early identification and treatment remains elusive, emphasizing the need for intelligent, prompt, and patient-specific clinical decision support. Huntsville Hospital reduced sepsis mortality by 53 percent and related readmissions by 30 percent using real-time surveillance of EHR data and evidence-based decision support to generate highly sensitive and specific alerts.

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

Sales

Kaleida Health (NY) chooses Ascend Software for accounts payable document imaging.

People

Baptist Memorial Healthcare (TN) adds CIO to responsibilities of Beverly Jordan, RN, its VP/chief clinical transformation officer.

Announcements and Implementations

Versus Technology announces a new Wi-Fi locating platform and asset tags.

Government and Politics

National Coordinator Karen DeSalvo, MD, MPH calls for health IT stakeholders to commit to providing consumer access, avoiding information blocking, and following standards to support her vision of a connected health system that includes an app store of FHIR-based consumer tools.

An essay in the Wall Street Journal says the Affordable Care Act is “neither the triumph trumpeted by its proponents nor the disaster suggested by its critics.” ACA’s positives include reducing the number of uninsured patients, its possible effect on slowing healthcare spending growth, the upcoming Cadillac tax that encourages employers to control low-value spending, and the creation of a more cost-conscious market than existed with employer-provided insurance. Its negatives are rising numbers of insured thanks to Medicaid expansion that is “more like welfare for the medical-industrial complex than support for the needy” and being promoted as budget-neutral when it isn’t. The article concludes, “Both sides also need to recognize that the changes in incentives necessary to bend the cost curve will be highly unwelcome to many Americans. Markets for health care are the perfect example of the old saying that ‘every dollar of waste is someone’s income.’”

Technology

Several high-profile Silicon Valley technology entrepreneurs, including Tesla’s Elon Musk, donate $1 billion to launch non-profit OpenAI, which will develop artificial intelligence technologies that benefit humanity without worrying about profit. They might be surprised to find that healthcare’s use of AI and other technologies always has profit first and foremost, with benefit to patients coincidental.

The Chicago Tribune observes EHR-caused doctor burnout, focusing on doctors turned into data entry clerks and patient visits that emphasize clicks and drop-downs rather than paying attention to what patients tell them.

Other

Turing Pharmaceuticals CEO Martin Shkreli is getting the publicity exposure of his life and not just for raising Daraprim prices 5,000 percent and buying $2 million rap albums. Shares in the failing biotech company he bought a few weeks ago for $1.50 are now trading at $28 as investors express confidence that newly named CEO Shkreli will figure out a way to rape the system. Apparently he has – the company has exclusively licensed a drug not available in the US that is used to treat an uncommon parasitic disease. The drug sells for $50 per course of therapy and Shkreli says he’ll raise the price to the $60,000 to $100,000 range. About 300,000 people in the US have the disease, almost all of them Latin American immigrants who entered the country with it, and Shkreli estimates that 3,000 to 7,000 of them will need treatment each year. Even if the market doesn’t pan out, Shkreli has another path to quick profits – he is petitioning the FDA to grant him a fast-track research voucher that he can resell to another drug company for up to $350 million, which benefitted Shkreli’s previous drug company that sold one of the free FDA vouchers for $245 million. I admit that I would invest in his companies since his entire focus is on enriching himself and his investors without letting altruistic emotions interfere with his lust for profit.

A new Missouri law addresses the physician shortage by eliminating residency requirements, allowing newly graduated medical students to start practicing immediately. Medical associations don’t like the law, saying medical schools aren’t set up to prepare their graduates to start practice immediately, perhaps forgetting that residencies were neither mandatory or common for non-specialists outside of urban areas in the early 1980s. So far no new graduates have taken advantage of the change, however, probably realizing that it’s a career gamble that won’t pay off if other states don’t follow suit.

A former part-time employee of New York cardiologist Hussain Khawaja, MD sues him, claiming he fired her looking up her computerized hospital records to determine that she was pregnant. She says the doctor told her while recruiting for other positions that he doesn’t hire applicants with children.

New York’s tax department notifies 1,900 taxpayers who worked for Erie County Medical Center in 2012 that they owe the state money because miscoded hospital W2 forms gave them a pension deduction to which they weren’t entitled. The hospital found a bug in its payroll system and says it will pay the interest, fees, and penalties for those affected and will even provide up to $200 to those who hire a tax preparer to amend their 2012 tax forms.

Medical helicopters seem to crash a lot given their small numbers, with 78 deaths in the past decade. In a new example, a patient and three rescue personnel die when a SkyLife air ambulance goes down in fog and rain in California. I’ve known folks on hospital helicopter teams and it’s a funny business, with such high cost for so few deployments that ROI (other than for dramatic hospital photos) is tough to justify. I would guess in the vast majority of countries where healthcare is a service rather than a private industry the number of such helicopters is low. As was eloquently stated in “The Right Stuff” even though it wasn’t talking about insurance companies or taxpayer subsidies, “no bucks, no Buck Rogers.”

Magician Penn Jillette turns into a pitchman for Withings after using the company’s smart scale and blood pressure monitor to lose 120 pounds in switching to a plant-based diet.  He explains, “It’s just making it automatic and instant. It doesn’t allow a guy like me to spin information — something I’m normally very good at. A little tool, a little bit of a nudge, can make a huge difference.” Penn will be all set if Withings invents a scale to monitor his still-overweight obnoxiousness.

Sponsor Updates

• TransUnion Healthcare identifies more than $1 billion in insurance payments for hospitals.
• Versus joins the Cisco solution partner program.
• Freakonomics author Stephen Dubner will keynote Zynx Health’s Care Guidance 2016 event May 23-26, 2016 in New Orleans.

Blog Posts

• Dissecting the healthcare dress code: Why professional appearances and behaviors matter (T-System)
• Operational Inefficiency can be Fixed (TeleTracking)
• Top Takeaways from NHCAA’s 2015 Annual Training Conference (Verisk Health)
• VUE in review (Voalte)
• 12 Days of Giveaways (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.

News 12/11/15

Top News

Maryland fires Computer Sciences Corp. from a $300 million Medicaid computer contract for unacceptable performance and may sue the company to recoup some of the $30 million it has already spent. It had suspended the contract in February. The state’s track record for health IT projects isn’t so good: it also threatened to sue Noridian Healthcare Solutions, the contractor of its health insurance exchange that failed within minutes of its October 1, 2013 go-live, but instead settled for $45 million in July 2015. Most of the wasted money for both Maryland projects, more than $200 million, came from federal taxpayers, although Maryland’s tally is less impressive than Oregon’s squandering of more than $300 million of federal money for an insurance exchange that never even went live. CSC’s record isn’t great, with state Medicaid system problems in North Carolina and a key role in the massive failure of NPfIT in England.

Reader Comments

From Rude Boy: “Re: Greenway. Taking direct aim at NextGen in this mailing sent to customers.”

From Clam Chowdah: “Re: Brigham and Women’s. Apart from cost overruns, the main operational issues have been because of radiology and one of their legacy systems. Overall, Epic has performed well.”

From Memphis Hank: “Re: executives of big software companies who not only studied, but also taught software engineering or computer science. Along with Epic, there’s also Adobe, SAS, and ESRI. An interesting follow-up analysis would be: what happens to products and customers when geek founders are replaced by private equity and other finance-centric executives?” Big companies run by technologists are about as rare as big health systems run by clinicians.

From Hot Tub Club: “Re: funny video. Remember this one you wrote up years ago?” I remember the dry-humored, four-part video from 2009 in which a slick but clueless salesperson (“I’m not really familiar with what our software things do”) meets with an annoyed and sometimes profane CIO. I was trying to recall the animation tool used and finally remembered that it was Xtranormal, which shut down in 2013.

HIStalk Announcements and Requests

I took my car in for an oil change and got a rare look at daytime TV with a laugh-inducing sight: Dr. Oz wearing scrubs on a talk show as though he might be called upon to perform an impromptu, on-screen surgery on one of the incessantly chatty hosts.

Watching: Jane the Virgin, a witty, fast-paced, and non-profane comedy that has Season 1 on Netflix. I had to give up on American Horror Story because of its overreliance on profanity and graphic violence in Season 2, but that’s OK since I rarely watch TV anyway.

Nick van Terheyden followed up on his observation that HIStalk is blocked by the government in United Arab Emirates, which I thought might be a technical issue instead since several of my Dubai readers say they can read it just fine.  Dr. Nick asked the Emirates Integrated Telecommunications Company to unblock it, but they said it’s intentional per Telecommunications Regulatory Authority. Beats me why.

Last chance to nominate your choices for the HISsies awards. I’ll be emailing ballots to the people who have signed up for HIStalk updates in the next few days. It’s easy to spot the company-encouraged employee responses because the respondents skip most of the categories except Best Vendor and Best Leader and enter their company and CEO names there.

This week on HIStalk Practice: Physicians in rural West Virginia feel the effects of high-speed broadband connections. Hattiesburg Clinic and HealthNet receive HIMSS accolades for their use of health IT. Performance Physical Therapy CEO Michelle Collie outlines the health IT challenges faced by PT practices. Allscripts breaks ground on a new office tower. MediKey partners with Teladoc and EDocAmerica. WebPT expands into new Phoenix digs. Brazilian physicians lead the way in communicating with patients via WhatsApp. Everseat CEO Jeff Peres details the impact of unfilled practice seats.

Webinars

December 15 (Tuesday) 1:00 ET. “CPSI’s Takeover of Healthland.” Sponsored by HIStalk. Presenters: Frank Poggio, CEO, The Kelzon Group; Vince Ciotti, principal, H.I.S. Professionals. Frank and Vince are back with their brutally honest (and often humorous) opinions about the acquisition. They will review industry precedents (such as Cerner-Siemens), the possible fate of each Healthland product, the available alternatives, and steps Healthland customers should take now. Their previous webinar that covered Cerner’s takeover of Siemens has drawn nearly 7,000 views and this one promises to be equally informative and entertaining.

December 16 (Wednesday) 1:00 ET. “Need for Integrated Data Enhancement and Analytics – Unifying Management of Healthcare Business Processes.” Sponsored by CitiusTech. Presenters: Jeffrey Springer, VP of product management, CitiusTech; John Gonsalves, VP of healthcare provider market, CitiusTech. Providers are driving consumer-centric care with guided analytic solutions that answer specific questions, but each new tool adds complexity. It’s also important to tap real-time data from sources such as social platforms, mobile apps, and wearables to support delivery of personalized and proactive care. This webinar will discuss key use cases that drive patient outcomes, the need for consolidated analytics to realize value-based care, scenarios to maximize efficiency, and an overview of CitiusTech’s integrated healthcare data enhancement and analytics platform.

December 16 (Wednesday) 2:00 ET. “A Sepsis Solution: Reducing Mortality by 50 Percent Using Advanced Decision Support.” Sponsored by Wolters Kluwer Health. Presenters: Rick Corn, VP/CIO, Huntsville Hospital; Stephen Claypool, MD, medical director of the innovation lab, Wolters Kluwer Health. Sepsis claims 258,000 lives and costs $20 billion annually in the US, but early identification and treatment remains elusive, emphasizing the need for intelligent, prompt, and patient-specific clinical decision support. Huntsville Hospital reduced sepsis mortality by 53 percent and related readmissions by 30 percent using real-time surveillance of EHR data and evidence-based decision support to generate highly sensitive and specific alerts.

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

Acquisitions, Funding, Business, and Stock

Express Scripts will invest $25 million in revenue-generating health IT companies related to drug adherence and personalized care. Actually the announcement says the investments will focus on “prescription drug adherence,” so I assume those who are addicted to street drugs are already adhering just fine on their own.

India-based Tata Consultancy Services will join Vanderbilt University Medical Center’s CTTC commercialization group to develop products related to bioinformatics, care management, and analytics.

Goldman Sachs and other investors provide $41 million in funding for doctor search site Vitals, raising its total to $86 million.

Sales

Adventist Health System chooses Athenahealth’s EHR, PM, and patient engagement services for its 1,600 employed physicians.

Ascension Health signs an exclusive, 10-year revenue cycle agreement with Accretive Health and will invest $200 million in the company. That’s an interesting development given that Ascension tried to buy Accretive this past June, was turned down by Accretive, and then announced that it would not renew its contract with Accretive that was to expire in 2017, forcing Accretive to “undertake a review of strategic alternatives” at the prospect of losing a customer that represented 50 percent of its business. Accretive shares jumped around 50 percent following the latest announcement, but are trading at 90 percent less than their mid-2011 price and at about half the share price at the time Ascension offered to buy the company. Accretive’s market cap is $300 million, so a $200 million investment must represent at least a 50 percent stake.

People

LogicStream Health names Jack Hauser (Ability Network) as CFO.

Scripps Health (CA) names Andy Crowder (MaineHealth)  as SVP/CIO.

Gurpreet Singh (MD Revolution) joins CareSync as VP of interoperability. The company says it has hired 60 employees since it announced $18 million in Series D funding in October.

HIMSS and CHIME name Craig Richardville, SVP/CIO of Carolinas HealthCare System, as John E. Gall, Jr. CIO of the Year.

Announcements and Implementations

SCL Health (CO) offers $40 physician video visits via Doctor On Demand.

Orion Health launches Amadeus, a data platform that offers predictive modeling and machine learning to support precision medicine. It also features open APIs for developers to create additional services.

Idaho HIE goes live on a clinical portal from Orion Health.

Government and Politics

CMS says that 2.8 million people have signed up for insurance via Healthcare.gov, one million of them first-timers. Healthcare.gov CEO Kevin Counihan say 80 percent of consumers can find coverage for less than $75 per month after government subsidies.

The White House announces mental health hackathons and data sprints on Saturday, December 12 in Boston, Chicago, New York, San Francisco, and Washington, DC.

Privacy and Security

A federal judge denies LabMD’s request for sanctions against security vendor Tiversa, which LabMD said intentionally breached its systems and then threatened to report the company to the government if it didn’t buy Tiversa’s security services, resulting in LabMD’s eventual shutdown after a long Federal Trade Commission fight. Meanwhile, Tivera’s CEO, stung by accusations of extortionate sales practices in LabMD’s case, writes a Wall Street Journal letter titled, “Tiversa Was a Good Samaritan, Not a Bully” in which he states that the company sent LabMD a services proposal at the company’s own request without any threat that it would otherwise tell the FTC about the exposed information. He blames a former Tiversa employee turned whistleblower who has “a history of not telling the truth.” He says Tiversa is suing LabMD and its former employee for defamation. 

The FBI finds patient information from MaineGeneral Health online and alerts the health system, which says radiology patient information is at highest risk. Employee and prospective donor information was also taken.

A hospital employee and his wife are charged with stealing the information of 80 patients to take over their credit card accounts and fraudulently charge $300,000 worth of upscale fashions and accessories.

Technology

A study finds that two-thirds of doctors in Italy and nearly 90 percent in Brazil communicate with their patients via the WhatsApp messenger app.

Shriners Hospital for Children (UT) tests its new telemedicine system by offering children video chats with Santa Claus.

Other

A Mayo Clinic Proceedings article looks at physician burnout, which it unsurprisingly concludes is getting worse. It should have added a third axis of average income by specialty, which would have shown that internal medicine and family medicine have high burnout paired with lower incomes compared to their equally burned out but higher-earning peers in orthopedic surgery and radiology.

A Kansas City TV station reports that Cerner is requiring its employees to sign an arbitration agreement that prevents them from suing the company for any reason, offering them $500 in stock options if they signed by December 8 but denying them future merit pay increases if they didn’t. Employees had previously filed two class action lawsuits claiming they were incorrectly classified as salaried employees and thus were denied overtime pay. The arbitration clause would eliminate the possibility of such lawsuits. An anonymous Cerner employs speculates on Reddit (not entirely convincingly) that Cerner is trying to work around terms of its Siemens HS acquisition that require it to use Siemens service years to calculate severance pays in the case of Malvern layoffs.

Regina Holliday is running a GoFundMe campaign in hopes of raising $10,000 toward her expenses in creating The Walking Gallery jackets. I should also mention her excellent book, “The Writing on the Wall,” that came out earlier this year. I see it’s now available for Kindle as well as softcover. I thought it was superb and I strongly recommend it.

The mystery buyer of the one-of-a-kind Wu-Tang Clan rap album — the most expensive in history at $2 million for the only copy that will ever be sold — is revealed to be the most-hated man on the Internet, Turing Pharmaceuticals CEO, pharma bad boy, and aspiring rap producer Martin Shkreli. Shkreli says be bought it hoping he can hang out with celebrities who want to hear the album (he’s hoping for Taylor Swift), but when asked if will stream it free for Wu-Tang fans, he replied with the same logic that’s behind his 5,000 percent price hike for Daraprim, “Why would I pay millions of dollars just to let everyone listen to it for free?” He says he may commission more bands to make albums for his ears only just because he can.

Weird News Andy predicts “Sold Out in Chicago,” as FDA approves commercial sale of a former military-only device that injects sponges into a bullet wound to stop bleeding in 20 seconds. The sponges are tagged with radiopaque markers so they can be detected and removed later.

Sponsor Updates

• PerfectServe adds Robert Rinek of Paper Jaffray and Brant Heise of Memorial Care Innovation Fund to its board.
• Health Catalyst is named a “best place to work” on three lists, two national and one regional.
• PeriGen’s Emily Hamilton is published in the American Journal of Obstetrics & Gynecology.
• Streamline Health Solutions signs a reseller agreement with outsourcing solutions provider Himagine Solutions.
• InterSystems receives the HIMSS Middle East Integrated Health Innovations Award 2015 – mHealth category.
• MedCPU will host four US-based hospital CIOs December 14 in Israel as part of a CHIME/Israel Export & International Cooperative Institute event.

Blog Posts

• Mission Possible: Making Data Available for Population Health (Medicity)
• A Case for Clinical Researchers to Launch Secure Texting Trials (Practice Unite)
• Mobility, Network Effects, and Smart Point-of-Care Mobile Solutions (PatientSafe Solutions)
• Private Cloud – A Good Choice for Regulated Industries (NTT Data)
• Three Ways to Reduce Strain on Your Training Team (Sagacious Consultants)
• The Ever-Expanding Discharge Summary (Streamline Health)
• Top Four Privacy and Security Predictions for 2016 (ID Experts)
• Get Connected! Technology Shapes Patient Engagement for Hospitals Nationwide (Influence Health)
• New Approach to Open Enrollment: The Key Role of Healthcare Payments (InstaMed)
• Physician Burnout: Only Getting Worse (MedAptus)
• Precision Medicine – The Greatest Healthcare Innovation since Antibiotics, Hygiene, and Immunization (Orion Health)

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.

News 12/9/15

Top News

Acting Assistant Secretary for Health and National Coordinator Karen DeSalvo, MD, MPH tells a group that US public health is “marginalized and under-funded” as 97 percent of available federal money is spent on delivery of medical services even though 80 percent of health factors don’t involve hospitals and doctors’ offices. She adds, “The notion of population health doesn’t end with a geographic boundary … it’s everybody in the community,” giving the example that parts of Baltimore have worse health than North Korea.

Reader Comments

From The Freshman Whisperer: “Re: Hour of Code. I was at a ninth-grade career fair last week telling students the story of technology and how the healthcare industry needs help. As a part our booth, we had students try Hour of Code. I was happy to hear that many students had tried coding before (lots even enjoyed it) and were considering a career in computer science. I wasn’t offered any coding classes in high school. Thumbs up for teachers teaching young coders. My company can’t hire enough of them!”

From Health Dataphile: “Re: HCA’s inpatient and outpatient facilities in the Southeast. Meditech went down over the weekend and, as far as I know, is still down as of Monday morning.” Unverified. Usually an outage of that magnitude would be related to data center communications or some type of network failure, which HCA might be prone to since it deploys Meditech and other systems regionally. That might be a lesson for everyone anxious to get out of the operations business and move to a cloud provider – cloud systems are probably better architected, but they can still go down or you can lose access to them if something happens to your real-world connectivity. A reader in an HCA hospital in Florida says the ICU nurses didn’t know the downtime protocol they were supposed to be following, but on the bright side, doctors fell back to writing and dictating orders instead of entering them into the computer, allowing them to leave for home earlier than ever. The nurses were worried about medication reconciliation between the MARs and Pyxis machines.

From This Is Just Silly: “Re: Judy Faulkner’s letter on exhibit at the Smithsonian. I would have rather seen the letter or email she sent to George Halvorson at Kaiser Permanente when she turned down KP’s interest in buying Epic.” The National Museum of American History’s just-opened “Giving in America” exhibit includes the letter Faulkner wrote in pledging that she will donate 99 percent of her $3 billion fortune to charity. I was just thinking that Epic must be one of very few hugely valued companies where both top executives studied computer science.

From Unscheduled: “Re: McKesson’s scheduling software. I’m hearing it is ending support. Do you know if that’s true?” I don’t, but anyone who does is welcome to comment.

From Ground Pounder: “Re: salary survey. Cute infographic hides terrible methodology.” It’s puzzling why reasonably smart people will believe a dumbed-down graphic instead of paying attention to what it’s based on, although far less puzzling why crappy “news” sites run the graphic as clickbait. The members-only report is based on a survey of only 700 people who were apparently self-selected, meaning any conclusions it attempts to draw are not believable, especially when it tries to segment the responses into subcategories. Here are some headlines the self-promoting report drew by sites that simply reworded the press release, with extra points for the first entry (which turned it into a “listicle” like you’d see on celebrity gossip sites) and the last entry (which seems to attempt a Donna Summer song pun):

• Health IT professionals think they’re underpaid: This and 9 more findings on IT salaries
• Average healthcare IT salary tops $87,000, job tracker survey finds
• Average Health IT Salary Down, but Job Satisfaction Up, Report Finds
• Health IT Professionals Report High Salaries, Job Satisfaction
• Survey: HIT workers get lower salaries than desired
• Infographic: Health IT workforce paid well, but perhaps not enough
• Health IT Pros See High Salaries Due to Increased HIT Needs
• Working Hard for the Money

HIStalk Announcements and Requests

HISsies nominations will remain open for a few more days. The best nomination I’ve received so far is in the “smartest vendor action taken” category, where someone offered, “Hiring hookers to seduce my COO.” Athenahealth has obviously put the word out to employees as indicated by both boilerplate nominations in several categories and repeated IP addresses that are dominating the responses, but that’s OK since the final ballot will be delivered by the unstuffable ballot box of direct email.

Ms. Lam from California says she assigned her first graders, most of whom are from immigrant families in which English is their second language, to work with fourth-grade partners using the hands-on Make Wonder programming and robotics kit we provided by funding her DonorsChoose grant.

I wrote earlier this week about a friend who keeps working for her vendor employer even while fighting the cancer that will almost surely kill her because she’s worried she isn’t replaceable at work. It resonated with a reader who sent me an internal executive email exchange from a few years ago. An employee of a large health IT vendor was determined to keep working despite having cancer (of which she died shortly after) so that her retirement plan could vest for her surviving family. I’m paraphrasing the exchange below:

[Executive to CFO]: The employee thinks she needs to push through and keep working even though it will be one of the last things she will do on this Earth. Without being too nosy, can we vest the retirement even though the dates haven’t arrived?

[CFO] I want to make this happen and will approve the change under my board-delegated authority. Consider this as my approval. This is the only time I have ever approved such an action, but it seemed appropriate. A great example of why it feels great to work at [vendor name omitted].

[CEO] I am in complete agreement. Today is a gift – that is why they call it the present. 

Webinars

December 9 (Wednesday) 12 noon ET. “Population Health in 2016: Know How to Move Forward.” Sponsored by Athenahealth. Presenter: Michael Maus, VP of enterprise solutions, Athenahealth. ACOs need a population health solution that helps them manage costs, improve outcomes, and elevate the care experience. Athenahealth’s in-house expert will explain why relying on software along isn’t enough, how to tap into data from multiple vendors, and how providers can manage patient populations.

December 9 (Wednesday) 1:00 ET. “The Health Care Payment Evolution: Maximizing Value Through Technology.” Sponsored by Medicity. Presenter: Charles D. Kennedy, MD, chief population health officer, Healthagen. This presentation will provide a brief history of the ACO Pioneer and MSSP programs and will discuss current market trends and drivers and the federal government’s response to them. Learn what’s coming in the next generation of programs such as the Merit-Based Incentive Payment System (MIPS) and the role technology plays in driving the evolution of a new healthcare marketplace.

December 15 (Tuesday) 1:00 ET. “CPSI’s Takeover of Healthland.” Sponsored by HIStalk. Presenters: Frank Poggio, CEO, The Kelzon Group; Vince Ciotti, principal, H.I.S. Professionals. Frank and Vince are back with their brutally honest (and often humorous) opinions about the acquisition. They will review industry precedents (such as Cerner-Siemens), the possible fate of each Healthland product, the available alternatives, and steps Healthland customers should take now. Their previous webinar that covered Cerner’s takeover of Siemens has drawn nearly 7,000 views and this one promises to be equally informative and entertaining.

December 16 (Wednesday) 1:00 ET. “A Sepsis Solution: Reducing Mortality by 50 Percent Using Advanced Decision Support.” Sponsored by Wolters Kluwer Health. Presenters: Rick Corn, VP/CIO, Huntsville Hospital; Stephen Claypool, MD, medical director of the innovation lab, Wolters Kluwer Health. Sepsis claims 258,000 lives and costs $20 billion annually in the US, but early identification and treatment remains elusive, emphasizing the need for intelligent, prompt, and patient-specific clinical decision support. Huntsville Hospital reduced sepsis mortality by 53 percent and related readmissions by 30 percent using real-time surveillance of EHR data and evidence-based decision support to generate highly sensitive and specific alerts.

December 16 (Wednesday) 1:00 ET. “Need for Integrated Data Enhancement and Analytics – Unifying Management of Healthcare Business Processes.” Sponsored by CitiusTech. Presenters: Jeffrey Springer, VP of product management, CitiusTech; John Gonsalves, VP of healthcare provider market, CitiusTech. Providers are driving consumer-centric care with guided analytic solutions that answer specific questions, but each new tool adds complexity. It’s also important to tap real-time data from sources such as social platforms, mobile apps, and wearables to support delivery of personalized and proactive care. This webinar will discuss key use cases that drive patient outcomes, the need for consolidated analytics to realize value-based care, scenarios to maximize efficiency, and an overview of CitiusTech’s integrated healthcare data enhancement and analytics platform.

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

Acquisitions, Funding, Business, and Stock

San Diego-based MD Revolution raises $23 million. It offers a patient engagement platform that allows providers to bill Medicare for delivering chronic care management services.

UL acquires InfoGard, an IT accreditor whose offerings include certification of EHRs and electronic prescribing of controlled substances systems.

EClinicalWorks will spend $30 million in India to build a data center and increase its 1,000-employee headcount there by at least 300 in the next three months. The company will offer consumers in India an app to view lab results, find doctors, maintain personal health records, and schedule appointments. The company has already signed 40 hospitals and 20 practices in India.

The Wall Street Journal summarizes the strategy behind the turnaround of Valeant Pharmaceuticals that has brought criticism as well as a 4,000 percent share price increase that gave its CEO $2 billion in holdings:

• Cut research and development expense.
• Take over dozens of drug companies.
• Buy undervalued drugs and raise their prices.
• Focus on skin treatments, mostly just redesigning old ones rather than researching new ones, knowing that dermatologists are responsive to drug salespeople and prescribe by habit.
• Sell its dermatology products through a now-closed mail order pharmacy that used aggressive sales tactics.

Twine Health, which offers health coaching software developed at MIT, raises $6.75 million.

San Francisco-based concierge medicine provider One Medical Group raises $65 million to expand its service area and to further develop its enterprise and mobile technology solutions, increasing its total to $182 million.

Google has renamed many of its business and does the same with Google Life Sciences medical device group, now known as Verily. Meanwhile, GV (formerly known as Google Ventures) says it is less interested in seed-stage investing and will instead pursue more mature companies, with an ongoing emphasis on healthcare and life sciences firms.

Harris Computer Systems relocates its QuadraMed EMPI Solutions business to a high security office in Plano, TX that can house up to 100 employees.

Sales

Weirton Medical Center (WV) chooses Besler Consulting’s Transfer DRG Revenue Recovery Service.

Scripps Health (CA) chooses the Health Gorilla Clinical Network to provide patients with access to imaging and lab information.

Announcements and Implementations

Intelligent Medical Objects announces GA of its 2.0 release that includes silent terminology updates, support for natural language processing, quarterly refreshes of major dictionaries, and a CQM dashboard.

PatientPay announces that customer Greenwood Pediatrics (CO) reduced its billing costs by 47 percent by switching from paper to the company’s online bill review and payment.

Cloud hosting provider Infinitely Virtual announces that it has passed the HIPAA audit that allows it to offer health IT hosting plans, including a $10 per month option for full-disk encryption for each virtual machine.

Telemedicine services company Virtual Radiologic announces that it has applied artificial intelligence to data from the 90,000 head CTs it performs monthly to create a real-time warning to its teleradiologists that a patient might be experiencing intracranial hemorrhage.

A Finland-based software vendor licenses a web-based geriatric assessment system developed by the University of Queensland in Australia. The software records and monitors the progress of elderly patients before, during, and after hospital stays and can be used to deliver telehealth services. The CeGa Online system is already offered by Queensland Health. The same researchers have also developed a residential care version.

SAP announces software for medical data analysis and clinical trials recruitment.

Government and Politics

The White House enlists ZocDoc and Oscar Health Insurance Corp. to provide free advertising that will urge uninsured people to buy insurance via Healthcare.gov in the final week of open enrollment. ZocDoc will target customers who have paid cash for the appointments they booked through its scheduling service, while Oscar chas reated an explainer video that it will distribute in the handful of states where it sells plans.

Privacy and Security

A physician-written editorial in the Journal of American Physicians and Surgeons says that patient privacy is an illusion because of electronic medical records that make data available without patient consent for oversight and research. The psychiatrist, Susan Israel, MD, wants EHRs redesigned to give patients control of their information via consent requirements “regardless of cost and complexities involved.” 

Innovation and Research

Google patents a needle-free blood draw system that uses compressed gas to pierce skin and then draw the resulting blood into a collection chamber. The patient covers two possible devices, one for diabetic finger-sticks and the other worn as a wristband. Companies seem to be enchanted with the idea that patients need an alternative to needles and the collection volume of standard blood draws, but for me, that’s far less important than avoiding the inhospitable long waits at LabCorp and Quest drawing centers full of people whose NPO stomachs growl as they watch awful TV shows that working people rarely see.

Technology

Carequality releases its interoperability framework (legal terms policies, technical specifications, and governance processes) that allows organizations to quickly establish data sharing agreements with partners.

Other

Brigham and Women’s Hospital misses its budget surplus target for FY2015 by $53 million, which it blames on weather, employee retirement costs, and the cost of transitioning to Epic. The hospital had budgeted $47 million for its Epic conversion, but instead spent $74 million. Revenue also fell short by $13.5 million as employees didn’t code cases correctly on Epic.

A summary of McKinsey’s previous healthcare consumerism studies concludes that while patients say their outcome is the most important factor in their satisfaction with providers, it’s actually clinician empathy (especially from nurses) and the information they are given before and after treatment that is most closely correlated to satisfaction. Access to medical records wasn’t all that important and neither was the perception of value received. A study also found that while 40-50 percent of patients aged 18-34 want to use technology to speak to their provider by phone, schedule appointments, and check health status, the percentage drops sharply for those aged 35-55. Respondents are also willing to share health monitoring data capture with their PCPs, but not very many would do so with friends, family, insurance companies, and employers.

Researchers mine EHR databases at two hospitals to detect a previously unknown correlation between the use of androgen deprivation therapy and later development of Alzheimer’s disease. The study used text-based data mining methods developed by one of the authors that were patented by Stanford University. The hidden value of a study like this is that researchers can look at the entire patient population of a health system rather than just individual patients who opt in for a study that was designed to test a particular theory.

A study in England proves that patients are as clueless about antibiotics as doctors keep saying. Two-thirds of them expect to get an antibiotic prescription for a cold or flu, one-third think they should stop taking antibiotics once they feel better, and three-quarters believe it’s the human body rather than bacteria that grow resistant to the drugs. Doctors who apply sound science to writing antibiotic prescriptions are seeing their patient satisfaction ratings fall, with a 3- to 6-percentile drop for every 25 percent reduction in prescriptions. The other GPs just keep cranking them out to keep patients happy, with half of those patients receiving an inappropriate antibiotic prescription. 

A Florida woman is jailed for hit and run when her car’s crash-triggered electronic monitoring system automatically calls 911. The operator, suspicious of the woman’s insistence that nothing had happened when the device clearly showed that it had, dispatched police, who found her car damaged with the airbag deployed.

Sponsor Updates

• Forrester Research ranks AirWatch as an enterprise mobile management leader.
• TransUnion Healthcare announces that its eScan product has found patient insurance coverage worth $1 billion in hospital payments that would have otherwise been written off to bad debt and charity care.
• Sixteen Influence Health clients receive eHealth Leadership Awards.
• LiveProcess exhibits at the National Healthcare Coalition Preparedness Conference through December 4 in San Diego.
• Oneview Healthcare launches an internship competition.

Blog Posts

• 5 Year-End Tips to Get the Most Out of 2016 (AdvancedMD)
• FHIR Up Population Health (Caradigm)
• The Fine Line Between Implementation & Optimization (Culbert Healthcare Solutions)
• The Biggest, Baddest Breaches of 2015 (ID Experts)
• Giving Thanks for Family (Impact Advisors)
• Healthcare’s Black Friday: Lessons Providers can Learn from Retail’s Biggest Day (InstaMed)
• Is Your Business a Center of Excellence? Probably! (Liaison Technologies)
• Key Steps to an Effective Image Exchange Implementation (LifeImage)
• The Top Ten Thanksgiving Mishaps via ICD-10 (MedAptus)
• Training Patient Service Representatives to Make a Difference (MedData)
• Ready to Take Your Place in the Cockpit? What Healthcare BI Strategies Have in Common with Altimeters and Accelerometers (Navicure)
• Dictate and Review Images Simultaneously: See How at RSNA 2015 (NVoq)
• Meet Susan Anderson, Managing Director for Orion Health Canada (Orion Health)

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.

Monday Morning Update 12/7/15

Top News

Kaiser Permanente will acquire Group Health Cooperative, a Seattle-based provider and insurer with 600,000 members and annual revenues of $3.5 billion. Kaiser will pay $1.8 billion upfront and says it will spend another $1 billion over the next several years in creating its Washington Region. The 70-year-old Group Health offers innovative member technologies, but has struggled with budget cuts and layoffs for several years.

Reader Comments

From Billy Gladstone: “Re: HIMSS. You pulled their self description from their latest press release. What happened to it being a “mission-driven not-for-profit?” This announcement contained more ambitious wording that aggressively pitches its data services. The latest Form 990 I could find for HIMSS was for FY2013, in which it reported a loss of $2.6 million on revenue of $82 million, of which $30 million came from the annual conference, $16 million from publishing and conferences, and $10 million from membership dues. It paid some big salaries for an organization of that size, many multiples of what a tiny hospital with $82 million in revenue would pay its executives.

HIMSS paid consultant Jack Beaudoin, formerly of HIMSS Media: $567,000. It also paid $1.4 million to Armin Scheuer Consulting, which I assume is related to its 2011 acquisition of his former company, Berlin-based So2say Communications. It reported $250,000 in lobbying expenses. HIMSS finished its acquisition of MedTech Publishing in 2013 and made it a disregarded entity to protect its own tax-exempt status, with the renamed HIMSS Media bringing in $14.4 million.

From Not From Me: “Re: Charles Sorenson, CEO of Intermountain Healthcare. Will step down as CEO effective fall 2016.” Unverified.

From RegularReader: “Re: Daughters of Charity in California. Gets AG approval to sell itself to a for-profit company.” A hedge fund will be allowed to invest in the struggling non-profit health system with the option to buy it outright after three years in the largest non-profit hospital transaction in California history. The hedge fund names its management company Integrity Healthcare without apparent intentional irony (although the “charity” part of the name would be equally ironic under its involvement). Looking on the bright side, yet another example of unapologetic, bare-knuckles profit-seeking on the backs of sick people just might — as in the case of Martin Shkreli’s Turing Pharmaceuticals — force the country to realize what a mess it made of its healthcare system starting in the mid-1960s and where that’s left us 50 years later.

From Sunquester: “Re: new Sunquest offices. I’m really looking forward to the new office. During the dark days of being private equity owned, little was done for employees.” I agree – other than an extended commute for some employees, it’s nice to get a fresh workspace with a view. Google Earth shows the new building in the foothills of some 8,000-foot Tucson mountains near many plush resorts and restaurants, which should upgrade the lunch options quite a bit. I’ve inhabited everything from a windowless hospital basement to a private office with a beautiful lake view, and while you quickly lose awareness of your surroundings through familiarity, it does indeed give you a sense of your value to your employer and their priorities. My one non-hospital job was working for a vendor whose ever-deepening financial distress was caused by ever-deepening management incompetence. Maintenance to our beat-up old office building was always being deferred until future good times that never came. Our salvage yard-quality cubicles were constantly being reconfigured to support the latest executive emissions that dribbled down from their top-floor, mahogany-walled bunker. The director of my area decided that we would all become energized by staying after work on our own time (it was mandatory) to paint the interior walls of our floor, complete with the jaunty stripes that he envisioned as being reflective of our newfound swagger and inevitable success. The company provided the paint and a terrible fried chicken dinner that — not surprisingly given our executive track record of cluelessness and questionable allocation of resources — was ordered in insufficient quantity to feed the people who gave up hours of their free time to perform menial labor, suffer through faux camaraderie, and elbow each other aside in a vulture-like attempt to snag a chunk of poultry carcass before it ran out (which was probably an apt metaphor for what it was like working there – those in the back of the line who found the chicken bowls empty heatedly accused those who preceded them of taking extra pieces). One week later, the company conducted its next round of layoffs and reorganizations, leading one of the managers who was fired and forcibly marched out of the building to declare bitterly afterward, “The worst part is that I wish I hadn’t painted those damned walls.”

HIStalk Announcements and Requests

Ninety percent of poll respondents will get their medical insurance through their job or via family coverage, with just five percent buying it directly from insurance companies or Healthcare.gov. Mak says he had to postpone retirement for a year because individual health insurance is now so expensive, adding, “Like all massive government programs, the cost is astronomical when compared to the number of individuals benefitting.” Lgro’s employer doesn’t offer a group plan, so he’s paying $14,000 for family insurance whose coverage doesn’t kick in until he has spent $8,000, doubling what he paid in his previous job that offered insurance. Jeff says Obamacare isn’t perfect but at least he can get family insurance from Healthcare.gov until a better option becomes available.

New poll to your right or here: what role does your job play in your existence? Vote and then click the poll’s Comments link to explain since I’m really interested in how people view their work as part of their overall lives.

Speaking of work and life, a friend who has barely survived repeated, horrific bouts of cancer was telling me that she plans to keep working at her health IT vendor employer because she’s worried that the large company can’t replace her even though her remaining lifetime will probably be short. That’s the saddest thing I’ve heard lately — expressing unconditional employer devotion under the misguided belief that such fealty is mutual and not recognizing that “irreplaceable employee” is an oxymoron regardless of your org chart altitude. You might be surprised at how quickly you are forgotten and how little difference your absence makes if strategies change, money gets tight, or you run afoul of someone who outranks you. I’ve never mistaken a paid job for a loving, supportive relationship and I hope others don’t – life is too short to place your entire identity and sense of well-being in the hands of a company (for-profit or otherwise) that is by definition incapable of returning the favor. Tombstones don’t contain job titles and hearses don’t pull U-Hauls full of meaningless company awards and unspent retirement funds. I recall the answer Ivo Nelson gave me in a 2009 interview when I asked him why he was starting another company (Encore Health Resources) when he was already immeasurably wealthy from selling Healthlink to IBM:

This is nothing more than me doing what I love to do. If it leaves a legacy, I think that’s OK, but I’m not sure what you really get out of that. When I’m hopefully up in my 80s or 90s and I pass away, the people that are going to come to my funeral are going to be my family. It’s not going to be clients. It’s going to be people that are close to me personally in my personal life, my kids and my sisters and a handful of friends probably that I have. That’s a legacy. You say, "What kind of legacy would I want to leave?" and it would be a legacy that’s more related to being a good father to my children and being a good husband to my wife. That kind of stuff. Not anything I do professionally.

I’m thinking about hiring someone part time to critically review journal articles related to health IT. Ideally it would be an informatics grad student with a clinical background, access to an online medical library, and the ability to critique research methods and conclusions for a general audience. Email me.

HIStalkapalooza

People are already emailing me about the February 29 event. Here’s what is happening.

• “I want to come” signups will start very soon for HIStalk sponsors, then for everyone in early January.
• We won’t be able to accept new event sponsors after next week because we need to move our focus to planning.
• I am still looking for a single “rock star CEO” sponsor who wants a significant HIStalkapalooza presence and involvement with private space, bar, and food to entertain 100 people or so.

Have you ever dreamed of playing your music on a big music hall stage in front of a bunch of cheering people screaming “Free Bird?” We’re exploring the idea of starting HIStalkapalooza early with music provided by volunteer health IT people who also have a significant musical history. Send Lorre a link to your video or audio and tell me what you would play on stage if chosen. You’ll have to bring any instruments you need unless we can work something out with HOB or the band. I remember years ago at HIMSS when the opening session started with a really good band that turned out to be Dave Garets, Jonathan Teich, and some other industry folks who had at one time paid the bills as musicians.

One last item: HISsies nominations are open. Nominate your choices and I’ll put the most-nominated ones on the final ballot that will be emailed to HIStalk subscribers in a couple of weeks. It’s like the presidential primary: vote now or don’t complain about the choices made by more responsible voters. I’ve added a new item just for fun, “Industry figure you’d most like to see on stage at HIStalkapalooza,” figuring maybe I can get someone famous if they know readers want to see them there.

Last Week’s Most Interesting News

• Welltok acquires Silverlink to expand its patient engagement capabilities.
• Private equity investor and former Vitalize Consulting Solutions Chairman and CEO Bruce Cerullo joins Nordic Consulting as chairman and CEO.
• MIT Hacking Medicine announces that it will publish reviews of digital health tools.
• The Health IT Policy Committee’s API Security Task Force holds its first meeting.
• NantHealth postpones its planned IPO because of unfavorable market conditions.

Webinars

December 9 (Wednesday) 12 noon ET. “Population Health in 2016: Know How to Move Forward.” Sponsored by Athenahealth. Presenter: Michael Maus, VP of enterprise solutions, Athenahealth. ACOs need a population health solution that helps them manage costs, improve outcomes, and elevate the care experience. Athenahealth’s in-house expert will explain why relying on software along isn’t enough, how to tap into data from multiple vendors, and how providers can manage patient populations.

December 9 (Wednesday) 1:00 ET. “The Health Care Payment Evolution: Maximizing Value Through Technology.” Sponsored by Medicity. Presenter: Charles D. Kennedy, MD, chief population health officer, Healthagen. This presentation will provide a brief history of the ACO Pioneer and MSSP programs and will discuss current market trends and drivers and the federal government’s response to them. Learn what’s coming in the next generation of programs such as the Merit-Based Incentive Payment System (MIPS) and the role technology plays in driving the evolution of a new healthcare marketplace.

December 15 (Tuesday) 1:00 ET. “CPSI’s Takeover of Healthland.” Sponsored by HIStalk. Presenters: Frank Poggio, CEO, The Kelzon Group; Vince Ciotti, principal, H.I.S. Professionals. Frank and Vince are back with their brutally honest (and often humorous) opinions about the acquisition. They will review industry precedents (such as Cerner-Siemens), the possible fate of each Healthland product, the available alternatives, and steps Healthland customers should take now. Their previous webinar that covered Cerner’s takeover of Siemens has drawn nearly 7,000 views and this one promises to be equally informative and entertaining.

December 16 (Wednesday) 1:00 ET. “A Sepsis Solution: Reducing Mortality by 50 Percent Using Advanced Decision Support.” Sponsored by Wolters Kluwer Health. Presenters: Rick Corn, VP/CIO, Huntsville Hospital; Stephen Claypool, MD, medical director of innovation lab and VP of clinical development and informatics for clinical software solutions, Wolters Kluwer Health. Sepsis claims 258,000 lives and costs $20 billion annually in the US, but early identification and treatment remains elusive, emphasizing the need for intelligent, prompt, and patient-specific clinical decision support. Huntsville Hospital reduced sepsis mortality by 53 percent and related readmissions by 30 percent using real-time surveillance of EHR data and evidence-based decision support to generate highly sensitive and specific alerts.

December 16 (Wednesday) 1:00 ET. “Need for Integrated Data Enhancement and Analytics – Unifying Management of Healthcare Business Processes.” Sponsored by CitiusTech. Presenters: Jeffrey Springer, VP of product management, CitiusTech; John Gonsalves, VP of healthcare provider market, CitiusTech. Providers are driving consumer-centric care with guided analytic solutions that answer specific questions, but each new tool adds complexity. It’s also important to tap real-time data from sources such as social platforms, mobile apps, and wearables to support delivery of personalized and proactive care. This webinar will discuss key use cases that drive patient outcomes, the need for consolidated analytics to realize value-based care, scenarios to maximize efficiency, and an overview of CitiusTech’s integrated healthcare data enhancement and analytics platform.

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

Acquisitions, Funding, Business, and Stock

India-based Indegene Lifesystems announces the acquisition that I mentioned was imminent last week, the SmartCare population health analytics platform from Vantage Point.

The Economist observes that despite the competition that the Affordable Care Act was supposed to create, America’s five biggest health insurers have seen their share prices triple in the past five years and all are making huge profits that are still trending upward after ACA’s implementation. They’re being helped by the federal government, which is handing off Medicare and Medicaid healthcare to insurance companies. The article concludes, “The vast expense and unintelligible complexity of American healthcare may be a national disgrace, but they are a huge opportunity for firms that can navigate the system and minimize costs.” I graphed the five-year share performance of Cigna (blue, up 273 percent), Humana (red, up 202 percent), Aetna (teal, up 244 percent), Anthem (pink, up 130 percent), and UnitedHealth Group (purple, up 221 percent) vs. the S&P 500 (blue, up 68 percent). Don’t bet against statistical experts.

Lee Equity Partners sells PDR Network to Genstar Capital. PDR Network was formed from Physician’s Desk Reference, Healthcare Notification Network, and LDM Group in moving the print-based publication to a digital business.

People

Premier, Inc. names David Vorhoff (Deloitte Corporate Finance) as SVP of corporate development and strategy.

Ingenious Med names David Lamm (United Allergy Services) as CFO.

Southeastern Health (NC) names consultant Steve Milston as CIO.

Announcements and Implementations

The American College of Cardiology, Geisinger Health System, and xG Health Solutions will develop software based on ACC’s guidelines and Geisinger’s methodology.

Allscripts and TeleTracking will integrate their products and sell each other’s offerings.

Privacy and Security

@CandidCIO found a fascinating security breach buried in the SEC filings of wireless networking vendor Ubiquiti Networks. The company discovered a phishing attack in June 2015 in which $47 million of its money had been transferred to the overseas accounts of scammers. Its ever-vigilant auditors concluded after the fact that, “the Company’s internal control over financial reporting is ineffective due to one or more material weaknesses.”

University of Rochester Medical Center will pay $15,000 to settle HIPAA charges after it gave one of its nurse practitioners a worksheet containing the names, address, and diagnoses of the 3,400 patients she had treated there. She gave the worksheet to Greater Rochester Neurology, at which she had accepted a new job, who mailed the patients letters announcing that the NP was joining them. URMC received patient complaints about the letters and fired the nurse practitioner.

Technology

I use Bitdefender and received an email pitching its Bitdefender Box, a router-attached, smartphone-controlled security appliance that protects every device that’s connected to a home network in what the company calls the “Security of Things.” It costs $199 upfront and then $99 per year for updates, which is a pretty good deal since it theoretically replaces a houseful of individual antivirus and firewall subscriptions. It works on Windows, Apple, and Android devices and also provides a personal VPN service to extend its security to wherever a mobile device is being used. I won’t buy it just yet until they get the bugs worked out, but I think this is the future of malware protection. It might be something hospitals make available to employees or doctors that work offsite or on personal mobile devices since they are often the network’s weak link. 

Other

Cerner and several Kansas City groups are sponsoring programming events for 400 female students this week, hoping to change their perceptions of technology careers. Two of the six locations are Cerner campuses. I hadn’t heard of the non-profit Hour of Code, but it’s pretty cool: anyone can organize an event and 150 million students worldwide have participated as the organization strives to improve diversity in computer science.

A Wells Fargo Securities report titled “Does Epic Own the Future?” finds that while the average physician EHR user is 49 years old, Epic’s user base is a little bit younger (by a year or so) and Practice Fusion has the highest average age of 51.7. The report theorizes that recent graduates are increasingly going to work for big, Epic-using health systems, while Practice Fusion’s free EHR attracts older doctors who don’t want to spend money or effort on an EHR close to their retirement. I don’t disagree with the theories, but the age spread isn’t enough to get too excited about, I doubt it signals anything important, and it doesn’t distinguish between inpatient and ambulatory use or physicians who are forced to use multiple systems. Slightly interesting is the statement that Epic has more than a 25 percent market share among new graduates vs. all of its competitors that are bunched up at between two and 10 percent.

The EDs of Cleveland’s hospitals will phase out ambulance diversions, which should be interesting presuming they occasionally had valid reasons for not taking new ambulance patients in the first place.

Flooding in the technology hub of Chennai, India causes its premiere, 1,000-bed hospital to lose power and life support systems, killing at least 18 inpatients in a Hurricane Katrina-type situation. Caregivers kept some patients alive by ambu bagging them for up to 48 hours. All communications were down and roads to the hospital were submerged under six feet of water.

This is fun: world traveler and Dell CMO Nick van Terheyden, MD tweets from Dubai that the United Arab Emirates government has blocked Internet access to HIStalk.

A Harvard Business Review article by Frederick Cerise, MD, MPH, CEO of Parkland Health and Hospital Systems (TX) says large, publicly supported safety net health systems like Parkland have an advantage because they are driven by community needs and give clinicians a greater voice in decision-making. He says Parkland has been operating like an ACO since 1989, receives 36 percent of its budget as a county allocation rather than for billing more services, and can resist the financial temptation to offer high-paying but questionably beneficial services. He mentions that the hospital’s tele-dermatology service loses money since half of its patients are uninsured, but it still offers an efficient way to deliver services.

Sponsor Updates

• HealthLoop publishes “5 Things You Need to Know About CMS’s First-Ever Mandatory Bundled Payment Program.”
• TierPoint will host an open house December 10 in Marlborough, MA.
• Visage Imaging debuts several products and enhancements at RSNA 2015.
• VitalHealth Software and Zynx Health will exhibit at the IHI National Forum on Quality in Healthcare December 6-9 in Orlando.
• Voalte releases a new case study, “How Avera McKennan Achieved Efficient Caregiver Communication with Voalte Platform.”

Blog Posts

• Strengthening Primary Care and Population Health Across Accountable Care (Verisk Health)
• A Collaborative Data Model: Separating ‘Marketing Speak’ from MDM Innovation (VisionWare)
• 5 More Reasons Healthcare Providers Can Be Thankful This Year (VitalWare)

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.

News 12/4/15

Top News

Patient engagement technology vendor Welltok acquires consumer communications company Silverlink, also announcing $45 million in new funding to support a portion of the acquisition.

Reader Comments

From Sport Pepper CMIO: “Re: EHRs. This is an interesting article which highlights what many of us know already.” The article in The Journal of Bone & Joint Survey looks at the post-implementation gap in EHR satisfaction, where IT people and administrators are happy but clinicians aren’t. That’s not too surprising since those non-clinicians have the most influence on which systems are chosen and how they are implemented. The article hints and what I’ve always claimed – it’s not so much that clinicians hate the concept of EHRs, they realize that both internal and external non-clinicians employ them as a blunt instrument (sometimes with the best of intentions, at least based on their own agendas) to create and enforce new rules that deliver minimal patient value. Few people enjoy using technologies intended to control their behavior – that would be like a prisoner loving their ankle monitor.

From Zealous Zygote: “Re: news. I always get what I need from your site. As an educator, I also note that it is presented so I remember it well.” That’s my goal. I use these methods to hopefully make myself and everybody who reads what I write a little bit smarter about healthcare IT:

• I choose only newsworthy stories that provide reader value. Curation takes probably 80 percent of the time I spend on each post as I wade through the mountains of poorly communicated junk. Unlike other sites, I have no fixed space to fill and I’m not paid per word, so I have no incentive to pad out a one-sentence story into 12 paragraphs that waste reader time.
• I summarize each item as succinctly as possible and make it as highly readable as I can.
• I add context where it provides value, whether that be a back story or my own opinion.
• I use illustrations when they make sense (no stock photos, in other words).
• I provide a link to a source when possible for those who want to read more.
• I provide a cynical, sometimes sarcastic point of view that doesn’t otherwise get much airplay in the fizzy, self-congratulatory world of health IT.

From Beeper King: “Re: smartphone app for secure communications. We tried one vendor’s solution. The big issue was that you couldn’t shut the thing up when you were with a patient by pushing a button in your pocket like you do with a beeper — you had to take out the phone, open the app, and engage with it. Then you lost the reminder for later. Also, there was no way to turn on or off your call status or transfer to another within the app itself. You had to call a paging company number, follow a phone tree of commands, and, if you were transferring call to someone else, to remember their damned number. The hospitalists rejected the thing out of hand.” It sounds as though it was designed by technologists rather than clinicians. 

HIStalk Announcements and Requests

I received generous donations for my DonorsChoose project from Carla, Mike, Chris, and an anonymous reader totaling $1,650, to which I applied matching funds from both my anonymous vendor executive as well as private foundations to fund this rather amazing list of teacher grant requests in their entirety:

• Math manipulatives for Ms. Brown’s elementary school special education resource room in Harper Woods, MI
• A Chromebook and accessories for math instruction for Mrs. Shaw’s fourth grade class in Philadelphia, PA
• Two Amazon Fire tablets for math and science self-study for Ms. Lacey’s elementary school class in Houston, TX
• Five tablets for Mrs. Chavis-Ramirez’s elementary school science class in Houston, TX
• An iPad Mini and programmable robot to create a Kids Coding Club for Ms. Carbo’s first grade class in Atlanta, GA
• A STEM early learning kit for Mrs. Almiron’s kindergarten class in Port St. Lucie, FL
• Four tablets and cases for math and science learning centers for the special education class (Down syndrome, cerebral palsy, traumatic brain injury, etc.) of Ms. Munoz’s Grades 5-6 in Pasadena, TX
• Five animation software and hardware kits to produce science movies in Ms. S’s elementary school class in Houston, TX
• A 3D printer for the high school science class of Mr. Swedman in Keaau, HI
• An anatomy model and learning kits for Ms. Wilson’s special needs class in Richmond, VA
• Two Chromebooks for targeted math study in Mr. Colasacco’s sixth grade class in Brooklyn, NY
• A programmable robot to create a makerspace in the school library and a learning club by Mr. Lincheck’s elementary school in Houston, TX
• Two tablet keyboards for Mrs. C’s elementary school class in Houston, TX
• Two Chromebooks for the high school physics class of Mr. Lewis in Houston, TX
• 20 sets of headphones for the elementary school inclusion class of Mrs. Ortego in Lake Charles, LA
• Seven sets of headphones and cables for computer learning in Mrs. Allen’s learning disabled class in Heath Springs, SC
• Microbiology lab equipment for the four full (and waitlisted) classes of the first microbiology course ever offered by Ms. Westover’s high school in Norcross, GA
• A science library for the elementary school class of Ms. B in San Bernardino, CA
• 40 portfolio binders for the gifted class of Mrs. Perez in St. Petersburg, FL
• A STEM bundle for the elementary school class of Mrs. Huynh in Houston, TX

Mrs. Kay from Wisconsin (near Epic, in fact) says that she and her elementary schoolers “love our Samsung tablet” that we provided via DonorsChoose that allows them to check out public library books electronically, some of which include audio files so the students can follow along. She says they use the tablet every day in reading block, adding, “I have truly seen a deeper love of reading from many of these students who we might think of as reluctant readers.”

The best reason to buy travel insurance for non-domestic trips is medical evacuation coverage that will pay to fly you back to a US hospital if you experience a medical catastrophe in a location with limited medical resources. I was thinking that someone should offer a US-only plan that will evacuate people with narrow-network insurance from the 99 percent of the country their policies don’t cover back to their home location to avoid otherwise likely financial ruin. An analysis finds that many 2016 plans do not have a maximum cap for out-of-network expenses they don’t cover, meaning a heart attack in another state is the patient’s financial responsibility at full list price. Of this I have zero doubt: medical bankruptcies are going to balloon in 2016 and many of the folks involved will be middle-class people with insurance they purchased through Healthcare.gov thinking it would protect their family just like employer-provide plans. The uproar will commence just in time to be a hotly debated topic in the 2016 presidential election. The only hope — and it’s a slight one — is that next year’s ACA enrollment will grow to reflect a more typical customer pool, i.e. healthy people will sign up and help pay for the unhealthy ones who quickly jumped on board last year.

This week on HIStalk Practice: Arizona’s Practice Transformation Institute leverages HIE capabilities. A physician’s propensity for EHR eye lock boils down to gender. Dr. Gregg gives thanks for HIT. Blue Cross and Blue Shield of Alabama begins covering telemedicine visits. Family physicians have trouble seeing the ROI of value-based payments. Two Point expands data-conversion services to providers. Physician awareness of prescription drug monitoring programs is surprisingly low. CVS Health EVP Andrew Sussman, MD discusses the company’s partnership with Epic and Health is Primary, plus plans for telemedicine.

This week on HIStalk Connect: Welltok raises $45 million in new funding and announces the acquisition of patient engagement vendor Silverlink for an undisclosed sum. GOQii raises a $13 million Series A to ramp up its personal wellness coach and activity tracker platform. Propeller Health signs a new R&D agreement with GSK to develop medication utilization sensors for its Ellipta dry-powder inhaler. Scripps Translational Science Institute will recruit 6,100 volunteers to wear a heart rate monitor for four months as part of a study designed to improve atrial fibrillation diagnosis in high-risk populations.

Webinars

December 9 (Wednesday) 12 noon ET. “Population Health in 2016: Know How to Move Forward.” Sponsored by Athenahealth. Presenter: Michael Maus, VP of enterprise solutions, Athenahealth. ACOs need a population health solution that helps them manage costs, improve outcomes, and elevate the care experience. Athenahealth’s in-house expert will explain why relying on software along isn’t enough, how to tap into data from multiple vendors, and how providers can manage patient populations.

December 9 (Wednesday) 1:00 ET. “The Health Care Payment Evolution: Maximizing Value Through Technology.” Sponsored by Medicity. Presenter: Charles D. Kennedy, MD, chief population health officer, Healthagen. This presentation will provide a brief history of the ACO Pioneer and MSSP programs and will discuss current market trends and drivers and the federal government’s response to them. Learn what’s coming in the next generation of programs such as the Merit-Based Incentive Payment System (MIPS) and the role technology plays in driving the evolution of a new healthcare marketplace.

December 15 (Tuesday) 1:00 ET. “CPSI’s Takeover of Healthland.” Sponsored by HIStalk. Presenters: Frank Poggio, CEO, The Kelzon Group; Vince Ciotti, principal, H.I.S. Professionals. Frank and Vince are back with their brutally honest (and often humorous) opinions about the acquisition. They will review industry precedents (such as Cerner-Siemens), the possible fate of each Healthland product, the available alternatives, and steps Healthland customers should take now. Their previous webinar that covered Cerner’s takeover of Siemens has drawn nearly 7,000 views and this one promises to be equally informative and entertaining.

December 16 (Wednesday) 1:00 ET. “A Sepsis Solution: Reducing Mortality by 50 Percent Using Advanced Decision Support.” Sponsored by Wolters Kluwer Health. Presenter: Stephen Claypool, MD, medical director of innovation lab and VP of clinical development and informatics for clinical software solutions, Wolters Kluwer Health. Sepsis claims 258,000 lives and costs $20 billion annually in the US, but early identification and treatment remains elusive, emphasizing the need for intelligent, prompt, and patient-specific clinical decision support. Huntsville Hospital reduced sepsis mortality by 53 percent and related readmissions by 30 percent using real-time surveillance of EHR data and evidence-based decision support to generate highly sensitive and specific alerts.

December 16 (Wednesday) 1:00 ET. “Need for Integrated Data Enhancement and Analytics – Unifying Management of Healthcare Business Processes.” Sponsored by CitiusTech. Presenters: Jeffrey Springer, VP of product management, CitiusTech; John Gonsalves, VP of healthcare provider market, CitiusTech. Providers are driving consumer-centric care with guided analytic solutions that answer specific questions, but each new tool adds complexity. It’s also important to tap real-time data from sources such as social platforms, mobile apps, and wearables to support delivery of personalized and proactive care. This webinar will discuss key use cases that drive patient outcomes, the need for consolidated analytics to realize value-based care, scenarios to maximize efficiency, and an overview of CitiusTech’s integrated healthcare data enhancement and analytics platform.

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

Here’s the recording of Wednesday’s VMware-sponsored webinar, “The Patient Is In, But the Doctor is Out: How Metro Health Enabled Information Decision-Making with Remote Access to PHI” by Josh Wilda, VP of IT at Metro Health (MI).

Acquisitions, Funding, Business, and Stock

A Washington Post investigation finds that the Department of Defense questioned the lab technology of Theranos in 2012, passing on its fingerstick methods. CEO Elizabeth Holmes asked four-star Marine General James Mattis, who later joined the company’s board, to dispel the DoD’s “blatantly false information.” Mattis pushed hard to have Theranos tested in Afghanistan, drawing a Marine Corps caution that he needed to stop personally pitching the company.

Seamless Medical Systems, which offers a mobile device check-in app for medical practices, closes a $2.5 million investment.

Sales

Baystate Health (MA) chooses Imprivata Cortext for secure communications.

Community Health Systems will offer $39 virtual doctor visits to patients in the communities where its 198 hospitals are located. It will use American Well’s telehealth platform.

Broward Health (FL) chooses Cerner HealtheIntent for population health management.

The UK Defence Medical Services chooses CGI to provide an integrated EHR for its 400 sites, which will be based on the PCS system from EMIS Health. CGI will host the system and manage its help desk.

For-profit Manipal Hospitals (India) chooses IBM’s Watson for Oncology for its 15 hospitals.

People

MedSys Group names P.J. deRijke (Warbird Consulting Partners) as VP of client relations.

Fairfield Medical Center (OH) names Alan Greenslade (Greenslade Consulting) as CIO.

Hal Wolf (McKinsey & Company) joins The Chartis Group as director.

Private equity investor Bruce Cerullo, formerly chairman and CEO of Vitalize Consulting Solutions that was sold to SAIC/Leidos in 2011, joins Nordic Consulting as chairman and CEO. He replaces Mark Bakken, who left the company in March 2014 to start an early stage venture capital fund.

Announcements and Implementations

Catalyze announces Redpoint, a set of EHR integration tools for digital health vendors that includes pre-configured scripts, EHR connectivity tools, and workflow components.

Health station vendor Higi will use Validic’s digital health platform to capture real-time consumer biometric information as part of its patient monitoring and wellness programs. Chicago-based Higi was founded by Chicago Sun-Times Founder Michael Ferro of Merrick Ventures,former chairman of Merge Healthcare. He’s credited with saving Merge in 2008, with the company’s $1 billion acquisition by IBM putting around $200 million in his pocket in return for his $15 million investment. 

Quality improvement, cost containment, and clinical content technology vendor LogicStream Health graduates from the accelerator program of TreeHouse Health, the first of its portfolio companies to achieve all transition milestones. The Minneapolis-based company was co-founded by a pharmacist and a physician and counts Texas Health Resources among its customers. 

HIMSS announces its Value Score measure of the value of healthcare IT, which I assume it will sell since the announcement didn’t indicate otherwise and its self description seems ambitious (although one might quibble at the inconsistent use of the essential Oxford comma in the announcement’s first sentence and spelling KPIs as KPI’s in the accompanying graphic):

HIMSS is a global voice, advisor and thought leader of health transformation through health IT with a unique breadth and depth of expertise and capabilities to improve the quality, safety, and efficiency of health, healthcare and care outcomes. HIMSS designs and leverages key data assets, predictive models and tools to advise global leaders, stakeholders and influencers of best practices in health IT, so they have the right information at the point of decision.

Zynx Health announces integration between its ZynxOrder evidence-based order set development system and Epic inpatient.

Government and Politics

CMS analysis finds that US healthcare spending jumped 5.3 percent in 2014 after years of low growth, which it says is primarily due to expanded coverage under the Affordable Care Act and increased drug spending. The $3 trillion in annual expense represents 17.5 percent of GDP and $9,523 per person. The increased rate of growth is still less than before the Affordable Care Act, which the White House touts as evidence that ACA is insuring more Americans without large cost growth increases. Critics point out that the modest spending increase may be masked by insured Americans who are being forced to pay ever-higher deductibles or who avoid seeking care they can’t afford even with insurance. Somehow hospitals evaded being named as being significantly responsible for higher healthcare costs. I maintain that if you want to see who is most responsible for high US healthcare costs, follow the money and check the 1040 tax forms of the individuals involved – you’ll see a lot of drug company executives, hospital administrators, high-powered surgeons, insurance company suits, and healthcare vendor executives who became millionaires (even in working for a supposedly non-profit organization) from the mess that is our healthcare system.

Privacy and Security

Centegra Health System (IL) exposes the information of 3,000 patients when the mailing equipment of contractor MedAssets was misconfigured to send two statements per envelope instead of one, with each patient receiving their own statement plus one from another patient.

Cottage Health System (CA) notifies 11,000 patients that an incorrectly configured server exposed their records to Google searches at the end of October. The problem was discovered by a cybersecurity firm hired to perform a security audit, which I suppose means the engagement’s ROI was substantial. Or maybe not – the cost of the breach response and any resulting fines or lawsuit awards might be the same regardless of who found the problem or whether it actually exposed any information.

Technology

MIT non-profit spinoff institute MIT Hacking Medicine will publish in the next few weeks a “best apps” list and consumer reviews of digital health tools. It says expert reviews are important because most apps have few downloads and reviews and don’t use good design practices. The institute’s co-directors are students: Tatyana Gubin is studying mechanical engineering at MIT with a focus on medical devices, while Christopher Lee is a Harvard-MIT PhD student and co-founder of a company that developed a disposable drug reconstitution system.

Other

Several patient advocacy groups launch Partners for Better Care, which seeks manageable out-of-pocket costs, cost transparency, adequate provider networks, reasonable healthcare costs, and equitable access to drug therapies. That last item justifiably raises a red flag given that the group’s initial funding came from drug maker Novo Nordisk, which took heat for jacking up the price of its Levemir insulin almost exactly in tandem with that of competitor Lantus to over $300 per vial, leading to questions about whether the brand name drug marketplace is really competitive. Shareholders of  Denmark-based Novo Nordisk probably like Levemir’s pricing a lot more than the patients who use  it – the company’s stock is up 22 percent in the past year and 161 percent in the last five, giving the company a market value of $145 billion. I couldn’t find a listing of the officers or board members for Partners for Better Care except that the announcement referenced without detail its executive director, Mary Richards, who I assume isn’t the WJM Minneapolis beret-tossing one.

Turing Pharmacecuticals CEO Martin Shkreli says he was wrong to increase the price of old but critical drug Daraprim by 5,000 percent – he wishes he had increased the price even more. He says, “Our shareholders expect us to make as much money as possible … the idea that pharmaceuticals are exempt from capitalism is insane.” As I’ve said, Shkreli is a saint in finally showing the true colors of drug companies as cartoonishly evil villains rather than the dulcet-toned suits who pretend to exude concern for patients rather than profits. Their indefensible prices, especially here in the US, speak for themselves.

BIDMC CIO John Halamka, MD concludes in his year-end review that “ICD-10 benefited no one” and expresses his hope that the industry moves to bundled payments so that ICD won’t be needed for billing, replaced for analytics purposes by natural language processing translation of unstructured text into SNOMED-CT codes. He’s optimistic about 2016, as he indicated in my interview with him a couple of weeks ago, now that the “weights around our ankles (ICD-10, MU) are finally coming off.”

Weird News Andy would have headlined this story as, “I bet you’re stupid.” A man in China desperate to raise rent money takes a $1,200 bet that he wouldn’t swallow a five-inch saw blade and a five-inch nail. The good news is that he won the bet, but the bad news is that the evacuation of the hardware occurred surgically rather than naturally, with the medical costs exceeding his winnings.

Sponsor Updates

• Sixteen Influence Health clients receive eHealth Leadership Awards.
• Valence Health publishes “Helping Solve the US Healthcare Crisis: The Provider’s Guide to Building a Successful Plan.” The 292-page electronic book is available on their site or on Amazon.
• An InterSystems survey of lab professionals in Australia finds that laboratory information systems aren’t equipped to deliver the desired cost savings and efficiencies.
• LiveProcess exhibits at the National Healthcare Coalition Preparedness Conference through December 4 in San Diego.
• Oneview Healthcare launches an internship competition. 
• LogicStream Health is exhibiting at the IHI National Forum in Orlando, FL next week.
• Pediatric Associates of Dallas reduces billing costs after implementing the PatientPay paperless payment solution.
• Former L&D nurse and clinical analyst Darcy Dinneny discusses her experience with PeriGen’s PeriCalm solution.
• Qpid Health will exhibit at the IHI National Forum on Quality Improvement in Health Care December 6-9 in Orlando.
• Streamline Health will exhibit at the HIMSS Revenue Cycle Solutions Summit December 7-8 in Atlanta.

Blog Posts

• The Biggest, Baddest Breaches of 2015 (ID Experts)
• Giving Thanks for Family (Impact Advisors)
• Healthcare’s Black Friday: Lessons Providers can Learn from Retail’s Biggest Day (InstaMed)
• Is Your Business a Center of Excellence? Probably! (Liaison Technologies)
• Key Steps to an Effective Image Exchange Implementation (LifeImage)
• The Top Ten Thanksgiving Mishaps via ICD-10 (MedAptus)
• Training Patient Service Representatives to Make a Difference (MedData)
• Ready to Take Your Place in the Cockpit? What Healthcare BI Strategies Have in Common with Altimeters and Accelerometers (Navicure)
• Dictate and Review Images Simultaneously: See How at RSNA 2015 (NVoq)
• Meet Susan Anderson, Managing Director for Orion Health Canada (Orion Health)
• Highlights from the 2015 Financial Performance Summit (Experian Health)
• Build Your Best Defense Against Data Breaches with a Mobile Game Plan (PatientSafe Solutions)
• Integrating Your Patient Revenue Cycle in 2016 (Patientco)
• A Resounding “Meh” from Hospital CIOs” (PatientKeeper)
• The State of Patient-Centric Secure Texting Initiatives (Practice Unite)
• Live from RSNA 2015 (Lexmark)
• Phynd Platform Facilitates Information Sharing (Phynd Technologies)
• Lessons that Babies can Teach Us About Providing Customer Support (PMD)
• Meaningful Use 3 Objectives: Computerized Provider Order Entry (Sagacious Consultants)

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.

News 12/2/15

Top News

The Health IT Policy Committee’s API Security Task Force held its first meeting Monday, co-chaired by Josh Mandel (Harvard Medical School) and Meg Marshall (Cerner). The group is charged with identifying privacy and security issues with open APIs. Its next meeting is this week.

Reader Comments

From Frying Burrito Brother: “Re: DonorsChoose. Our company would like to donate and I don’t see instructions.” I have matching money left, which I will apply to your donation made as follows:

1. Purchase a gift card in the amount you’d like to donate.
2. Send the gift card by the email option to mr_histalk@histalk.com (that’s my DonorsChoose account).
3. I’ll be notified of your donation and you can print your own receipt for tax purposes.
4. 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.

From Equine Hindquarters: “Re: EHR databases. You wrote a long time ago that they should all use the same basic schema and compete on additional tables as well as their UI.” I’ll update my suggestion as follows. Each EHR should contain a basic set of tables with a universal format so that any authorized party can retrieve patient demographics, visits, medication lists, etc. That eliminates the need to convert proprietary tables or run the query through an HIE that may or may not be translating correctly. That also places onus for the data accuracy and completeness on the EHR vendor, who is best equipped to manage that task. Those interoperability tables would be separate from the existing EHR tables to avoid exposing proprietary information or methods. It’s like exporting a CCDA or other document except that it resides permanently in the vendor’s database with real-time updates and could be accessed via standard APIs with minimal effort or system knowledge. The vendors know their own systems, so let them populate these standard tables instead of forcing everybody who needs access to their patient information to figure it out for themselves.

From Pippi Longstocking: “Re: Microsoft Lync. Does anyone know of an acute care facility that has fully converted to it? If so, how was HL7 addressed and is backup and stability similar to a traditional communication platform?”

HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor Spok (pronounced “spoke”). The Springfield, VA-based company is a market leader in critical communications solutions – clinical alerting and notification, secure hospital communications, physician and nurse scheduling, paging, and contact center technologies. The company chose its new name in 2014 following the 2011 acquisition of Amcom Software by USA Mobility. The Spok Mobile secure texting app allows users to send images and video along with text, with full logging and HIPAA compliance. Spok Critical Test Results Management helps meet National Patient Safety Goal #2 in quickly sending radiology and lab results to the right clinicians on their mobile devices, accelerating the treatment plan and discharge process as appropriate and protecting against malpractice lawsuits. The FDA-approved Spok Messenger sends mobile alerts from nurse call systems while routing non-clinical requests to the appropriate team member. Paging remains relevant as an essential part of critical healthcare communications due to its high reliability and low cost and Spok offers both wide-area and onsite versions of it. Thanks to Spok for supporting HIStalk.

Here’s a YouTube video case study that describes Banner Health’s use of Spok solutions to create patient-centric communications.

I’m among the one-third minority who pronounce the name of this site “H-I-S-talk” rather than the “Hizz-talk” preferred by two-thirds of 335 poll respondents. Dean says he doesn’t like turning acronyms into words and was baffled when people at his previous employer pronounced “URL” as “earl,” which reminds me of my annoyance at people pronouncing Joint Commission back in its JCAHO days as “jayco,” which makes no sense at all but is at least less annoying than lowbrow humorists who gleefully turn FHIR into tediously non-clever “fire” puns. Two respondents offered a variation I hadn’t though of in “hisstalk.” At least nobody said they incorrectly assume that: (a) the “his” is the opposite of “hers,” or (b) the name has a religious connotation.

Mrs. Jarrell from Louisiana reports that her seventh graders are learning about integers as they use the math manipulatives and electronic quiz tools we provided via DonorsChoose.

I get a bit queasy when I see how HIMSS advises its vendor members on how to sell their products to its provider members, as evidenced by the pitch for its recent webinar that gets me going in several ways:

• It uses “social” as a synonym for “social media,” which it is not (although I’m at least happy it’s not the retch-inducing “sosh”). It also bleats out “leverage” and “utilize” instead of the less-pompous and perfectly serviceable “use.”
• It pitches the use of social media to “generate excitement about your brand before and during HIMSS16 utilizing its expert team,” with the expert team to be “utilized” being that of HIMSS Media, which seems to have happily eliminated the firewall between alleged news reporting and for-hire pitching. I’ve yet to experience tweet-induced excitement about a company, especially when the tweets in question emanated from those folks.
• It claims that screwing around with Twitter and Facebook will result in “transforming yourself from a vendor into a trusted advisor.” That’s asking a lot from simply assigning some 20-something kid to post unoriginal, corporate-approved thoughts that decision-makers will never read because they have far better things to do than monitoring Twitter. It’s usually a really bad idea to make a vendor your “trusted advisor” unless the advice you seek is that you should buy whatever they’re selling.
• It reminds me that HIMSS makes millions from pimping low-paying provider members to high-paying vendor members while also selling itself. I like some of what HIMSS does, but the emphasis on its own bottom line keeps increasing. They’re almost as bad as AAA, which bombards me trying to sell insurance, car repair, vacations, sponsor-supported products, credit cards, and even used cars when all I want is roadside assistance and maybe an occasional hotel discount.

Webinars

December 2 (Wednesday) 1:00 ET. “The Patient is In, But the Doctor is Out: How Metro Health Enabled Informed Decision-Making with Remote Access to PHI.” Sponsored by VMware. Presenters: Josh Wilda, VP of IT, Metro Health; James Millington, group product line manager, VMware. Most industries are ahead of healthcare in providing remote access to applications and information. Some health systems, however, have transformed how, when, and where their providers access patient information. Metro Health in Grand Rapids, MI offers doctors fast bedside access to information and lets them review patient information on any device (including their TVs during football weekends!) saving them 30 minutes per day and reducing costs by $2.75 million.

December 2 (Wednesday) 1:00 ET. “Tackling Data Governance: Doctors Hospital at Renaissance’s Strategy for Consistent Analysis.” Sponsored by Premier, Inc. Presenters: Kassie Wu, director of application services, Doctors Hospital at Renaissance; Alex Eastman, senior director of enterprise solutions, Premier, Inc. How many definitions of “complications” (or “cost” or “length of stay”…) do you have? Doctors Hospital at Renaissance understood that inconsistent use of data and definitions was creating inconsistent and untrusted analysis. Join us to hear about their journey towards analytics maturity, including a strategy to drive consistency in the way they use, calculate, and communicate insights across departments.

December 2 (Wednesday) 2:00 ET. “Creating HIPAA-Compliant Applications Without JCAPS/JavaMQ Architecture.” Sponsored by Red Hat. Presenters: Ashwin Karpe, lead of enterprise integration practice, Red Hat Consulting; Christian Posta, principle middleware architect, Red Hat. Oracle JCAPS is reaching its end of life and customers will need a migration solution for creating HIPAA-compliant applications, one that optimizes data flow internally and externally on premise, on mobile devices, and in the cloud. Explore replacing legacy healthcare applications with modern Red Hat JBoss Fuse architectures that are cloud-aware, location-transparent, and highly scalable and are hosted in a container-agnostic manner.

December 3 (Thursday) 2:00 ET. “501(r) Regulations – What You Need to Know for Success in 2016.” Sponsored by TransUnion. Presenter: Jonathan Wiik, principal consultant, TransUnion Healthcare Solutions. Complex IRS rules take effect on January 1 that will dictate how providers ensure access, provide charity assistance, and collect uncompensated care. This in-depth webinar will cover tools and workflows that can help smooth the transition, including where to focus compliance efforts in the revenue cycle and a review of the documentation elements required.

December 9 (Wednesday) 12 noon ET. “Population Health in 2016: Know How to Move Forward.” Sponsored by Athenahealth. Presenter: Michael Maus, VP of enterprise solutions, Athenahealth. ACOs need a population health solution that helps them manage costs, improve outcomes, and elevate the care experience. Athenahealth’s in-house expert will explain why relying on software along isn’t enough, how to tap into data from multiple vendors, and how providers can manage patient populations.

December 9 (Wednesday) 1:00 ET. “The Health Care Payment Evolution: Maximizing Value Through Technology.” Sponsored by Medicity. Presenter: Charles D. Kennedy, MD, chief population health officer, Healthagen. This presentation will provide a brief history of the ACO Pioneer and MSSP programs and will discuss current market trends and drivers and the federal government’s response to them. Learn what’s coming in the next generation of programs such as the Merit-Based Incentive Payment System (MIPS) and the role technology plays in driving the evolution of a new healthcare marketplace.

December 9 (Wednesday) 1:00 ET. “Looking ‘Back to the Future’ on Clinical Decision Support and Data Warehousing.” Sponsored by Health Catalyst. Presenter: Dale Sanders, SVP of strategy, Health Catalyst. Dale will use a 2006-era slide deck (complete with old-school graphics) on using an enterprise data warehouse in clinical decision support, as it was originally presented to several masters-level informatics classes nearly 10 years ago. Some of the information in the “time capsule” will be laughably wrong, while some will still be relevant. Either way, reviewing the past will help inform the future. A highly interactive Q&A will follow.

December 16 (Wednesday) 1:00 ET. “A Sepsis Solution: Reducing Mortality by 50 Percent Using Advanced Decision Support.” Sponsored by Wolters Kluwer Health. Presenter: Stephen Claypool, MD, medical director of innovation lab and VP of clinical development and informatics for clinical software solutions, Wolters Kluwer Health. Sepsis claims 258,000 lives and costs $20 billion annually in the US, but early identification and treatment remains elusive, emphasizing the need for intelligent, prompt, and patient-specific clinical decision support. Huntsville Hospital reduced sepsis mortality by 53 percent and related readmissions by 30 percent using real-time surveillance of EHR data and evidence-based decision support to generate highly sensitive and specific alerts.

December 16 (Wednesday) 1:00 ET. “Need for Integrated Data Enhancement and Analytics – Unifying Management of Healthcare Business Processes.” Sponsored by CitiusTech. Presenters: Jeffrey Springer, VP of product management, CitiusTech; John Gonsalves, VP of healthcare provider market, CitiusTech. Providers are driving consumer-centric care with guided analytic solutions that answer specific questions, but each new tool adds complexity. It’s also important to tap real-time data from sources such as social platforms, mobile apps, and wearables to support delivery of personalized and proactive care. This webinar will discuss key use cases that drive patient outcomes, the need for consolidated analytics to realize value-based care, scenarios to maximize efficiency, and an overview of CitiusTech’s integrated healthcare data enhancement and analytics platform.

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

Acquisitions, Funding, Business, and Stock

Allscripts announces a share buy-back of up to $150 million.

Sunquest Information Systems will move its Tucson, AZ headquarters to an office building on the north side. Google Maps indicates that it’s a 26-minute drive between the offices, just in case you’re an employee trying to assess your quality of life impact. I’ve had my hospital commute involuntarily changed a few times by an office move, where the folks in charge seemed surprised that most employees weren’t thrilled about wasting more hours driving every week just to stare at the same cubicle walls moved to a further-flung part of town. My limited analysis was that somehow the new building was always closer to the wealthier neighborhoods where hospital executives lived and featured an even nicer version of Mahogany Row on whose plush carpet the peons rarely trod except as guests at their own termination.

Blue Cross Blue Shield of Michigan acquires insurance company software vendor IkaSystems, which has some executive team members who have worked for various health IT vendors.

Sales

University of Chicago Medicine (IL) chooses Valence Health to support its clinically integrated network, the 30th such organization to implement the company’s unified clinical information solution.

Skagit Regional Health (WA) chooses Epic at an estimated cost of $72 million over five years. ECG Management Consultants, which managed the selection, says Skagit will displace Meditech in the hospital and NextGen in its clinics.

People

Online second opinion provider 2md.MD hires Kirk Rosin (Aetna) as chief strategy officer and Kristin Herrera (UnitedHealthcare Global) as chief growth officer.

Florent Saint-Clair (DR Systems) joins Dicom Systems as EVP.

CTG promotes Amanda LeBlanc to VP/chief marketing officer.

Kate Crouse (Smart Exec Tech LLC) is named network CIO at Kings County Hospital – Central Brooklyn (NY).

Vital Images names Paul Markham, DBA (Origenetics) as VP of marketing.

Rob Senska, Esq., MBA (Somerset Medical Center) joins Besler Consulting as director of compliance services and associate general counsel.

Announcements and Implementations

Yale-New Haven Hospital (CT) implements Mobile Heartbeat’s MH-Cure clinical smartphone app, with three-fourths of its physician users saying it has improved patient workflow and safety.

Naunce and the National Decision Support Company announce their collaboration to support ACR’s Imaging 3.0 by offering NDSC’s ACR Select appropriate use criteria along with Nuance PowerScribe 360 and PowerShare Network.

National Decision Support Company also announces that it has signed an exclusive agreement with Cerner to make its ACR Select imaging appropriate use criteria available to Millennium users.

Craneware will demonstrate a new version of its Pharmacy ChargeLink solution at the ASHP Midyear Clinical meeting, which includes predefined formulary mapping to Epic Willow and Cerner PharmNet.

Privacy and Security

In Canada, a former administrative assistant of Alberta Children’s Hospital is charged with 26 counts of inappropriately accessing patient records. She had already been fired for snooping.

Technology

Microsoft announces PowerApps, which it says will allow non-technical employees to create apps that work on any device by using Office-like templates, a drag and drop workflow designer, and connections to cloud and on-premises services such as Salesforce, Dropbox, and databases. That would be pretty cool if it works as described since subject matter experts typically struggle when trying to move handy, Office-powered workgroup apps to web or mobile environments without technical help.

Other

The US Supreme Court declines to hear the case of a retired Texas veterinarian whose license was suspended for offering online pet advice in yet another clash between Texas professional boards and telemedicine providers. The vet says the state’s requirement that he physically examine an animal before offering telephone advice violates his free speech rights. He was offering only advice, not the writing of prescriptions.

WakeMed (NC) blames its $50 million FY2015 loss on major expenses that include its Epic implementation, construction of a new 61-bed hospital in Raleigh, and running a care management program, but says the numbers are deceiving because the investments will pay off later. Meanwhile, neighboring Duke University Health System, which reported $355 million in profit on $3 billion in revenue, says its Epic-related financial hit from last year is history and Epic is now delivering the expected results. UNC Health Care System made $119 million on $3.2 billion in revenue.

Coca-Cola’s chief science and health officer retires following a New York Times report that described how the company secretly funded a non-profit that urged Americans to exercise more instead of drinking less soda as advocated by what Coke called “public health extremists.” The CEO of the non-profit, which has since shut down, accepted honoraria and travel expenses from Coca-Cola before he formed the group. He’s a professor at the University of Colorado School of Medicine, which returned Coke’s $1 million donation following the article’s publication. Coke also paid $500,000 to University of South Carolina, which says it’s not giving the money back.

A Wall Street Journal investigative report finds that Americans provide most of the global drug industry’s profits because of pharma’s political clout, an unwillingness by Americans to limit use of expensive drugs regardless of proven therapeutic benefit, laws that prohibit Medicare from negotiating drug prices, the fragmented US healthcare system in which lack of a single government buyer allows drug companies price their products however they like, and demand-generating direct-to-consumer advertising that most countries don’t allow.

In the Cayman Islands, the former board chair of the health services authority is on trial for defrauding the public after the HSA awarded a patient swipe card contract to a firm in which he held partial ownership. Witnesses testified that the technical committee’s choice of Cerner angered him to the point he a sent a copy of Cerner’s proposal to the owner of eventual winner AIS Jamaica, with whom he planned to open a pharmacy business.

Facebook CEO Mark Zuckerberg announces in a letter written to his newborn daughter Max that he and his wife Priscilla Chan, MD will give away 99 percent of their Facebook shares – worth $45 billion today – via a foundation that will focus on personalized learning, curing disease, connecting people, and building strong communities.

A KPMG survey finds that 80 percent of organizations report their ICD-10 transition as smooth, although its methodology of surveying 300 attendees of an ICD-10 webinar is lazy.

A tiny observational study finds that doctors who enter information into the EHR during patient visits not only communicate less as you might expect, but also argue more with their patients and earn lower satisfaction scores. That may mean that those doctors don’t communicate well, but it could also indicate that the observations made involved patients who were sicker or newer, thus requiring more data entry and less catering to the patients’ every whim. The most telling aspect would be how the computer and monitor were positioned in the exam room, which heavily drives patient perception as being either exclusionary or participatory.

Websites that offer estimated medical procedure costs, including those run by insurance companies, often give consumers incorrect cost information that leaves them paying higher-than-expected expenses out of their own pockets, according to an NPR review. Reasons include health systems that quietly buy other providers and increase their prices, use of historic or aggregated prices, and not knowing exactly what procedures a doctor might perform during a visit or how the doctor will code and bill it. Price transparency is also nearly non-existent as prices are hidden inside non-public contracts between payers and providers.

Weird News Andy enjoyed the programmer jokes I ran recently and offers “Mr. Boole Comes to Tea” in a belated celebration of George Boole’s 200th birthday.

Sponsor Updates

• Anthelio Healthcare Solutions will exhibit at the HIMSS Gulf Coast Chapters event December 4-5 in Birmingham, AL.
• Capsule will exhibit at the IHI National Forum on Quality Improvement in Health Care December 6-9 in Orlando.
• Divurgent ranks amongst CIOReview’s 50 most promising healthcare solution providers.
• Fujifilm debuts an updated version of Synapse RIS at RSNA.
• Visage Imaging is demonstrating Visage Ease mobile imaging results enhancements at RSNA.
• Healthfinch will exhibit at The Institute for Healthcare Improvement Annual Conference December 6-9 in Orlando.
• Huntzinger Management Group interviews client ProMedica CIO Rose Ann Laureto about the organization’s Epic go live.

Blog Posts

• 4 Reasons Private Physicians Should be Thankful That They’re Employed (AdvancedMD)
• 16 Tweet-imonials We’re Thankful for This Season (AirWatch)
• Update: The CCJR is distinctly different from other bundled payment models (Besler Consulting)
• The Roadmap to HIT Success Part 1: 5 Guiding Principles for Use Case Development (Burwood Group)
• Go Big or Go Home: The Importance of Scale in Population Health (Caradigm)
• Bringing Up Baby with Healow (EClinicalWorks)
• Chronic Care Management – Are you getting paid for the work already being done? (Galen Healthcare Solutions)
• 6 Ways to Avoid Squandering Consulting Hours (Galen Healthcare Solutions)
• HIMSS EMRAM Site Visit Presentation – 4 Key Questions (The HCI Group)
• Pharmacy’s Role in Reducing Readmissions: New Findings (Healthcare Data Solutions)
• The Business Case for Patient Engagement: Convenience and the Wild Card (Healthwise)

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.

Monday Morning Update 11/30/15

Top News

Billionaire Patrick Soon-Shiong, burned by poor IPO and biotech markets that evaporated $1 billion of the value of his NantKwest following its July IPO, postpones his planned IPO of NantHealth. “There is no reason to go out in a bear market,” he says.

Reader Comments

From Turkey Trotter: “Re: poll idea. How do readers pronounce HIStalk?” You can vote here. It’s always been H-I-S-talk for me, but I don’t know which is more common know since I rarely hear it spoken by anyone else as I write it in solitude. The name’s back story is that when I first started putting random thoughts online back in 2003, the old blogging tool I was using (Blog City) required entering a site name. The term for hospital IT back then was “hospital information systems,” and from that, I quickly (and not very creatively) came up with “HIStalk.” Not that it really mattered since literally nobody was reading other than me.

From Publius: “Re: New York-Presbyterian. I predict they will go Epic in the next 1-2 years. They are the only major NYC healthcare organization not on Epic, new CIO Daniel Barchi was CIO at two Epic organizations, and a plethora of experienced Epic consultants will be available from NYC Health + Hospitals, NYU, HSS, Montefiore, etc.” I had the same thought as soon as I heard Daniel was going there, plus the Weill Cornell physician group is already on Epic while the rest of the organization is on Allscripts. A NYP contact tells me they aren’t planning to look elsewhere, but I would be surprise if they don’t at least consider it.

From Steeple People: “Re: clearinghouses. How many EMR/PM vendors own their own? And if they don’t, which one do they use?” Vendor folks are welcome to provide their answer by leaving a comment.

From Vince Ciotti: “Re: CPSI acquiring Healthland. CPSI’s revenue had flattened out in the last couple of years. Healthland’s customer base is very small facilities such as Critical Access Hospitals that have little funding as the company struggles to convert its Classic users to Centriq. CPSI has a strong sales and marketing team and must be aiming to sell Healthland customers its Thrive system – like Cerner acquiring Siemens, each replacement of the Classic system that will be sunsetted in two years will mean several million in booked revenue, quite a windfall for CPSI if they can make the sales. Healthland has made few new sales in the past few years and the privately held company has revenue of only around $80 million with 500 employees. It was acquired by Francisco Partners in 2007.” Vince has offered to do a webinar on the acquisition, which I think might be fun. 

From Kaiser Cutter: “Re: programmer joke. A programmer’s wife asks him, ‘Can you pick up a loaf of bread, and if they have eggs, get a dozen?’ He returns home with 13 loaves of bread. She asks, ‘What happened?’ He said, ‘They had eggs.” I returned the favor with this one. Why do programmers always mix up Halloween and Christmas? Because Oct 31= Dec 25.

HIStalk Announcements and Requests

Sixty percent of poll respondents think everybody — not just covered entities — should be regulated by federal patient privacy laws. Mak doesn’t want taxpayers footing the bill for the inevitable bureaucracy, but HIT Geek says we need a common, simple nationwide privacy standard that can be easily enforced by built-in mobile device security controls. New poll to your right or here: where will you get your 2016 medical insurance? Click the Comments link on the poll after voting and let me know whether you’re happy with your coverage and its cost.

Our DonorsChoose project provided an iPad for the Nevada first grade class of Mrs. Sensibaugh, who says the students are using it daily to study math and language concepts. She adds, “My students have been motivated and truly excited to use this wonderful technology. They can’t believe that someone actually cares so much about their education that they would donate such a wonderful, thoughtful gift.” Mrs. Owen from Indiana says that only two students per class have their own calculators and rulers, with our donation of 25 of each allowing students to perform dimensional analysis, mole conversion, and density graphing. I like how she attached them to clipboards and labeled them.

One of my recurring off-topic rants is the ridiculous price of razor blades, whose non-interoperable cartridges are so expensive that many stores bizarrely lock them away with the electronics. I found a solution: a safety razor like my grandfather used and high-quality blades that cost $9 per hundred (all blades fit all razors). The blades are not only good for several shaves, but are also double-sided, so I figure the $9 worth will last me for at least 2-3 years. Now I just need to convince people of the absurdity of high-technology cars riding on expensive and dangerous rubber balloons.

Last Week’s Most Interesting News

• CPSI announces that it will acquire small-hospital systems competitor Healthland for $250 million, also giving the company a presence in 3,300 skilled nursing facilities.
• AcademyHealth takes over the Health Datapalooza conference.
• A research firm predicts that ransomware will infect medical devices for the first time in 2016.
• The DoD announces that its Joint Legacy Viewer, which allows users to view combined data from the VA’s systems and its own, meets the federal requirement that the two organizations deploy interoperable systems.
• A court rules that Tata Consultancy employees who downloaded proprietary Epic material while posing as client consultants constitutes “inside hacking.”

Webinars

December 2 (Wednesday) 1:00 ET. “The Patient is In, But the Doctor is Out: How Metro Health Enabled Informed Decision-Making with Remote Access to PHI.” Sponsored by Vmware. Presenters: Josh Wilda, VP of IT, Metro Health; James Millington, group product line manager, VMware. Most industries are ahead of healthcare in providing remote access to applications and information. Some health systems, however, have transformed how, when, and where their providers access patient information. Metro Health in Grand Rapids, MI offers doctors fast bedside access to information and lets them review patient information on any device (including their TVs during football weekends!) saving them 30 minutes per day and reducing costs by $2.75 million.

December 2 (Wednesday) 1:00 ET. “Tackling Data Governance: Doctors Hospital at Renaissance’s Strategy for Consistent Analysis.” Sponsored by Premier, Inc. Presenters: Kassie Wu, director of application services, Doctors Hospital at Renaissance; Alex Eastman, senior director of enterprise solutions, Premier, Inc. How many definitions of “complications” (or “cost” or “length of stay”…) do you have? Doctors Hospital at Renaissance understood that inconsistent use of data and definitions was creating inconsistent and untrusted analysis. Join us to hear about their journey towards analytics maturity, including a strategy to drive consistency in the way they use, calculate, and communicate insights across departments.

December 2 (Wednesday) 2:00 ET. “Creating HIPAA-Compliant Applications Without JCAPS/JavaMQ Architecture.” Sponsored by Red Hat. Presenters: Ashwin Karpe, lead of enterprise integration practice, Red Hat Consulting; Christian Posta, principle middleware architect, Red Hat. Oracle JCAPS is reaching its end of life and customers will need a migration solution for creating HIPAA-compliant applications, one that optimizes data flow internally and externally on premise, on mobile devices, and in the cloud. Explore replacing legacy healthcare applications with modern Red Hat JBoss Fuse architectures that are cloud-aware, location-transparent, and highly scalable and are hosted in a container-agnostic manner.

December 3 (Thursday) 2:00 ET. “501(r) Regulations – What You Need to Know for Success in 2016.” Sponsored by TransUnion. Presenter: Jonathan Wiik, principal consultant, TransUnion Healthcare Solutions. Complex IRS rules take effect on January 1 that will dictate how providers ensure access, provide charity assistance, and collect uncompensated care. This in-depth webinar will cover tools and workflows that can help smooth the transition, including where to focus compliance efforts in the revenue cycle and a review of the documentation elements required.

December 9 (Wednesday) 12 noon ET. “Population Health in 2016: Know How to Move Forward.” Sponsored by Athenahealth. Presenter: Michael Maus, VP of enterprise solutions, Athenahealth. ACOs need a population health solution that helps them manage costs, improve outcomes, and elevate the care experience. Athenahealth’s in-house expert will explain why relying on software along isn’t enough, how to tap into data from multiple vendors, and how providers can manage patient populations.

December 9 (Wednesday) 1:00 ET. “The Health Care Payment Evolution: Maximizing Value Through Technology.” Sponsored by Medicity. Presenter: Charles D. Kennedy, MD, chief population health officer, Healthagen. This presentation will provide a brief history of the ACO Pioneer and MSSP programs and will discuss current market trends and drivers and the federal government’s response to them. Learn what’s coming in the next generation of programs such as the Merit-Based Incentive Payment System (MIPS) and the role technology plays in driving the evolution of a new healthcare marketplace.

December 16 (Wednesday) 1:00 ET. “A Sepsis Solution: Reducing Mortality by 50 Percent Using Advanced Decision Support.” Sponsored by Wolters Kluwer Health. Presenter: Stephen Claypool, MD, medical director of innovation lab and VP of clinical development and informatics for clinical software solutions, Wolters Kluwer Health. Sepsis claims 258,000 lives and costs $20 billion annually in the US, but early identification and treatment remains elusive, emphasizing the need for intelligent, prompt, and patient-specific clinical decision support. Huntsville Hospital reduced sepsis mortality by 53 percent and related readmissions by 30 percent using real-time surveillance of EHR data and evidence-based decision support to generate highly sensitive and specific alerts.

December 16 (Wednesday) 1:00 ET. “Need for Integrated Data Enhancement and Analytics – Unifying Management of Healthcare Business Processes.” Sponsored by CitiusTech. Presenters: Jeffrey Springer, VP of product management, CitiusTech; John Gonsalves, VP of healthcare provider market, CitiusTech. Providers are driving consumer-centric care with guided analytic solutions that answer specific questions, but each new tool adds complexity. It’s also important to tap real-time data from sources such as social platforms, mobile apps, and wearables to support delivery of personalized and proactive care. This webinar will discuss key use cases that drive patient outcomes, the need for consolidated analytics to realize value-based care, scenarios to maximize efficiency, and an overview of CitiusTech’s integrated healthcare data enhancement and analytics platform.

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

Acquisitions, Funding, Business, and Stock

The Boston newspaper covers the previously announced sale of Partners HealthCare’s GeneInsight genetic testing  software to Sunquest, which will pay Partners sales royalties. The article mentions similar software deals between Partners and Health Catalyst and Beth Israel Deaconess Medical Center and Athenahealth.

India-based healthcare software vendor Indegene Lifesystems expects to hit $250 million in annual revenue by 2020 and plans to go public within 2-4 years. The company says it will announce an acquisition in the next few days and is also in acquisition talks with an unnamed population health management analytics company.

Georgia-based Brightee, which offers durable medical equipment and hospice software,  will expand R&D headcount at its Scotland offices to 150-200 employees. President and CEO Dave Cormack, who is from Scotland and was a director of Aberdeen Football Club, hopes to double annual sales to $240 million within 3-4 years.

People

Culbert Healthcare Solutions promotes Jaffer Traish to VP of its Epic practice.

Announcements and Implementations

Peer60 releases Trends in Medical Imaging Technology just in time for RSNA. It finds that radiology providers are most excited about breast tomosynthesis and cloud-based imagine sharing. VNA vendor preference is fragmented but Merge holds the lead, ACR Select enjoys a 60 percent mindshare in clinical decision support, and Nuance leads the “favorite imaging IT leaders overall” category. 

GE announces the GE Health Cloud for its imaging devices. The company also announces Centricity radiology apps: Cloud Advanced Visualization, Multi-Disciplinary Team Virtual Meeting, Case Exchange, and Image Access Portal.

Government and Politics

Medical testing firm LabMD, which says it was driven out of business after seven years of fighting Federal Trade Commission charges of lax data security, fires back by suing three of the FTC’s lawyers for illegal and unethical prosecution. The FTC’s case, which was dismissed last week by a federal judge who found that no consumer harm occurred, was based on information from security vendor Tiversa. LabMD claims that Tiversa illegally hacked its systems and then threatened to expose the breach unless LabMD signed up as a Tiversa customer. LabMD CEO Michael Daugherty says the FTC should focus on real data breaches instead of potential ones and should be more transparent in conveying its expectations to companies, especially healthcare ones. He adds that FTC is made up of enforcement lawyers rather than technology experts and spent millions of taxpayer dollars pursuing his case, observing that HHS is a lot more willing to work with providers in trying to improve data security.

Other

In Western Australia, a government committee finds that 783-bed Fiona Stanley Hospital is still riddled with IT problems a year after an opening that was marked by delays and cost overruns. Employees report that  a patient admission requires 15 minutes, the incompatible ICU system requires staff to print and scan a transferred patient’s record, and a poorly designed Wi-Fi system with limited coverage forces nurses to communicate via walkie-talkie. The report adds, “No hospital in the North Metropolitan Health Service is able to electronically access a medical record created at FSH,” although it concedes that given limited IT budget and skills, limited interoperability is reasonable and the new system is still better than paper records. The committee expressed concerns that no system in Australia can issue a delivery receipt for discharge summaries, leaving the sender unaware of whether it was received and acted upon appropriately.

In Australia, a cancer patient is given an incorrect chemotherapy dose due do a typo on a printed protocol form. Royal Adelaide Hospital’s hematology service noticed its error after six months and sent a group email with the subject line, “Updated AML … protocol uploaded.” Flinders Medical Center didn’t update its forms and gave the man half the desired dose. He’s one of 10 leukemia patients who were underdosed, of which two have relapsed and died. An independent review questions why Royal Adelaide sent a bland email that didn’t highlight the urgency of the required change and to alert clinicians that they likely underdosed their patients if they didn’t double-check the form’s incorrect dose calculations.

Samaritan Healthcare (WA) will spend $12 million to implement Epic, increasing its annual system maintenance cost from $500,000 to $2 million. According to the CFO, “It is a much, much more expensive system than we are using right now, so our whole trick is, how do we maximize the investment in the system? Because it will give us so much more and better information. Can we extract the information to reduce cost and improve care? That’s really what our task is as management.”

PatientKeeper offers a Thanksgiving-specific ICD-10 infographic.

Hospitals in England urge consumers to avoid their EDs on Tuesday as 40,000 junior doctors and their British Medical Association labor union plan a 24-hour strike on Tuesday during which they will treat only emergency patients. The doctors will strike again on December 8 and 16, but on those days they won’t treat any patients at all, even those with urgent conditions. BMA expects the government to send Army medical staff to cover the EDs. The residents are protesting a change proposed by Secretary of State for Health Jeremy Hunt that would expand hospital services to seven days per week following reports that patients are 15 percent more likely to die if admitted on Sunday instead of Wednesday. Junior doctors already work weekends and nights, but worry the proposed changes will cut their overall pay.

The Columbus, OH newspaper finds that Ohio’s medical records copying costs are among the highest in the country, as providers can charge $3.07 per page for the first 10, $0.64 for pages 11-50, and $0.26 for additional pages. Neighboring Kentucky, in contrast, mandates that providers give patients the first copy of their records at no charge. Actual charges for a 10-page record range from $3.60 at OhioHealth to $30.70 at Mount Carmel and Ohio State.

The New York Post reports that North Shore-LIJ Health System paid its president and CEO $10 million last year, much of it as a retirement payout even though he’s not retiring. New York-Presbyterian paid its CEO $4.6 million and gave several of its “honchos” housing allowances and chauffeurs, while Montefiore Medical Center paid its head $4.8 million. The state hospital association gave the standard checklist of excuses: it’s a tough job and the market is so competitive that hospitals would lose their executives if they didn’t pay them millions.

Vince Ciotti provides a tongue-in-cheek overview of system longevity.

Weird News Andy titles this story “To Womb It May Concern.” in which a not very convincing article (“it blew our minds,” reports the gushy writer) predicts that surgeons will within 5-10 years successfully transplant a uterus into a former male (transgender woman). WNA quotes Homer Simpson addressing Marge in bed: “But it’s uterus, not uter-you.”

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.

CPSI Will Acquire Healthland for $250 Million

Computer Programs and Systems, Inc. (CPSI) announced this morning that it will acquire its main small-hospital technology competitor Healthland Holding Inc., which includes Healthland Inc., American HealthTech, and Rycan Technologies. Healthland has 350 hospital customers, while American HealthTech serves 3,300 skilled nursing facilities. Rycan has 290 hospital customers of its revenue cycle management system and was acquired earlier this year by Healthland.

CPSI will pay $250 million, 65 percent in cash and 35 percent in stock. The company will also take on $150 million in funded debt to complete the transition.

CPSI Board Chair David Dye will take the role of chief growth officer, TruBridge President Chris Fowler will become COO, and Matt Chambless will be promoted to CFO. Healthland President Chris Bauleke will remain in that role.

CPSI shares rose sharply on the news Wednesday, but are still 26 percent off their 52-week high. 

News 11/25/15

Top News

Health Data Consortium turns over the spring Health Datapalooza conference to the non-profit AcademyHealth, saying it’s time to shift its theme from data liberation to data application. I attended one event and didn’t find it all that interesting, but it seems to have developed a following, particularly among people who seem to spend most of their working lives traveling conspicuously to conferences of questionable value to their doting employers. I’m not really clear about what else the membership-supported Health Data Consortium does beyond writing lofty vision and mission statements. It was created by an advertising agency working for the federal government and some non-profits.

Reader Comments

From Parse Person: “Re: ACA deductibles. The ACA passed over five years ago after years of debate. How is it only now, in its second active year, are we realizing that the average American doesn’t have the savings to pay a multi-thousand dollar deductible? The US savings rate has been at or below zero for quite a long time and mountains of actuaries and accountants studied the ACA details since the debate first began.” The ACA was a reasonably good idea that was hacked to pieces by high-powered insurance and pharma lobbyists whose own actuarial prowess is legendary. Insurance companies realized they could jack up prices as much as they wanted or needed in the supposedly competitive Healthcare.gov marketplace, while drug companies enjoyed a big sales uptick without any additional pricing pressure. The biggest flaw in the ACA is that it addressed health insurance, not healthcare and its cost, and had to compromise nearly everything to draw enough political support to pass. I don’t think anyone expected premiums and deductibles to jump so quickly or for inexpensive, high-deductible catastrophic plans to morph into expensive, high-deductible regular plans. However, I’m optimistic that ACA’s dramatic setbacks will either be reversed within a year or two as risk pools become more predictable or its spectacularly expensive failure will convince more people that the system we’ve allowed to happen is unsustainable without paying more attention to the high cost of everything related to healthcare, ranging from million-dollar hospital CEO salaries to drug companies worth hundreds of billion dollars to insurance companies that always seem to emerge from the scrum with our wallets in their hands. Our US problem isn’t overutilization, it’s cost, and one person’s high medical costs is the high income of another person who won’t give it up without a fight.

HIStalk Announcements and Requests

HIStalkapalooza (and thus, by inference, the HIMSS conference) is just three months away. We’ve booked the venue and band, we will have a fun cast of industry characters involved as always, and I’ll be ordering beauty queen sashes before you know it. I have capacity for another sponsor or two if your company would like to join an impressive list of those that have already signed up. Contact Lorre. She can also help if your company is planning next year’s budget and wants to sponsor HIStalk, which quite a few vendors have done recently (thanks!)

Mrs. Gamache from Florida sent photos of her gifted students, saying they are excited to be working with the LEGO Mindstorms robot we provided via DonorsChoose, using its drag-and-drop programming to make it move and perform tasks. Also checking in was Mrs. McKnight of South Carolina, who says she immediately started using the copy paper and ink we provided to replace that which was lost in flooding there, allowing her to prepare materials for students to take home for self-study. She added, “I gathered my students during our morning meeting and told them that someone donated the supplies to our class. They were so thrilled. My students began cheering!”

Webinars

December 2 (Wednesday) 1:00 ET. “The Patient is In, But the Doctor is Out: How Metro Health Enabled Informed Decision-Making with Remote Access to PHI.” Sponsored by Vmware. Presenters: Josh Wilda, VP of IT, Metro Health; James Millington, group product line manager, VMware. Most industries are ahead of healthcare in providing remote access to applications and information. Some health systems, however, have transformed how, when, and where their providers access patient information. Metro Health in Grand Rapids, MI offers doctors fast bedside access to information and lets them review patient information on any device (including their TVs during football weekends!) saving them 30 minutes per day and reducing costs by $2.75 million.

December 2 (Wednesday) 1:00 ET. “Tackling Data Governance: Doctors Hospital at Renaissance’s Strategy for Consistent Analysis.” Sponsored by Premier, Inc. Presenters: Kassie Wu, director of application services, Doctors Hospital at Renaissance; Alex Eastman, senior director of enterprise solutions, Premier, Inc. How many definitions of “complications” (or “cost” or “length of stay”…) do you have? Doctors Hospital at Renaissance understood that inconsistent use of data and definitions was creating inconsistent and untrusted analysis. Join us to hear about their journey towards analytics maturity, including a strategy to drive consistency in the way they use, calculate, and communicate insights across departments.

December 2 (Wednesday) 2:00 ET. “Creating HIPAA-Compliant Applications Without JCAPS/JavaMQ Architecture.” Sponsored by Red Hat. Presenters: Ashwin Karpe, lead of enterprise integration practice, Red Hat Consulting; Christian Posta, principle middleware architect, Red Hat. Oracle JCAPS is reaching its end of life and customers will need a migration solution for creating HIPAA-compliant applications, one that optimizes data flow internally and externally on premise, on mobile devices, and in the cloud. Explore replacing legacy healthcare applications with modern Red Hat JBoss Fuse architectures that are cloud-aware, location-transparent, and highly scalable and are hosted in a container-agnostic manner.

December 3 (Thursday) 2:00 ET. “501(r) Regulations – What You Need to Know for Success in 2016.” Sponsored by TransUnion. Presenter: Jonathan Wiik, principal consultant, TransUnion Healthcare Solutions. Complex IRS rules take effect on January 1 that will dictate how providers ensure access, provide charity assistance, and collect uncompensated care. This in-depth webinar will cover tools and workflows that can help smooth the transition, including where to focus compliance efforts in the revenue cycle and a review of the documentation elements required.

December 9 (Wednesday) 12 noon ET. “Population Health in 2016: Know How to Move Forward.” Sponsored by Athenahealth. Presenter: Michael Maus, VP of enterprise solutions, Athenahealth. ACOs need a population health solution that helps them manage costs, improve outcomes, and elevate the care experience. Athenahealth’s in-house expert will explain why relying on software along isn’t enough, how to tap into data from multiple vendors, and how providers can manage patient populations.

December 9 (Wednesday) 1:00 ET. “The Health Care Payment Evolution: Maximizing Value Through Technology.” Sponsored by Medicity. Presenter: Charles D. Kennedy, MD, chief population health officer, Healthagen. This presentation will provide a brief history of the ACO Pioneer and MSSP programs and will discuss current market trends and drivers and the federal government’s response to them. Learn what’s coming in the next generation of programs such as the Merit-Based Incentive Payment System (MIPS) and the role technology plays in driving the evolution of a new healthcare marketplace.

December 16 (Wednesday) 1:00 ET. “A Sepsis Solution: Reducing Mortality by 50 Percent Using Advanced Decision Support.” Sponsored by Wolters Kluwer Health. Presenter: Stephen Claypool, MD, medical director of innovation lab and VP of clinical development and informatics for clinical software solutions, Wolters Kluwer Health. Sepsis claims 258,000 lives and costs $20 billion annually in the US, but early identification and treatment remains elusive, emphasizing the need for intelligent, prompt, and patient-specific clinical decision support. Huntsville Hospital reduced sepsis mortality by 53 percent and related readmissions by 30 percent using real-time surveillance of EHR data and evidence-based decision support to generate highly sensitive and specific alerts.

December 16 (Wednesday) 1:00 ET. “Need for Integrated Data Enhancement and Analytics – Unifying Management of Healthcare Business Processes.” Sponsored by CitiusTech. Presenters: Jeffrey Springer, VP of product management, CitiusTech; John Gonsalves, VP of healthcare provider market, CitiusTech. Providers are driving consumer-centric care with guided analytic solutions that answer specific questions, but each new tool adds complexity. It’s also important to tap real-time data from sources such as social platforms, mobile apps, and wearables to support delivery of personalized and proactive care. This webinar will discuss key use cases that drive patient outcomes, the need for consolidated analytics to realize value-based care, scenarios to maximize efficiency, and an overview of CitiusTech’s integrated healthcare data enhancement and analytics platform.

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

Acquisitions, Funding, Business, and Stock

Payer mobile messaging platform vendor HealthCrowd raises $2.1 million. Co-founder Neng Bing Doh is a UW-Madison computer science graduate who started out as software engineer at InstallShield and HP, while co-founder Bern Shen, MD, MPhil is a double-boarded physician who ran a VA ED and served as a South Pole doctor, later becoming chief healthcare strategist for Intel. 

Drug company Pfizer will buy Allergan for $160 billion, with one of Allergan’s prized jewels being that it is headquartered in Ireland, where Pfizer will move its headquarters to reduce its US tax bill. Crafty lawyers structured the deal as the smaller Allergan buying Pfizer, which blocks some US interference even though the merged company will be called Pfizer and will keep Pfizer’s CEO. Merging companies always talk synergy and increased consumer value to wriggle the deal through FTC and SEC concerns, but somehow prices always increase as service falls apart.

People

Patrick Anderson (Ochsner Health System) is named SVP/CIO of Hoag Memorial Hospital Presbyterian (CA).

New York-Presbyterian names Daniel Barchi (Yale New Haven Health System and Yale School of Medicine) as CIO, as he confirmed on HIStalk last week. He replaces the retiring Aurelia Boyer.

Announcements and Implementations

Medical benefits manager EviCore Healthcare will use Merge Healthcare’s iConnect Network Services to manage imaging study prior authorizations.

El Camino Hospital (CA) goes live on Epic with a project cost of $150 million.

Privacy and Security

A Forrester Research report predicts that 2016 will see the first infection of a medical device or wearable by ransomware.

Dell acknowledges a customer-reported security flaw in which the company shipped PCs with a certificate that inadvertently uses the same private key on every device, making it easy for hackers to impersonate that device. Dell has provided instructions for fixing the problem and says its just-released update will remove the certificate entirely.

Technology

The Robert Wood Johnson Foundation funds a project to develop a framework that will allow researchers to port their iOS ResearchKit apps to Android with minimal effort.

Other

KQED discusses biometric patient ID with a mixed level of credibility. It leads off with an overly provocative headline (“Would You Trust a Hospital to Scan Your Fingerprint?”); erroneously declares biometric ID to be “an alternative to a national patient identifier;” and fails to comfort fingerprint-nervous readers that the scanners don’t save the actual fingerprint or look it up in other databases – it simply records a mathematical model of the fingerprint to confirm a match. It does bring up the good point that it’s a big problem if someone were to hack a biometric database because users can change their password but not their fingerprint.

I will extend the premise of MIT Technology Review’s predictable article “Your Doctor Doesn’t Want to Hear About Your Fitness Tracker Data” to posit that “Nobody Gives a Crap About Your Workouts, So Stop Yapping About Them.” There’s no reason other than navel-gazing narcissism to tell a breathlessly anxious world – whether in the break room or on Facebook — about your latest Runkeeper-recorded run or your just-completed kettlebell swing count. The fact that you use a fitness tracker means you’re probably pleased with yourself – it’s the people who don’t use wearables who might elicit a doctor’s exercise question or suggestion that would be worth the time required. Today’s medical model is that you tell your doctor what you’re experiencing in maybe 60 seconds, you get back 2-3 minutes of questions at best based on the doctor’s aggregated experience with other patients, and then the wrap-up is one or more of these options: (a) let me know if it gets worse; (b) get this test performed; (c) take this drug; or (d) go see this other doctor. Nobody is going to turn every encounter into a detailed probe into your health status in return for the small payment they’re getting as the waiting room backs up, so the last thing they want to see is patients waving around their irrelevant Fitbit step counts.

The BBC quotes the founder of a telemedicine company who says, not surprisingly, that the mobile phone will change the face of healthcare. Babylon Health actually looks pretty good, offering online physician consultations via text message or video, appointment scheduling, answering medical questions via text message, and maintaining health records. It’s available only in the UK and Ireland, with UK customers paying $7.50 per month for unlimited consultations between 8 a.m. and 8 p.m with no contract required.

I’m getting hooked on the blog of Chad Hayes, MD, a PGY-3 pediatrics resident at Greenville Health System (SC) and US Naval Academy graduate who describes himself medically as “a skeptic and a minimalist.” He’s a really good writer, to which I submit as evidence “The Presidential Candidates’ Brief Guide to Vaccines” and “On The Seventh Day, The Devil Created Gluten.” I almost never read blogs because those who write them are usually deficient in insight, writing skill, and often both, but this one’s a keeper.

The Internet seems fascinated with the story of a 24-year-old uninsured man who was about to start his first job out of college in Pittsburgh, only to be rushed to an UPMC ED with a subdural hematoma. His uneventful treatment and recovery required only administration of an anti-hemophilia drug and a five-day inpatient stay. UPMC charged him over $1 million while warning him that the total could increase as it adds up the time spent by specialists (he says they spent only 40 seconds per visit each day asking him how he was doing and he said OK). The patient is likely to need the hemophilia drug for life at $200,000 per year, but the medical insurance he finally obtained from his new employer carries such a high co-pay and deductible that he can still barely afford it. The article includes comments from ZDoggMD (Zubin Damania, MD), who adds, “Our electronic health records are not designed for patient care at all—they are designed to be cash registers so the hospital can effectively bill for every little widget.” The patient concludes, “The US healthcare system is corrupt … the fact that it’s there for the sake of profit makes me sick.” UPMC, which pays its CEO $6 million per year, clarifies that the document isn’t actually a bill but rather a total of hospital charges, with the fact that they aren’t the same thing neatly encapsulating much of what’s wrong with the US healthcare non-system.

A study finds that requiring fast food restaurants to include calorie counts on their menu boards did not change consumer behavior a bit in five years – people just ignored the alarmingly high values and kept on choosing unhealthy food. McDonald’s admirably posted its calorie counts early, but I still see most people drinking milkshakes posing as coffee for breakfast and scarfing down piles of greasy fried foods in carefully avoiding the dreaded salads, apple wedges, and bottled water. The Affordable Care Act requires such menu labeling nationwide by 2016. Meanwhile, an investigative report finds that Coke heavily funded an anti-obesity group that promised to help the company avoid the wrath of what Coke calls “public health extremists” who want to use taxes or distribution restrictions to try to convince people to stop sucking down vast quantities of its sugar water like crazed hummingbirds attacking a feeder.

China Southern Airlines apologizes after a passenger with abdominal pain tweeted out that he wasn’t taken to the hospital until 15 hours after the flight’s emergency landing on his behalf. The plane’s captain didn’t open the door until 50 minutes after landing and then crew members argued with with ambulance workers over whose job it was to carry him to the ambulance. He ended up climbing down by himself and having emergency surgery at the hospital. The airline said it will work better with airport medical workers.

Just in time for some spirited RSNA discussion: researchers find that trained pigeons rewarded with food pellets can analyze mammograms and biopsy slides for signs of breast tumors just as well as radiologists and pathologists. One bird, hopefully without a real-world radiologist counterpart, was never able to perform better than just picking randomly.

Sponsor Updates

• Wellcentive is named #172 on the Deloitte Fast 500, also winding up at #2 in Georgia and #6 in healthcare IT overall.
• Visage Imaging will demonstrate Visage 7 multimedia reporting and XML-based reporting integrated with Nuance PowerScribe 360 at Nuance’s booth at RSNA.
• Voalte deploys its 11,000th Zebra mobile hand-held computer.

Blog Posts

• Build Your Best Defense Against Data Breaches with a Mobile Game Plan (PatientSafe 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.

Monday Morning Update 11/23/15

Top News

The Department of Defense notifies the House Appropriations Committee that it has met the federal requirement that it share records with the VA. The demonstrated solution was the Joint Legacy Viewer, a combined visual view of the information stored in separate DoD and VA systems. The DoD and VA spent several billion dollars trying unsuccessfully to integrate their systems, finally settling for a questionable level of “interoperability” in putting information from their respective systems on the same user screen.

Reader Comments

From Concerned Insider: “Re: Blue Shield’s lawsuit against its former executive. This has far-reaching implications on several issues – non-profit status, corporate corruption, and H-1B visas – all of which hinder healthcare efficiencies.” The non-profit insurer Blue Shield of California sues its former policy director, who launched a public campaign after his departure criticizing the company for running itself like a for-profit company and providing too little value to the public. Michael Johnson says he won’t back down from his demand that Blue Shield either provide $500 million per year in community benefits or return the $10 billion in assets it holds. Blue Shield claims Johnson is exposing confidential company information, which the company discovered after having forensic analysis of his laptop performed while he was still an employee. California revoked Blue Shield’s tax-exempt status earlier this year and ordered it to pay back taxes. The organization has 5,000 employees, a payroll of $426 million, and $9 billion in annual revenue. Healthcare is full of theoretically non-profit organizations that pay multi-million dollar salaries, hold fortunes in assets, and predatorily acquire competitors to protect their market position.

From CIO Boy: “Re: webinars. I might be a geek, but since I found the HIStalk webinar channel on YouTube I’ve watched several of them just to see what’s going on.” I’ll offer a confession of my own – I sometimes bring up the channel on my Roku streaming player and watch previous HIStalk webinars on the living room TV with surround sound. I don’t explore the Roku menus often and didn’t realize YouTube was an option.

From Court Watcher: “Re: Epic’s lawsuit against Tata. The court called Tata’s employees ‘hackers’ and Tata’s arguments ‘meritless.’ Any lawyers want to give an opinion?” A Wisconsin court denies a motion from India-based Tata Consultancy to dismiss Epic’s claims that Tata used its confidential information and trade secrets. Epic claims that Tata’s employees, working as consultants to Kaiser Permanente, misrepresented themselves as customer employees in gaining access to Epic’s UserWeb, after which they downloaded Epic’s proprietary information from India. The court rules that the actions of Tata’s employees meets the definition of inside hacking and leaves it to other courts to assess Epic’s claims of damages.  It’s a pretty big deal for a huge, international company to be labeled as a hacker rather than a hackee.

From FlyOnTheWall: “Re: Cleveland Clinic. Warns patients accessing its medical records to expect inaccuracies and incomplete documentation. Lowering the bar much?” The clinic warns patients that its clinician documentation isn’t written for them, may make it seem that their doctor is uncaring or grammatically challenged, that records may contain boilerplate information or facts collected for reasons other than patient care, and that references to weight or alcohol consumption aren’t personal. I admire their honesty, but I hope public pressure doesn’t turn otherwise meaningful notes into the cheery, falsely complimentary drivel that’s in the summary notes of dogsitters and daycare centers.

HIStalk Announcements and Requests

It’s a respondent toss-up as to whether the flurry of recent Quality Systems changes are positive or negative. New poll to your right or here: should federal privacy laws be expanded to include everybody instead of covered entities only?

Welcome to new HIStalk Platinum Sponsor Wolters Kluwer Health’s POC Advisor. POC Advisor combines evidence-based clinical decision support with advanced clinical and change management consulting services to help detect and treat sepsis. It’s built on the proven Sentri7 infrastructure that is used by 400 hospitals, integrating CDS products (UpToDate, Lexicomp, Medi-Span, Provation clinical content, Language Engine, and surveillance engine) into a clinician-friendly mobile interface and cloud-based rules engine. Hospitals define sepsis-related detection and treatment alerts and then POC Advisor brings in vital signs, nurse notes, and lab results from the EHR via HL7, applying hundreds of rules to send targeted, multi-disciplinary care alerts. The addition of change management supports the integration and use of POC Advisor and sepsis protocols, resulting in a greater than 50 percent reduction in sepsis mortality in partner hospitals. Thanks to Wolters Kluwer Health and its POC Advisor platform for supporting HIStalk.

I found this YouTube video that introduces Wolters Kluwers Health POC Advisor.

Red Hat is supporting HIStalk at the Platinum level. The Raleigh, NC-based company believes that open, hybrid technology is the future of IT and that open source is the operating system for the cloud. Red Hat supports architecture that is modernized, standardized, and virtualized, offering Red Hat Enterprise Linux Server and the Red Hat Enterprise Linux OpenStack Platform for building public or private clouds. Red Hat Satellite allows enterprises to keep Red Hat infrastructure running efficiently and securely, offering complete life-cycle management (provisioning, configuration management, software management, and subscription management) in a single console that offers an average payback period of seven months and allows enterprises to identify and respond to vulnerabilities. The company offers a December webinar titled “Creating HIPAA-Compliant Applications Without JCAPS/JavaMQ Architecture.” Thanks to Red Hat for supporting HIStalk.

Here’s a great video of Red Hat CEO Jim Whitehurst opening the company’s summit a few months ago in Boston as he talks about economic change and how companies operate in the Information Age. He points out that Uber owns no cars, Facebook creates no content, Alibaba owns no inventory, and Airbnb owns no real estate.

Mrs. Hatley from Washington says her kindergartners are enjoying the listening center we provided via DonorsChoose, learning the basics of reading as they following along with narrated stories. Also checking in is Ms. Perkins, whose Louisiana elementary school students are using the iPad and math manipulatives we provided to  make math fun.

I received two emails from the same conference last week, one urging me to register and the other issuing a call for speakers. It reminded me of scalpers who stand outside of a sporting event carrying two signs, one saying “Have Tickets” and the other saying “Need Tickets.” It’s all about the arbitrage.

Listening: new from Jeff Lynne’s ELO, which grabbed me instantly with its moving first track that sounds like a cross between the classic Electric Light Orchestra and the Beatles (it’s at 18:30 in the video). It’s the first ELO album since 2001 and the best since their mid-1970s prime. Rolling Stone positively gushed at the band’s first live US performance in 30 years, which required security to ask Paul McCartney to refrain from dancing in the aisle. Purists might debate whether this is ELO or just Jeff Lynne with some stellar pick-up players who are replacing former ELO members who left or died, but whatever it is, I’m a fan.

I’m fascinated by what’s going on with the Healthcare.gov marketplace as insurance companies back away following huge losses. The country’s biggest insurer, UnitedHealth Group, was saying just a month ago that it would expand ACA coverage but now says it will lose $600 million on ACA-issued policies this year and will scale back its participation even after implementing big premium increases. I talked to a friend who sells individual and company medical insurance, who made these points:

• Insurance companies have greatly reduced their 2015 plan choices. UnitedHealth Group pulled many of its plans offline early last week, including most of its Silver-level plans, which my friend says customers can still buy, but not via Healthcare.gov – she has to call the company (with hours-long wait times) to get a paper application form. Apparently the laborious process allows the company to meet the government’s requirement of offering such plans that it doesn’t really want to sell while making it difficult enough that few people will buy them.
• Insurers have raised their deductibles from around $1,500 last year to $6,500 this year. Read that again:  the insurance company pays nothing until the patient has spent $6,500.
• I ran a Healthcare.gov cost estimate for a 50-year-old, non-smoking male in Chattanooga, TN whose income precludes a federal subsidy. UHG’s Bronze-level plan costs $352 per month with a $6,400 deductible and a $6,500 out-of-pocket maximum. That means a single ED visit or hospitalization will cost the insured their full $6,500 plus what they already paid for their annual premium, or nearly $11,000 cash out of pocket for the year. That’s for an individual, not a family. The hospital implications are enormous since they now have to attempt to collect the money owed to them by someone who almost certainly doesn’t have that kind of cash lying around. These days, having insurance doesn’t mean being free of the risk of medical bankruptcy.
• Healthcare.gov can’t ask any demographic questions except whether the applicant smokes, their age, and where they live. Prices vary considerably by state based on claims experience as well as local market provider competition.
• Some of the plans I pulled up online have as few as 4-5 doctors who participate in a given area.
• Co-insurance has become a lot more common in addition to deductibles, meaning patients keep paying a fixed percentage of billed costs until they hit their out-of-pocked maximum. Many available plans don’t offer a fixed doctor or ED visit co-pay – the insured patient pays a percentage that is usually around 30 percent instead of the formerly common $20 per PCP visit or $250 per ED encounter. That will put a lot of pressure on providers to collect those large amounts.
• Insurance companies have changed their prices, coverage, and availability hugely from last year, forcing consumers to change plans.That means starting over with new providers, trying to find doctors that are accepting new patients, and wiping their medical records slate clean as lack of interoperability means their new doctors will hand them the ubiquitous clipboard on which to provide their medical history.

My friend’s conclusions:

• Employer-provider medical insurance offers better coverage for a lot less money than Healthcare.gov or other individually sold plans, even if your employer sticks you with a higher cost.
• The ACA is providing a lot of unpleasant surprises to both insurance companies and their customers, as too few young and healthy people are signing up to offset more expensive customers who are catching up on medical treatment after years of not having insurance to foot the bill.
• ACA addressed availability of insurance, not healthcare costs, and the coverage and premiums are reflecting that.
• Insurance companies keep armies of accountants and actuaries busy trying to find ways to reduce risk and increase profit. Selling directly to individuals who sign up only if they expect their medical expenses to exceed their cost of insurance means someone has to pay. Employer-provided plans give companies a broader risk pool and often require big employers to accept some of the risk of their employee population, which helps control medical utilization and cost.
• Rapidly increase drug costs have forced insurance companies to make dramatic formulary changes, especially for specialty drugs, with some companies requiring a $250 deductible and 30 percent co-pay for drugs like Humira that can cost several thousand dollars per month. Lack of generic competition has also caused some insurers, such as UHG, to require patients to try other products for which they’ve negotiated a better price even though the patient response may not be the same.
• Most of those who don’t have Medicaid, Medicare, or employer-provided insurance aren’t likely to be able to afford either the insurance or their out-of-pocket costs. That means middle-class people who are self-employed or who work for companies that don’t provide insurance are taking the biggest hit.
• People can buy expensive medical insurance and still go broke trying to pay their portion of their medical expenses.

I’m interested to see how the government assesses penalties for people who don’t buy insurance. That should be coming as people file 2015 taxes. I suspect many folks will simply continue to not buy it and won’t be penalized, especially the younger, healthier people upon whose participation the entire ACA is built. 

I’m not sure where this free-market experiment is going, but I suspect that the political backlash will be significant and the calls for healthcare price controls and/or universal coverage will get louder even though it’s political suicide to suggest either. As health economist Uwe Reinhardt says, “Of all the conceivable ways to finance healthcare, Americans have found the dumbest way to do it.”

Last Week’s Most Interesting News

• The concept of offering individual medical insurance coverage via Healthcare.gov took blows as insurance companies announced that losses have forced them to scale back their offerings, raise prices significantly, and consider pulling out of the Affordable Care Act insurance marketplace completely.
• Venture capital firm Andreesen Horowitz launches a $200 million investment fund that will focus on digital therapeutics, tech-enabled biology, and computational medicine.
• A federal judge dismisses charges and scolds the Federal Trade Commission for taking action against a lab services provider that was driven out of business by the FTC’s claims of security deficiencies that were based on the accusations of a security services company whose services the lab company had declined to purchase.
• Connecticut’s attorney general states that, contrary to published reports in Politico, his office is not investigating Epic or anyone else for “information blocking.”
• A Kentucky hospital is notified by the FBI that keystroke-logging software had been running within the hospital for years, potentially exposing anything information the hospital entered via the keyboards of the infected computers.

Webinars

December 2 (Wednesday) 1:00 ET. “The Patient is In, But the Doctor is Out: How Metro Health Enabled Informed Decision-Making with Remote Access to PHI.” Sponsored by Vmware. Presenters: Josh Wilda, VP of IT, Metro Health; James Millington, group product line manager, VMware. Most industries are ahead of healthcare in providing remote access to applications and information. Some health systems, however, have transformed how, when, and where their providers access patient information. Metro Health in Grand Rapids, MI offers doctors fast bedside access to information and lets them review patient information on any device (including their TVs during football weekends!) saving them 30 minutes per day and reducing costs by $2.75 million.

December 2 (Wednesday) 1:00 ET. “Tackling Data Governance: Doctors Hospital at Renaissance’s Strategy for Consistent Analysis.” Sponsored by Premier, Inc. Presenters: Kassie Wu, director of application services, Doctors Hospital at Renaissance; Alex Eastman, senior director of enterprise solutions, Premier, Inc. How many definitions of “complications” (or “cost” or “length of stay”…) do you have? Doctors Hospital at Renaissance understood that inconsistent use of data and definitions was creating inconsistent and untrusted analysis. Join us to hear about their journey towards analytics maturity, including a strategy to drive consistency in the way they use, calculate, and communicate insights across departments.

December 2 (Wednesday) 2:00 ET. “Creating HIPAA-Compliant Applications Without JCAPS/JavaMQ Architecture.” Sponsored by Red Hat. Presenters: Ashwin Karpe, lead of enterprise integration practice, Red Hat Consulting; Christian Posta, principle middleware architect, Red Hat. Oracle JCAPS is reaching its end of life and customers will need a migration solution for creating HIPAA-compliant applications, one that optimizes data flow internally and externally on premise, on mobile devices, and in the cloud. Explore replacing legacy healthcare applications with modern Red Hat JBoss Fuse architectures that are cloud-aware, location-transparent, and highly scalable and are hosted in a container-agnostic manner.

December 3 (Thursday) 2:00 ET. “501(r) Regulations – What You Need to Know for Success in 2016.” Sponsored by TransUnion. Presenter: Jonathan Wiik, principal consultant, TransUnion Healthcare Solutions. Complex IRS rules take effect on January 1 that will dictate how providers ensure access, provide charity assistance, and collect uncompensated care. This in-depth webinar will cover tools and workflows that can help smooth the transition, including where to focus compliance efforts in the revenue cycle and a review of the documentation elements required.

December 9 (Wednesday) 1:00 ET. “The Health Care Payment Evolution: Maximizing Value Through Technology.” Sponsored by Medicity. Presenter: Charles D. Kennedy, MD, chief population health officer, Healthagen. This presentation will provide a brief history of the ACO Pioneer and MSSP programs and will discuss current market trends and drivers and the federal government’s response to them. Learn what’s coming in the next generation of programs such as the Merit-Based Incentive Payment System (MIPS) and the role technology plays in driving the evolution of a new healthcare marketplace.

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

Acquisitions, Funding, Business, and Stock

Turing Pharmaceutical, which in August promised to reconsider its 5,000 percent price hike for the old but critical drug Daraprim following massive public and political backlash, will offer hospitals a discount of up to 50 percent based on usage, which would still leave them paying nearly 30 times the pre-Turing price. The company won’t offer any other discounts, maintaining the full 50-fold increase in effect for patients who take the drug at home. Meanwhile, Turing is planning another funding round that will value the company at $500 million, with an IPO to follow. Former hedge fund manager turned Turing CEO Martin Shkreli also acquired majority control of a struggling biotech company last week.

Shares of Castlight Health keep dropping, having lost 90 percent of their March 2014 IPO price in valuing the company at $380 million at last week’s closing share price. The company lost $20 million in the most recent quarter on revenue of $19.5 million.

Arizona-based lab testing vendor Sonora Quest, jointly owned by Banner Health and Quest Diagnostics, will open lab draw stations in Safeway grocery stores. Safeway spent $350 million reconfiguring 800 of its pharmacies to add Theranos draw stations, but backed out after Safeway executives questioned the methods and validity of Theranos tests. Sonora Quest has also taken advantage of the Theranos-backed change to Arizona law that allows consumers to order their own lab test, but unlike Theranos, Sonora Quest will perform tests without a doctor’s order only for tests it believes the average consumer can understand.

Sales

Cook County Health & Hospitals System chooses Chicago-based Valence Health to provide claims approval and payment services for its Medicaid managed care plan in a contract worth $72 million.

Children’s Hospital & Medical Center (NE) chooses Strata Decision’s StrataJazz for decision support and cost accounting.

People

Arthur Harvey is named VP/CIO of Boston Medical Center (MA).

IBM promotes Kyu Rhee, MD, MPP to chief health officer for Watson Health.

Announcements and Implementations

Martin Ventures-backed Lucro announces an innovation solutions marketplace that features a catalog of participating companies and user-provided ratings. Bruce Brandes is founder and CEO.

Lexmark Health and Center for Diagnostic Imaging announce a National Image Exchange for participating sites.

Interbit Data announces the NetRelay secure messaging solution.

Glytec earns a patent for its software-driven automated insulin administration method.

Government and Politics

Hawaii’s health department issues an RFP for an online medical marijuana inventory and sales tracking system that will allow tracking “from seed to sale.”

Privacy and Security

The Washington Post seems surprised that HIPAA covers only providers, meaning patients are on their own when it comes to sending their information or wearables information to non-provider websites and public databases. The article says that OCR hasn’t taken action on 60 percent of the HIPAA complaints it receives, either because they weren’t filed quickly enough or because HHS has no authority over the accused entity. A woman who used a paternity test kit that reported results on a public web page filed an HHS complaint when she noticed she could see everybody’s results and not just her own was quoted in the article as saying, “It was shocking to me to get that message back from the government saying this isn’t covered by the current legislation and, as a result, we don’t care about it.” I’m not sure what she expects OCR to do, but perhaps she should be contacting her elected representatives to consider whether medical privacy laws should be extended to all organizations and not just providers (thus my poll this week).

Technology

FDA approves Medtronic’s MyCareLink Smart Monitor, which sends a patient’s pacemaker data over their smartphone to a database that physicians can review.

Other

Athenahealth removes its Epocrates Bugs + Drugs app from the app store. It was announced in 2013 to criticism that it contained obvious errors and offered no evidence of rigorous testing or peer review. The company hadn’t updated the app since January 2014.

The bond ratings agency of Baptist Health (KY) affirms its A+ rating, but warns that its profitability and liquidity will decline in FY2016 due to its Epic implementation, investments in population health management, an unfavorable payor mix, and the subsidies it providers to its physician group. It adds, however, that Epic will produce positive returns in 2017-2018.

Sponsor Updates

• Impact Advisors offers a white paper titled “The New World of the Health System CIO: Consumers, Consolidation, and Crooks.”
• Experian Health recaps its successes in the first half of 2015.

Blog Posts

• Flashback Friday: ACEP Scientific Assembly 15 (T-System)
• Carilion Clinic Recognized for Taking Command (TeleTracking)
• Supporting Actionable FWA Investigations with Deep Data (Verisk Health)
• The Joint Commission & Trinitas Regional Medical Center Publish ‘Leading Practice’ on Portable Panic Alert System (Versus Technology)
• RSNA 2015: Faster. More Powerful. Enterprise Imaging. (Visage Imaging)
• Catalytic Communication (Voalte)
• 6 Ways to Avoid Squandering Consulting Hours (Hayes Management Consulting)

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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