November 25, 2015NewsComments Off on 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.
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.
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.
November 20, 2015NewsComments Off on News 11/20/15
Top News
HHS partners with OptumLabs – an Optum/Mayo Clinic venture – to bring its data analytics capabilities to the department and its researchers. The first research project will be led by AHRQ, which will compare Optum’s healthcare utilization database to its own Medical Expenditure Panel Survey dataset with an eye to increasing the value of MEPS to researchers exploring care costs. Future HHS/OptumLabs projects will likely focus on research pertaining to the economics of healthcare and population health.
HIStalk Announcements and Requests
This week on HIStalk Practice: Health IT frustrations take up a good bit of time at AMA’s Interim Meeting in Atlanta. CVS Health offers new digital health tools, partners with Health is Primary to emphasize the need for care coordination between retail clinics and PCPs. PCPs share their recommendations for CQMs in Stage 3 MU.PSCH incorporates mobile patient engagement tools from Sense Health into its Medicaid mental health program. Peter Weigel, MD offers best practices to physicians looking to get into the CCM game. TMA PracticeEdge helps San Antonio-based ACO ramp up IT capabilities.
This week on HIStalk Connect: Deep-learning algorithms take center stage at Singularity’s annual xMed conference. Andreessen Horowitz Partners launches a $200 million digital health investment fund. Boston-based PatientPing raises a $9.6 million venture round led by Google Venture and FPrime Capital that it will use to ramp up its care coordination network. Former American Diabetes Association chairman Larry Ellingson launches an Indiegogo campaign to raise funds for his startup’s flagship product, a smartphone case that doubles as a glucometer.
Webinars
November 20 (Friday) 2:00 ET. “The Athenahealth Leadership Institute Presents: Dr. John Halamka Interviewed by Jonathan Bush.” Sponsored by Athenahealth. Presenters: John Halamka, MD, MS, CIO, Beth Israel Deaconess Medical Center; Jonathan Bush, CEO, Athenahealth. Providers are fed up with interface fees and the lengthy, fragmented narratives we’re exchanging today. But what is the right course of action to help deliver better care across the continuum? Bring your questions as we join Dr.Halamka and Jonathan Bush to discuss the current state of healthcare and how we can improve care coordination and interoperability.
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
Andreessen Horowitz Partners announces a $200 million investment fund that it will direct toward digital health startups, specifically those working at the intersection of health data and machine learning. Lt. Dan breaks down the details here.
The local paper hints at the bidding war that may erupt between Orion Health and Allscripts as each comes closer to submitting RFPs for Nova Scotia’s planned migration to a single EHR. The “One Person, One Record” system will replace three hospital systems used across different parts of the province.
After a 5-percent drop in shares and resultant scaling back of earnings projections, UnitedHealth Group issues a thinly veiled threat it will back out of public health insurance exchanges in 2017. “We cannot sustain these losses,” said CEO Stephen Hemsley. “We can’t really subsidize a marketplace that doesn’t appear at the moment to be sustaining itself.”
Experian Health reports 15 percent year-over-year growth and an expanded client base that now includes University of Utah Health Care, Wake Forest Baptist Medical Center (NC) and Stanford Healthcare (CA).
Alpine Investors invests an undisclosed amount in Palm City, FL-based Optima Health Solutions, which provides therapy management software to the post acute care market. Alpine CEO in Residence Josh Pickus will become CEO of Optima.
People
Molly Doyle (Predilytics) joins MeQuilibrium as chief product officer.
Health Systems Informatics promotes Stephanie Hojan and Kathie Crane, RN to vice president and Epic practice director, respectively.
Announcements and Implementations
Sentara Healthcare (VA) rolls out Wellpepper’s mobile app for headache care.
Centura Health, a 16 hospital chain in Colorado and Kansas, receives a 2015 HIMSS Enterprise Davies Award. I interviewed Centura Health SVP/CIO (and HIStalk DonorsChoose contributor) Dana Moore about the system’s decision to replace Meditech with Epic last year.
Galway Clinic will become the first hospital in Ireland to offer patients full access to their health records when it transitions to Meditech 6.1 next year. The hospital received Stage 6 accolades from HIMSS Europe in 2014.
The Center for Diagnostic Imaging partners with Lexmark Healthcare to create a National Image Exchange, enabling participating providers to exchange images with each other and with others outside of CDI’s network. Lexmark will base the NIE’s infrastructure on its enterprise medical imaging portfolio.
Privacy and Security
UC Health (OH) notifies over 1,000 patients of a “data security lapse” in which emails containing patient medical record data was mistakenly sent to the wrong email address in nine separate incidents going back to August 2014. Discovered in September, the lapse has not yet resulted in any suspicious activity.
Government and Politics
CHIME sends a letter to CMS arguing that the MU program and quality reporting requirements will need to be streamlined if health systems are going to transition to value-based reimbursement models fast enough to meet transition goals outlined by HHS.
The Rural Health Connectivity Act of 2015 advances to the Senate Commerce Committee. The bill, introduced by committee chair and Senator John Thune (R-SD), aims to give FCC the authority to funnel broadband dollars to skilled nursing facilities in rural areas via its Healthcare Connect Fund.
NIH rolls out funding opportunities for the Precision Medicine Initiative, including one that will support communication efforts for PMI research programs, especially its Cohort Program; and one that will support development of cohort recruitment technology.
Technology
LifeImage releases the fourth generation of its medical image exchange platform, offering physicians the ability to share exams with patients through the RSNA Image Share network.
CVS launches a new app that generates medication reminders and allows users to submit prescriptions and insurance cards by taking a picture of them.
Analytics vendor Apixio develops a cognitive computing tool capable of accessing, processing, and interpreting medical record data.
Innovation and Research
A team of researchers from the University of Arizona determine that combining Twitter, ED, and air pollution sensor data can help to predict surges in asthma-related ED visits. The team hopes to develop a tool that will enable hospitals to predict the number of asthma visits they’ll have on any given day.
Other
Real-time clinical surveillance vendor PeraHealth joins the National Patient Safety Foundation’s Patient Safety Coalition.
St. Joseph’s Healthcare (Ontario) transforms a lab into a pub as part of its research into environmental triggers that can prompt alcohol cravings and affect addiction. Researchers will use the bar to study how cravings are affected by the sight, smell, and feel of a glass of alcohol. (Surely there’s a wearable out there that could assist?) As one would expect, bottles of alcohol will be locked away after each research session.
Sponsor Updates
Impact Advisors offers a new white paper, “The New World of the Health System CIO: Consumers, Consolidation and Crooks.”
Ingenious Med ranks #341 on Deloitte’s Technology Fast 500 list.
Liaison Technologies’ Alloy Platform is certified compliant with three major standards for ensuring data privacy, security, and trust.
The Certified Technology Comparison Task Force of ONC’s HITPC held its kickoff meeting Tuesday. The task force is charged with developing a Consumer Reports-type EHR comparison tool.
Reader Comments
From IsIT True: “Re: Daniel Barchi, CIO of Yale New Haven Health System. He will succeed Aurelia Boyer, CIO at New York-Presbyterian, when she retires this year.” I asked Daniel, who verifies that he will be leaving YNHHS and the Yale School of Medicine at the end of this month, joining New York-Presbyterian as CIO in December.
From Repurposed Turkey: “Re: Southern Illinois Healthcare. Has selected Epic to replace Meditech, NextGen, and McKesson Practice Partner. Epic jobs have been posted.”
HIStalk Announcements and Requests
Welcome to new HIStalk Platinum Sponsor National Decision Support Company, the exclusive distributor of ACR Select, the American College of Radiology’s Appropriateness Criteria (ACR AC) that supports value-based imaging. It offers integration-ready Web services that allow healthcare organizations to present evidence-based ACR AC guidelines to ensure that the right patient gets the right scan for the right indication. Up to 10 percent of the rapidly growing number of diagnostic imaging orders are medically unjustified or duplicated, causing needless expense and excessive patient radiation exposure. National Decision Support Company provides physicians with guidance as they enter orders, presenting an appropriateness score for the selected modality and indications and prompts them to consult a radiologist when appropriate. The score can also be silently recorded to help health systems understand and manage quality improvement opportunities. Medicare will in 2017 require ordering physicians to prove that they have reviewed Appropriate Use Criteria when ordering MRI, CT, nuclear medicine, and PET. Thanks to National Decision Support Company for supporting HIStalk.
Mrs. Buscho from Colorado sent photos of her English as a Second Language students using the tablet and keyboard we provided via DonorsChoose, saying they use it to look up photos and words to boost their vocabularies. Ms. Cassidy says her class of students with autism is using the set of 22 instructional CDs we bought for interactive circle time, with non-verbal students now able to point at the screen to answer questions and remain part of the group.
I ran across 100Kin10, a New York non-profit whose goal is to train and place 100,000 new STEM teachers by 2021. It has 230 public and private partners and has placed 28,000 teachers so far since it was formed in 2011 in response to President Obama’s challenge. Teacher candidates from all walks of life complete a nine-month program.
Webinars
November 18 (Wednesday) 2:00 ET. “Making VDI Secure and Simple for Healthcare.” Sponsored by Park Place International. Presenters: James Millington, group product line marketing manager, VMware; Erick Marshall, senior systems engineer of virtual desktop infrastructure, Park Place International. Deployment of a virtual solution can optimize the experience of clinician users. Attendees will learn how to address the evolving demands of security and mobility in clinician workflow to improve the quality of care.
November 20 (Friday) 2:00 ET. “The Athenahealth Leadership Institute Presents: Dr. John Halamka Interviewed by Jonathan Bush.” Sponsored by Athenahealth. Presenters: John Halamka, MD, MS, CIO, Beth Israel Deaconess Medical Center; Jonathan Bush, CEO, Athenahealth. Providers are fed up with interface fees and the lengthy, fragmented narratives we’re exchanging today. But what is the right course of action to help deliver better care across the continuum? Bring your questions as we join Dr.Halamka and Jonathan Bush to discuss the current state of healthcare and how we can improve care coordination and interoperability.
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 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
Real-time ADT notifications vendor PatientPing raises $9.6 million from investors that include Google Ventures. The Boston-based company was founded by David Berkowicz, MBChB (Massachusetts General Hospital), Jay Desai (Center for Medicare and Medicaid Innovation), and Lara Sinicropi-Yao (Kyruus).
Medical scribe provider ScribeAmerica acquires Essia Health, the third competitor the company has absorbed this year.
Sales
Gifford Medical Center (VT) chooses Medhost’s EDIS.
An unnamed “large German government hospital” selects the Visage 7 Enterprise Imaging Platform.
An unnamed Texas ACO chooses ZeOmega’s Jiva population health management solution.
Anne Arundel Medical Center (MD) selects receiving dock software from Jump Technologies. The company is fully confident that everyone who reads its press release already knows or doesn’t care that the hospital is in Annapolis, MD since it failed to mention that fact in its announcement.
People
Shannon Epps joins Divurgent as VP of activation management.
Fujifilm Medical Systems names Johann Fernando, PhD (Accuray) as COO and promotes Diku Mandavia, MD to chief medical officer.
Paul Kleeberg, MD (Stratis Health) joins Aledade as medical director.
Announcements and Implementations
Spok chooses Guthrie Clinic (PA) as winner of its innovation award for having OR nurses text updates to patient families using the company’s Spok Mobile secure texting app.
Nuance announces PowerScribe 360 version 3.5, which includes multimedia reports with embedded PACS images, advanced lung cancer screening registry reporting, and enhanced quality guidance content for radiologists at the point of documentation. The company will demonstrate the product at RSNA.
HealthMyne integrates Epic EHR information into its quantitative imaging analytics platform.
Inspira Health Network (NJ) announces a 26 percent increase in HCAHPS scores for hospital quietness at one of its hospitals that deployed Practice Unite’s communications solution to reduce overhead pages at night.
Privacy and Security
Microsoft announces formation of a 24×7 Cyber Defense Operations Center to detect and respond to threats.
A survey finds that most people don’t mind sharing their health information with their physician and their family, but the percentage expressing a willingness to share drops off considerably after those two. Patients don’t want the government seeing their information, perhaps unaware that CMS knows just about everything about those on Medicare unless they choose to pay cash instead.
A federal judge dismisses an action brought against lab testing firm LabMD by the Federal Trade Commission, which claimed that consumers were injured in two old data security incidents. The first incident was reported by Tiversa, a security vendor who was trying to sell its services to LabMD. A former Tiversa sales manager said its warning to LabMD was “the usual sales pitch” and said no breach actually occurred. The second involved documents recovered in an identity theft investigation. The judge ruled that any consumer risk was theoretical and scolded the FTC for relying on Tiversa’s “unreliable” claims. It appears that Tiversa is still in business selling peer-to-peer cyberintelligence services, while LabMD shut down after being buried in court costs and customer defection due to the now-dismissed charges. LabMD was never charged with a HIPAA violation, only with deceptive trade practices, which seems to make little sense in this case (as the judge validated).
Innovation and Research
Keith “Motorcycle Guy” Boone urges licensed providers to complete an HL7 survey that seeks to determine which data elements are needed to support continuity of care.
Technology
India-based Practo will offer Uber integration with its doctor search app in India, Singapore, Philippines, and Indonesia. It will give users a “call Uber” button along with their appointment reminder so they can get a ride.
Other
Cerner protests the terms under which University of Missouri Chancellor R. Bowen Loftin accepted a demotion following student protests that also triggered the resignation of the president of the entire university system. The separation agreement between Loftin and the university says he will take a leadership role with the Tiger Institute for Health Innovation, which is a partnership of the university and Cerner. Cerner wants references to Cerner and the Tiger institute removed from the agreement, saying that Cerner as a partner should have been consulted or notified in advance before Loftin was promised that role.
Epic trademarks App Orchard as the name of its upcoming app store.
A Politico article recently claimed that Connecticut’s attorney general “has reportedly opened investigations into Epic Systems and hospital networks” for information blocking. I emailed the Connecticut AG and received the response above. That’s Strike 2 against Politico, which previously stirred up a lot of hot air about non-existent EHR gag clauses in a much-cited article that offered no proof whatsoever.
Michael Arambula, MD, PharmD, president of the Texas Medical Board, defends the board against the “continued widespread perception that Texas is behind the times and restricting access to healthcare when it comes to telemedicine.” He was responding to a previous editorial that criticized the board’s requirement that doctors conduct a face-to-face exam on a patient before treating them by video visit. Arambula says “there are very few telemedicine scenarios which are prohibited in Texas.”
AMA President Steven Stack, MD says physicians can’t be blamed for IT failures. By that logic, all automobile accidents, including those caused by careless or unskilled drivers, are the fault of car manufacturers.
In England, insiders at Cambridge University Hospital NHS Foundation Trust blame its struggling Epic implementation on an unrealistic budget, an overly aggressive timeline, and inadequate user training.
A judge will hear the case of two IT professionals who were fired from their jobs at the decommissioned Hanford nuclear power plant in Washington after they complained that the company’s EHR was not tracking medical restrictions correctly. OSHA had previously ordered contractor Computer Sciences Corporation to pay the pair $186,000 in back wages.
Weird News Andy notes that one of several failed insurance co-ops, New York’s Health Republic, may stick hospitals with the $160 million it owes them now that the state has shut it down. The failed insurance company owes physician practices “tens of millions of dollars” as well. The state has ordered the insurer to stop paying some claims even though providers are still contractually obligated to keep providing services to its policyholders. New York denied part of the insurer’s rate hike request earlier this year even though it knew it was failing financially.
Sponsor Updates
Medical staff scheduling system vendor Lightning Bolt Partners will integrate its product with Imprivata Cortext.
AdvancedMD reports a smooth ICD-10 transition for its independence practice customers and billing services partners, with 100 percent of them ready on October 1 and the first practice receiving ICD-10 payment seven days after.
Huntzinger Management Group is named as one of the consulting industry’s fastest-growing firms.
Premier posts a promotional video for PremierConnect Enterprise.
EClinicalWorks will exhibit at the New York Health Plan Association 2015 Annual Conference November 18-19 in Albany.
SyTrue’s natural language processing technology is featured in “Unlocking the Value in Unstructured Data.”
Healthcare Call Center Times features Healthfinch client Essentia Health’s efficiency gains.
Built in Colorado ranks Healthgrades ninth in its list of Top 100 Colorado Tech Companies.
Huntzinger Management Group ranks tenth in Consulting Magazine’s list of fastest growing firms.
Burwood Group is recognized as a Cisco TelePresence Video Master Authorized Technology Provider Partner.
Muhlenberg Community Hospital (KY) notifies all patients, providers, and employees prior to July 1, 2015 that their information may have been exposed by a keystroke logging program that had been running on some PCs for several years. Interestingly, the FBI noticed “suspicious network activity involving third parties” and told the hospital it might have a problem.
I’m surprised it’s taken so long for a hospital to be hit by keylogger software since it is widely available and inexpensive (even Sears sells a USB memory stick version). This software is sold by B&H Photo for $40 and promises to run in stealth mode and to disable spyware detectors.
Reader Comments
From Blues Traveler: “Re: CareZone. My 90-year-old father is using it to share medical information. He can take smartphone photos of his medication bottles and it will convert those to create a med list that is 90 percent accurate (would love to see that technology in physician EHRs). You can set up reminders to take meds and order refills. Now my dad has his med list with him at all times and can print it. I also stored his insurance cards on it. You can make health notes and track your vitals. It’s great for managing the health of an older parent and I have access to his account for an emergency.” I mentioned Seattle-based CareZone when it was launched in early 2012 by former the former CEO of Sun Microsystems, but the company seems to have had nothing new to say since then.
From Parse Person: “Re: Bitcoin blockchain for storing patient information. As you mentioned, it’s a giant database that appends data to itself without every deleting anything. The problem is that even if you encrypt and anonymize EHR information, it still sits around forever. While it may be uncrackable now, 10 years from now the technology will probably advance enough that anyone interested can find and read your old health records. The only way around this is to just use the blockchain to link to some other database, which it sounds like the hackathon group did, but in that case you might as well not bother with the blockchain and just send your providers to the EHR database in the first place.”
From Pam Ramhofer: “Re: Voalte’s first user group conference. This was one of the most relevant conferences I have attended this year. Communication and alarm management challenges resonate throughout the healthcare industry. The user group shared creative solutions and best practice to provide communication efficiencies that result in getting critical patient information to the right person at the right time.” Pam is CIO at Sarasota Memorial Hospital.
From The PACS Designer: “Re: ICD. With the specificity that we get with ICD-10-CM/PCS, it makes real-time clinical decision support systems more practical. By using real-time processing, we get more efficient usages of resources and clinical staff with better patient treatment outcomes. What do you think about this concept?”
HIStalk Announcements and Requests
Slightly more poll respondents consider the impact of VC/PE as positive rather than negative. Frank Poggio added a comment, “The simple positive is VC/PE money funds the development that would not occur if there were no, or limited, funds available. But this real positive usually gets over run by the big negative. That is, VC/PE has a relatively short-term time horizon which typically forces decisions to be made based on near term ROI criteria first, and end user requirements (product) last.” New poll to your right or here: are recently announced Quality Systems (NextGen) changes positive or negative?
Mrs. Jones in South Carolina sent photos of her students, all of whom have been identified with intellectual or emotional disabilities, using the math manipulatives provided by our DonorsChoose grant. She says the students have so much fun with the tools that they don’t even realizing they are doing math practice, adding that the items will help close the educational gap between her students and their peers. Also sending photos was Ms. Sobczak, whose special need students in Grades 1-2-3 love the math games that “are a really fun way for the kids to learn and interact with one another while practicing some much-need skills.” I noticed that I’ve deployed $22,000 in reader donations and matching funds so far in 2015, with outside matching funds increasing the value of funded projects to a much larger amount.
Ben Rooks of ST Advisors sent $500 to my DonorsChoose project as part of his company’s program to donate a percentage of revenue to charity. The company’s donation provided these items:
Two Chromebooks, math manipulatives, and easel pads and markers for Mr. Weber’s math class in Kealakekua, HI,
A document camera for Mrs. Twigg’s elementary school class in Kansas City, MO.
Printer supplies and paper for Mrs. McKnight’s first grade class in Columbia, SC to replace what they lost in the recent flooding there.
A large math book library for Ms. Ahrstrom’s third grade class in Bronx, NY.
Hands-on math games for Ms. Keplinger-Williams’ second grade class in Erwin, TN.
A LEGO Mindstorms programmable robot for Mrs. Gamache’s gifted class in Davenport, FL.
A Dot and Dash Wonder Pack and launcher to develop basic coding and problem solving skills for Mrs. Pryor’s kindergarten class in Woodward, OK.
One of the teachers we supported emailed to say that students will decide by fourth grade whether they love or hate math, so we’re hopefully influencing some of them in time to make a difference.
Last Week’s Most Interesting News
Bloomberg Businessweek puts hospital medical device vulnerability to hacking on its cover.
BIDMC CIO John Halamka, MD expands his call to dismantle the Meaningful Use program to reduce interference with patient care, free up vendors and providers for more innovative work, and prevent auditors from adding regulatory burden.
Walgreens integrates MD-Live-powered video visits into its app and expands the program to 25 states.
Quality Systems replaces its board chair as founder and board chair Sheldon Razin retires to make way for Jeffrey Margolis.
Webinars
November 18 (Wednesday) 2:00 ET. “Making VDI Secure and Simple for Healthcare.” Sponsored by Park Place International. Presenters: James Millington, group product line marketing manager, VMware; Erick Marshall, senior systems engineer of virtual desktop infrastructure, Park Place International. Deployment of a virtual solution can optimize the experience of clinician users. Attendees will learn how to address the evolving demands of security and mobility in clinician workflow to improve the quality of care.
November 20 (Friday) 2:00 ET. “The Athenahealth Leadership Institute Presents: Dr. John Halamka Interviewed by Jonathan Bush.” Sponsored by Athenahealth. Presenters: John Halamka, MD, MS, CIO, Beth Israel Deaconess Medical Center; Jonathan Bush, CEO, Athenahealth. Providers are fed up with interface fees and the lengthy, fragmented narratives we’re exchanging today. But what is the right course of action to help deliver better care across the continuum? Bring your questions as we join Dr.Halamka and Jonathan Bush to discuss the current state of healthcare and how we can improve care coordination and interoperability.
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 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.
Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.
Announcements and Implementations
Voalte announces integration with Uber in a pilot project at Sarasota Memorial Hospital (FL), which will discharged patients a pre-arranged Uber ride to their medical appointments. The company also announces its work with UCSF to develop a clinician-facing patient wall that will use Twitter-like social media symbols and an upcoming reporting and analytics tool.
TeleTracking launches a cloud-based patient flow platform called TeleTracking IQ that integrates the user experience with multiple modules and reduces upgrade complexity.
Government and Politics
FDA launches a closed beta of PrecisionFDA, an open source cloud-based platform that allows researchers to upload and share precision medicine data such as reference genomes, bioinformatics pipelines, and genomic data.
Privacy and Security
A Verizon Enterprise Solutions analysis finds that PHI breaches happen in all industries, not just healthcare, as insiders and hackers can get insurance and other health demographic information from information stored by all kinds of companies. Many companies aren’t even aware that they are storing PHI, which has a high value to hackers.
North Carolina’s HHS reports that the information of 524 people was exposed when one of its employees sent a worksheet to health directors via unencrypted email.
Technology
Southern Hills Hospital (NV) pilots AccendoWave, tablet-powered software that monitors a patient’s EEG via a headband and earbuds to detect and report pain levels. The tablet also provides video and audio content to distract from the pain.
Apple co-founder Steve Wozniak tells conference attendees that the Apple Watch is improving, but he still isn’t a big fan of anything that comes between him and his phone. He also likes laptops better than tablets and adds that he’s not an Apple fanboy: “I don’t like being in the Apple ecosystem. I don’t like being trapped. I like being independent.”
Other
In England, the family of a woman who died in 2011 when her referral for gall bladder removal was lost between two hospitals in the same NHS trust that use different IT systems is awarded an unspecified settlement.
San Francisco Magazine gushes about the new UCSF Medical Center at Mission Bay and its 65-inch flat screen patient room TVs with built-in social media, robot-delivered meals, rooftop gardens, a teen lounge, and weekly bingo games. The 289-bed hospital and medical complex should be pretty swanky given that its first phase was estimated to cost $1.5 billion. Let’s see if outcomes improve.
The New York Times covers an ominous phenomenon I reported weeks ago after playing around with Healthcare.gov, Stride Health, and insurance company sites: ACA-mandated plans may or may not carry reasonable premiums, but the real gotcha is in annual deductibles that can range from $3,000 to $6,000 and more. The paper found that more than half of Healthcare.gov plans have a deductible of at least $3,000, leaving patients (especially the desirable young and healthy ones) with insurance they can’t afford to use. That encourages them to simply drop their policies since they’ll be paying all of their medical expenses out of pocket anyway. It’s bad enough that middle-class patients have to come up with thousands of dollars before their hard-won insurance contributes anything, but another to providers who have to try to collect the money patients owe them (knowing that people don’t rank medical bills high on their must-pay list). It’s obvious to me that both patients and providers are going to be complaining loudly about what they thought ACA was going to do for them vs. what has actually happened. Not many people have a spare $5,000 lying around to pay an unexpected ED or surgery bill. Providers had better (a) look at point-of-service collections; (b) figure out ways to get patients on payment plans; and (c) expect their income and cash flow to take a beating due to commercially insured patients rather than just Medicare recipients. “Real” insurance is starting to look like that fake, late-night TV hawked “insurance” from years ago that was really just a discount card that few providers would accept.
This tweet by Nick Dawson of Sibley Memorial Hospital provides a good story that explains how uncoordinated healthcare (and healthcare information) is.
November 12, 2015NewsComments Off on News 11/13/15
Top News
Bloomberg Businessweek puts medical device hacking on its cover, profiling a security expert who was criticized for announcing that he had found that medical devices are full of security holes. “All their devices are getting compromised. All their systems are getting compromised. All their clinical applications are getting compromised and no one cares. It’s just ridiculous, right?” The security expert was hospitalized himself and played around with an automated dispensing machine for medications just outside his room, which he easily penetrated using a known, hard-coded password that let him open any drug drawer he wanted. He’s buying his own medical devices to prove how vulnerable they are.
Experts say hospitals rely on device manufacturers to implement security, but they remain a weak link in exposing a hospital’s entire network. A security firm describes what it learned by creating a “honeypot” fake medical device to see who tried to penetrate it:
The decoy devices that TrapX analysts set up in hospitals allowed them to observe hackers attempting to take medical records out of the hospitals through the infected devices. The trail, Wright says, led them to a server in Eastern Europe believed to be controlled by a known Russian criminal syndicate. Basically, they would log on from their control server in Eastern Europe to a blood gas analyzer; they’d then go from the BGA to a data source, pull the records back to the BGA, and then out … In addition to the command-and-control malware that allowed the records to be swiped, TrapX also found a bug called Citadel, ransomware that’s designed to restrict a user’s access to his or her own files, which allows hackers to demand payment to restore that access.
Reader Comments
From Occasional Angel: “Re: Theranos. I thought you’d get a laugh out of the company’s job posting for a communications director, which includes the requirement for an ‘agile thinker ability to respond quickly in shifting situations.’” Theranos certainly continues to experience shifting situations, nearly all of them causing further damage to the company. The latest headline is that grocery store chain Safeway is trying to wangle its way out of a previously unannounced Theranos partnership going back several years to put draw stations in 800 of its stores. The chain’s executives noticed that Theranos results sometimes differed wildly from the same test run by other commercial labs. Safeway also questioned why Theranos often drew samples from both a finger stick and by vein, with one of its executives astutely questioning “If the technology is fully developed, why would you need to do a venipuncture?” Safeway spent $350 million on the in-store clinic areas that featured granite countertops and video monitors, but is now using those areas only to administer vaccines.
My most positive impression of Theranos is that they were able to get the funding to invest in what must have been an ultra-expensive array of automated lab testing equipment (Nanotainer-powered or otherwise) that allowed it to undercut the price of huge-scale competitors. Lab testing is a lot more like a factory than a Silicon Valley startup and it requires brick-and-mortar drawing stations that send samples off to centralized labs, which as why I assume Theranos tries to convince everyone it’s the next Apple instead of an ambitious drop-off dry cleaner. It’s hardly a national diagnostic powerhouse given that its only locations are in California, Arizona, and Pennsylvania. In addition, most of those locations are in the drugstores of Walgreens, which seems to be distancing itself from Theranos pending review of its test process.
From Marketeer of the Beast: “Re: your rebranding of a health system to the made-up name Blovaria. Here’s how I would explain it. ‘Blovaria is a unique way to recognize our evolution in the marketplace. Our new name is the ideal platform to help us deliver market-leading bloviation with extreme variation in patient outcomes’… and on and on.” I like marketing folks that see the humor in what they do. I disdain marketing-speak and committee-driven company depersonalization into a “brand” that often tries to rewrite history and overpromises future company performance, but I believe strongly in much of what makes up marketing. Honest marketing tries to effectively convey a company’s values and vision in a noisy market, which is problematic when the paying customer wants marketing to cover up their incompetence or misplaced mission of simply pocketing cash by any means possible. Marketing people usually write well and are entertaining, so I’d be interested in running a guest article (anonymously, if that helps) from someone willing to explain the goods and bads of what they are asked to do.
HIStalk Announcements and Requests
Mrs. Read from Florida sent photos of her students using the STEM exploration tools we provided via her DonorsChoose grant request. She says they’re working on a project where they’ve programmed the Sphero app-enabled robotic ball to detect underwater forces, adding that some of the students have been motivated to join the school robotics team as a result. Ms. Santoro from Connecticut sent photos of her first graders working with the tablets we provided, saying some of them don’t have access to technology at home and are asking to use them even when their assigned work is finished.
I got a kick out of this tweet from Nick Kennedy, who apparently enjoyed my mhealth Summit rant. He has history in healthcare IT, but is now the founder and CEO of a private flight-sharing company. It’s fun knowing that someone reads HIStalk just because it entertains them.
This week on HIStalk Connect: Walgreens expands its telehealth offering to 25 states and updates its wellness app to capture glucose and blood pressure readings from its line of wireless medical devices. Researchers from Cedars Sinai Medical Center and UCLA find no improvement to 30-day readmission rates or six-month mortality rates when enrolled in a remote patient monitoring program. The American Association for Cancer Research has launched a data-sharing campaign that will create a central repository for researchers to store and analyze tumor gene mutation data. TigerText raises a $50 million Series C investment to help it expand its healthcare-focused communications platform.
This week on HIStalk Practice: The Wright Center receives the 2015 HIMSS Ambulatory Davies Award. Rep. Tom Price introduces the Meaningful Use Hardship Relief Act. The Patriot Promise Foundation launches to help connect veterans with better, technology-enabled care. PracticeMax acquires Medical Management Corp. of America. Greenway Health’s Rob Newman dishes on the KLAS Keystone Summit. The Retina Group of Washington selects a new EHR from Modernizing Medicine. New DreamLab app crunches cancer research data while you sleep. Ask the Doctor acquires Patients Connected.
Webinars
November 18 (Wednesday) 2:00 ET. “Making VDI Secure and Simple for Healthcare.” Sponsored by Park Place International. Presenters: James Millington, group product line marketing manager, VMware; Erick Marshall, senior systems engineer of virtual desktop infrastructure, Park Place International. Deployment of a virtual solution can optimize the experience of clinician users. Attendees will learn how to address the evolving demands of security and mobility in clinician workflow to improve the quality of care.
November 20 (Friday) 2:00 ET. “The Athenahealth Leadership Institute Presents: Dr. John Halamka Interviewed by Jonathan Bush.” Sponsored by Athenahealth. Presenters: John Halamka, MD, MS, CIO, Beth Israel Deaconess Medical Center; Jonathan Bush, CEO, Athenahealth. Providers are fed up with interface fees and the lengthy, fragmented narratives we’re exchanging today. But what is the right course of action to help deliver better care across the continuum? Bring your questions as we join Dr.Halamka and Jonathan Bush to discuss the current state of healthcare and how we can improve care coordination and interoperability.
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 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.
Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.
Here’s the recording of Thursday’s webinar titled “Top Predictions for Population Health Management in 2016 and Beyond,” sponsored by Medecision.
Acquisitions, Funding, Business, and Stock
TigerText raises $50 million in Series C funding to expand the rollout of its secure messaging app.
The HCI Group acquires UK-based High Resolution Consulting and Resourcing. HCI CEO Ricky Caplin says the company is in “major expansion mode” and will likely announce additional acquisitions shortly.
Arizona-based HealthiestYou gets a $30 million investment from Frontier Capital. The company offers video visits, insurance connectivity, a provider director, and drug pricing lookup.
Turing Pharmaceuticals, the most-hated company in America after pharma-brat founder and former hedge fund manager Martin Shkreli jacked up prices on ancient but vital drug Daraprim, records a $15 million loss on revenue of $5.6 million for Q3. The privately held company will soon start clinical trials for drugs for treating epileptic encephalopathies and PTSD, introducing both hope and despair among those patients who might benefit from the drug but know how hard Turing will put the financial screws to them or their insurance company to obtain it. The first drug earned the FDA’s fast track designation, which makes it surprising that Shkreli didn’t just sell that certificate on the open market since they’ve gone for as much as $350 million. Shkreli is also looking for producers for his upcoming (c)rap album. Those with artistic aspirations but minimal talent always seem to settle for being posers in recording rap, writing children’s books, or appearing on reality TV shows.
People
Galen Healthcare Solutions hires Steve Brewer (Origin Healthcare Solutions) as CEO. Former CEO Jason Carmichael will remain on the board.
Former IDX CFO Jack Kane joins the board of Health Catalyst. He also serves on the boards of Aesynt (which was just sold for $275 million), T-System, and Athenahealth. He’s also involved with several other former IDXers (including former CEO Jim Crook) in OpenTempo, which offers staff scheduling and workforce management solutions for large medical practices.
Practice Fusion names interim CEO Tom Langan to the permanent role.
Jeff Surges (Healthgrades) will join health plan enrollment technology vendor Connecture as CEO.
Gene Amdahl, who went from being educated in a one-room South Dakota school without electricity to leading the development of the IBM’s System/360 mainframe and later the formation of compatible mainframe competitor Amdahl Computing, died Tuesday at 92.
Announcements and Implementations
Caradigm adds electronic prescribing of controlled substances (EPCS) to its Identity and Access Management solutions (single sign-on, context management, and identity management).
Privacy and Security
A proof-of-concept medical records project wins the Blockchain Hackathon in Ireland. It uses the blockchain to anonymize a patient’s electronic records and make them viewable to doctors or others to whom the patient gives their public identifier, retrieving the information via BitTorrent. A blockchain database securely stores a public ledger of transactions, in essence an ever-growing, append-only transaction log that does not require the participation of any third party to change hands. If you’re excited about the potential healthcare use of blockchain, consider writing an HIStalk guest article so educate the rest of us who have heard the word but don’t know much about it.
Technology
The Philadelphia-based Health Care Innovation Collaborative issues a call for chronic disease health project ideas, from which it will choose winners who will work with one or more of its partners that includes CHOP, Drexel University, Independence Blue Cross, Jefferson Health, and University of Pennsylvania Health System. The group was formed by the Greater Philadelphia Chamber of Commerce to increase Philadelphia’s health IT activity.
In England, hospitalized children are being monitored by early warning software originally developed for Formula One race drivers. The pilot project involves wireless vital signs sensors attached to the chest and ankle that send data for real-time analysis and alerts.
Other
BIDMC CIO John Halamka, MD expands on his observations and recommendations for the Meaningful Use program, which he says served its purpose but should be dismantled as it tries to do too much and interferes with patient care. Some of his observations:
EHR certification threatens usability, interoperability, and EHR quality while also diverting resources away from more important work.
Nobody is intentionally blocking information exchange – it’s really “incompetence that feels like blocking.”
Government regulation isn’t the answer to solving societal problems and each new requirement adds a layer of clueless auditors.
Prescriptive regulation, additional structured data elements, and new quality measures don’t help create disruptive innovation. A business imperative is required.
The MU program should be rolled into other CMS incentive programs such as Alternative Payment Models and MIPS.
ONC has become distracted by political agendas, excessive focus on certification, and issuing grants, where it would provide better results as a policy shop that addresses specific problems such as safety and error reduction.
Stop blaming health IT vendors and providers as the enemy.
Focus on the few things that really matter, not the 117 goals in the Federal Interoperability Roadmap.
A Health Affairs article says the Meaningful Use program increased hospital EHR adoption, but the effect of penalties as opposed to rewards is uncertain and small and rural hospitals continue to lag. Hospitals cited their challenges as cost, lack of physician cooperation, and the complexity of the MU program.
The San Diego paper profiles startup Doctible, which has created a network of local providers who offer discounted cash prices and online booking for people with high-deductible medical insurance. It bugs me that, like most other sites that list physicians, it puts “Dr.” in front of their name and “MD” after, which is incorrect.
Epic and Cerner face off on interoperability at the Disruptive Healthcare Conference at UW-Madison. A Cerner VP again calls for Epic to join CommonWell, while Epic’s VP says the company already helps its customers connect to CommonWell and shouldn’t have to “buy in” to CommonWell just to keep doing that, explaining, “There is not a magic future down the road in which there is one health information exchange network called CommonWell.” Both VPs agree that hospitals and practices need more incentives to share information.
Sponsor Updates
AdvancedMD offers a $10 Amazon gift card to anyone who requests their information kit.
PDR will exhibit at the McKesson Chain & Health System Pharmacy User Conference November 17-18 in Pittsburgh.
Stella Technology is sponsoring and attending the NYeC Gala Awards to promote health IT in New York City November 18.
Liaison Healthcare will exhibit at the PointClickCare Summit November 16-19 in Palm Desert, CA.
LiveProcess will exhibit at the first annual Association of Healthcare Emergency Preparedness Professionals Conference November 17-18 in Omaha, NE.
MedData will exhibit at the HFMA Region 9 Conference November 15-17 in New Orleans.
Walgreens expands its $49 MDLive-powered telemedicine services to 25 states, integrating it into the Walgreens mobile app rather than requiring users to install and run MDLive’s own app. The company also launches the ability for Walgreens Balance Reward members to connect to Walgreens-brand glucometers and blood pressure machines and will pay members for recording their measurements regularly. The company says 500,000 active devices are already connected. It’s amazing what can be accomplished with healthcare technology when incentives are aligned.
I have zero doubt: Walgreens is the most technologically advanced and most consumer empowering company in healthcare. They’ve driven more innovation into the health experience than anyone.
Reader Comments
From Solid-State Component: “Re: mHealth Summit. Is it just me or is the conference the same recycled buzz year after year? Everybody is always talking about what they’re going to do or how wonderful mHealth and wearables will eventually be, but I don’t see a lot of real-life action or results.” The conference’s premise has moved from shaky to absurd as the expiration date has been reached on the idea that mobile health is an edgy concept that stands separate from any other kind of health or healthcare. Everything is mobile by definition – when did you last hear the phrase “mobile banking” or “mobile music?” Wearables have run their course (no pun intended) without accomplishing anything other than to allow healthy people to stroke their egos. I’ve heard of nearly none of the companies or presenters at this week’s conference, which seems unchanged from the two I’ve attended previously that were painfully unfocused and uninformative, a weird conglomeration of mobile messaging projects in Africa, mostly bored venture capitalists, pedantic academics, and clearly doomed startups with laughably minimal healthcare experience. It has become the industry’s Single A farm team, where most of the players will deservedly never see an inning in The Show but keep plugging away hoping to attract a paying customer or paying acquirer, huddling together for validation in National Harbor, MD and pretending they wouldn’t really rather be at the HIMSS conference with the big boys. I ran across a few interesting people and companies when I attended previously, but mostly I was kind of embarrassed to be part of it, rather like the one and only time I attended the TEPR conference as it was wheezing its last breaths.
From Nom de Nonsense: “Re: pointless company rebranding and strange names. I thought you would enjoy this Economist editorial.” I did indeed, as the author calls out the “ever-sillier ways” in which companies are identifying themselves. Examples: AbInBev/SABMiller (the multi-merged global beer conglomerate) and Diageo (another alcoholic beverage conglomerate that hides cool names like Guinness under its bland skirt). It calls Yahoo “tediously wacky,” dislikes made-up conjoined names (PingStamp), and loathes misspellings (Kabbage). It calls out PricewaterhouseCoopers (one of those infuriating “we can’t decide which name is most important after we’ve merged” company names, later rebranded to PwC) for being convinced by a branding agency to call its spinoff consulting business Monday, although it sold the business to IBM before the change. The article concludes that plenty of good names remain (Alphabet was good enough for Google) to obviate the need for “Scrabble spillage,” assuring that great companies will do just fine with boring names but clever names won’t save struggling ones. The article’s only omission is not mentioning companies that pointlessly capitalize their entire name, the marketing equivalent of shrieking and stomping childishly to be heard over the competitive din. Here’s my challenge to you: what are the most-contrived, least-informative, or most-annoying company names in healthcare IT? Let me know and I’ll run a list of what I’m sent.
From What’s the Vector Victor: “Re: SNOMED. Has terms for the number of prior abortions. Our vendor, Practice Fusion, displays quantities of 1, 6, and 8 under the search. Does this happen in other SNOMED crosswalks?”
From Truven Watcher: “Re: Truven Health. Continued dismal operational performance.” The latest 10-Q shows that the company lost $15 million in the quarter and $66 million in the first nine months of the fiscal year. It contains a lot more financial detail than my attention span can manage.
HIStalk Announcements and Requests
Welcome to new HIStalk Gold Sponsor TierPoint. The St. Louis-based IT and data center services provider offers flexible, scalable, and secure solutions: production and disaster recovery clouds, co-location, and managed services (managed backup and business continuity, managed security, managed networks, DDoS protection, and enterprise hosting). A case study from services provider Clario Medical describes its migration from TierPoint-hosted servers to a private cloud infrastructure (load-balanced servers and SSD drives running VMware’s VSAN) with managed security services and HIPAA compliance. Some of the company’s 3,000 customers include Kootenai Health, WellDoc, and the Bill & Melinda Gates Foundation. Thanks to TierPoint for supporting HIStalk.
My inexpensive but capable Asus tablet developed a charging problem after a couple of years of reliable use, which gave me the excuse I needed to skip a repair and instead get something zippier and slicker (although it turned out to have been a curling iron-scorched power cord that I’ve replaced and it’s working fine again). A bit of research turned up my deal: Walmart has the iPad Mini 2 16GB for $199 with free shipping or in-store pickup. I had it running almost instantly after I picked it up yesterday at the store — it automatically brought over most information from my iPhone, even (shockingly) my recent browser searches and auto-completes. Screen resolution on the Retina display, Netflix streaming, and speed are great and the battery life seems excellent. I had considered a direct-from-China off-brand that has good reviews for $60, but I think it’s probably worth the difference to get Apple, plus the eight-inch screen is much better for reading or streaming than the seven-inch standard while not being as bulky as the 10-inch iPad. It would make a great Christmas gift for almost anyone since it’s really easy to set up and use. I’m far from being an Apple fanboy, but this is a great deal, especially since Apple sells the same model for $269.
Ms. W sent photos of her Washington fourth graders using the headphones and flash drives we provided via DonorsChoose. She says struggling readers are getting more engaged by using the audio versions of some textbooks and are using the flash drives to take their writing assignments home or to the public library.
I’m annoyed at banks and other companies whose recorded greeting asks me to say or enter my account number, reads it back painfully slowly from the computer for my confirmation, but when I finally get a human on the phone, they have no idea who I am or why I’m calling.
I’m also annoyed at doctors and others who smugly observe (with no originality whatsoever) that EHRs were designed “just for billing,” as though they wouldn’t stoop so low as to use computers to get paid. I suspect they aren’t seeing patients pro bono or as a hobby.
Unrelated, but for fellow geeks: Joel Hodgson launches a $2 million Kickstarter campaign to bring back the original Mystery Science Theater 3000 with 12 new episodes. We’ve got movie sign!
Webinars
November 11 (Wednesday) 2:00 ET. “Trouble Upstream: The Underinsured and Cash Flow Challenges.” Sponsored by TransUnion. Presenter: Jonathan Wiik, principal consultant, TransUnion Healthcare. The average person spends nearly $15,000 per year on healthcare as deductibles keep rising. Providers must educate their patients on plan costs and benefits while controlling their own collection costs by using estimation tools, propensity-to-pay analytics, and point-of-sale collections. This webinar will highlight industry trends in managing underinsured patients and will describe ways to match patients to appropriate funding.
November 12 (Thursday) 1 :00 ET. “Top Predictions for Population Health Management in 2016 and Beyond.” Sponsored by Medecision. Presenters: Tobias C. Samo, MD, FACP, FHIMSS, CMIO, Medecision; Laura Kanov, BS, RRT, MBA, SVP of care delivery organization solutions, Medecision. With all the noise and hype around population health management, the presenters will share their predictions for 2016 and their insight into meeting the mounting pressures of value-based reimbursement and the tools and technology needed to manage care delivery.
November 18 (Wednesday) 2:00 ET. “Making VDI Secure and Simple for Healthcare.” Sponsored by Park Place International. Presenters: James Millington, group product line marketing manager, VMware; Erick Marshall, senior systems engineer of virtual desktop infrastructure, Park Place International. Deployment of a virtual solution can optimize the experience of clinician users. Attendees will learn how to address the evolving demands of security and mobility in clinician workflow to improve the quality of care.
November 20 (Friday) 2:00 ET. “The Athenahealth Leadership Institute Presents: Dr. John Halamka Interviewed by Jonathan Bush.” Sponsored by Athenahealth. Presenters: John Halamka, MD, MS, CIO, Beth Israel Deaconess Medical Center; Jonathan Bush, CEO, Athenahealth. Providers are fed up with interface fees and the lengthy, fragmented narratives we’re exchanging today. But what is the right course of action to help deliver better care across the continuum? Bring your questions as we join Dr.Halamka and Jonathan Bush to discuss the current state of healthcare and how we can improve care coordination and interoperability.
Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.
Acquisitions, Funding, Business, and Stock
GE Healthcare acquires consulting firm The Camden Group.
Sales
Great Plains Health Alliance chooses Cerner Millennium for its 25 affiliated critical access hospitals in Nebraska and Kansas.
Heart of the Rockies Regional Medical center (CO) chooses Aprima for its ambulatory clinics.
People
DeLicia Maynard (Christus Health) joins Besler Consulting as VP of solution strategy.
Orion Health hires Susan Anderson (Alberta Health) as managing director of its operations in Canada.
OhioHealth Marion General Hospital promotes interim Regional VP of Medical Affairs Mrunal Shah, MD to the permanent role. He was previously SVP of healthcare informatics at OhioHealth.
University of Vermont Medical Center promotes Doug Gentile, MD to CMIO.
Announcements and Implementations
Validic and Quintiles will work together to develop digital health technologies to recruit drug study participants via disease-specific patient communities, capture the remote activity biometric information of drug study participants, and monitor the long-term drug efficacy of drugs after their FDA approval.
Flatiron Health enhances its OncologyCloud to link to EHR and practice management systems to find missed or incorrect drug charges.
University of Mississippi Medical Center will provide telehealth monitoring services to 1,000 new patient enrollees each month by the end of 2016 using technology from Intel-GE Care Innovations.
Boston Children’s Hospital will use IBM’s Watson in a project that will match genetic mutations to kidney disease to identify treatment options.
Nuance announces that its cloud-based Dragon Medical voice recognition is capturing 100 million “patient stories” each year as sales have increase 30 percent month over month since the beginning of the year.
Bottomline Technologies announces that its Investigation Center, which it describes as a surveillance camera for monitoring user and network activity for privacy and security problems, has earned Meaningful Use Modular Certification.
XG Health Solutions launches XGLearn, an educational platform for population health management that uses approaches developed by Geisinger Health System.
Government and Politics
The Department of Defense awards CACI a three-year, $77 million contract to develop clinical analytics tools. CACI created its healthcare business by acquiring analytics vendor IDL Solutions in January 2013. CACI announced just five days ago that it had been awarded a three-year, $39 million contract to continue support of the DoD’s Theater Medical Information Program. Shares of the publicly traded CACI value the company at $2.5 billion.
A Minneapolis TV station finds that local VA hospitals are listing phony board certifications for some of their doctors. An ED doc whose profile says he is licensed in Michigan and Wisconsin was actually turned down for Wisconsin licensure because he owed $69,000 in back taxes.
The Senate’s HELP Committee asks HHS to explain what it’s doing to prevent medical identity theft. The first four of its 12 questions are above.
Privacy and Security
Hackers develop encryption ransomware for Linux servers, requiring website administrators to pay a Bitcoin ransom of several hundred dollars to regain access to their files.
A judge rules that University of Cincinnati Medical Center isn’t liable for the Facebook posting of a patient’s medical records by an employee. The patient was the new girlfriend of the employee’s former boyfriend. The photo of the medical records, which contained a diagnosis of maternal syphilis, was accompanied by the employee’s comments that the patient was a “hoe” and a “slut.”
Technology
Apple CEO Tim Cook says that while he doesn’t want to put the company’s Watch through FDA’s approval process as a medical device, he “wouldn’t mind putting something adjacent … maybe an app, maybe something else.”
The Sequoia Project (the former Healtheway) and Care Connectivity Consortium propose a framework and maturity model for a national patient matching. They’re seeking feedback.
Other
ECRI Institute lists its top 2016 technology hazards. Most interesting to me was #10, where people plug a random gadget into the USB port of a medical device that causes it to malfunction.
Another New York hospital system rebrands itself, with the New York City Health and Hospitals Corp. asking everybody to call it NYC Health + Hospitals. The president of the system, which wants people to stop calling it HHC, vomits up the marketing blather he was obviously force fed in explaining, “Our new brand graphics symbolize a true evolution as we transition from a hospital-centric corporation to a healthcare delivery system focused on providing an exceptional patient experience and building healthy communities.” The package includes a new tagline, “Live Your Healthiest Life.” The organization formerly known as HHC declined to say how much the name change will cost. My view of how encounter-driven hospitals have renamed themselves over the years without really changing anything goes like this:
Smithtown Hospital
Smithtown Medical Center
Smithtown Regional Medical Center
Smithtown Health – Regional Medical Center
Blovaria (my idea for a made-up descriptive name, although I need a marketing person to come up with an overwrought and thoroughly unconvincing explanation of what it means and why a new name was necessary)
Publicly traded genomic test kit vendor Foundation Medicine, alarmed by reduced test ordering volume, says it will “educate” oncologists on ordering more tests, market itself harder, and push for higher reimbursement from Medicare.
A woman sues a gym after she falls asleep in its sauna for two hours and the resulting burns require amputating all of her toes. She says the gym “should at least watch out for your safety and well-being,” adding a backup argument that the sauna was improperly installed. As is always the case, the woman says it’s not about the money, but her heartfelt desire to prevent it from happening to others.
Sponsor Updates
USA Today features AirStrip President Matt Patterson, MD and innovation partner IBM.
Anthelio Healthcare Solutions will exhibit at HFMA Region 9 November 15-17 in New Orleans.
AHA Solutions endorses the YourCareUniverse consumer engagement platform.
Aventura explains how its Roaming Aware Desktop works in a new video.
Bernoulli CEO Janet Dillone is featured in OR Today.
Xconomy profiles Qualcomm Life’s acquisition of CapsuleTech.
CoverMyMeds will exhibit at the Medicaid Health Plans of America 2015 Conference November 11-13 in Washington, DC.
Experian Health will host its annual Financial Performance Summit for clients in San Antonio November 16-18.
Divurgent receives the Inside Business Roaring 20s Award, ranking as one of the area’s top 20 fastest-growing companies.
EClinicalWorks will exhibit at the 2015 Western States Health-e Connection Summit & Trade Shows November 17 in Scottsdale, AZ.
Extension Healthcare will exhibit at the National Veterans Small Business Engagement November 17-19 in Pittsburgh.
Medecision is recognized by Black Book Market Research as a top financial solution for value-based healthcare.
Healthcare Growth Partners advises iVantage Health Analytics on its sale to The Chartis Group.
Healthgrades Chief Marketing Officer Emeritus Judy Blackwell receives the John A. Eudes Vision and Excellence Award.
Healthwise will exhibit at the ACO Congress November 16-18 in Los Angeles.
Sheldon Razin, who founded Quality Systems, Inc. (NextGen) and has served as the company’s board chair for 41 years, retires. He will be replaced by board member Jeffrey Margolis, who is also chairman and CEO of Welltok and the founder of TriZetto.
Razin’s first QSI retirement came in 2000, when he resigned his president and CEO roles as a result of longstanding power struggle with activist shareholder Ahmed Hussein. Hussein resigned his own board position in 2013 with a parting shot in publicly announcing that Razin’s board involvement was damaging the company. QSII shares are trading at less than half their 2010 price and about the same as their value in mid-2005. Razin holds shares worth $150 million.
Reader Comments
From PM_From_Haities: “Re: Allscripts’ quarterly results. Don’t fall for anything less than standard accounting, which shows the company lost money in Q3. See here – no one ever adjusts EPS down.” I’ve always been torn by whether to report GAAP or adjusted earnings, but leaned toward the latter only because the big investment firms seem to favor excluding supposed one-time events that are under the company’s control such as stock compensation and restructuring costs. Allscripts turned its most recent quarter’s $5 million GAAP loss into a $25 million non-GAAP gain; the company hasn’t reported a GAAP profit since September 2012. The article eloquently describes why CEOs love less-stringent accounting measures that are similar to the “our patients are sicker” excuses that hospitals embrace in explaining objectively measured but unimpressive outcomes:
Insofar as CEOs and CFOs understand their job to be upholding the fragile psychological state of their shareholders by managing earnings in an emotionally supportive way, GAAP makes their jobs harder by sometimes requiring firms to issue financial statements that are not uplifting. But companies have a response. Because GAAP rules must cover a broad variety of circumstances, firms can usually make the argument that GAAP fails to comprehend relevant complexities. Everyone is special, especially when they miss earnings estimates.
From Lawn Dart Trauma: “Re: Main Line Health. Word is they’ve chosen Epic. They’ve always been Siemens – I’m surprised Cerner wasn’t able to keep them in the fold.” Unverified.
FromI’ll Show You Mine If You Show Me Yours: “Re: Epic. I’m a director at a customer hospital. Our analysts are getting calls from Epic’s support representatives asking for our hospital’s operating margin. A friend of mine at Epic told me that Judy asked employees to get this information for all Epic customers. I suspect they’re trying to assess if there’s financial trouble at other Epic sites in the way of some recent news reports. It’s frustrating since the general sense I get from colleagues is that development and service of Epic’s billing applications have atrophied greatly with the outsized focus they’ve had on clinical applications and when Epic is opaque about how it spends our money. The slow reaction times in the past few years is galling when I go to UGM and see where most of the money has been spent. I enjoy the show one day a year in Deep Space, but the quality of the other 364 days is suffering.” Unverified.
HIStalk Announcements and Requests
It was a 60-40 split on whether customers or patients would be impressed with the respondent’s employer if they had inside information. New poll to your right or here: is the impact of private equity and venture capital firms on the health IT industry positive or negative?
Ms. W. from Texas was so excited to hear that reader donations had funded her DonorsChoose grant request for electronic quiz tools and math activity stations that she immediately emailed, “I cannot express the excitement and happiness that has consumed me. When I saw the email that said ‘funded,’ my eyes began to water. As a classroom teacher, I saw the struggles and have come out of pocket for so many other projects. It hurt that this was something I couldn’t provide them with. Then we were blessed by you. Your generosity will help so many students better grasp the concept of math.” Meanwhile, Mrs. S in Colorado says her fifth graders vie for the chance to use the math games and materials we provided, sending the photo above.
A reader who wishes to remain anonymous donated $500 to my DonorsChoose project, asking that I fund elementary/pre-school science and math classes. I applied various sources of matching money, including from my anonymous vendor executive, to fully fund these grant requests:
Two Amazon Fire HD Kids Edition tablets for Ms. Torres’ pre-K class in Dallas, TX.
Five physics STEM kits for Ms. Owens’ elementary school class in Indianapolis, IN.
Math manipulatives for Mrs. Johnson’s elementary school class in Tulsa, OK.
Four Chromebooks for Mr. Wild’s high school math classes in Kealakekua, HI (I deviated a bit from the donor’s wishes in choosing a high school project because available matching money made the cost nearly nothing).
Two refurbished iPad Minis for Ms. Desai’s elementary school class in Alvin, TX.
Hands-on STEM learning tools for Ms. Lam’s first grade class in San Francisco, CA.
Thanks to the following sponsors, new and renewing, that recently supported HIStalk, HIStalk Practice, and HIStalk Connect. Click a logo for more information.
Last Week’s Most Interesting News
MedAssets will be acquired for $2.7 billion by Pamplona Capital Management, which will divest the company’s group purchasing and consulting business and combine the revenue cycle segment with Precyse, another of its holdings.
Cerner’s quarterly report meets earnings expectations but falls short on revenue.
Meditech’s quarterly report shows the continuation of an ongoing slide in revenue and profit, with services rather than product sales making up an ever-greater percentage of total revenue.
Francisco Partners sells it Aesynt pharmacy robotics business to Omnicell for $275 million just two years after acquiring it from McKesson.
Quality Systems announces that it will acquire cloud EHR vendor HealthFusion for up to $190 million.
Webinars
November 11 (Wednesday) 2:00 ET. “Trouble Upstream: The Underinsured and Cash Flow Challenges.” Sponsored by TransUnion. Presenter: Jonathan Wiik, principal consultant, TransUnion Healthcare. The average person spends nearly $15,000 per year on healthcare as deductibles keep rising. Providers must educate their patients on plan costs and benefits while controlling their own collection costs by using estimation tools, propensity-to-pay analytics, and point-of-sale collections. This webinar will highlight industry trends in managing underinsured patients and will describe ways to match patients to appropriate funding.
November 12 (Thursday) 1 :00 ET. “Top Predictions for Population Health Management in 2016 and Beyond.” Sponsored by Medecision. Presenters: Tobias C. Samo, MD, FACP, FHIMSS, CMIO, Medecision; Laura Kanov, BS, RRT, MBA, SVP of care delivery organization solutions, Medecision. With all the noise and hype around population health management, the presenters will share their predictions for 2016 and their insight into meeting the mounting pressures of value-based reimbursement and the tools and technology needed to manage care delivery.
November 18 (Wednesday) 2:00 ET. “Making VDI Secure and Simple for Healthcare.” Sponsored by Park Place International. Presenters: James Millington, group product line marketing manager, VMware; Erick Marshall, senior systems engineer of virtual desktop infrastructure, Park Place International. Deployment of a virtual solution can optimize the experience of clinician users. Attendees will learn how to address the evolving demands of security and mobility in clinician workflow to improve the quality of care.
Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.
Recurring revenue made up 75 percent of the company’s total revenue.
Non-GAAP earnings removed $9.9 million in expenses for severance, work on the company’s unsuccessful DoD bid, and settlement of outstanding litigation.
GAAP earnings were reduced by $1.4 million to account for the company’s equity investment in NantHealth.
The company says that inpatient EHR competitors who are leaving the market (presumably McKesson and the former Siemens) give Allscripts more opportunities.
President and CEO Paul Black says TouchWorks and Sunrise will begin integration with NantHealth’s protocol and algorithm work within six months.
The company says it has under-penetrated its client base in services sales compared to “one of our large competitors” (presumably Cerner) and hopes to improve that.
Evolent Health announces Q3 results: adjusted revenue up 45 percent, adjusted EPS –$0.16 vs. –$0.31. Shares rose 13 percent on Friday, but are still down 20 percent from their first day of trading in June.
People
As a reader previously reported, Graham King, former president of Shared Medical Systems and McKessonHBOC, died last week at 75.
Privacy and Security
Hartford Hospital (CT) and EMC will pay a $90,000 settlement to the state for allowing an unencrypted laptop to be stolen in June 2012 from the home of the hospital’s contractor, EMC. Both organizations agreed to encrypt patient data and provide privacy and security training to employees.
Police officers who wear body cameras have to remember to turn them off when entering a hospital to avoid violating patient privacy, according to the Kinston, NC police department. The department says officers will otherwise be violating HIPAA, which isn’t true because police departments aren’t covered entities and therefore have no obligation to follow HIPAA requirements.
Other
A Texas man pleads guilty to wire fraud for conspiring with others to pose as Cerner employees in order to sell hospital equipment and to defraud investors. The group registered a Cerner LLC corporate name, opened a bank account under that name, and registered Web domain CernerInc.com in selling a $1 million MRI machine to a Texas hospital, which the hospital reported to authorities when the real Cerner declined to help them install it.
CMS reinstates Faxton St. Luke’s Healthcare (NY) after it says it fixed ED problems that allowed a violent psychiatric patient to be released without evaluation. He killed three family members hours later. The hospital changed its order entry system to make it easier to order mental health assessments, added a hard stop so that triage nurses can’t skip documenting suicide risk assessment, and ordered physicians with illegible handwriting to use dictation software.
A judge orders Geisinger Health System to provide salaries of its executives and doctors to the family of one of its medical residents who died of a brain hemorrhage while admitted to one of its hospitals. The family is suing Geisinger and wants the salary information to determine the value of the resident’s lost life. The health system has fought the disclosure of executive salaries, arguing that the information is proprietary and strategic.
A Bellevue, WA orthopedic surgeon sues a patient who posted an unflattering Yelp review of his work, saying she damaged his business and personal reputation. The patient’s also filed a complaint with the state medical board, but they dismissed it as lacking evidence of a violation.
The New York Times profiles a Nepal-based ophthalmologist nicknamed the “God of Sight” who developed a five-minute, $25 cataract removal procedure that he has used to restore the vision of 120,000 people. The doctor manufactures his own $3 replacement intraocular lenses to avoid the $200 cost of commercially produced ones. His success rate is the same as that of US doctors who use $1 million machines.
The Pensacola, FL paper profiles local businessman and philanthropist Quint Studer, who worked his way up through hospital administration to become CEO of Baptist Health Care (FL), a job he left to start consulting firm Studer Healthcare Group in 1998. He sold 70 percent the company for $217 million in 2011, after which it was sold to Huron Consulting Group for $325 million in January 2015.
Johns Hopkins BSN student Stephanie Olmanni, whose background includes education and experience in music and film scoring, creates a nice parody of Adele’s “Hello” that describes her frustration trying to wade through the bureaucracy of obtaining a California RN license.
Sponsor Updates
TransUnion President and CEO Jim Peck is featured on the cover of The CIO Review.
Valence Health and Aldera share insights on risk-based healthcare landscape.
Health Catalyst ranks first among healthcare technology companies on the list of Utah’s 100 Fastest Growing Companies of 2015.
Winthrop Resources SVP Brad Swenson will present at the Virginia Hospital and Healthcare Association Annual Meeting November 11-13.
Xerox Healthcare wins the Best New Venture Award as part of Market Gravity’s 2015 Corporate Entrepreneur Awards.
ZeOmega places twelfth on the Metroplex Technology Business Council’s 2015 Fast Tech Awards List. The company also received MTBC’s Momentum Award for placing on the list five years in a row.
Allscripts announces Q3 results: revenue up 3 percent, adjusted EPS $0.13 vs. –$0.06, meeting revenue expectations and beating on earnings.
Reader Comments
From Worried: “Re: HHS and Department of Justice. Investigating [vendor name omitted] for fraud in EHR certification and safety issues.” Unverified, so I’ve left out the company’s name. Let me know if you have specific information.
From All Hat No Cattle: “Re: KLAS’s proposed interoperability measures. These are good and will really help highlight the issues, especially those that allow users to call out issues from within their own provider organizations. Issues like opt-in/opt-out are huge. I think it will also highlight the incredible job that Epic has done in allowing its clients to share information, which is becoming the gold standard.” The draft KLAS questionnaire for providers to assess their interoperability capability and use is indeed pretty good, targeting high-value connections rather than giving credit for connections that patients and clinicians don’t really care about. My only tiny quibble is that the document defines interoperability as “the ability” to exchange and use information, while the survey far more importantly assesses whether providers are actually doing it. The downside of the provider survey approach is that those who are unwilling to share information will point fingers at everyone else, skewing the results since it’s easier to blame generic “technical barriers” than to admit that you don’t want to provide information to your competitor and vice-versa. I guarantee that if health systems and doctors were paid a per-record fee for sharing their information, they would quickly overcome every alleged barrier and would pressure their technology vendors to figure it out (see: Meaningful Use bribes). The business case for helping patients being seen elsewhere is shaky.
From Poor Quality: “Re: University of Mississippi Medical Center. Gets an F in quality from Leapfrog, making it the worst in the state.” The hospital responds with the standard “our patients are sicker” excuse, saying other hospitals dump their problem patients on UMMC and that patients should not avoid the hospital just because it earned a failing grade. Sicker patients or not, UMMC scored horribly in all six surgical safety categories, such as leaving objects in the bodies of surgery patients. The chief medical officer says it’s not about whether the hospital earns an F or an A, it’s about improving outcomes for patients as a group, although not leaving sponges in patients might be a good start toward accomplishing both.
HIStalk Announcements and Requests
Welcome to new HIStalk Gold Sponsor LogicStream Health. The Minneapolis-based company, co-founded by a pharmacist and a physician, applies algorithms to hospital or clinic EHR data to develop clinically appropriate protocols, with one client reducing its post-surgical venous thromboembolism by 80 percent in improving outcomes and saving $1.1 million by applying individual risk assessments. The company’s platform quickly identifies clinical process problems to support data-driven adjustments that improve quality and provider satisfaction. It offers specific quality improvement modules for VTEs, catheter-associated UTIs, and central line-associated blood stream infections; cost containment solutions for high-cost labs and drugs; and the ability to measure the impact of order sets and nursing flowsheets. Co-founder Daniel Rubin, MD, MHI presented a webinar on reducing care variation that provides background. Thanks to LogicStream Health for supporting HIStalk.
Reader donations of $150, to which I applied available matching funds via DonorsChoose, provided math activity stations and wireless quiz technology for the fourth grade class of Ms. Williams in Lancaster, TX; a CD player, lapboards, and clipboards for small-group math instruction for the class of Ms. Penagos in Carrollton,TX; and math supplies and games for Mrs. Johnson’s kindergarten class in Silvis, IL. Meanwhile, Mr. Moore sent an update from Minnesota with the photo above of his students using the STEM materials we provided.
A brilliant Twitter enhancement request comes from @Farzad_MD as he’s getting bombarded by conference attendees (some of them reporters paid by their conference presenter employer) live-tweeting banal observations and quotes that are useless out of context (and often within context). His idea: allow Twitter muting by hashtag. That would work great for squelching dull tweetchats as well, or to allow users to create Twitter “folders” that you could follow separately to bypass their sports cheerleading and instead focus only on their work-related tweets. I might add a second variant: allow muting a Twitter account for a user-defined time out, like shushing them until the conference they’re yapping about is over. The few people I follow on Twitter are mostly insightful 95 percent of the time but some of them are insufferable when they get unduly aroused by some meeting, sporting event, or personal accomplishment.
I still haven’t heard a word from anyone who has actually seen an EHR gag clause, so I’m calling BS on the reporter who stirred up that whole issue in the first place (along with the mindless parrots who squawked about that article despite its lack of evidence and obvious confusion as to what a “gag clause” even is). My assertion is unchanged: the pressure you feel to avoid speaking up about patient-endangering software problems is far more likely to come from the executive suite of your health system, not that of your software vendor.
This week on HIStalk Practice: Healthcare.gov opens with no signs of IT trouble … yet. EClinicalWorks breaks into the UK market via a new partnership. The NC Medical Society Foundation works with Chess to transition rural practices to ACOs. Sanctus Healthcare implements CCM services from McKesson BPS. Wellero President Hanny Freiwat offers physicians advice on increasing patient payments before the end of the year. SHIN-NY targets physician practices after reaching RHIO milestone. The Toledo Clinic joins the Ohio Independent Collaborative. Culbert Healthcare Solutions Director Jaffer Traish offers best practices for streamlining the efforts of IT and operations.
This week on HIStalk Connect: Teladoc’s stock price falls 10 percent after reporting its Q3 results, which showed signs of impressive organic growth but still shows the company operating in the red after 13 years in business. Fitbit reports its Q3 results, posting better than expected earnings. The company was also named in a countersuit from rival Jawbone alleging that it has established a monopoly in the fitness tracker market. Monclarity raises $5 million to launch a "brain games" cognitive training app, despite widespread skepticism from neuroscientists over the effectiveness of such apps. Lumo raises $10 million to launch a B2B wearables platform that sets a company up with sensors, software, and an API to launch their own fitness tracking wearables powered with Lumo’s technology.
Webinars
November 11 (Wednesday) 2:00 ET. “Trouble Upstream: The Underinsured and Cash Flow Challenges.” Sponsored by TransUnion. Presenter: Jonathan Wiik, principal consultant, TransUnion Healthcare. The average person spends nearly $15,000 per year on healthcare as deductibles keep rising. Providers must educate their patients on plan costs and benefits while controlling their own collection costs by using estimation tools, propensity-to-pay analytics, and point-of-sale collections. This webinar will highlight industry trends in managing underinsured patients and will describe ways to match patients to appropriate funding.
November 12 (Thursday) 1 :00 ET. “Top Predictions for Population Health Management in 2016 and Beyond.” Sponsored by Medecision. Presenters: Tobias C. Samo, MD, FACP, FHIMSS, CMIO, Medecision; Laura Kanov, BS, RRT, MBA, SVP of care delivery organization solutions, Medecision. With all the noise and hype around population health management, the presenters will share their predictions for 2016 and their insight into meeting the mounting pressures of value-based reimbursement and the tools and technology needed to manage care delivery.
November 18 (Wednesday) 2:00 ET. “Making VDI Secure and Simple for Healthcare.” Sponsored by Park Place International. Presenters: James Millington, group product line marketing manager, VMware; Erick Marshall, senior systems engineer of virtual desktop infrastructure, Park Place International. Deployment of a virtual solution can optimize the experience of clinician users. Attendees will learn how to address the evolving demands of security and mobility in clinician workflow to improve the quality of care.
Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.
Acquisitions, Funding, Business, and Stock
Consulting firm The Chartis Group acquires iVantage Health Analytics.
EVP/CFO Marc Naughton said the company is disappointed about missing revenue expectations by $20 million, but delivered record bookings and has a strong pipeline that includes a $13.9 billion revenue backlog. The drive is that clients are tying payments to milestones and even to specific health system performance targets.
The former Siemens Health Services brought in $250 million in revenue, 22 percent of Cerner’s total revenue, but was responsible for half of its $20 million revenue miss as some former Siemens clients dropped their maintenance agreements. Cerner says sales of the former Siemens products are “minimal … Siemens is negligibly impacting us” and that was the plan all along.
President Zane Burke says the company differentiates itself from Epic by “the ability to deliver value along with predictable costs and timelines” as opposed to “their list of clients, where the significant costs of deploying and maintaining their systems have been cited as a key reason for financial challenges is starting to impact them in the marketplace.”
The company says Epic-using Geisinger chose Cerner for population health management because “our capabilities could not be equaled by a competitor.”
The company had two displacements of an unnamed ambulatory cloud competitor (presumably Athenahealth) due to “their lack of execution, failure to meet established objectives, rising costs after teaser rates, and a realization by the client that they ended up needing similar or more staff even though they thought they had outsourced the function to our competitor because they left much of the harder work and complex work to the client.”
The company warns that revenue from its Department of Defense subcontracting will be slow, with the first Leidos task order representing less than 1 percent of Cerner’s quarterly bookings. That task order was valued at $98 million and 1 percent of Cerner’s quarterly bookings is $16 million, so at least for the quarter, Cerner’s cut of the DoD contract is less than 16 percent.
Cognizant reports Q3 results: revenue up 24 percent, adjusted EPS $0.76 vs. $0.66, beating revenue expectations but falling short on earnings. The company’s healthcare segment, which includes its $2.7 billion acquisition of TriZetto last year, contributed 30 percent of Cognizant’s revenue ($939 million) in a 43 percent jump.
Dell is rumored to be planning the sale of $10 billion worth of its non-core divisions to ease the $50 billion in debt it will take on to acquire EMC, with the former Perot Systems being one of the assets that could be placed on the block. Dell bought Perot for $3.9 billion in 2009.
Sales
For-profit, 16-hospital Iasis Healthcare (TN) chooses Cerner for EHR and revenue cycle systems.
San Joaquin General Hospital (CA) will implement Cerner.
Walgreens will implement Epic’s EpicCare in its 400 retail clinics beginning early next year, replacing its proprietary EHR. I think the drug chain’s 8,200 pharmacies use Greenway’s EHR, which I would expect to be at significant risk of eventual displacement since they obviously looked elsewhere for the clinics and they are bragging on the interoperability opportunities Epic will provide. Some of the sites and fast-on-the-draw tweeters missed the fact that this announcement pertains only to the in-store clinics, not all of Walgreens (yet).
ZappRX chooses the e-prescribing state law review data set and services from Point-of-Care Partners.
People
Rush Health (IL) hires Julie Bonello (Access Community Health Network) as CIO. I’m fascinated by her LinkedIn profile that shows she earned a BSN and then an MS in computer science, dropped out of the CIO role for several years to run the family’s chain of noodle shops as she cared for her aging parents, then jumped right back in as CIO of Cook County Health and Hospitals.
J. P. Fingado (Francisco Partners) joins healthcare talent manager software vendor HealthcareSource as president and CEO. Francisco Partners acquired the company in May.
Community Health Systems announces that SVP/CIO Gary Seay will retire at the end of the year.
Orion Health hires Robert Pepper (NeuroTrax) as VP of marketing for North America.
Announcements and Implementations
Influence Health announces a new version of its Connect clinical portal, which alerts physicians of frequent visitors who may be at risk for readmission and integration of DynaMed’s clinical information.
Medecision and Forward Health Group partner to provide population health management solutions to New York DSRIP participants.
Quest Diagnostics will sell de-identified patient lab results through analytics vendor Medivo to drug companies, which will then use the information to target their marketing to individual physicians. Medivo calls their business “delivering the promise of precision medicine by providing decision support on the use of targeted therapeutics,” which is probably not what pie-in-the-sky “precision medicine” dreamers have in mind when they picture using data to treat patients rather than to sell more drugs.
Healthgrades will expand its online appointment scheduling capabilities in partnership with MyHealthDirect.
Lincoln Surgical Hospital (NE) uses Summit Scripting Toolkit to import scanned documents from clinical modalities into Meditech, requiring just eight hours of analyst time to create and test the script and move it to production.
Durham, NC-based Touchcare, which offers a $99 per provider per month telemedicine app, adds a web-based provider dashboard and integrated billing capability.
Government and Politics
John Halamka, MD, recapping the November HIT Standards Committee meeting, repeats his call to dissolve the Meaningful Use program and move Stage 3 requirements into CMS’s upcoming Merit-Based Incentive Programs (MIPS).
Privacy and Security
An ED study finds that 71 percent of patients who use Facebook or Twitter don’t mind doctors looking at their accounts, although I can’t imagine any ED doctor who would find that any more useful that the uneventful stream of wearables data they rightfully ignore. Maybe that would be more useful for PCPs who could possibly wade through all the inevitable junk to piece together some sort of social history that the patient could have just told them directly. Or, perhaps there’s your startup idea: a private, Facebook-like app just for the intuitive entry of health status information that you share with whomever you want (doctor, family member, etc.) Maybe you post your weight or sleep schedule and your doctor gives it a “like” or adds a slightly scolding comment.
Technology
Amazon Web Services could bring in $16 billion in annual revenue by the end of 2017, making it the company’s most valuable business at up to $160 billion.
Researchers from Vanderbilt University School of Engineering make the hardware and software of their swallowable medical robots available via open source. The devices, also known as wireless capsule endoscopes, can be guided rather than just carried along by intestinal activity as are PillCams.
Precision medicine is here after all: CDX develops a chemical sensor that also uses big data and machine learning to analyze a sample of marijuana and apply the experience of that strain’s users to determine whether it will deliver the desired outcome (medical or otherwise) to the app user. The company will earn revenue from displaying paid advertising of dispensaries. The company plans to expend its “electronic nose technology” into other areas, such as air and water quality. This is a brilliant business model all around.
Other
In Pakistan, Hayatabad Medical Complex, alarmed by employees and physicians moonlighting in nearby medical facilities on company time, requires them to clock in using biometric ID. Board members also mandated that all procurement be moved online.
I’m amused that the AMA’s Thursday tweetchat on digital medicine innovation was led by its CMIO – who doesn’t even have a Twitter account.
I don’t understand this at all. A DC business paper profiles ListenPort, which it contrasts to Yelp and Twitter in providing a private place to complain directly to management. I thought we had that already in products called “email” and “texting.” They offer a free basic account, so maybe I’ll try it out.
A former purchasing assistant with England-based health IT firm Ascribe is sentenced to four and a half years in prison for stealing $900,000 from the company over five years. She used the money, obtained by paying phony invoices to herself, for vacations, cars, a house, and to pay off her son’s drug debts. Ascribe hired her even though she had previously been convicted for stealing from a previous employer. Ascribe sold itself to EMIS Group in 2013 for $88 million but says it could have gotten $5 million more had the theft not reduced its profitability.
AMIA will induct 13 new Fellows in the American College of Medical Informatics on November 15.
An Atlantic article says programmers should stop calling themselves “engineers” since they aren’t regulated, certified, or required to take continuing education. It says the tech industry has cheapened the term “engineer” by applying it to everybody who isn’t in sales, marketing, or design.
I haven’t watched TV for years, but this week’s episode of “CSI: Cyber” titled “Hack E.R.” (although “Hack E.D.” would have been better) apparently spins a tale of a hospital whose network was penetrated by ransom-seeking hackers through a smart TV (what the heck hospital has those?), causing the death of a patient when they disable her heart monitor. The hospital couldn’t take the network down because it would disable all their ventilators (huh?) Then a patient died when the malware-affected EHR didn’t give his doctor an allergy warning as he entered an order. The entire episode, which seems absurdly hammy and unrealistic (being TV, after all), streams here with a ton of commercials and gratuitous on-screen graphics as annoying as those “pop up” shows from years ago. I couldn’t hack (no pun intended) more than a few seconds’ worth, but I notice the series stars Ted Danson (who looks like Sam Malone’s grandfather even with his wig on) and the episode was directed by Eriq La Salle, who played Dr. Peter Benton on “ER.”
Sponsor Updates
A hospital group in Indonesia reports success in deploying InterSystems TrakCare.
A Rand Corporation study finds that Health First (FL) improved patient throughput significantly using systems from study sponsor TeleTracking Technologies to identify bottlenecks and improve processes.
InterSystems publishes a new white paper, “Creating Sustainable 21st Century Health Systems: EHealth and Health Information Technology.”
Navicure will exhibit at MGMA Mississippi November 6 in Pearl.
Strata Decision Technology announces highlights from its Decision Summit.
PeriGen will demonstrate its new PeriCALM CheckList at the Synova Associates Perinatal Leadership Forum November 11-14 in Dallas.
Obix will exhibit at 2015 Perinatal Leadership Forum November 11-14 in Dallas.
Medecision and its customer Baystate Health will present a session on population health management at the HIMSS 2015 Big Data & Healthcare Analytics Forum this week.
Experian Health will exhibit at the HMA CFO Forum November 11-14 in Utah.
Jefferson College of Public Health recognizes PatientSafe Solutions VP of PatientTouch Coordinated Care Amber Thompson as a 2015 Health Education Hero.
PDS CEO Asif Naseem is profiled in the local paper.
Validic announces client growth and enhancements that allow mobile app developers to connect to clinical devices and to Apple Health.
PerfectServe will exhibit at the American Association for Physician Leadership Fall Institute November 13-17 in Scottsdale, AZ.
Sandlot Solutions will exhibit at the HIMSS Connected Health Conference November 8-11 in National Harbor, MD.
The SSI Group will host a user group meeting in Nashville on November 10.
Streamline Health will exhibit at the HFMA Big Data Analytics Conference November 10-12 in Denver.
Pamplona Capital Management will acquire MedAssets for $2.7 billion, announcing plans to divest the company’s group purchasing and performance improvement segments to VHA-UHC and merge its revenue cycle business with another of Pamplona’s recent acquisitions, Precyse. Pamplona says the new, privately company will be a national leader in outsourced revenue cycle, technology, and education, explaining:
Existing and prospective customers of the new, realigned company should expect a business that is dedicated to investing in integrating our technology both internally and with EMR software providers; improving the visualization and utility of our data; scaling our front, middle, and back-end services businesses; and, developing offerings in patient payments and value-based reimbursement. MedAssets and Precyse employees will be part of a growing, focused business that prioritizes long-term value creation
Pamplona will pay a 30 percent premium for shares of MedAssets. MedAssets said this summer that it was exploring strategic alternatives even as an activist investor called for it to replace some of its board members due to questionable acquisitions and undervalued shares. It also lost a key customer and and announced plans to lay off 5 percent of its workforce just a few weeks ago.
Pamplona acquired Precyse in July 2015 for an undisclosed price from Altaris Capital Partners and NewSpring Capital.
HIStalk Announcements and Requests
Want to connect with me on LinkedIn? I’m here, as is Dann’s 3,649-member HIStalk Fan Club.
Mr. Graham in Illinois sent photos of his students using the STEM materials we provided, saying, “The students have shown a great interest in science. They enjoy working with these activities and do the research that goes along with them. They have learned more from these kits than I would have ever been able to teach them using our science textbooks. It is very rewarding for me to see how much they enjoy science now and how engaged they are with these activities. We would like to thank you for supporting our grant and putting these awesome materials into our classroom.”
HIT Geek donated $100 for my DonorsChoose project, which with double matching funded $400 worth of classroom projects:
Eight scientific calculators for Ms. Tyler’s Algebra 2 class in La Mesa, CA.
Green screen broadcasting equipment for Mr. Ventura’s classes in Omaha, NE to allow students to produce morning news broadcasts and video projects.
A field trip to the Wildlife Science center for Ms. B’s Grade 6-8 class of emotionally disabled students in Brooklyn Park, MN.
HIT Geek likes reading about my funding choices. For others who would like to donate, here’s how to do it:
Send the gift card by the email option to mr_histalk@histalk.com (that’s my DonorsChoose account).
I’ll be notified of your donation and you can print your own receipt for tax purposes.
I’ll pool the money, apply the matching funds, and publicly report here (as I always do) which projects I funded, with an emphasis on STEM-related projects.
Webinars
November 11 (Wednesday) 2:00 ET. “Trouble Upstream: The Underinsured and Cash Flow Challenges.” Sponsored by TransUnion. Presenter: Jonathan Wiik, principal consultant, TransUnion Healthcare. The average person spends nearly $15,000 per year on healthcare as deductibles keep rising. Providers must educate their patients on plan costs and benefits while controlling their own collection costs by using estimation tools, propensity-to-pay analytics, and point-of-sale collections. This webinar will highlight industry trends in managing underinsured patients and will describe ways to match patients to appropriate funding.
November 12 (Thursday) 1 :00 ET. “Top Predictions for Population Health Management in 2016 and Beyond.” Sponsored by Medecision. Presenters: Tobias C. Samo, MD, FACP, FHIMSS, CMIO, Medecision; Laura Kanov, BS, RRT, MBA, SVP of care delivery organization solutions, Medecision. With all the noise and hype around population health management, the presenters will share their predictions for 2016 and their insight into meeting the mounting pressures of value-based reimbursement and the tools and technology needed to manage care delivery.
Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.
Acquisitions, Funding, Business, and Stock
Cerner reports Q3 results: revenue up 34 percent, adjusted EPS $0.54 vs. $0.42, meeting earnings estimates but falling short on revenue expectations. The company projects Q4 revenue and earnings lower than consensus, sending shares down 9 percent in after-hours trading following the announcement.
EClinicalWorks announces the opening of a London office and the signing of its first UK customer, the 1,700-store Specsavers optical chain. ECW says it booked $100 million in international business in the past year.
Teladoc reports Q3 results: revenue up 83 percent, EPS –$0.37 vs. –$2.68, with its loss meeting expectations and its $20 million in revenue beating slightly. From the earnings call:
The company touted future potential given its 60 percent telehealth market share in a market that’s only 1 percent penetrated.
Subscription fees made up 85 percent of the quarter’s revenue, with the remaining $3 million coming from telehealth visits.
The company will raise its visit fee from $40 to $45 on January 1.
Teladoc spent $1.6 million in the quarter on its legal fight with the Texas Medical Board and expects to spend up to $750K more in Q4.
The company emphasizes that customers get what they pay for, with some lower-priced offerings failing to deliver value.
The company says health systems are using its product to acquire patients, while health plans are using it for population health and care management.
Teladoc believes CMS will allow fee-for-service telehealth payments via Medicare and Medicaid.
The company is working with health systems to design a post-discharge program.
Two co-founders and a former executive of travel and expense management system vendor Concur (sold to AP last year for $8.3 billion) join Accolade. The Plymouth Meeting, PA company offer Health Assistants who work with technology and analytics to engage with consumers to reduce utilization and costs. The company claims a 98 percent user satisfaction rate, contacting healthy members an average of five times annually and reaching out to the least-healthy ones 24 times per year.
Referral and access management technology vendor SCI Solutions acquires Clarity Health, which offers authorization and referral management services.
Meditech announces Q3 results: revenue down 3.5 percent, EPS $0.37 vs. $0.50 as product revenue dropped 16 percent year over year due to lower sales. Nine-month net income slid to $51 million vs. $104 million in 2014. Here’s the five-year change:
Product revenue: $60,102,900 (2010) vs. $37,004,099 (2015) – down 38 percent Service revenue: $58,368,348 (2010) vs.$82,102,999 (2015) – up 41 percent Total revenue: $118,471,248 (2010) vs. $119,107,098 (2015) – flat Net income: $31,957,358 (2010) vs. $13,591,077 (2015) – down 57 percent Earnings per share: $0.89 (2010) vs. $0.37 (2015) – down 58 percent Shareholder equity: $408,525,252 (2010) vs. $529,738,300 (up 30 percent)
People
Best Doctors names Peter McClennen (Allscripts) as CEO.
HealthMedx founder Charlie Daniels (CS Funding) will return to the company as COO.
Sam Miller, former CIO at Massachusetts General Hospital and University Medical Center (AZ), died last month in Canada. He was 77.
A reader reports that Graham King, former president of Shared Medical Systems and McKessonHBOC’s IT business, passed away this week.
Announcements and Implementations
A two-year Geisinger study finds that patients given online access to their clinical documentation via OpenNotes have a slightly higher rate of adhering to their medication regimens. It’s an unimpressive finding, but perhaps asked the wrong question in the first place since the two observations don’t seem to have much intuitive correlation.
Wheaton Franciscan Healthcare’s southeastern Wisconsin operations will join Ascension Health, which already had 150,000 employees and 131 hospitals. Ascension pays big salaries: the CEO made $8.5 million, the CFO $4 million, the chief medical officer $2.7 million, and quite a few executives at $1.5 million and up.
In England, Addenbrooke’s Hospital is testing an online tool that allows prostate cancer patients to set PSA testing reminders and to track their own PSA levels.
A small study of outpatient diabetic patients finds that use of Glytec’s Glucommander insulin management software reduced the average A1C level from 10.4 percent to 7.4 percent within 30 days.
Middle Park Medical Center (CO) will implement Epic via Centura Health, replacing Healthland.
Government and Politics
The just-announced 2016 work plan for HHS’s Office of the Inspector General includes examining the effectiveness of the FDA’s oversight of medical device security to determine if it adequately protects patients.
The FDA seeks input on how technologies such as apps, telemedicine, and biomedical sensors might be used in performing clinical trials for drugs. FDA wants to know what technologies are being used, how FDA can encourage their use, and what challenges need to be overcome, especially regarding the use of patient-owned devices.
I’m bored with taxpayer trough-lappers biting the hand that feeds them, including the AMA, which announces that the Meaningful Use program is “doomed” unless Congress lowers the bar. It says the market needs new EHRs to support the way doctors practice, not mentioning how many of its members bought whatever a salesperson stuck in front of them in their zeal to pocket a seemingly easy $44,000 taxpayer bribe. AMA blames Meaningful Use for physician data entry time, the requirement to collect pointless information, and for creating interoperability barriers. AMA concludes that physicians embrace new technology, but are stymied by bureaucracy. I hope they are right, actually – it would be just fine with me if Meaningful Use went away.
Medicare will eliminate higher payments for medical practices acquired by hospitals starting in 2017, lowering their payments to be the same as for non-hospital owned practices and saving $9 billion per year. However, the change isn’t retroactive, so it effects only newly acquired practices, meaning hospitals may buy practices even more aggressively to lock in their high Medicare rates. The AHA is predictably lobbying against the change, saying it will reduce access to care. The change may have limited impact anyway depending on how far value-based care has progressed by the time the change kicks in.
Two senators are investigating why 12 of 23 non-profit state co-op insurers funded by $2.3 billion in ACA loans have failed. The senators also express concerns that the surviving co-ops may be using “creative accounting” that may lead to even more failures. A report from a few weeks ago found that all but one co-op is struggling financially, with some of their leaders blaming Republican-led funding cuts. Observers say the co-ops set their premiums too low and had to use their federal loans to pay medical claims.
A national human resources team sent by the VA’s national headquarters to help fix widespread problems (including extended wait times) and massive employee shortages at the Phoenix VA hospital was sent home by the hospital’s acting director, who told them that he “calls the shots.” The team says hospital management was “obstructionist” and “clearly lacked integrity.” The Phoenix VA’s HR department uses paper-based systems with no tracking capability, hampering its hiring efforts. The team observed chronic abseentism that left clueless people in charge and noted that several HR employees refused to learn new IT systems because they would then be held accountable for completing tasks.
Privacy and Security
An unnamed hacker earns a $1 million prize for creating a Web-based exploit for iOS 9, which is mostly interesting because company that sponsored the challenge sells hacks non-exclusively to the highest-bidding world governments and to the NSA. An ACLU technologist referred the earlier company as a “merchant of death” that sold “the bullets for cyberwar.” The new company, Zerodium, will undoubtedly sell the hack many times for far more than $1 million to governments interested in performing electronic surveillance.
Innovation and Research
The Birmingham business paper covers Alabama Eye Bank’s self-development of a FileMaker iPad app for collecting information from cornea donors. The CIO likes that developers only need to learn one tool to deploy to both mobile and to the Web.
Technology
The Glow fertility app comes under scrutiny after the company presents data that claims women who use it to track their fertility cycles are 40 percent more likely to conceive. Researchers immediately pounced on that assertion since the analysis proved correlation but not causation. The study also didn’t control for important variables such as prior fertility treatments. An expert says the results most likely reflect selection bias rather than an app-inspired change in behavior.
Other
The Boise newspaper digs up old news from 2012 saying that the implementation of Epic at St. Luke’s caused provider productivity problems. It appears that the reporter was just playing in some legal databases and decided to throw some factoids together to create a non-story.
Here’s an infuriatingly stupid and insulting comment from an oncology site that also declared the ICD-10 switch to be “much ado about almost nothing.” I suppose the next time an oncology intervention saves someone from dying of cancer we should just say the tumor “blew over” instead of thanking the oncology team for saving them.
A small survey finds that people prefer receiving their lab results via a patient portal rather than by email, traditional mail, or voice mail.
In England, NHS launches its digital maturity self-assessment that trusts are required to complete. NHS England created its own assessment in which trusts will rate themselves on how well they use their systems. NHS declined to use the HIMSS EMR Adoption Model, saying it measures use only within a given organization and NHS wants to focus on interoperability.
A New York business paper delves into the expensive and not universally loved “rebranding” of North-Shore LIJ Health System to Northwell Health, chosen because it’s a neutral name that won’t limit the system as it expands. The system rejected similarly dull, feel-good names such as Laudica Health, Dedication Health, and Northstar. It will spend $20 million to roll out the new name.
Experts debate whether surgeries should be recorded on video as a “surgical black box” that could be used for learning or to defend malpractice lawsuits. Naysayers don’t like the possibility that recordings could be used to prove malpractice, would increase costs, and would expose the sometimes secretive goings-on of a typical OR.
Weirton Medical Center (WV) protests the $1.5 million an arbitrator awarded to a management company the hospital hired to turn its finances around, saying the company miscalculated payment rates and failed to prepare it to earn $1.8 million in Meaningful Use money.
Weird News Andy leans on the bar and starts his story with, “A deer walks into an ER …” An injured deer walks through the automatic doors of Strong Memorial Hospital’s ED and wanders down the corridor. Unlike other ED patients, the deer was taken out to the parking lot, where animal control officers killed it.
Sponsor Updates
Medicity celebrated Halloween with an ICD-10 graveyard titled “You Don’t Want to Die on This Hill.”
Fox Business profiles AirStrip’s integration with Apple Watch and its use at Montefiore Medical Center.
Wellcentive wins the “Emerging Company of the Year” award presented by the Metro Atlanta Chamber of Commerce.
Aprima will exhibit at the American College of Rheumatology Annual Meeting November 8-10 in San Francisco.
Awarepoint will exhibit at the iHT2 Health IT Summit November 3-4 in Beverly Hills, CA.
Bernoulli will exhibit at the American Association for Respiratory Care Congress November 7-9 in Tampa, FL.
Besler Consulting wins a 2015 Bright Bulb B2B Marketing Award for best small team in-house campaign.
CenterX will exhibit at the NCPDP Workgroup Meeting November 4-6 in St. Louis.
Sunquest will exhibit with GeneInsight at AMP 2015 November 5-7 in Austin, TX.
Nordic releases a video titled “After ICD-10: Minimizing pain, increasing gain.”
Direct Consulting Associates sponsors the HIMSS North Ohio Chapter Conference November 5 in Akron.
Connected for Care introduces its telemedicine solution and integrate it with HealthMedx’s LTPAC EHR.
Divurgent will exhibit at the Virginia HIMSS Fall Conference November 5-6 in Williamsburg.
EClinicalWorks and Healthwise will exhibit at the mHealth Summit November 5-6 in National Harbor, MD.
FormFast helps hospitals move away from paper documentation.
The Colorado Technology Association nominates Healthgrades EVP/CIO Douglas Walton for Apex CIO of the Year.
Medication management technology vendor Omnicell will acquire Aesynt, which offers pharmacy robotics, for $275 million. As reader WhoKnows points out, McKesson bought the former Automated Healthcare in 1996 for $65 million and then sold it in late 2013 to Francisco Partners for a rumored $52 million. That’s either horrible McKesson mismanagement or a truly spectacular performance by Francisco Partners, which gets a five-bagger in just two years. The only acquisition I recall Aesynt having made was Italy-based Health Robotics, which was having limited success with its IV room robotics technology. FP didn’t even change the CEO when it bought the company – Kraig McEwen came on board in November 2011 and remains to this day.
Reader Comments
From All Hat No Cattle: “Re: John Glaser. I noticed his CV lists his HIStalk Lifetime Achievement Award from 2011. I wonder if any of the other HIStalk award winners list theirs?” Probably not, but someone new will have that chance in around four months when we do it again.
From Over Easy: “Re: Hoag Hospital in Orange County. Rumor is another senior IT leader was released or resigned, which makes the third in the last four months. The hospital has implemented drastic budget cuts in IT and overall in the past two years.” Unverified. I don’t think I know anyone there.
From Wayne Tracy: “Re: VA-DoD interoperability. As a retired Naval Officer having commanded a field hospital (Fleet Hospital 13B) I have come to the conclusion that until Congress holds the Surgeon Generals of the Army, Air Force, and Navy as well as the head of the VA personally responsible, nothing is going to change. Give them a two-year deadline and withhold all medical computer budget funds until they are fully interoperable in real time (say, using HL7’s FHIR) or the budget goes away. It seemed to work when the railway system was not going to meat the end-of-year (2015) deadline — the New York to Washington line miraculously got done in two weeks. Somebody with big brass ones needs to be put in charge. Congressional oversight hasn’t worked to date, just more deadline extensions. Congress, grow some!”
From Wealthy and Wise “Re: Highmark. As patients grovel for care and medications, these guys are raking it in. No wonder they are struggling financially and cutting care and services. Shameful and despicable.” It’s big money in Pittsburgh healthcare, where Highmark Health’s former CEO earned $10 million in 2014 having worked there less than two years before he was paid to go away. Highmark paid its human resources chief $2.7 million and its treasurer $3.3 million. The CEO of arch-rival UPMC made $6.4 million.
From Purple Hay: “Re: UnityPoint Health System, Iowa. VP/CIO Joy Grosser is gone.” Unverified. Her LinkedIn profile is unchanged, but her patch of real estate on the health system’s executive page is now vacant. I searched their site for information and found only that she was paid $591K last year, with other fun information from their Form 990 being that their largest-expense contractors were all IT related: Epic ($7.8 million), McKesson ($4.7 million), and IBM ($4.5 million). Fifth-highest was a “branding agency” that earned $4 million for doing whatever vital, patient care-focused work that branding agencies are known for doing.
From Maven PR: “Re: headlines. You need sexier ones to bring more attention to what you write. I can help you.” I won’t stoop to the level that many or most sites do in shamelessly fooling readers into clicking over to crap stories by using CNN-type click-bait headlines, mind-numbing slide shows, pointless stock photos, and “listicle” articles that start with a number (in the form of “6 Tricks You Won’t Believe that Lame HIT Sites Use to Suck In Readers.”) I would hope that health IT people and advertisers are smart enough to realize that the steak they hear sizzling is usually just cotton candy, but regardless, I would rather have 100 smart, influential, engaged readers than 1,000 who mindlessly click on whatever shiny object is thrust in their face without recognizing that they’ve been had.
From Atom Heart CIO: “Re: DonorsChoose. I think your legacy will be more about the charitable work you have done than with HIStalk, which is amazing given how successful HIStalk has become.” I don’t seek or expect a legacy either way, but it’s exciting thinking about how the donations readers make to DonorsChoose might, through some unlikely chain of events, help some kid become a legacy themselves. One of these days I’ll either decide to quit writing HIStalk or just die in the saddle, in which case I’ll fade away with my planned or unplanned final post being the only artifact of my anonymous existence (and leaving Weird News Andy homeless).
From The PACS Designer: “Re: ICD. With our first month under ICD-10-CM with no major issues, it’s time to focus on the next aspect, ICD-10-PCS (Procedure Codes). Since it will be done first here in the US, it gives us the opportunity to choose where we do it initially. TPD proposes that we do it with the VA and DoD so that a breakdown occurs to the barriers each of them currently have against each other working together to improve healthcare for our military and veterans.”
HIStalk Announcements and Requests
Poll respondents were evenly split on whether they’d want Theranos running their lab tests. I agree with Don, who said that using the company’s services has nothing to do with a pinprick blood sample and everything to do with convenience and pricing. I enjoy visiting LabCorp and Quest about as much dealing with the people at the driver’s license office. New poll to your right or here: if your customers (or patients) knew what you know about your employer, would they be more impressed or less impressed?
Mrs. G sent photos of the printer supplies, reading games, and early literacy books we provided to her Los Angeles pre-kindergarten class via her DonorsChoose grant request, adding, “There are no words to describe the impact this has had on my life. My students and I feel so blessed for your kind donations.” Ms. G from Oklahoma sent photos of her students using the earbuds we provided to her elementary school class for online math intervention work.
I thought sure Facebook would collapse this weekend under the weight of every single parent in America posting pictures of their costumed children. Speaking of which, I was also thinking that people seem to like spending Halloween prowling around old buildings where people have died, making any former hospital an ideal choice since the number of deaths inside any of them must be huge.
Last Week’s Most Interesting News
A diverse group of lawmakers slams the VA and Department of Defense for their expensive and stubborn failure to integrate their electronic medical records systems.
Theranos restructures its board and takes another hit when the FDA labels its proprietary Nanotainer blood draw system as an uncleared medical device.
CMS reports a quiet, non-eventful October following the ICD-10 switchover.
The AMA and MedStar Health rank EHRs on user-centered design without actually doing any research or measuring usability.
Xerox and Lexmark announce poor quarterly results and announce plans to review and possibly restructure their operations.
Athenahealth shares jump sharply after beating quarterly expectations, while those of Huron Consulting tank on lowered guidance due to delays in two academic medical center projects.
Webinars
November 11 (Wednesday) 2:00 ET. “Trouble Upstream: The Underinsured and Cash Flow Challenges.” Sponsored by TransUnion. Presenter: Jonathan Wiik, principal consultant, TransUnion Healthcare. The average person spends nearly $15,000 per year on healthcare as deductibles keep rising. Providers must educate their patients on plan costs and benefits while controlling their own collection costs by using estimation tools, propensity-to-pay analytics, and point-of-sale collections. This webinar will highlight industry trends in managing underinsured patients and will describe ways to match patients to appropriate funding.
November 12 (Thursday) 1 :00 ET. “Top Predictions for Population Health Management in 2016 and Beyond.” Sponsored by Medecision. Presenters: Tobias C. Samo, MD, FACP, FHIMSS, CMIO, Medecision; Laura Kanov, BS, RRT, MBA, SVP of care delivery organization solutions, Medecision. With all the noise and hype around population health management, the presenters will share their predictions for 2016 and their insight into meeting the mounting pressures of value-based reimbursement and the tools and technology needed to manage care delivery.
Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.
Acquisitions, Funding, Business, and Stock
Quality Systems Inc. will acquire cloud EHR vendor HealthFusion for up to $190 million. QSI announced just over a week ago that it sold its NextGen hospital business to QuadraMed.
CPSI announces Q3 results: revenue down 16 percent, EPS $0.31 vs. $0.83. Shares took a 15 percent dive Friday on the news. The company seems to be struggling now that HITECH-fueled hospital EHR sales are drying up, leaving it to hope that a replacement market emerges. Above is the one-year share price chart of CPSI (blue, down 39 percent) vs. the Nasdaq (up 9 percent).
People
Sarika Aggarwal, MD, MHCM (Fallon Health) joins XG Health Solutions as SVP of population health and chief medical officer.
LifeImage names Matthew Michela (Healthways) as president and CEO. He replaces co-founder Hamid Tabatabaie, who will move to EVP and remain on the board.
Former Siemens Healthcare North America President and CEO Gregory Sorenson, MD takes a minority interest in Deerfield Imaging, which offers image guiding technology, and will become its executive chairman.
Jim Macaleer, co-founder, chairman, and CEO of Shared Medical Systems until he sold the company to Siemens in 2000, died last Thursday.
Announcements and Implementations
Fitch Ratings holds its rating of MetroHealth’s bonds as stable, concluding that the Ohio health system “has demonstrated the ability to be profitable with its challenging payor mix due to its longstanding electronic medical record (Epic), closed medical staff, and care management processes.”
Other
Peer60 publishes “Healthcare IT Trends in England.” NHS hospital executives say their top challenges are physician and nurse shortages, care coordination, and managing and analyzing data. Allscripts, Cerner, and Epic hold high mind share in both EPR (above) and PAS, suggesting they are well positioned to gain business in both clinical and administrative areas.
Greencastle Associates Consulting is named as one of three finalists for the US Chamber of Commerce Foundation’s “Hiring Our Heroes” award for hiring veterans and military spouses. Malvern, PA-based Greencastle was founded by Army Rangers and its three primary executives are all veterans.
Struggling Kinston Hospital (NC) ends its shared services agreement with Novant Health — which included IT improvements — after less than a year,
In Northern Island, Belfast NHS Trust underpays 1,500 employees due to a software error. The union declares the situation to be “totally unacceptable,” apparently finding it even worse than just “unacceptable.”
A healthcare IT entrepreneur says entrenched software vendors are stifling innovation by refusing to open up their systems to startups, causing new companies to burn through their seed rounds without sales to sustain them. He concludes that patients are harmed because “interoperability into the legacy systems of their customers still remains a primary roadblock.” To which I would offer a counterpoint: rightly or wrongly, we’ve defined healthcare (and therefore healthcare IT) as a business. As with any business, it’s irrational to expect competitors to behave in any way that isn’t self-serving, as much as we like to pretend that everybody’s primary motivation is altruistic patient care. Provider or vendor, you are naive and likely to be insolvent if your business plan assumes that your computers will voluntarily lower your barrier to entry.
I asked Vince Ciotti if he would write something about Jim Macaleer in way of tribute for the folks who knew him and who may not have heard that he passed away.
Sponsor Updates
DataMotion publishes an infographic titled “A Brief History of Data Breaches and Security Regulations in Healthcare.”
Ear, Nose and Throat Associates of Texas describes its easy implementation of Talksoft’s RemindMe application.
Vital Images will exhibit at HIMSS Latin America November 4-5 in São Paolo, Brazil.
VitalWare SVP of Operations Doug Picatti is featured in a CNBC report on key issues in the presidential debate.
Huron Consulting Group releases the latest edition of its clinical research management briefing.
ZeOmega will exhibit at the TAHP Managed Care Conference & Trade Show November 2-3 in San Antonio, TX.
Zynx Health will exhibit at the Meditech Physician and CIO Forum November 5-6 in Foxborough, MA.
Rep. Tammy Duckworth (D-IL), a former Army helicopter pilot who lost her legs when her Black Hawk took rocket-propelled grenade fire in Iraq, joins several other members of Congress who are fed up that the VA and Department of Defense still haven’t integrated their systems. Lawmakers are reviewing VA-DoD progress in a joint hearing of two House committees this week. Duckworth says that as a former VA employee, she regularly saw the DoD stonewall the VA’s projects in defending its turf. She’s also still mad about her first VA visit where she was asked to take her clothes off to prove that she was still an amputee since the VA wasn’t allowed to accept her DoD medical records, to which she replied to the physician assistant, “I’m not a gecko. They don’t grow back.” Chris Miller, who runs the DoD’s DHMSM project, testified that connecting the VA with DoD is harder than it seems, while the GAO’s IT director observed that her watchdog agency still doesn’t understand why the DoD and VA decided not to build a single system together in the first place. The GAO still wants that answer, but says that neither the VA nor DoD are responding to its inquiries. The GAO suspects that the VA and DoD have spent more than billion dollars in trying and failing to share information, which doesn’t even include the countless mega-billions of taxpayer money that was spent building and supporting their systems.
Speaking of the VA-DoD imbroglio, some members of Congress are convinced that the only way to get the VA and DoD play nicely together is to have the President personally make them. Rep. Dan Benishek (R-MI) says of his peers, “We can’t stand the fact that we’re spending a billion dollars on integrating healthcare and you tell us it can’t be done. We get sick of this.” DHMSM’s Chris Miller says the organizations weren’t ready in 2011 because while the IT part is easy, nobody wanted to address the people and process issues. He opined that interoperability is worse in civilian healthcare, raising the ire of Rep. Gerry Connolly (D-VA), who scolded him by saying that both agencies deal with a specific population but “can’t get their acts together on behalf of the men and women we’re serving.”
Reader Comments
From Don’t Mess with Texas: “Re: vendors pressuring clients. I heard that the day Texas Health Resources issued its press release blaming Epic for its improper treatment of its Ebola patient, Judy and Carl flew to THR that night to pressure the CEO into putting out a retraction, which they did. Epic plays hardball – they’ve done it at our site, too. I don’t blame Epic for being unhappy with the press release, and while veteran CIOs like me knew to take the release with skepticism, flying down in person to get a retraction is pretty heavy handed. I’m sure Epic’s spin is that they care so much for their clients that they wanted to show up in person and offer their help.” That entire process was bungled, although nothing in the THR recap describes a visit by anyone from Epic. THR leadership appears to have thrown Epic under the bus as a knee-jerk reaction without even talking to their own IT folks, who would have been involved with the configuration of the system that was blamed incorrectly (given their quick retraction) for missing their patient’s travel history. Any EHR vendor would have protested and asked for proof of their customer’s claim, although I agree that Epic is among the most vigorous enforcers of its own interests and I’m sure calls were made. THR wasn’t great at managing the Ebola virus, but it was much more aggressive in trying to manage the viral spread of unfavorable publicity.
From Uneasy Detente: “Re: vendor gag clauses. I’ve never seen them pre-loaded into one of my contracts, but I’ve signed a few with a major health IT software vendor as condition of contract settlement, where software doesn’t work and we refuse to go live, for example. The vendor may offer concessions or a refund conditional on signing a number of terms, which generally includes not going out and talking about the problem we’ve discovered. Here’s an example for your eyes only.” I can see why both parties would approve that condition given that they are reaching agreement on either a parting of ways or deciding not to implement a specific application. I’m on the fence about whether that’s a gag clause, but leaning toward no since the customer never actually went live. You would think that customers who did actually implement the application would see and report the same issue, but that’s wishful thinking. That leads us back to the same challenges we have with interoperability – as much as we as patients would like providers to publish and share information that might benefit us, there’s no incentive for those providers to do so and therefore they don’t bother. In fact, going public with software problems introduces the near-certain risk of creating an adversarial relationship with the vendor to which they’ve expensively hitched their wagon. I don’t know of any solution except maybe FDA-type oversight that requires companies to report the patient-endangering defects they discover. Just about any solution that requires providers – competing or otherwise – to voluntarily share information is not likely to succeed. Replace “providers” with “attorneys” or “car dealers” in the previous sentence to put it into a less emotional perspective.
From QM Employee: “Re: NextGen Hospital Solutions. Can anyone explain why QuadraMed acquired it? QuadraMed has not sold their current solution for three years and their product has so many holes (surgery, emergency, scheduling, etc.). There are constant layoffs and some really great employees have left. NextGen customers are in the under-100-bed hospital range and their product is unstable.” The Canada-based parent of QuadraMed (Constellation Software) seems to have broken its own acquisition rules in buying both QuadraMed and NextGen Hospital Solutions since it claims to be interested only in companies that are #1 or #2 in their market, have at least “hundreds” of customers, and face “unimposing” competitors. I can see why QSI wanted rid of its failed hospital business, but agree that it’s puzzling why someone else would want it, although that brings up the strong possibility that it was basically given away just to eliminate distraction and appease torch-wielding QSI shareholders.
From Erstwhile ICD-9er: “Re: Georgia Medicaid’s stance on ICD-10 coding specificity. The CMS leniency was limited to Medicare. Medicaid was given the authority to make the decision for themselves. Georgia is the first to come out with aggressive messaging around their acceptance of ICD-10 specificity. An important distinction is that they related all of their ICD-10 edits for UB claims, but are holding firm on CMS 1500 claims. They have posted notice of this to providers along with a list of codes that will likely be denied. They are accepting feedback from providers about which codes should be accepted.” Thanks for that clarification.
From Kilt Lifter: “Re: ICD-10. Select Health Medicaid in SC refused to do any user testing prior to implementation. They are now telling practices they will not pay any claims until the end of November at the earliest.” The company’s ICD-10 FAQ page brags confidently about their testing, remediation efforts, and overall readiness for October 1.
From Public Health Helpful: “Re: public health. I’m a long-time HIStalk fanboy, but you hit it out of the park with your comment that we ‘irrationally celebrate advancements that are very narrow in scope.’ We should be doing what will benefit the most people in the most significant way – immunizations, blood pressure control, weight loss, cancer screening, following preventive guidelines, and using proven treatments.” The only way to fix “healthcare” is to embrace public health as other countries have done rather than tinkering with how we deliver reactive health-related interventions. We don’t like thinking about that because it requires uncomfortable discussions about social services and the role of government that quickly degrade into political divisiveness. It’s easier and much more profitable to focus on expensive interventions that benefit a small percentage of the population while the far larger population suffers (and drags down economic growth) with chronic conditions whose management standards are well known, just not well practiced by either providers or the patients themselves. We have all the knowledge we need to make the country healthier and therefore more economically competitive, just not the will to use it.
HIStalk Announcements and Requests
I put the $750 raised by Dana Moore’s Epic vs. Centura basketball game to immediate use, applying matching money from my anonymous vendor executive as well as from other charitable organizations to fund these DonorsChoose projects:
A document camera for Mrs. Marler’s third-grade class in Phenix City, AL.
A video camera and accessories for recording advanced placement calculus and physics lessons so that absent students can review them later for Mr. Blachly’s high school class in Indianapolis, IN.
A STEM bundle for Ms. W’s elementary school class in Englewood, NJ.
An iPad Mini to support STEM studies in Mrs. K’s middle school class in Brooklyn, NY.
Four science activity tubs for Mrs. N’s elementary school class in Dothan, AL.
Two tablets for Ms. S’s first grade class in East Haven, CT.
A laptop and accessories for Ms. M’s class of eight emotionally disturbed first grade boys in South Bronx, NY.
Hands-on materials for Ms. M’s advanced placement statistics seniors in Denver, CO.
This week on HIStalk Practice: The wave of physician "Just Say No to Meaningful Use" movements rolls on. American Well digs further into the employer market. AdvantageCare Physicians achieves Stage 6 EHR adoption. ZocDoc and Kareo top the list of US-based deals with Q3 VC funding. A GAO "sting" results in further Healthcare.gov scrutiny. The Interstate Medical Licensure Compact Commission meets for the first time. Maine ups its healthcare price transparency efforts.
This week on HIStalk Connect: the FDA releases its inspection findings from an unannounced visit to Theranos, concluding that their nanotainer technology is an uncleared medical device. IBM Watson will debut on the Apple Watch in 2016 within a patient engagement app being developed by Welltok. Carnegie Mellon University researchers create an app that uses iBeacon technology to provide navigational support for blind users. The team behind the app hopes to add facial recognition features in the coming years. HealthTap launches a suite of new patient engagement apps in a bid to move into the enterprise healthcare space.
Webinars
November 11 (Wednesday) 2:00 ET. “Trouble Upstream: The Underinsured and Cash Flow Challenges.” Sponsored by TransUnion. Presenter: Jonathan Wiik, principal consultant, TransUnion Healthcare. The average person spends nearly $15,000 per year on healthcare as deductibles keep rising. Providers must educate their patients on plan costs and benefits while controlling their own collection costs by using estimation tools, propensity-to-pay analytics, and point-of-sale collections. This webinar will highlight industry trends in managing underinsured patients and will describe ways to match patients to appropriate funding.
November 12 (Thursday) 1 :00 ET. “Top Predictions for Population Health Management in 2016 and Beyond.” Sponsored by Medecision. Presenters: Tobias C. Samo, MD, FACP, FHIMSS, CMIO, Medecision; Laura Kanov, BS, RRT, MBA, SVP of care delivery organization solutions, Medecision. With all the noise and hype around population health management, the presenters will share their predictions for 2016 and their insight into meeting the mounting pressures of value-based reimbursement and the tools and technology needed to manage care delivery.
Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.
Acquisitions, Funding, Business, and Stock
McKesson announces Q2 earnings: revenue up 10 percent, adjusted EPS $3.31 vs. $2.79, beating Wall Street expectations for both. The company raised guidance and announced an additional $2 billion in share repurchases. Technology Solutions revenue dropped 6 percent, much of that due to “our decision to exit the Horizon hospital software business,” with good performance from payer solutions and RelayHealth.
Theranos continues its fascinating, overly defensive implosion by eliminating seven of its 12 board member positions – including those held by Henry Kissinger and George Shultz – but creating a new board of counselors (which includes all of the old board members) and a medical advisory board. CEO Elizabeth Holmes claims the changes were made in July, although as in the case of the company’s proprietary lab methods, she provides no data to back up that assertion. The company’s new board includes Holmes, her COO, a billionaire who inherited his grandfather’s construction business, a retired general, and a wealthy lawyer who sues big companies. Some speculate that the departed board members wanted to distance themselves from the company and any potential litigation that may result. Meanwhile, Theranos, which has already raised $752 million, authorizes new shares that will value the company at over $10 billion, although that happened right before the critical Wall Street Journal came out.
Leidos reports Q3 results: revenue up 2 percent, adjusted EPS $0.71 vs. $0.65, beating expectations for both.
Sales
Carilion Clinic (VA) chooses Sagacious Consultants, now owned by Accenture, for revenue cycle improvement.
People
Timothy Johnson, DO, MMM (Children’s Mercy Integrated Care Solutions) joins Valence Health as SVP of pediatrics.
Ingenious Med names Scott McClintock (Have Marketing, Will Travel) as chief marketing officer.
Corepoint Health names Dan Simenc (3M HIS) as sales VP.
Announcements and Implementations
Analysis by The Advisory Board Company finds that hospitals are increasingly implementing CDC-recommended antibiotic stewardship programs to reduce inappropriate use, but many of them are too short on staffing and data to be effective. Most organizations have pharmacists rather than the prescriber review orders, most don’t record monitoring overall antibiotic use by prescriber, and few have adequate data to determine whether their programs are improving patient outcomes.
UV Angel announces an ultraviolet-powered patient room IT device disinfection system that automatically runs a cleaning cycle up to 40 times per day when it detects that a targeted device has been used.
Atlantic Medical Imaging (NJ) goes live on patient self-scheduling from OpenDr.
Hackensack University Medical Center (NJ), which self-styles itself with the annoying one-word nonsense of “HackensackUMC,” will integrate Gauss Surgical’s iPad-powered Triton blood loss estimation system with Epic.
Government and Politics
A study finds that the FDA is approving cancer drugs based on short-term patient response rather than their effect on overall survival, with the agency often neglecting to require manufacturers to perform the post-marketing studies that FDA required as a condition of approval. That means many of the most expensive and most important drugs on the market haven’t proven that they actually work, which has been a problem with oncology drugs for decades – drug companies, oncologists, and hospitals make tons of money pumping them into patients with soothing optimism but no guarantee that the patient will live longer or better.
While deaths from overdoses of heroin and prescription narcotics are skyrocketing – the former because addicts are switching from expensive and heavily marketed prescription drugs to cheaper heroin – 80 percent of addicts couldn’t get treatment even if they wanted it because capacity is lacking. I was talking to a first responder the other day who said exactly the same thing – in his tiny, rural town, heroin deaths are common since addicts can buy it on the street for a few dollars per dose vs. the high cost (no pun intended) of oxycodone and other prescription narcotics. The so-called war on drugs has been lost as prisons and morgues fill up and suppliers get even richer as reduced availability drives up prices (a lesson possibly learned from their legal but equally morally challenged pharma counterparts). As usual, these studies are coming from public health experts (Johns Hopkins Bloomberg School of Public Health in this case) since it’s not considered a healthcare or medical issue that provides a business opportunity.
The Department of Justice arrests the former president of drug maker Warner Chilcott, owned by Allergan, for conspiring to pay kickbacks to doctors who prescribed its drugs. The company will also pay $125 million in fines and plead guilty to criminal charges. Meanwhile, Ireland-based Allergan and competitor Pfizer begin merger talks in what would create the world’s biggest drug company with a combined market value of $340 billion, making that $125 million fine look like a valet tip. It would also provide a way for US-based Pfizer to dodge US taxes in declaring the headquarters of the newly created company to be Ireland.
CMS announces that it’s been a quiet October for ICD-10, with the number of claims submitted due to incomplete or invalid information remaining unchanged at 2 percent. The denial rate and percentage of claims rejected due to invalid ICD codes also hasn’t changed much. It a bit early to declare ICD-10 victory, but CMS seems to have defied the naysayers who didn’t believe its optimistic testing status reports.
Other
The AMA and MedStar Health publish their review of EHRs for user-centered design, which instead of looking at actual user usability or testing anything against standards, simply reviewed ONC’s certification test results for use of best practices. The top-scoring products were Allscripts Enterprise, Allscripts Sunrise, McKesson Paragon, McKesson IKnowMed, and Athena Clinicals. Bottom-scoring products are EClinicalWorks Version 1.0, Dr Systems, Greenway PrimeSuite, Epic EpicCare Ambulatory, and NextGen Ambulatory. The analysis used factors such as the vendor’s self-reported UCD process, the involvement of clinicians in testing, and the design of rigorous use cases for testing. It’s a puzzling list when the ancient Meditech Magic finishes one spot behind Cerner in the top 10. I also wonder how meaningful it is to critique user-centered design process by repurposing certification submissions for individual products – you would think a given vendor would use the same design and testing methods for all of their products. The end result will be what it always is in healthcare IT: the top-ranked vendors will brag loudly about the results while glossing over the methodology and applicability, while the low-ranked ones will criticize the methodology and applicability while glossing over the results.
Santosh Mohan, a management fellow at Stanford Health Care and long-time HIStalk reader, sent over this photo if the IT department’s Halloween celebration, in which the three folks above are dressed up as the (a) electronic (b) medical (c) record. I like subtle humor like this because once you get it, you can feel superior in imagining folks who didn’t get the joke.
Meanwhile, PatientSafe Solutions tweeted out this photo of its team. It brings back not-so-fond memories of my hospital’s IT department Halloween celebration, which despite featuring nothing more interesting than pumpkin bowling and orange-iced cupcakes, had to be renamed to the politically correct “fall festival” when a couple of employees complained that it celebrated devil worship.
Weird News Andy cries, “Bring out your dead” as he reads how New York’s health insurance exchange enrolled 354 dead people for health insurance, paying out $325,000 in claims to 230 of them. Design flaws, including people having multiple identification numbers, caused another $3.4 million in overpayments in the program’s first year.
Sponsor Updates
Healthcare Data Solutions publishes a white paper titled “Understanding the Opportunities & Challenges of Telehealth 2015.”
Impact Advisors sponsors an article titled “A Unique Approach to Business Analytics: The Scottsdale Institute Health IT Benchmarking Program.”
Stella Technology and DataMotion will participate in the interoperability showcase at the New Jersey and Delaware Valley HIMSS chapters conference in Atlantic City October 29-30.
InterSystems CEO Terry Ragon is featured in MIT’s Spectrum Magazine.
PDR and Leidos Health will exhibit at the NextGen User Conference November 1-4 in Las Vegas.
LiveProcess will exhibit at the New England Rural Health Round Table November 5-6 in South Bridge, MA.
Wellcentive CEO Tom Zajac will present at the inaugural meeting of The Leader’s Board for Population Health Management November 5 in Dallas.
MedCPU is recognized as one of Entrepreneur’s “Best Entrepreneurial Companies in America.”
Navicure will exhibit at Michigan MGMA October 30 in Mount Pleasant.
Recondo Technology and Sutherland Healthcare Solutions will sell each other’s solutions.
Over 1,000 health and human services leaders attended Netsmart’s Connections 2015 client conference, which featured mental health advocate and former Congressman Patrick J. Kennedy.
NTT Data will exhibit at the 2015 LeadingAge Annual Meeting and Exposition November 1-4 in Boston.
Obix will exhibit at the 14th annual Perinatal Conference November 5 in Dublin, OH.
Epworth Eastern Hospital (Australia) realizes improved outcomes with Oneview interactive patient care technology solutions.
PerfectServe will exhibit at ASN Kidney Week November 3-8 in San Diego.
The SSI Group will exhibit at the Georgia HFMA Fall Institute November 4-6 in Savannah.
Streamline Health will exhibit at the Health IT Leadership Summit November 3 in Atlanta.
Surgical Information Systems will exhibit at HealthAchieve 2015 November 2 in Toronto.
Surescripts will exhibit at the NextGen 2015 user group meeting November 1-4 in Las Vegas.
FDA declares the proprietary nanotainer blood draw containers used by Theranos to be an “uncleared medical device” following a Wall Street Journal report that the company had voluntarily already stopped using the finger-stick containers for all but one test. A September FDA inspection of the company’s Alameda, CA facility noted a number of deficiencies, including shipping its nanotainer collection tubes across state lines without having them approved by the FDA; not performing quality audits; and documenting required software validation on a shared Excel worksheet. Meanwhile, Theranos says it will now publish data proving the effectiveness and accuracy of its methods.
Reader Comments
From Prostetnic Vogon Jeltz: “Re: ICD-10. Georgia Medicaid is denying claims that use unspecified ICD-10 codes even though CMS said that wouldn’t happen. When I first see a patient with atrial fibrillation, I might not know whether it is paroxysmal, persistent, or chronic – that’s what the unspecified codes are for. I think this is important for HIStalk readers to know about.” The agency didn’t say it wouldn’t be ready for ICD-10, so it appears to have simply made the decision that it will not conform to CMS’s policies.
From Unbridled: “Re: PatientSafe Solutions. They have parted ways with CEO Joe Condurso.” Joe is still listed as president and CEO on the company’s web page, but an internal email sent my way says he resigned last Friday in a mutual decision and that Chief of Staff Si Luo will take over as president. The company announced last Wednesday that it has acquired readmission technology vendor Vree Health.
From Publius: “Re: VA. I predict the VA will go full Epic, forcing Epic and Cerner to get serious about developing interoperability with each other since DoD will be on Cerner. This will benefit all customers. A Cerner-Epic ROI exchange will be as seamless as Care Everywhere (Epic to Epic ROI module).” Politicians seem to be fretting that since VistA uses old technology (just like Epic), it therefore should be replaced with a commercial product despite the VA’s decades-long satisfaction with its internally developed system. The VA and DoD always seem to find reasons to not work together, so perhaps choosing Epic would prolong the hostilities.
From All-Around Good Guy: “Re: Lee Marley, SVP/CIO, Presbyterian Healthcare Services in Albuquerque. She has left and will be missed. The data center was built and Epic was installed during her tenure.” Unverified.
HIStalk Announcements and Requests
A reader who wishes to remain anonymous donated $250 to my DonorsChoose project, to which I applied double matching (from my anonymous vendor executive and from charitable foundations) to purchase materials for Mrs. Sandler’s elementary school class in Aurora, CO (math games), Mrs. Jones’s K-2 class of intellectually and emotionally disabled students in Galivants Fry, SC (math manipulatives), Ms. Sobczak’s Grade 1-3 class of students with communication disorders in South Holland, IL (math games), and the elementary school class of Mrs. Bowers of Oklahoma City, OK (headphones for online math intervention programs).
I’m regularly puzzled when people email me story links that I covered days before, apparently thinking that because other sites ran the news days later that I missed it. I don’t think I’ve ever missed a significant story, so I can only implore you to read all of HIStalk each time I post news on Tuesday and Thursday nights and over the weekend. Reason: other sites keep repeating the same news over and over trying to get more clicks, while I assume readers are smart enough to only need to see it once and therefore I don’t run repeats. Obviously my logic is incorrect if folks are either skimming or skipping certain posts. My other suggestion is to avoid assuming that just because I can summarize a big story in a few sentences doesn’t mean it’s not important – I don’t pad out the content with a lot of filler.
Who should I interview? Tell me someone who: (a) doesn’t work for a for-profit organization; (b) is smarter than most people; (c) is interesting and opinionated; and (d) I haven’t already interviewed recently. I like to expose fresh viewpoints, but those who possess them don’t always volunteer to be interviewed.
I was thinking that what we need to learn in this country that advancing health for a tiny percentage of the population (via precision medicine, expensive celebrity surgeons and surgical gadgets, and dramatic and expensive interventions) is the wrong goal. Our overall health (and health expense) isn’t driven by new developments for the wealthiest and best informed, but rather how well we can move the public health needle for the most people who are involved alongside the medical experts. Research and new medical technology aren’t needed when we can’t even broadly roll out basic services such as prenatal care, end-of-life counseling, mental health treatment, and addressing the social determinants of health. I worry that we irrationally celebrate advancements that are very narrow in scope and outcomes.
Gag Clauses: I Find No Evidence They Exist
Some of the worst and most sensationalistic healthcare IT reporting I’ve seen (and I’ve seen a ton) involves so-called gag clauses, where IT vendors supposedly insert standard contractual terms that prohibit users from openly discussing patient-endangering software errors. That inflammatory topic, like the Loch Ness monster, has generated a lot of rhetoric (some of it political) despite the lack of proof that gag clauses actually exist.
Take the above hype-filled story, in which the reporter not only provides no examples of the gag clauses he claims to have seen, he completely confuses standard intellectual property (IP) terms — like not being allowed to post source code or product documentation on the Internet — with prohibiting EHR-using providers from speaking publicly about product problems via a non-disparagement clause.
The folks at HIMSS Analytics gave me access to its CapSite Database, which contains actual vendor contracts they obtained using Freedom of Information Act requests. I reviewed dozens of contracts from Epic, Cerner, Meditech, Allscripts, EClinicalWorks, Athenahealth, and several other vendors.
I didn’t see a single clause that prohibits customers from speaking out about software problems. I had previously challenged readers to give me a real-life example of a gag clause and I didn’t receive any there, either.
My experience working for providers is that any pressure to keep quiet about software problems is self-imposed. Health system executives don’t want to jeopardize an expensive implementation or annoy their vendor “partner,” so internal policies require that employees obtain approval before making any public comments or publishing articles. The CIO of one of the health systems I’ve worked for said outright that nobody in the IT department (including clinicians) was allowed to publicly comment on anything without his explicit review and approval (“I’ve been burned by that before”) or they would be subject to termination, which may give you insight as to why I remain anonymous.
Epic has raised the most ire by enforcing the intellectual property provision to include screen shots. Customers can’t publish or share Epic screen images – even those involving customizations of Epic they perform themselves – without approval from Epic. The company’s rationale is that screen design exposes IP, where just seeing what fields are captured provides a lot of insight as to what’s happening under the covers such that a competitor could steal the logic. They give permission to publish the screenshots when that isn’t the case.
That doesn’t prevent users from talking about or describing Epic software problems. It just means they can’t publish screen shots, documentation excerpts, or source code (yes, Epic customers receive source code) to make their point without the company’s permission. I saw nothing to prohibit or even discourage that kind of discussion in any of the contracts I reviewed. Perhaps it is included elsewhere, such as in the particulars of Epic’s support fee rebate program where customers get money back for voluntarily following Epic’s suggestions, but I haven’t seen it or heard of a real-life example. I’ve also not heard of a vendor taking formal action against a provider for making unflattering software comments.
I’ll throw out one more challenge and them I’m calling gag clauses a Snopes-like false rumor spread by misinformed people. If you’ve seen an example of a vendor software contract that includes anything resembling a gag clause that prohibits customers and their users from talking about product or company problems, send it my way anonymously and confidentially. I would also like to hear of examples where a provider has spoken unfavorably about a company or product and was pressured to stop, either from the vendor or from their employer, since I suspect that information pressure is far more common.
Webinars
November 12 (Thursday) 1 :00 ET. “Top Predictions for Population Health Management in 2016 and Beyond.” Sponsored by Medecision. Presenters: Tobias C. Samo, MD, FACP, FHIMSS, CMIO, Medecision; Laura Kanov, BS, RRT, MBA, SVP of care delivery organization solutions, Medecision. With all the noise and hype around population health management, the presenters will share their predictions for 2016 and their insight into meeting the mounting pressures of value-based reimbursement and the tools and technology needed to manage care delivery.
Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.
Acquisitions, Funding, Business, and Stock
Sunquest owner Roper Technologies acquires CliniSys Group and Atlas Medical, which offer laboratory information systems to 2,000 labs in Europe and lab-customer connectivity in the US, respectively.
Walgreens is rumored to be preparing for a Wednesday announcement that it will buy competitor drugstore chain Rite Aid for up to $10 billion and will take on its $7.4 billion debt load. The deal would give Walgreens 17,800 stores worldwide vs. the 7,800 owned by CVS. Walgreens would also gain Rite Aid’s walk-in clinics, wellness stores, and EnvisionRX pharmacy benefits business. Italian-born businessman Stefano Pessina became the CEO and majority shareholder of Walgreens when it acquired his British pharmacy chain Alliance boots Group in 2012, giving the 74-year-old net worth of $14 billion.
Xerox reports Q3 results: revenue down 10 percent, EPS –$0.04 vs. $0.22 following a $385 million write-down after pulling out of two state Medicaid system contracts. The company says it won’t sell itself, but “a comprehensive review of structural options for the company’s portfolio is the right decision at this time.” Above is the one-year share price chart of XRX (blue, down 28 percent) vs. the Dow (red, up 4 percent). Shares dropped 8.3 percent Tuesday to a 52-week low on 13 times average volume.
Lexmark announces Q3 results: revenue down 7 percent, adjusted EPS $0.57 vs. $0.96. The company’s board has authorized “the exploration of strategic alternatives to enhance shareholder value and unlock the intrinsic value created by the company.” Shares dropped 13 percent following Tuesday’s announcement before the market’s open. Above is the one-year share price chart of LXK (blue, down 25 percent) vs. the Dow (red, up 4 percent).
San Francisco-based, 15-employee medical image analysis vendor Enlitic raises $10 million from an Australian diagnostic imaging company.
HCA announces Q3 results: revenue up 6.9 percent, adjusted EPS $1.17 vs. $1.18. The company blames lower profit on patients who were previously insured but stopped paying their Affordable Care Act premiums. The board authorized the repurchase of up to $3 billion of the company’s shares.
Dialysis Clinic (TN) chooses the EClinicalWorks EHR.
UNC Health Care (NC) and UF Health Shands Hospital (FL) choose Lexmark’s vendor-neutral archive.
Catholic Health Initiatives will expand its agreement with Allscripts to include managed services and its FollowMyHealth patient engagement platform. Mineopie reported as a rumor on October 21 that CHI had signed managed service agreements with both Allscripts (outpatient) and Cerner (inpatient). CHI signed a three-year, $200 million infrastructure outsourcing deal with India-based Wipro in March 2013 with little fanfare since except for IT employees complaining on Glassdoor that outsourcing, layoffs, and marginal management has put IT in shambles. The CEO said in 2010 that the organization would spend $1.5 billion on EHRs and other IT systems.
People
Jyotishman Pathak, PhD (Mayo Clinic) is named chief of health informatics at Weill Cornell Medicine.
Announcements and Implementations
IBM releases Datacap Insight Edition, which can classify and route scanned documents using advanced imaging, natural language processing, and machine learning. It provides an unconvincing healthcare example: “Where doctors and hospitals are transferring hand written notes and images into electronic health records for analysis or filing.”
Truman Medical Centers (MO) and Cerner will work together in piloting healthcare IT and giving Cerner employees on-site experience.
Peer60 publishes “Into the Minds of the C-Suite 2015.”
The American Dental Association’s ADA 2015 conference chooses DataMotion to provide Direct Secure Message and secure e-mail solutions as the technology backbone for secure digital exchange demonstrations.
Privacy and Security
In a remarkable statement, an FBI cyberattack expert says the agency often advises people to just pay cybercriminals the demanded money when a PC is infected with ransomware, which locks their computer information until payment is made to release it. He suggests that the malware is so sophisticated that payment is the best option, with the others being to revert to a backup or pay a security expert to try to remove the malware. Knowing that most people never make backups means they’ll pay either way. It’s a bit surprising that people still store their one single copy of valuable data on their local hard drive, which is a problem we’ve always had in hospitals where employees ignore strong suggestions (or policies) to store everything on the shared drive only. You can easily determine those who didn’t by the volume of their whining when they report a problem that requires immediately replacing or re-imaging their laptop or desktop.
Investigators conclude that China-based hackers breached insurer Anthem because the Chinese government is desperate for ideas on how to care for its aging population. Chinese citizens were promised universal access to healthcare by 2020, but they are not satisfied with the cost, quality, and gaps between the rich and the poor. Somehow the hackers missed the fact that the US has failed equally spectacularly on those same issues despite spending many times more than China and everybody else, so perhaps our cyber-retaliation involves hoping they follow our pitiful example.
Celebrity gossip site TMZ says several employees of Sunrise Hospital (NV) have been fired for trying to take photos and look up the medical records of former NBA star and comatose brothel patron Lamar Odom.
Other
A observational study by Massachusetts General Hospital finds that medication errors were made in half of its surgeries, a third of which caused patient harm. The most common errors involved mislabeled drugs, incorrect doses, failing to treat situations indicated by vital signs, and documentation mistakes.
In Australia, the Queensland government will provide an extra $4.2 million to support the Cerner rollout at the newly opened Lady Cilento Children’s Hospital, which has had many planning-related problems since its opening including an IT budget estimated at $29 million now standing at $67 million.
A state audit finds that South Australia’s Cerner Millennium pathology information system implementation skipped project steps and will fall short of money to complete the project, as additional costs for an unplanned disaster recovery center, legacy system decommissioning, and absence of an electronic ordering module are expected to exceed originally estimated costs of $22 million by several million dollars.
UMass Memorial Health Care (MA) will staff its $700 million Epic implementation by moving its 500-employee IT team to downtown Worcester to create room to house the 250 new hires needed. That’s what the local business paper says, although I would bet a lot of those new IT people are assigned there temporarily for the Epic implementation only. A common Epic implementation model is to choose existing IT team members for the Epic project via interviews and scores on Epic-mandated personality tests, hire new people as needed using the same interviews and tests, bring on temporary resources from clinical and administrative departments to provide subject matter expertise, and move everybody to a sequestered location where they won’t be bothered by unrelated IT work. A lot of those folks are borrowed until after go-live, when they return to their home departments. Hospitals usually hire experienced consultants as well to get them through implementation, after which they go away.
I mentioned previously that I had run into problems using Stride Health to look up available health insurance in various parts of the country to see how many plans involve high deductibles (answer: just about all of them). The company quickly responded with a request for details, then let me know that they had fixed the problems, one of which they hadn’t heard of until my report. It’s working great now.
In bizarre irony, the SXSW festival cancels two panel discussions covering the bullying of females in the online gaming industry after it receives threats of on-site violence. Members of Gamergate, whose members claim a lack of game journalism transparency, have threatened gaming industry women, vowing to publish their personal information or to rape or kill them.
Weird News Andy calls this story “You Don’t Know Squat.” A hospitalized woman in labor passes on the nurse’s recommendation that she perform squats to hasten her delivery, instead choosing to dance down the hall to a rap tune.
Sponsor Updates
Medecision will sponsor the HIMSS Summit of the Southeast 2015 October 29-30 in Nashville and HIMSS Big Data and Analytics Forum November 5-6 in Boston.
AirStrip will exhibit at The Health Management Academy’s CMO and CMIO Forums October 28-30 in Deer Valley, Utah.
Bernoulli becomes a sponsoring partner of the AAMI Foundation’s Coalition for Alarm Management Safety and Coalition to Promote Continuous Monitoring for Patients on Opioids.
Bottomline Technologies sponsors the nonprofit Leadership Seacoast for the fourth consecutive year.
Divurgent wins Business of the Year and Executive of the Year awards from the Business Intelligence Group.
EClinicalWorks will exhibit at the 2015 NJPCA Annual Conference October 28-29 in Las Vegas.
Extension Healthcare receives a 2015 Innovation Award in the Technology category from the Greater Fort Wayne Business Weekly.
FormFast will host a virtual user group meeting November 3 and 4.
HCS will exhibit at the LeadingAge 2015 Annual Meeting November 1-4 in Boston.
HDS will exhibit at Summit of the Southeast 2015 October 28 in Nashville.
Healthcare Growth Partners advises Lavender & Wyatt Systems on its sale to Netsmart.
Zynx Healthcare SVP of Mobile Strategy Siva Subramanian, PhD will participate as a panelist at Partners HealthCare’s Connected Health Symposium October 29-30 in Boston.
Burwood Group becomes one of the first Citrix Solution Advisors to complete three Citrix specializations in virtualization, networking, and mobility.
CitiusTech will exhibit at the NAHC Annual Meeting 2015 October 28-30 in Nashville.
October 25, 2015NewsComments Off on Monday Morning Update 10/26/15
Top News
Athenahealth shares jump 28 percent Friday after the company announces better-than-expected quarterly results. It’s now valued at $6.3 billion, with Jonathan Bush holding $51 million worth.
From the Athenahealth earnings call:
Jonathan Bush says three small hospitals are submitting inpatient claims via AthenaNet using what is basically an interface to the acquired RazorInsights hospital information system.
When asked about the company’s direction as HITECH winds down, Bush said, “The satisfaction and the feeling of being on-mission as opposed to on the tip of an Obama spear is phenomenal for us. No offense, Barack, I know that you’re Mr. President, but that’s just how it feels.”
Bush described telemedicine and the addition of Chiron to its “More Disruption Please” program as, “Imagine a store whose entire inventory rots instantly at the end of each day. That’s a doctor’s office … We’ve tried hammering them too much and that hasn’t been great, e-mailing and texting and auto-calling. We’re working on a partnership with a bunch of different makers of apps. We’ve got a small team that’s toying with a universal Athena app … I imagine someday the store brand of telemedicine for Athena will expand, of course. But right now, I think the right focus is getting those new players with their new energy into the tent.”
When asked to compare the company’s position vs. that of its competitors, Bush said, “We are the only company that’s selling a cloud-based service … No one has even a plan to think about starting to try in the sector that you guys think of as our competitors. I think of them as just a business model from a different era … That you run faster than a three-legged horse is not good enough. We really got to think about what’s emerging in the venture world and what’s possible in our business model and compare ourselves to that. We still feel like we have a long way to go on those results.”
Bush said of the impact of Medicare’s merit-based incentive program, “The thing about the MIPS program is it creeps up on you. This year’s performance is then submitted and the government takes a year to look at the performance. Then in two years, your rates are adjusted according to this year’s performance … It’s trickier to jolt the market with it, but it’s a really big deal. It’s an 11 percent, 12 percent swing in a doctor’s Medicare take-home pay based on how he performs, or she, on this program. So we should be able to sell against it. It’s just harder to explain and to create urgency around.”
Reader Comments
From Dixie Whistlen: “Re: top 25 blogs to read. Why did the magazine list Ed Marx on HIStalk but not the rest of HIStalk? Some of those they mentioned are not even popular.” You would have to ask the magazine. I don’t read those sites or pay attention because, like all such “awards,” it’s just a scheme to get people to click through the endless slide show to fool advertisers with a higher but meaningless metrics. One of the blogs that made the Top 25 hasn’t posted anything new since March 2011 and another winner’s newest post is from December 2013, which suggests a superficial editorial vetting process.
Speaking of junk health IT reporting and meaningless reporting intended to sell ads, I just noticed that US News and World Report is announcing its “Most Connected Hospitals” list, which it has apparently been running for years. That must offer competition to the equally pointless “Most Wired” list from H&HN that achieves little except allow CIOs to pad their resumes and hospital marketing people to place yet another logo on their ads that attempt to convince the locals of their organizational competence.
From Bob Wyer: “Re: cancelled sponsors. You said you would list them each month with the new and renewing ones, but I haven’t seen any.” I did promise to do that but I promptly forgot. Companies decide to stop sponsoring for a variety of reasons: they decide to spend their marketing money elsewhere, they are unreasonably obsessed with ad clicks, I wrote something unflattering but true that made them mad, they don’t have money in the budget, or the decision was made by a marketing person who knows nothing about HIStalk or the industry in general. Anyway, here’s the list of dearly departed sponsors going back several months. I appreciate their previous support, especially those that had sponsored for several years.
From Exotic Delicacy: “Re: Caremark. They won’t allow my prescription to be filled locally, so they ship by next-day air a 12×10 inch carton containing a 9×11 inch Styrofoam cooler packed with five ice packs. The actual meds are about 1×3 inches. Besides the cost, all of that (including the chemicals) goes into the landfill.” I was musing this week of what I call the Amazon Prime effect, where my near-daily Amazon orders create a never-ending mountain of boxes and packing material that I have to scrunch and tear to squeeze them into the large recycling bin that goes to the curb weekly. It reminds me of the department store stock boy job I had while working my way through college, in which the fun chore was feeding heaps of big, flattened boxes into the mall’s paper crusher deep in the bowels of the building. I also learned to hate Christmas gift wrap since it was stored in huge quantities in a truck trailer parked out back, causing me to freeze several times a day in November and December in bringing in more big boxes of it. It wasn’t nearly as fun as my summer job working at a public radio and TV station, which didn’t require me to do a whole lot except download satellite programs like “All Things Considered” to tape for later broadcast and to read the news for our infrequent live programming.
HIStalk Announcements and Requests
It’s apparently not just me that doesn’t see Dell as a significant healthcare IT player from my extra poll last week. Machete’s comment is an admirably concise interrogatory: “Dell’s in healthcare?”
The results of my regular poll are sobering, in which 6 percent of males and 52 percent of females say they’ve been sexually harassed at work in mostly unreported incidents. Woodstock Generation hopes a lot of the harassment happened in the 1990s when reporting was uncommon, while It’s Everywhere (Unfortunately) adds, “I was harassed by multiple attending physicians in medical school and witnessed them harassing other students and even patients. It was disgusting. As a practicing physician, I have been harassed by peers. Working with software vendor employees and consultants, I have seen entirely too much harassment, mostly fueled by alcohol and testosterone.”
New poll to your right or here: would you be willing to have your lab tests performed by Theranos?
I was interested after running a TV station’s photo of a hospital documentation sheet for a chemo overdose that a couple of readers complained that I had violated HIPAA, which is surprising since we’re supposed to be the HIPAA experts. First, the family took the photos and sent them to the TV station, presumably to bolster public opinion for their lawsuit against the hospital that was involved. Second, only covered entities (health plans, clearinghouses, and providers) are covered by HIPAA. Any other perceived breach of patient privacy can be addressed only through a lawsuit, which has nothing to do with HIPAA.
Reader Derek sent $50 for DonorsChoose, which thanks to the magic of matching funds from my anonymous vendor executive and The NEA Foundation, will provide four tablets that will be shared by three pre-K classrooms in Buffalo, NY, which they will use for math practice. Meanwhile, the photos above are of Mrs. Cole’s Minnesota first graders using the math games we provided and Mr. Burnitt’s Florida elementary school class working with the model rocketry equipment we bought.
Last Week’s Most Interesting News
Quality Systems sells its NextGen Hospital Solutions division to QuadraMed.
Lab upstart Theranos melts down after reports question the validity and limited use of its proprietary methods.
Vendors and providers agree on objective measures of interoperability, although not stating what those measures are or how they will be used.
IBM turns in another unimpressive quarter despite high-profile investments in Watson.
EClinicalWorks announces a cloud services platform, free client interoperability, and an Internet of Things cloud.
Webinars
None in the next few days. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.
Acquisitions, Funding, Business, and Stock
Lab innovator Theranos continues to unravel as its highest-profile partner, Walgreens, says it won’t open any new Theranos testing centers until the company answers questions about its technology and why nearly all the samples it draws are full-volume ones that are analyzed by traditional lab equipment rather than its proprietary microfluidics machines. In more bad news for CEO Elizabeth Holmes, CMS says its surveyor found nothing innovative in the company’s facilities but did observe quality control problems; some of its claimed partners (Pfizer, GSK, Cleveland Clinic) say they’ve never actually done anything with Theranos; and records show that the company has hired poorly qualified lab directors, including a part-time dermatologist who is not certified by the American Board of Pathology. Questions are also swirling about why the Theranos board is made up of old, politically connected white men without scientific or medical expertise.
Huron Consulting Group shares dropped 24 percent Friday after the company turned in decent Q3 results but also lowered revenue guidance due to expected delays in two big academic medical center projects. The company also says it has “seen a softening in demand for our performance improvement solutions,” which it attributes to stabilized hospital margins due to ACA-insured patients such that “cost reduction work at some hospitals is no longer seen as an urgent concern.”
Fort Lauderdale, FL-based healthcare business services vendor Intermedix will open an operations center, innovation lab, and executive offices in Nashville, TN, creating 116 jobs. The company says the state and city “have welcomed Intermedix with open arms,” not mentioning the open taxpayer wallet that must have influenced its decision.
Announcements and Implementations
Westchester Medical Center Health Network (NY) opens its $7 million, 5,500 square foot eHealth operations center, which contains 20 telehealth monitoring stations that will be staffed around the clock by physicians and nurses.
Government and Politics
CMS goes live with an upgraded Healthcare.gov, saying the site will be 40 percent faster and will include the ability for users to see their estimated yearly costs for each plan. Features not yet ready will eventually allow consumers to filter the list of plans to those that cover a specific doctor, hospital, or drug.
Privacy and Security
A Springfield, MA gynecologist is indicted for accepting drug company bribes for prescribing its drugs and allowing its sales rep to dig through the medical records of her patients. The smoking gun is that as soon as the drug company stopped paying her, she stopped prescribing its products.
Local police in North Carolina speculate that scammers are using data from one of the recent high-profile healthcare data breaches to send unordered diabetic supplies by mail to people who who don’t need them. A recipient whose name, Social Security number, and doctor information was included on the unordered package tried to call the pharmacy number on the invoice, but it was phony.
The Miami-Dade division of Florida’s children’s medical services program mistakenly faxes a clinic roster to four vendors, exposing the information of 150 clients.
Technology
Israel-based MobileODT offers an $1,800 cervical cancer screening tool that connects a mobile colposcope to a cell phone, allowing clinicians to quickly take a cervical image that can also be sent out for a second opinion. The technology, which was trialed at Penn and Scripps, is being used in developing countries that can’t afford a traditional $15,000 colposcope. It will be sold in the US once the company obtains FDA approval.
Other
AMA’s VP of professional satisfaction says EHRs are the biggest driver of physician dissatisfaction. She cites studies that show doctors waste 80 percent of their time performing activities that don’t benefit patients, suggesting that they hire scribes.
A study of nephrology patients finds that patient portals are being used more widely but also more selectively, with less involvement by patients who are poor, black, and elderly.
Like that old Chicago song, nobody really knows what time it is in Turkey, whose government decides to push back the end of daylight saving time until after upcoming elections. The government doesn’t control computers and smartphones, which change time automatically based on rules rather than last-minute political pronouncements, so everybody is confused.
Centura Health SVP/CIO Dana Moore, whose ideas launched my DonorsChoose project during the last HIMSS conference, sent photos of the fundraising basketball game between the tie-dyed Centura team (which eventually won the game) and Epic. He said everybody had a great time and he’s sending me the $620 raised to fund more classroom projects, which will actually fulfill more grants when I apply the matching funds I have available. Good work by Centura, Epic, and Dana.
Weird News Andy deems Sunday’s Dilbert as “HIStalk worthy.” It’s a big panel – click the image to see it full size.
Sponsor Updates
T-System and Wellsoft will exhibit at the ACEP Scientific Assembly October 26-29 in Boston.
TeleTracking will host its client conference October 25-28 in Las Vegas.
Health Catalyst releases a documentary titled “Measured Outcomes: A Future View of Value-Based Healthcare.”
Valence Health will exhibit at the Arkansas HFMA Chapter Fall Conference October 29 in Little Rock.
Versus Technology helps cancer clinics nationwide enhance the patient experience with real-time workflow technology.
Huron Consulting Group will exhibit at the Connected Health Symposium October 29-30 in Boston.
Quality Systems sells its NextGen Healthcare hospital systems business to QuadraMed, which is part of Canada-based Constellation Software’s N. Harris Computer Corporation. QSI formed its hospital business by acquiring Opus Healthcare Solutions in 2010, ViaTrack Systems in 2011, and the Poseidon Group in 2012. It appears that NextGen will keep its Mirth interoperability product (the announcement didn’t say, but while the hospital solutions web pages are gone, the Mirth ones remain).
Meanwhile, Quality Systems reports Q2 results: revenue up 4 percent, adjusted EPS $0.21 vs. $0.13, beating Wall Street estimates for both.
Reader Comments
From The PACS Designer: “Re: HHD vs. SSD. The need for 500GB or 1TB hard drives for computers will start to diminish with the growth of cloud services. One option that could accelerate the replacement of HHDs is solid state drives (SSD). As the price of SSDs declines they become more attractive to manufacturers who will then shun the HHDs in favor of a 256GB SSD-4GB DRAM system. Western Digital’s acquisition of SanDisk seems to validate the SSD concept of lowering the purchasing costs of systems.”
From So Cal Surf Legend: “Re: Antelope Valley Hospital, Lancaster, CA. Has selected Cerner. Official announcement coming soon.” Unverified, but Cerner was their vendor of choice a few months back. It’s a 420-bed hospital.
HIStalk Announcements and Requests
HIStalkapalooza sponsorships are looking good, meaning I probably won’t have to write a personal (and thus NSF) check for many dozens of thousands of dollars to personally cover the cost. The remaining sponsorship slot is the top-level one I call “Rock Star CEO” that includes:
100 invitations.
A private lounge (capacity 100) with its own bar and food plus two VIP boxes for entertaining prospects, partners, and company executives.
The company CEO introduces the band, gets four all-access passes, and enjoys a meet-and-greet with the band back stage after their performance.
An on-stage banner.
Special recognition from the stage.
Contact Lorre if you enjoy the HIStalkapalooza vibe and want to play a key (and visible) role in producing it for the fun and influential attendees. She would be happy to consider any special needs our Rock Star CEO might have, right down to removing the brown M&Ms.
An anonymous reader donated $50 to my DonorsChoose project, to which I added double matching funds from my anonymous vendor executive and The NEA Foundation to fund a grant for Mrs. Smock’s elementary school class in Buena Park, CA that provides an Apple TV and external hard drive so that students can gain confidence and presentation skills by sharing their ideas with their classmates. Meanwhile, Mrs. Rice sent photos of her Washington third and fourth graders doing programming projects on the laptops we provided, noting particularly an increase in programming interest by the female students.
Early bird registration for the HIMSS conference ($765 for members) ends December 14, just in case you (like I) haven’t signed up yet. I was interested to see in the registration policies that attendee emails aren’t shared with exhibitors, so nobody should get promotional emails, instead having their snail mailbox filled with the usual junk that keeps coming weeks after the conference has concluded. The last policy acknowledges agreement of a condition involving photographic images that isn’t actually listed, so apparently you can take all the pictures you want, not that the old policy stopped anyone anyway. The cheapest hotel still available is Linq at $90. I’m pretty much dreading the conference, especially with the screwy Monday through Friday schedule driven by the overriding desire of casinos and hotels to fleece the weekend tourists.
My Twitter feed has been barraged this week with uninteresting cheerleading updates from Dell’s technology conference. I admit that I don’t think of Dell as a significant, committed healthcare player despite its previous acquisition of companies like Perot Systems and InSite One, any more than I think of other big hardware vendors like IBM and HP as anything more than low-margin vendors dabbling in higher-margin services du jour. I’m interested in whether I’m in the minority and thus created this special poll: how much healthcare influence does Dell have? You can explain what I’m missing in the poll’s comments.
This week on HIStalk Connect: KLAS analyzes interoperability across EHR vendors, naming the best technologies and vendors from a provider perspective. Jawbone wins an injunction against several key Fitbit employees in its suit alleging trade secret theft. Rock Health reports on consumer engagement, outlining which digital health categories are attracting the most attention. Theranos closes out its week of public feuding with the Wall Street Journal with a blog post confirming accusations that has stopped using its finger-stick lab test technology for the time being.
This week on HIStalk Practice: Healthcare.gov bashing ramps up. Virtual tools could be the panacea PCPs have been looking for. Hello Health CEO Nat Findlay explains what physicians need to know about getting paid for CPT 99490. Teladoc celebrates 1 millionth visit. American College of Cardiology members take their EHR usability woes to Washington, DC. Kenneth Iwuji, RN explains what med students really think about healthcare IT. Practice managers weigh in on how the rise in high-deductible health plans has fueled their technology spend. Hologram house calls become a reality.
Webinars
None in the next few days. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.
Acquisitions, Funding, Business, and Stock
PatientSafe Solutions acquires Vree Health, which offers patient engagement and care management tools. It was owned by drug company Merck.
Post-acute EHR vendor Netsmart acquires behavioral EHR provider Lavender & Wyatt Systems.
Athenahealth reports Q3 results: revenue up 24 percent, adjusted EPS $0.36 vs. $0.27, beating both revenue and earnings estimates. Share price jumped 8 percent in after-hours trading following the announcement.
Microsoft reports Q1 results: revenue down 12 percent, adjusted EPS $0.67 vs. $0.65, beating earnings estimates and sending shares up sharply after the market’s close Thursday.
The Milwaukee business paper covers the launch of Waukesha-based Intellivisit, which offers virtual diagnosis, triage, and appointment scheduling.
Sales
Behavioral Center of Michigan and Samaritan Behavioral Center (MI) will implement Medsphere’s OpenVista.
Jellico Community Hospital (TN) will implement Medhost’s clinical and financial applications.
People
Micky Tripathi, PhD (Massachusetts eHealth Collaborative) joins the board of The Sequoia Project.
Ed Caldwell (MediTract) joins CarePayment as chief revenue officer.
Announcements and Implementations
DrFirst announces myBenefitCheck, which offers prescribers real-time “what will this prescription cost this patient” advice that uses the patient’s drug benefit insurance coverage to display their out-of-pocket cost. It integrates with 300 EHRs via the company’s e-prescribing system.
TransUnion Healthcare’s eScan solution is named the #1 product in collections outsourcing and AR debt by Black Book.
The Delaware Health Information Network forms a joint program with ISpecimen that will allow researchers to search the de-identified medical information of patients whose lab samples are being stored by DHIN members. The researchers then request the samples that look potentially useful and the hospital ships them to the researcher. It’s an interesting funding source for DHIN, which will then discount its fees for participating members. ISpeciment founder and CEO Christopher Ianelli, MD, PhD was a managing director for investment bank Leerink Swann and co-founded Health Insight Technologies, which was renamed Humedica and then acquired by UnitedHealth group for an undisclosed but assuredly large amount.
Healthgrades research finds that one in six Americans received care in a one-star rated hospital, observing that had they chosen a five-star hospital instead, they would have had a 71 percent less chance of dying and a 65 percent risk reduction for complications. It also observes that hospitals may excel only in specific areas, such as the 14 Chicago hospitals that earned a five-star rating for heart attack treatment but had a one-star rating for total knee replacement, hopefully helping consumers understand the “focused factory” concept similar to the idea that you don’t order the steak at a seafood restaurant just because it’s on the menu.
T-System posts a conceptual video that will be presented to the ACEP Scientific Assembly next week that describes how cars equipped with GM’s OnStar system could send details of an accident to a T-System-equipped ED before the patient arrives. The OnStar system can predict severity of injury using vehicle, crash dynamics, and occupant information.
Imprivata Cortext is named in a KLAS secure messaging report as the most-considered product for physician-to-nurse communications.
Qualcomm’s Capsule subsidiary earns FDA 510(k) clearance of its SmartLinx Vitals Plus patient monitoring system.
Cedars-Sinai becomes the zillionth health system to get involved with a health accelerator, which would seem to be late in the game except for the fact that those that preceded them appear to have accomplished basically nothing anyway. It would be interesting to survey all of those eager startups who are seeing firsthand just how monolithic, indecisive, and change-resistant big health systems accelerator operators are.
A CoverMyMeds study finds that 70 percent of EHR vendors are committed to offering electronic prior authorization, up from 54 percent in March 2015.
Park Place International announces an expanded set of high availability solutions for Meditech and 100 other healthcare applications via its OpSus Healthcare Cloud and Microsoft Failover Clustering Services.
Privacy and Security
A Germany-based cybersecurity company says that 27 percent of all website malware attacks targeted healthcare-related sites so far in 2015.
Other
An unfocused article in left-leaning magazine Mother Jones blames left-leaning Judy Faulkner and Epic for lack of interoperability, blasting a blitzkrieg of marginally related facts that seem overly focused on how much money Epic makes and how elaborate its campus is. It observes that HITECH didn’t address interoperability. The reporter misses the fact that EHR vendors deliver what customers demand and few turf-protecting health systems are interested in sharing information with their competitors even if their EHR already supports that capability. The reporter concludes the piece by expressing his frustration that his multiple providers don’t share his information, conveniently not bothering to ask those providers why that’s the case. He also complains about the lack of information sharing by his hospital (George Washington University Hospital), which he fails to note uses Cerner, which he lauds elsewhere in the article for its interoperability as evidenced by the DoD deal and joining CommonWell. Lastly, he misses the point that providers weren’t required to buy anything from Epic, Cerner,or anyone else to collect HITECH bribes – they only had to use them in the prescribed manner. It’s valid that HITECH was mostly a waste of taxpayer money and that interoperability is nearly non-existent, but the market forces that created that situation aren’t nearly as simple as he describes.
The Albuquerque newspaper digs into the tax records of Presbyterian Healthcare Services to find that three of its highest-paid contractors are connected to its EHR. The health system paid Epic $14.5 million, T-Systems North America $9.9 million, and Leidos Health $9 million. Presbyterian has spent over $200 million on Epic. It has $1.5 billion in annual revenue and paid its CIO $429K last year.
Jamie Stockton of Wells Fargo Securities sent over their latest analysis of MU Stage 2 attestation. Epic led the hospital numbers with 97 percent of eligible hospitals attesting, while the lowest-performing vendors (in the 50 percent range) are Medhost, Allscripts, and Healthland. Epic and Athenahealth lead the MU Stage 2 physician attestations at just over 70 percent, while users of systems from Allscripts, NextGen, Greenway, Cerner, McKesson, and GE Healthcare have an extremely low attestation rate. All of this may be more of an indictment of the MU process than whose system they’re on.
Siemens Soarian user SoutheastHealth (MO) will move to Cerner Millennium, although they will stick with Soarian billing.
Prescription compounding firm Imprimis Pharmaceuticals will sell a generic version of Daraprim – the old rare-disease drug whose new owner increased the price 5,000 percent to $750 per dose – for $1 per custom-made capsule. The San Diego-based company says it will start making cheap versions of other one-source generics whose price has skyrocketed, exploiting the fact that compounding pharmacies are not required to submit their products through lengthy and expensive FDA approval. Shares of Imprimis are traded on the Nasdaq, where the company has a market cap of $57 million.
Cherokee Nation’s health services are live on Cerner.
A child at St. Christopher’s Hospital for Children (PA) is given a tenfold overdose of cancer chemotherapy due to a manual dose calculation performed from instructions on a custom roadmap that contained a typographic error.
Weird News Andy codes this story as W20.8XXA, as a man napping under a tree in a San Francisco park is struck on the head by a falling 16-pound pine cone. He’s suing the US Department of the Interior and the park for $5 million, which his attorney says he will need for long-term care.
Sponsor Updates
Experian Health will exhibit at the Healthcare IT Transformation Assembly October 25-27 in Miami.
PDS IT will exhibit at the Midwest 2015 Fall Technology Conference October 25-27 in Detroit.
Extension Healthcare will receive the Greater Fort Wayne Business Weekly 2015 Innovation Award in the technology category for its alarm safety and event response platform.
The local paper interviews retiring Healthwise founder and CEO Don Kemper and his wife, SVP Molly Mettler.
InterSystems is recognized for the second year in a row as a leader in the Gartner Magic Quadrant for operational database management systems.
Intelligent Medical Objects will exhibit at Netsmart’s Connections 2015 user group meeting October 25-28 in National Harbor, MD.
LiveProcess will exhibit at the 2015 Vermont Healthcare and EMS Preparedness Conference October 22-25 in Jay.
MedData will exhibit at the ACEP Scientific Assembly October 26-28 in Boston.
Phynd Technologies http://welcome.phynd.com/eBookoffers a new e-book, “The Benefits of a Unified Provider Management Platform.”
Navicure will exhibit at MedTrade Fall Conference October 27-29 in Atlanta.
Netsmart will exhibit at the Ohio Council Annual Conference October 22 in Columbus.
Orion Health hosts the 2015 North American Healthcare Collaborative October 26-28 in Scottsdale, AZ.
KLAS rather histrionically reports (placing itself prominently in the story) that vendor CEOs and provider CIOS will “lock arms to make a difference” in supposedly agreeing to unstated objective measures of interoperability as John Halamka reported on his blog October 6. They will then “work closely with Washington to help alleviate the interoperability measurement burden faced by the government.” The obvious problem is that technical standards reflect capability, not reality, and the ultimate test of interoperability is best assessed by patients trying to get all of their providers working from the same basic information. It matters little that a provider’s EHR scores high on interoperability if it isn’t willing or able to share information.
Reader Comments
From Stewart Scrooged: “Re: Ministry Health Care. CEO announces that 500 employees will be RIF’d in what he calls ‘future-sizing.’ Last day for the chosen ones will be 11/28/15. Merry Christmas!” Unverified. Any organization that lays off employees in November or December is desperate, incompetent, or cold. The best thing about layoffs is that while companies jettison their least-valued employees, their best ones get the message and start looking elsewhere, closing the karmic loop.
From Lab Matters: “Re: Jeb Bush’s health plan overhaul. This is not a repeal and replace proposal. This tinkers on the edges of the ACA. And, not to be cynical, but wouldn’t the reduction in the barriers to entry really benefit his cousin Jonathan? He’s another phony crony wanting more giveaways to the private sector at the expense of the public good. Is the ACA perfect? Not by any means. But fix it. Stop with the ‘repeal’ madness that will go nowhere. Playing to his base by saying that is what he is doing and then NOT actually doing it is disingenuous at best. Sorry, Jonathan. Maybe you are the smart Bush people keep referring to since clearly isn’t Jeb.” Jeb Bush’s health plan says Obamacare has made a messed up health system even worse as the federal government took over one-sixth of the country’s economy, concluding that it “embodies the liberal idea that Washington needs to and can solve every problem,” hurting middle-income families in the process as premiums increase and healthcare choices decrease. Bush’s health IT proposals involve eliminating the Meaningful Use program and associated penalties and publicly releasing all raw, de-identified Medicare and Medicaid claims data. I agree with a lot of what he suggests, although I think his emphasis on innovation as a solution is probably misplaced, repealing the ACA is unlikely, and the idea that all of America (including Fortune 100 companies, medical associations, pharma, and their cadre of lobbyists) will obediently line up and scrap a system that made them rich is naive. His main focus seems to be letting the states run healthcare, which isn’t how it was done in those many countries whose citizens enjoy better and cheaper care than we do.
From Pilsner: “Re: Peer60 EHR report. It does not meet the basics to be called credible. Could you please ask for and publish the N value and demographic information?” The report did not cover EHRs in general – it specifically looked at ambulatory “organizations” that are either hospital-owned or independent. It was what Peer60 calls a “First Reaction” report that collects and publishes information quickly rather than exhaustively, which in this case involved 184 respondents, according to the company. It should be noted that Pilsner has a vested interest in Meditech and therefore in questioning the Meditech-unfriendly survey results.
From Follicular Folly: “Re: Cardinal Health. I was bidding for a health IT services contract and was required to take a hair follicle drug test through DC-based Metro Labs. The location was in a tiny hall, the office was beat up, and supplies were thrown all over the shelves as the entire staff conversed in Ethiopian. They said the hair had to be three inches long, and without warning, the manager chopped off two handfuls worth! I reported this to Cardinal Health, who asked what they could do, and I gave them some requests. They removed me from consideration because they couldn’t accommodate those requests. Now I have a chunk of hair missing and can’t get work .” The Yelp reviews for Metro Labs are mostly scathing.
From Mineopie: “Re: Catholic Health Initiatives. Recently entered into a managed services agreement with both Cerner (inpatient EHR) and Allscripts (outpatient EHR), just announced same for Deloitte AMS to manage Epic markets.” CHI announced the Cerner contract in July 2015 and an Allscripts hosting agreement in November 2014. They’ve been working for years with Deloitte, which announced earlier this year that it would turn its CHI Epic work into a service called Evergreen.
From Bilge Water: “Re: tweets. Your social media posts on Facebook and Twitter get good attention from companies. Nice!” Correction – they sometimes get the attention of twenty-something marketing assistants who are assigned the task of making companies look hipper than they really are by tweeting and Facebook posting on their carefully controlling behalf. It’s not as though any big company’s CEO has actually seen what goes out under the company’s Twitter and Facebook accounts, much less that he or she is writing it personally or retweeting it. It’s easy to forget in a Twitter-induced fog of pedantic kindred spirits that that most of the world, including a high proportion of business executives, has zero interest in what’s on Twitter because it’s just people talking to themselves hoping desperately that someone else is listening.
From Yukon Gold: “Re: Medicare Part A hold for outpatient claims due to Local Coverage Determinations needing to be updated in their system. They are targeting an October 23 turnaround, but this is exactly what hospitals worried about — the federal government NOT being ready for ICD-10. This is a big deal for anyone without large cash reserves that has a payer mix that isn’t mostly commercial.” Unverified.
HIStalk Announcements and Requests
Just over half of poll respondents are interested in Meaningful Use news, while the almost-half that includes me has grown weary of the topic. New poll to your right or here: have you ever been sexually harassed at work? I’ll trust your own definition.
Thanks to Jenn for covering the last couple of posts for me. You will agree with me that she did her job well if you didn’t notice anything different.
I’ve been following the Theranos drama, happy that I had long ago already covered all of the now-hot questions about the company in previous HIStalk posts — that only one of its tests is FDA approved, that its microfluidic methods haven’t been independently validated against traditional ones and make up a minority of its tests, and that the still-small company seems secretive and has a weird but high-powered board. Here’s the thing, though – the microfluidic and nanotainer stuff makes the company sexy to Silicon Valley types and hypes its potential valuation as a technology play, but its real innovation is rock-bottom lab test pricing. Patients will get lab work done no matter how their blood is drawn even though they might prefer the Theranos-exclusive finger stick. Investors might like the company less than before, but patients should be happy that Theranos is trying to break the oligopoly of big lab companies and hospital labs whose technology allows them to process most tests for nearly no incremental cost while charging high prices. Theranos is lucky it isn’t publicly traded yet since the stock would otherwise be tanking on the barrage of criticism.
Ms. L says her Indiana kindergartners love using the two Kindle Fires we bought via the DonorsChoose project, enjoying small-group Kindle Station time every day for practicing letters, numbers, and shapes. I have a few weeks left to use the matching funds generously provided by an anonymous vendor executive for donations of $100 or more. Companies or individuals can follow these steps:
Send the gift card by the email option to mr_histalk@histalk.com (that’s my DonorsChoose account).
I’ll be notified of your donation and you can print your own receipt for tax purposes.
I’ll pool the money, apply the matching funds, and publicly report here (as I always do) which projects I funded, with an emphasis on STEM-related projects as the matching funds donor prefers.
Here’s another DonorsChoose photo I received from Ms. Klotz, whose Illinois kindergarten class received math learning centers from us. She says the students love hands-on math work in practicing measurement, geometry, number operations.
Webinars
None in the next few days. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.
Acquisitions, Funding, Business, and Stock
Former HBOC Chairman Charlie McCall has been paying an army of lawyers for years in trying to have his 2009 criminal conviction for securities fraud and his 10-year prison sentence overturned. He failed again this week as the US Supreme Court rejects his argument that his legal counsel was ineffective.
IBM announces Q3 results: revenue down 1 percent, adjusted EPS $3.34 vs. $3.68, with its sexy product lines like Watson, cloud computing, and mobile computing failing to stop the bleeding. Revenue fell for the 14th straight quarter, missing analyst expectations and sending shares down sharply on Monday. Above is the five-year share price of IBM (blue, down 2 percent) vs. the Dow (red, up 55 percent).
MMRGlobal, a self-proclaimed personal health records vendor whose business focus instead is filing patent infringement lawsuits, will conduct a one-for-five reverse stock split in hoping to strike deals with health IT firms (presumably to buy vague, dormant patents to keep their suit-filing lawyers busy). Maybe they should have gone 1,000-to-one since the OTC market shares are trading at $0.0038, valuing the company at $3 million (the price is so low that the major markets just report it as zero). Both share price and revenue are down 70 percent in the past year and cash flow is negative. Bob Lorsch owns 46 million shares, which sounds like a lot until the calculator shows their value as $175,000.
The Right Place, which connects hospitals with nursing homes for patient placement, raises $2 million.
India-based Attune, which offers a hospital information system and medical device integration, raises $10 million in Series B funding from Qualcomm Ventures and Norwest Venture Partners.
Welltok acquires children’s health gamification platform Zamzee from HopeLab, a non-profit started by eBay founder Pierre Omidyar.
Payments and EDI vendor InMediata raises $4 million
West Georgia Health (GA) chooses Agilum Healthcare Intelligence.
Cooper University Health Care (NJ) selects eHealth Technologies for record aggregation and analytics.
Baptist Health Care (FL) chooses Allscripts products Sunrise, Sunrise Revenue Cycle Management, EPSi, FollowMyHealth, and dbMotion, beating out Cerner and Epic. Baptist was running McKesson Horizon for inpatient and NextGen for outpatient.
Hartford HealthCare (CT) will implement Glytec’s eGlycemic Management System in its five hospitals.
People
Cynthia Kilroy (Optum) joins Huron Consulting Group as managing director.
Announcements and Implementations
In England, a doctor on trial for killing a six-year-old boy by ordering a Code Blue team to stop trying to save him after confusing him with another patient who had a DNR order admits that she also missed abnormal blood test results that were read to her over the telephone during hospital computer system downtime.
New Zealand announces plans to implement a single national EHR over the next 3-5 years.
Johns Hopkins University School of Medicine and Microsoft will work together on technology that will collect ICU monitor data to highlight big-picture trends for a given patient. They will revise Project Emerge, a Hopkins ICU redesign project that integrates ICU monitoring data via a tablet app.
Aspen Valley Hospital (CO) will implement Epic with the help of University of Colorado Health. The announcement says the implementation will give UCHealth “expanded opportunities for clinical collaboration with the goal of keeping care close to home,” which sounds a lot like using Epic to lock in referrals.
Beaumont Hospital – Farmington Hills (MI) — the former Botsford Hospital — goes live with Epic. They previously ran McKesson Paragon.
Summit Healthcare announces that four hospitals have implemented its Scripting Toolkit – Wellspan Health, Halifax Health, Nathan Littauer Hospital, and Phoebe Putney Health System. Also announced were upcoming upgrades to the product.
Qpid Health announces GA of Qpid Groupers for Epic, a subscription service of clinical content uploaded via an Epic-provided import tool.
Privacy and Security
Apple removes several hundred apps from its App Store that were found to be using technology developed by a China-based advertising company that collects user information to push targeted ads.
Other
A New York healthcare staffing agency apologizes for running a nurse employment ad in the local Pennysaver that specified, “no Haitians.”
ZDoggMD has turned out some impressive music videos, but now he’s pimped himself out as an Athenahealth spokesperson and is making commercials rather than art. His new one incorrectly blames EHR vendors rather than regulators and bill-payers for the computer work he and his peers are required to perform as a condition of being well compensated, which is like complaining that TurboTax is terrible because it involves paying taxes. He also fails to mention that the employer of those providers (or they themselves) purchased those EHRs voluntarily. Given the functionality requirements of the typical hospital or practice, an innovatively designed new product would look quite a bit like the old ones, excessive clicks and all. We’re the only profession in which the highest-paid workers are expected to peck on computers all day – you would dump your attorney or accountant in a heartbeat if they wasted their expensive time typing while you’re talking. You may also correctly assume that the top-ranking executives of health systems and health IT vendors rarely sit at a keyboard despite their evangelism of the idea for everybody but themselves.
A KLAS interoperability study of minimally described methodology finds that Athenahealth’s EHR is easiest to connect to, followed by Cerner and Epic. That conclusion is pretty much negated by the admission by both vendors and providers that the technology isn’t the problem with lack of interoperability – it’s lack of agreement on standards and the willingness to actually share information.
More drug pricing nonsense and unintended consequences: Congress requires FDA to issue “priority review vouchers” as a reward to companies that develop a drug for underfunded diseases.The vouchers guarantee that FDA will review their next drug in six months instead of its usual 10 months. Drug companies are selling their FDA-issued vouchers on the secondary market, with AbbVie recently buying one from another drug company for $350 million just to cut the FDA’s bureaucratic review time by four months. You can bet that whatever drug they’re developing will be expensive if getting it on the market a few weeks earlier is worth that kind of money.
A study finds the obvious – large health systems are buying up physician practices and then jacking up their prices in using their consumer brand recognition clout to force insurance companies to pay more. What’s unknown is whether those notoriously inefficient health systems will fare better than they did in the 1990s, when they bought a lot of practices only to be shocked by the resulting drop-off in physician productivity.
Weird News Andy says, “I’m not dead yet … well …” in describing a man in India who wakes up as his autopsy begins, only to die later in the ICU.
Bernoulli releases a new case study featuring Hospital for Special Care, “Achieving Clinical Clarity from Ventilator Overload.”
Forward Health Group will sponsor the American Heart Association’s Heart Innovation Forum in Chicago on October 29.
CapsuleTech will exhibit at Anesthesiology 2015 October 24-28 in San Diego.
Impact Advisors publishes a white paper titled “Summary and Analysis of the MU Final Rule: Modifications in 2015-18 and Stage 3 Requirements.”
Caradigm and CoverMyMeds will exhibit at the Midwest 2015 Fall Technology Conference October 25-27 in Detroit.
CareTech Solutions launches a new video series, “Women in IT.”
CenterX CEO Joe Reinardy will speak at the 2015 Real-Time Benefit Verification & ePrior Authorization Forum October 22-23 in San Francisco.
CitiusTech will exhibit at IBM Insight 2015 October 25-29 in Las Vegas.
Craneware and its client Parkview Health (OH) will present “Enterprise Pharmacy and Supply Chain Revenue Integrity’ at HFMA’s MAP Event on October 26 in Fort Lauderdale, FL.
Re: What your repository experience says For me, it was Y2K that really drove home the lesson: No one knows…