Recent Articles:

EPtalk by Dr. Jayne 10/10/19

October 10, 2019 Dr. Jayne 1 Comment

The ONC blog this week featured a discussion on Electronic Prescribing of Controlled Substances (EPCS). Among physicians who prescribe controlled substances, those who use electronic systems to transmit those orders remains relatively low at 32%. Although some states have mandated the use of EPCS, others haven’t forced the issue with providers. EPCS requires multifactor authentication, and the reality for those of us who prescribe relatively few controlled substances is that the amount of work (and additional technology needed) doesn’t outweigh the potential for reducing drug diversion or other bad acts.

When I do recommend controlled substances, our practice has in-house dispensing capabilities that prevent the prescription from being diverted since we fill it right there. On the off chance that a patient wants a paper script, we print it on compliant paper. I’ve issued one paper script in the last two weeks, and it was a situation where the patient didn’t really want the medication but since they had a complicated fracture I was concerned about them going through the weekend without a backup plan for something stronger. I don’t think that script for five tablets of Tylenol with codeine has a high likelihood of contributing to the opioid epidemic. Still, mandates are coming including the SUPPORT Act, which requires that certain drugs covered under Medicare Part D must be prescribed electronically beginning in 2021. Depending on the frustrations generated by the clinician’s EHR, I wonder if some providers might just consider no longer prescribing agents that will require additional technology.

Lots of chatter in the physician lounge about the recent New York Times piece regarding wasteful spending in the US healthcare system. The comments are also a good read, especially those that note that although burdensome and wasteful, if we cleaned up these processes a lot of people would wind up unemployed. The piece actually draws on a special communication published in the Journal of the American Medical Association that estimates that 20 to 25% of US health spending is wasteful. In order to truly eliminate waste, a number of solutions would have to be employed, including following principles of evidence-based medicine, which would reduce unnecessary testing and treatments that unfortunately some patients demand. The estimated $760 billion exceeds our spending on education and the military, which is a shocking number. Evidence-based care would shave $200 billion off of that, and trimming administrative costs could reduce it another $226 billion. Better care coordination could reduce another $205 billion in wasteful spending. Another big chunk of spending is related to fraud and abuse, ringing in between $60 billion and $80 billion each year. Lots of food for thought, for sure.

image

I’m not sure what to think about Devoted Health and its decision to offer coverage for Apple Watches for members of its private Medicare plans. Many Apple Watch users drive me crazy, with the constant checking of their watches as messages and information flows through to their wrists. It’s every bit as annoying as having someone in front of you checking their phone instead of paying attention – having a smaller form factor doesn’t excuse the behavior. The Devoted Health program will pay up to $150 towards the cost of the device for its members in a move to stand above other Medicare Advantage plans. The jury is still out on whether wearables truly drive improved health outcomes, so this may end up being little more than a gimmick to try to entice members to join the plan. The $150 earmarked for Apple Watches can also be used for health-related classes and other programs, some of which are actually proven to drive outcomes. Devoted Health has roughly four thousand members but hopes to scale to 100,000 members over the next four years as it expands beyond its Florida footprint.

image

The workflow at my practices requires me to perform initial readings on plan radiographs while we wait for an overread. Although I’ve had a fair amount of training, some findings can be subtle and are easily missed unless you maximize the contrast and other enhancements available as you view the images on the screen. Despite my accuracy statistics, I’m always relieved when I see the overread and know that the radiologist agrees. I’m eager to see artificial intelligence applied to radiology at the point of care for rank and file physicians, not just in the intensive care units where a lot of the research is being done. Recently, several radiologist’s organizations released a joint statement warning that increased use of AI in radiology can raise the risk of system errors leading to adverse patient events. They call on regulatory boards to monitor AI systems to ensure patient safety, and also call for development of codes of conduct covering the ethics of AI use and warned against using radiology algorithms for financial gain. I can’t wait to see what diagnostic imaging looks like in a decade – it’s one of the areas with the most promise for delivering high-tech solutions to the bedside.

image

As the leaves are falling and summer is way behind us, I’m going to continue to call out CMS and its Primary Care First program. Their promised Request for Application was due “summer 2019” since the first performance year starts on January 1, 2020. It’s a little difficult to gear up for a program when you don’t know if you’ve been accepted or even if you want to apply since you don’t know what the details are. CMS hasn’t even done the courtesy of updating its website, which still says it anticipates a summer release. Come on, folks, either release the app or officially delay the program. Don’t leave people hanging – and acting like a practice could realistically target a January 1 start date just makes you look out of touch.

image

Since my favorite smart jewelry company Ringly went dark, I’ve been on the look out for other smart jewelry items. I’m still baffled by Amazon’s Echo Loop smart ring. It’s not fashion forward in the least but belongs to a group of devices that may or may not fill a consumer need along with Echo Frames glasses and Echo Buds earbuds. It’s a bit pricey at $130, but has potential for people who want another way to control their smart devices. Amazon refers to the group of devices as “Day 1 Editions,” which are past the beta stage but haven’t been fully proven for consumer purposes. The company describes them as “things that we’ve found delightful internally and we want to get customer feedback on it so we can continue to innovate.” It only comes in black and is only available in ring sizes nine and up, so not exactly dainty. Interested customers have to request an invitation to try the product.

What do you think of Amazon’s new wearables? Leave a comment or email me.

button

Email Dr. Jayne.

Morning Headlines 10/10/19

October 9, 2019 Headlines No Comments

This startup just raised $8 million to help busy doctors assess the cognitive health of 50 million seniors

BrainCheck raises $8 million in a Series A funding round that will enable it to further develop its cognitive assessment software for seniors.

Marathon Health and General Atlantic Announce Strategic Partnership

General Atlantic acquires onsite health center and technology company Marathon Health from Goldman Sachs.

Top 10 Health Technology Hazards for 2020

The ECRI Institute includes alert fatigue, cybersecurity risks, and medication errors from dosing discrepancies in EHRs on its list of top HIT hazards for 2020.

Morning Headlines 10/9/19

October 8, 2019 Headlines No Comments

WellSky to Acquire ClearCare, Solidify Position in Personal Care Market

WellSky will acquire ClearCare, a San Francisco-based developer of cloud-based management software for home care agencies.

One Medical, the health clinic chain backed by Alphabet, has hired banks ahead of an IPO

Membership-based primary care company One Medical reportedly hires several banks to help it prepare for an IPO next year.

Cerner CEO Unveils Next-Generation Cognitive Platform in Health Conference Keynote

Cerner CEO Brent Shafer reveals details about “Project Apollo,” new cloud-based technology that will leverage the company’s previously announced partnership with AWS.

News 10/9/19

October 8, 2019 News 3 Comments

Top News

image

Researchers from the University of Pittsburgh School of Medicine and Humana determine that 25% of healthcare spending – between $760 billion and $935 billion per year – can be characterized as wasteful. They believe that $191 billion to $282 billion could be saved if interventions were put in place.

image

The study looked at waste across six categories:

  • Failure of care delivery.
  • Failure of care coordination.
  • Overtreatment or low-value care.
  • Pricing failure.
  • Fraud and abuse.
  • Administrative complexity.

Administrative complexity was found to be the biggest driver. Researchers couldn’t estimate administrative cost-savings through interventions like more seamless interoperability and value-based care due to a lack of previous studies done on the topic – a sadly laughable, highly ironic state of affairs that those working in healthcare will likely not be surprised by.


Reader Comments

From EHRWhisperer: “Re: Advocate’s conversion. Advocate Aurora Health began it’s Cerner to Epic conversion in the first of four waves today at Advocate Condell Medical Center and Advocate Good Shepherd Medical Center. There were no major issues. The project will extend the existing Aurora Epic license to all twelve Advocate Illinois hospitals over the next twelve months. The merged system will be the largest single Epic database in the world.” The merger of Advocate Health Care and Aurora Health Care was approved in March 2018, resulting in an organization that has 27 hospitals, 3,300 employed physicians, 70,000 employees, and annual revenue of $11 billion. AHC was an Allscripts and Cerner site before the merger. Its conversion from Allscripts to Epic took place last December.


Webinars

None scheduled in the coming weeks. Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

image

Filings with the Wisconsin Department of Natural Resources show that Epic intends to expand its Verona campus to accommodate another 1,200 employees over the next five years.

image

WellSky acquires ClearCare, a San Francisco-based developer of cloud-based management software for home care agencies.

image

One Medical reportedly hires several banks to help it prepare for an IPO next year. Valued at between $1.5 billion and $2 billion, the tech-heavy chain of membership-based primary care clinics has raised over $500 million since launching in 2007.


Sales

  • Lafayette General Health (LA) selects provider search, scheduling, and data management technology from Kyruus.
  • West Virginia University Health System selects IntelliGuide software and services from PatientMatters to connect uninsured patients with available benefits.
  • Salem Health (OR) will install Omnicell XT Automated Dispensing Cabinets at Salem Hospital.
  • The BCBS-managed Federal Employees Health Benefits Program signs a two-year contract with Livongo for its remote diabetes monitoring and coaching program.
  • Marshfield Clinic Health System will implement Sectra’s PACS at seven hospitals and 50 clinics.
  • Geisinger (PA) expands its adoption of Cerner’s HealtheIntent population health management software with a new 10-year agreement.

People

image

Niki Buchanan (Philips Wellcentive) joins Jvion as SVP of customer success.

image

Streamline Health Solutions names Wyche “Tee” Green president and CEO. He has been serving in those roles on an interim basis since July.

image

Jerry Henderson, MD (MD Anderson) joins healthcare analytics company PotentiaMetrics as CMO.


Announcements and Implementations

Change Healthcare adds AI capabilities to its CareSelect Imaging decision-support software.

image

InterSystems develops data cleansing and normalization services for use in machine learning and analytics applications.

image

Devoted Health becomes the first Medicare Advantage plan to subsidize the Apple Watch purchases of its 4,000 members in Florida. Launched by health IT veterans Ed and Todd Park in 2017, the company has raised over $350 million and plans to expand to Texas.

image

The Harvard Pilgrim Health Care Institute will use TriNetX’s EHR data network in its management of the FDA’s Sentinel System, a national program that uses digital health data to monitor the safety of FDA-approved drugs and medical products.

image

Patients accessing Meditech’s Expanse or 6.0 EHR can now do so through the Apple Health app. 


Other

image

Roadblocks to digital health market entry include a lack of expertise and rigid business and reimbursement models that make getting to market difficult, according to a recent survey of 284 healthcare professionals. Digital health clinician end users say poor reimbursement, lack of expertise, and privacy/security concerns hinder their decisions to purchase new products.

image

Kaiser Health News looks at the small but growing trend of health systems getting into the housing business. Denver Health, for example, is converting a 10-story building near its campus to senior housing and transitional living for homeless patients who otherwise could occupy a hospital bed at a cost of up to $2,700 a night. The hospital estimates it could house a patient at its new facility for $10,000 a year, though transitional patients will be given help in finding more permanent housing within 90 days.

image

The Cerner Health Conference gets into full swing today in Kansas City, MO. During his keynote, CEO Brent Shafer touched on interoperability improvements; new cloud-based technology dubbed “Project Apollo” that will leverage the company’s previously announced partnership with AWS; AI and analytics enhancements to its opioid toolkit; and free online training tools.


Sponsor Updates

  • Cambridge University Hospitals NHS Foundation Trust saves $3.15 million in equivalent staff time and reduce turnaround time after implementing medical device integration technology from Capsule Technologies.
  • AdvancedMD will exhibit at the AAO meeting October 12-15 in San Francisco.
  • Clinical Architecture will exhibit at Epic’s App Orchard Conference October 16-18 in Verona, WI.
  • CoverMyMeds and Culbert Healthcare Solutions will exhibit at MGMA October 13-16 in New Orleans.
  • Dimensional Insight will exhibit at the New England HIMSS HIE event October 10 in Worcester, MA.
  • Goliath Technologies exhibits at the Cerner Health Conference with new partner Igel through October 9 in Kansas City, MO.

Blog Posts


button


Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates. Send news or rumors.
Contact us.


125x125_2nd_Circle

Morning Headlines 10/8/19

October 7, 2019 Headlines No Comments

Private Medicare plan Devoted Health says it is the first to cover Apple Watch as a benefit

Devoted Health becomes the first Medicare Advantage plan to subsidize the Apple Watch purchases of its 4,000 members.

Livongo Awarded Diabetes Contract for Eligible Population for Approximately 5.3 Million Beneficiaries Through the Federal Employees Health Benefits Program

Livongo’s stock jumps 18% on the news that it has signed a two-year contract with the Federal Employees Health Benefits Program to offer its remote diabetes monitoring and coaching program to eligible beneficiaries.

Journal of the American Medical Association (JAMA) Publishes Humana Study on Health Care Spending

Researchers from the University of Pittsburgh School of Medicine and Humana determine that 25% of healthcare spending – between $760 billion and $935 billion per year – can be characterized as wasteful.

Curbside Consult with Dr. Jayne 10/7/19

October 7, 2019 Dr. Jayne 1 Comment

image

Normally my issue of Health Data Management goes straight into the recycle bag, since it’s usually a regurgitation of material I’ve already seen or even written about. The fall issue’s headline caught my eye, since “Great Expectations” is one of the novels I had to suffer through several times during my high school and undergraduate years. I’m sure they didn’t intend to evoke Charles Dickens, but maybe they did considering the major characters include a naïve youngster, a convict, and an eccentric who wants everything to be just like it did at a singular time in their youth. That sounds a bit like healthcare IT, especially when you add in the themes of rich versus poor, love versus rejection, and the ongoing struggle of good versus evil.

All literary parallels aside, I’m not sure what kind of expectations I have for what is to come in healthcare IT in the next decade. I think we all have enormous wish lists, but whether those items are brought to fruition or continue to dwell in the world of pipe dreams will remain to be seen. I think about some of the things I dreamed of as a child that currently exist. What if you could have a soundtrack for your daily life, that could play whatever song you were in the mood for? If the iPod and numerous MP3 players were close but not quite, now we have Spotify to satisfy most of our music cravings. What if you could talk to your computer and get information without even typing? Siri, Alexa, and Cortana can continue to duke it out, but I’m happy to be able to see what the weather is like while I’m scrambling around in the morning doing three things at once.

On the other hand, we see an industry that continues to remain somewhat hobbled by regulatory requirements, where many vendors have had to cast aside true innovation in lieu of checking a host of boxes for functionality that their users not only don’t want but find tedious or annoying. It doesn’t matter how good they might be for patient care, if no one uses them it’s a fairly moot point. Unless there’s a carrot or stick involved, organizations and their users aren’t going to just adopt things for the sake of adopting new features. There’s too much else at stake and too many other things that demand (and deserve our attention).

With that in mind, I’m not sure what I think about the upcoming requirements to (finally) institute Medicare’s Appropriate Use Criteria Program, which has been in the wings for years. Health Data Management happened to cover it in the issue that caught my eye, and I have to admit I had kind of forgotten about it, since it’s been coming at us in fits and starts for so long.

Essentially, on January 2, physicians who order advanced imaging tests (such as MRI, CT, and PET scans) for Medicare patients have to consult qualified clinical decision support systems before ordering those tests. The software is supposed to incorporate evidence-based guidelines and Appropriate Use Criteria (AUC) to make sure people aren’t just ordering expensive tests for every little thing, or because patients demand them. Commercial payers have already tackled this issue by requiring prior authorization for these kinds of tests, which Medicare is trying to avoid by instituting the AUC requirement. There are eight conditions that are being targeted, including low back pain and headaches.

The problem with the proposal is that the penalty occurs in the wrong place. If ordering physicians don’t do the right thing, then radiology providers won’t be paid for the test. This puts them in the position of having to make sure their referral base is doing the right thing, with some even offering access to clinical decision support systems for their referring physicians, who might also have that support within their EHRs. The prior authorization requirements used by commercial insurers put the burden squarely where it belongs – on the ordering physician who needs to be ordering tests that are needed and that will provide useful diagnostic information.

The first year of the program is designed to be an educational and testing opportunity for all involved, with the nonpayment penalty being applied starting January 1, 2021. Ultimately, CMS plans to force providers who don’t follow requirements for clinical decision support to seek a prior authorization. With all the work that organizations have put in during the last several years for this requirement (during its on again, off again progression), one could wonder whether it just would have been easier to institute a prior authorization requirement in the first place. Ordering physicians already have those workflows in place in their practices and the lion’s share of work is done by non-provider staff members. Medicare could have been the leader here, standardizing the requirements and drawing commercial payers into line to create a single set of prior authorization rules across all payers. Instead, it has created an additional burden that no one in the process (other than CMS apparently) wants to deal with.

I’ve been in the clinical trenches for a long time, and frankly I can only remember one time a prior authorization was denied for one of my patients. It was a scenario I can only describe as a goat rodeo. The CT scan was ordered urgently, as the patient was in my urgent care with severe abdominal pain and a host of abnormal blood tests. Since no one is sitting at the insurance company at 7pm on a Friday night to handle a prior auth, we proceeded with the test and tried to get the auth retroactively on Monday morning. The reviewer was demanding more information, because in my note I described one of the areas of abdominal tenderness as “mild” rather than using a more serious-sounding word or even omitting a qualifier altogether. It didn’t matter that the patient had guarding and rebound tenderness in another area of the abdomen, which are ominous findings on their own; the reviewer had the word “mild” stuck in her craw.

I had to admit I became rather hot around the collar, and might have asked her if she gave a damn about the fact that the patient had a 6cm tumor in their pancreas that was causing obstruction and mayhem. She certainly hadn’t bothered to look at the test result itself, which more than showed the study was warranted. By the time we were trying to get the prior auth, the patient had already been admitted to the hospital, undergone a number of invasive tests, and was coping with a cancer diagnosis and the high likelihood that he’d never see his children graduate high school. Eventually the reviewer relented and approved the test, but it was silly that we even had to go through the exercise.

Maybe that should be my “great expectation” for the 2020s, that some day physicians who are spot-on with their test ordering won’t have to jump through hoops on behalf of their patients. I don’t have a lot of hope for it, though. What’s your great expectation for healthcare IT in the next decade? Leave a comment or email me.

button

Email Dr. Jayne.

Morning Headlines 10/7/19

October 6, 2019 Headlines No Comments

DCH Hospital System pays Russian hackers in ransomware attack

DCH Health System in Alabama agrees to pay Russian hackers after an October 1 ransomware attack forced it to divert patients and revert to paper processes.

3 lawyers defending Theranos founder Elizabeth Holmes say they haven’t been paid in over a year and would like to quit

Court documents reveal that attorneys defending ex-Theranos CEO Elizabeth Holmes in a civil suit filed by former Theranos patients have asked to withdraw from the case because they haven’t been paid in over a year.

MUHC computer crash caused by two successive malfunctions

Hardware malfunctions in the sub-basement data center of $1.3 billion “superhospital” McGill University Health Centre in Montreal cause its computers and back-up system to crash.

A hospital’s ‘Wall of Shame’ used private records to mock disabled patients. Now officials are apologizing.

St. Mary’s Regional Medical Center (ME) officials apologize for a semi-secret collage kept by employees that mockingly showcased pictures and details of patients with disabilities.

Monday Morning Update 10/7/19

October 6, 2019 News 9 Comments

Top News

image

DCH Health System in Alabama agrees to pay Russian hackers after an October 1 ransomware attack forced it to divert patients and revert to paper processes. Officials haven’t been able to pinpoint when systems will be back up and running normally: “We have been using our own DCH backup files to rebuild certain system components, and we have obtained a decryption key from the attacker to restore access to locked systems. We have successfully completed a test decryption of multiple servers, and we are now executing a sequential plan to decrypt, test, and bring systems online one-by-one. This will be a deliberate progression that will prioritize primary operating systems and essential functions for emergency care. DCH has thousands of computer devices in its network, so this process will take time.”

image

DCH, plus hospitals in Ontario and Australia, attribute their recent ransomware attacks to Ryuk malware, named for a Japanese comic book character who can’t be destroyed by conventional human weapons. A total of 13 facilities were impacted, with all still in various states of recovery.


Reader Comments

image

From concerned: “Re: Athenahealth. Athenahealth will be leaving the hospital market in the next few months.” A company marketing exec responded with this statement: “We continue to be active in the hospital market through our support and investment in the experience of our existing athenahealth hospital customers. We are also committed to our customers who use the Centricity Business product, and are actively building that customer base, investing in that product, and are focused on our relationships with hospital and IDN revenue cycle clients.”


HIStalk Announcements and Requests

image

Responses are nearly evenly split, which isn’t surprising given the schismatic nature of healthcare these days. A deeper dive might look into insurance status, health savings accounts, employer contributions, and the like. The one thing I’m sure most respondents have in common is feeling an increasing squeeze on their wallets for healthcare services that may be hard to access and are priced so that they’ll never truly understand what they’re paying for until the debt collectors come calling. Mr. T says American patients fear the cost of a diagnosis more than the diagnosis itself, while North American attic laughs at the thought of a Canadian being in such a situation: “Deferred or declined recommended medical care for financial reasons? Canadians would not even comprehend the question.”

Nick van Terheyden paints a bleak but realistic picture for many: “Yes. At one end of my personal extreme I broke my ankle (or at least as best as I could tell clinically) but refused to visit any doctor or facility for an X-ray and treated myself with a boot that I had already been charged a huge sum of money for for a pervious fracture. I have told my family and any friends that I do not want an ambulance called under any circumstances – get me to a hospital if you must but by taxi or car. I don’t want my family lumbered with crushing medical debt from me. I buy my drugs overseas to save money – in bulk and at double strength, and use a pill cutter to save money. Were I to get cancer, I highly doubt I would take treatment given the debilitating nature of medical debt that accompanies this and the thought of leaving my family to lose what little we have to some large healthcare billing corporation. I’ll manage any chronic disease I have the misfortune of getting under any and all circumstances – again rather than be a burden to my family leaving them with debt they will struggle to pay. What a sorry commentary on a system that works precisely as designed.”

New poll to your right or here: For those with employer-sponsored health plans, would you be willing to use employer-approved providers if given a financial incentive to do so? As Walmart pilots a program that will do just that, and Amazon offers virtual employee care, I wonder how many of us would go that route to save a few bucks.


Webinars

None scheduled in the coming weeks. Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

image

NextGen Healthcare acquires Topaz Information Solutions, a NextGen reseller that works with behavioral health providers and social services organizations.

Court documents reveal that attorneys defending ex-Theranos CEO Elizabeth Holmes in a civil suit filed by former Theranos patients have asked to withdraw from the case because they haven’t been paid in over a year. The Cooley LLP lawyers believe they’ll never be paid given the “dire financial situation” of Holmes, whose blood-testing startup was once valued at $4.5 billion.


Decisions

  • Fayette County Memorial Hospital (OH) will switch from Medhost to Cerner in February.
  • Butler County Health Care Center (NE) will switch from Meditech to Cerner In November.
  • St. Francis Medical Center (NJ) will switch from Sunquest To an Epic Beaker laboratory information system in 2021.
  • Franciscan Health Rensselaer (IN) will switch from Omnicell to BD Pyxis automated dispensing machines next year.

These provider-reported updates are supplied by Definitive Healthcare, which offers a free trial of its powerful intelligence on hospitals, physicians, and healthcare providers.


People

image

Retail pharmacy tech vendor OmniSys names David Pope chief innovation officer. Pope co-founded Strand Clinical Technologies, which OmniSys acquired in July.

image

Peyman Zand (Community Health Systems) joins CereCore as VP of advisory services.


Announcements and Implementations

Banner Health (AZ)  implements online scheduling using Kyruus ProviderMatch for Consumers.

image

Health Catalyst announces GA of Closed-Loop Analytics to offer providers deeper clinical insights within workflows at the point of care.


Privacy and Security

image

UAB Medicine (AL) notifies nearly 20,000 patients of an August email phishing scheme in which hackers tried without success to divert automatic employee payroll deposits to an account they controlled.


Other

image

Iris Kulbatski petitions the government of Ontario to enforce fee regulations related to accessing medical records after University Health Network charged her $1,100 to retrieve her late father’s medical records. She appealed the charges for the 3,000-page file, saying that the health system backdated its policy so that it could charge her – and other patients requesting digital copies – more. UHN eventually honored the newer policy, charging Kulbatski the $40 she originally anticipated.

image

Hardware malfunctions in the sub-basement data center of $1.3 billion “superhospital” McGill University Health Centre in Montreal cause its computers and back-up system to crash. MUHC suffered a similar event last year when back-up generators failed during a blackout, and in 2013 when a goose got into the electrical system at an off-site vendor, starting a fire that eventually caused similar downtime.

image

The local paper commemorates the centennial of South County Health with a look at how computers have impacted provider workflows (and lab hygiene) at the Wakefield, RI hospital. While SCH physicians acknowledge the game-changing benefits of electronic records, they bemoan the lack of interoperability when logging into five different EHRs every day. Cost is a big barrier to getting all systems on the same page. Hospital officials say it would cost $12 million to integrate its inpatient and outpatient systems. It pays $30,000 to $40,000 per year per physician to keep systems updated.


Sponsor Updates

  • Meditech will host its 2019 Revenue Cycle Summit October 8-9 in Foxborough, MA.
  • Mobile Heartbeat will exhibit at the ANCC Magnet Conference October 10-12 in Orlando.
  • Waystar, Experian Health, and Relatient will exhibit; and SymphonyRM will present at MGMA October 13-16 in New Orleans.
  • Netsmart will exhibit at the NAHC Annual Meeting October 13-15 in Seattle.
  • Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the AWHONN 3rd Annual Fall Conference October 11 in Traverse City, MI.
  • PatientPing congratulates customer Bane Care Management on its silver ribbon in the McKnight’s Excellence in Technology Quality Awards.
  • Pivot Point Consulting, StayWell, Summit Healthcare, Surescripts, TransformativeMed, and Zynx Health will exhibit at the Cerner Health Conference October 7-10 in Kansas City, MO.
  • Redox will host its Interoperability Summit October 15-16 in Boston.
  • Vocera will exhibit at the ANCC National Magnet Conference October 10-12 in Orlando.
  • Wolters Kluwer Health releases an enhanced version of its Lipincott CoursePoint+ digital education solution for nursing education programs.

Blog Posts


button


Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates. Send news or rumors.
Contact us.


125x125_2nd_Circle

Weekender 10/4/19

October 4, 2019 Weekender 2 Comments

weekender


Weekly News Recap

  • Northwell Health (NY) will work with Allscripts to develop a cloud-based EHR incorporating voice recognition and artificial intelligence.
  • Walmart will pilot several programs across the country to connect its employees to healthcare services that it hopes will offer quality care at more affordable prices.
  • Private equity firm Francisco Partners will acquire laboratory information systems vendor Orchard Software.
  • Beginning next year, the VA will automatically share health data with community providers using the Veterans Health Information Exchange.
  • Siemens Healthineers subsidiary Siemens Medical USA will acquire ECG Management Consultants from Gryphon Investors.
  • FDA issues an alert about Urgent/11, a cybersecurity vulnerability found in IPnet third-party software that attackers may exploit to take over medical devices and hospital networks.
  • After laying off half its staff this summer and filing for Chapter 11 earlier this month, UBiome will cease operations and liquidate assets.
  • Canada’s New Brunswick Medical Society will close Velante, the for-profit company it created in 2012 as the sole EHR provider for the province’s doctors.

Best Reader Comments

Re: Walmart connecting employees to health services around the country. I like the concept. I would love to be able to go to the best of the best for treatment of a very serious illness if my insurance allowed. The travel, the hotel, etc., to be arranged and paid for through my insurance. I would welcome that. If I had serious heart problems, I would want to go to the Cleveland Clinic; if I had a rare form of cancer, I would want to go to MD Anderson; if I had kidney disease, I would want to go to Johns Hopkins. Will the next generation of Healthcare define Centers of Excellence around the country for various diseases and allow the insured to pick? I gotta say, it is a concept that I am slowly warming up to as I watch what Walmart and Amazon are up to. (X-Tream Geek)

I think naughty lists based on reports generated from the EHR are the way to go. It’s also easy to automate with the IT team. First time you mess up, automated email at the end of the week with quick note about what not to do. Second time, note+policy with manager cc’ed. Third time someone calls you. Fourth time … (Santa)

RE: Your comment: “I can’t recall an EHR vendor in recent memory putting boots on the ground at a single client site to design, develop, and implement a product before releasing it to the market. ” GE Healthcare attempted to do the same thing (well…kinda) with Intermountain Healthcare 2007-2013. GE invested approx $500M and the final product wound up being a meager ‘white board’. The project essentially killed the careers of numerous execs as well as what was left of IDX/GE. (leftcoaster)

Re: HealthTech “Influencers” — I agree on all shared above, and I know Mr.HISTalk has well documented his concerns over the years (as well as created a brilliant suggested scoring system), so I won’t elaborate on the lunacy of such lists. EXCEPT to comment that the most glaring concern are those named whose role is marketing on behalf of an organization/group/client. Marketing Brand experts should be invisible, not found on these lists. Especially considering the fact that they likely have a very warm fuzzy relationship with a publisher as they are the go between for the client. That does not make them an “influencer”. Their sole job is making money off of media placements and brand recognition, NOT to revolutionize technology for improved health delivery or outcomes like some on the list. I find it VERY poor form for the publisher to do a favor to recognize the man who brands himself and actually believed he is changing healthcare. Worst part….said man inspires countless others like himself, and is creating a small army of brand promoters. I kind of feel like John Legend in the R.Kelly documentary…..no one else in music would speak up. Often times when I do, I receive countless IMs from people telling me they agree with me, but refusing to go on record. Folks….can we change this, or is this social media world such that we just have to roll with it? (BehindtheScenes)


Watercooler Talk Tidbits

image

In Florida, AdventHealth and Philips commit to becoming anchor partners of Metro Development Group’s third Connected City. The mixed-use development will offer residents concierge telemedicine services, a wellness park, and on-site Advent services including a standalone ER.

image

Healthcare fraudster Jesse Lopez will spend more time behind bars after attempting from jail to hire a hit-man to kill her husband, a witness in her court case. Lopez was previously found guilty of posing as a nurse and performing unlicensed medical procedures at the Drop It Like It’s Hot Weight Loss Clinic and Jesse’s Gym in Florida.

image

Saratoga Hospital (NY) will move some of its non-clinical operations to an anchor space in nearby Wilton Mall in order to free up space on its campus for more patient care. Information systems employees will be among the first to transition to the former Sears space.

image

Micron Technology has developed a toilet that uses artificial intelligence to analyze a user’s waste to diagnose potential health issues. CEO Sanjay Mehrotra urges skeptics to “[I]magine smart toilets in the future that will be analyzing human waste in real-time every day. You don’t need to be going to visit a physician every six months. If any sign of disease starts showing up, you’ll be able to catch it much faster because of urine analysis and stool analysis.”

image

Kaiser Health News profiles the secretive world of Instagram dolls, a community of women who have taken to the social media platform to share their cosmetic surgery journeys. 

image

In Virginia, Joel Smithers, MD is sentenced to 40 years for prescribing over a half million doses of opioids – at least one prescription per patient – since opening his practice in 2015.

image

Weird News Andy asks, “Perhaps they should start a new one and put up the names of those responsible?” St. Mary’s Regional Medical Center (ME) officials apologize for a “Wall of Shame” kept by employees that mockingly showcased pictures and details of patients with disabilities. Kept on the inside of a cabinet door, the collage was discovered and reported on in 2016 by an employee who told administrators about it. Citing a toxic work environment, she later quit after colleagues retaliated against her by looking up her medical records and discriminating against her because of her own disability. St. Mary’s has been quick to assure the media that no identifying patient details were kept on the wall.


In Case You Missed It


Get Involved


button


125x125_2nd_Circle

Morning Headlines 10/4/19

October 3, 2019 Headlines No Comments

New Associate Benefits Aim to Simplify Health Care and Focus on Appropriate Care

Walmart will pilot several programs across the country to connect its employees to healthcare services that it hopes will offer quality care at more affordable prices.

Epic Systems gearing up for yet another expansion in Verona

Filings with the Wisconsin Department of Natural Resources show that Epic intends to expand its Verona campus to accommodate another 1,200 employees over the next five years.

abeo Acquires Computer-Assisted Coding Platform, Trusted i10, LLC

Practice management and billing vendor Abeo acquires AI-powered coding company Trusted i10 for an undisclosed sum.

News 10/4/19

October 3, 2019 News 7 Comments

Top News

image

Not to be outdone by Amazon, Walmart announces it will pilot several programs across the country to connect its employees to healthcare services that it hopes will offer quality care at more affordable prices.

Featured Provider programs in Arkansas, Florida, and Texas will incentivize employees to use physicians in their areas that provide appropriate, high-quality care. Health data aggregator and analysis vendor Embold Health (the brainchild of former Walmart Care Clinics CMO Daniel Stein, MD) will provide Walmart with data it will use to create lists of physicians that the company will share with employees. Those who wind up seeing a provider not on the list will pay more for their benefits.

The company will try out a Personal Healthcare Assistant concierge service that will help employees in the Carolinas find providers, deal with billing, understand diagnoses, and find transportation and childcare.

Walmart has tapped Doctor on Demand, Grand Rounds, and HealthScope Benefits to offer employees in Colorado, Wisconsin, and Maryland expanded telemedicine visits at $4 a pop, as well as the option to access care coordination services.


Reader Comments

From PizzaSlinger: “Re: Adventist’s Cerner contract. Adventist Health West Coast is ending the contract with Cerner RevWorks after only 2 years on 11/4. Work will revert back to Adventist and employees have option to convert to Adventist at same pay rate. If employees do not convert they will lose employment on 12/1. Huron is taking over management functions as well. Around 300 employees are affected.” PizzaSlinger’s numbers line up with those of the Kansas City Business Journal, which reports that 360 Cerner staffers will be impacted by Adventist’s decision. At least half of those probably came over from Adventist when the health system started outsourcing jobs last year.

From SoftwareSavvyShrink: “Re: Appriss Health’s acquisition of OpenBeds. I found it interesting that you highlighted the Appriss Health acquisition of OpenBeds software aimed at helping connect behavioral health patients with inpatient and outpatient care. This is a prime example of a technological workaround to a system defect. No matter how good the software is, it’s unlikely to solve the underlying problems, which are:

  • Insufficient numbers and erratic geographic distributions of beds for inpatient psychiatric and substance use disorder treatment.
  • Insufficient supply (and erratic geographic distribution) of psychiatrists and other mental health professionals to provide outpatient care and even smaller numbers of treatment programs for substance use disorder treatment.
  • Insurance reimbursements and utilization review practices that cause many of the existing mental health professionals to avoid taking insurance altogether (including Medicare and Medicaid, so don’t hold out hope for single payer).
  • Fragmentation of mental health services and no mandated accountability so that no one is interested in treating individuals with the most severe disorders or the most complex comorbidities (and value-based care and other performance measures make challenging patients even more challenging to treat without losing money).

Even the best software won’t solve issues of inaccurate information on bed availability and a lack of ability to predict discharges.

Hospitals tend to keep a bed open for their own services (ED or transfers from medicine) and are more reluctant to accept transfers from other hospitals because you often don’t get the full story on the patient from the referring hospital. (The person who’s ‘totally straightforward, has great insurance and their own house’ has multiple medical issues, doesn’t want to take medications, has been filing false complaints to the police, has already reached the coverage limits of their great insurance, and has a home but it’s in foreclosure.)

We had a software system almost 30 years ago to track available inpatient beds in our county but it was never very helpful because we couldn’t get accurate data on bed availability. And getting data on outpatient appointment availability was even more challenging.

The best system that I’ve ever seen for mental health referrals was the one we used 35+ years ago. Our region was divided into catchment areas and every catchment area had a designated community mental health center, an affiliated primary psychiatric hospital, a backup hospital, and a corresponding state hospital. We didn’t need any complicated processes or insurance authorizations. The psych resident on call carried a 1/4 inch bound volume known as ‘the magic book.’ If a patient needed referral, you looked up their address in ‘the magic book’ and learned their catchment area. You either gave them the number of the outpatient service for that catchment area, which was obligated to provide mental health or substance use treatment. Or you called the hospitals in sequence. It was never more than three calls and if they had a bed, they took the patient. If the other one (or two) hospitals had no beds, the patient was automatically accepted at the state hospital.

Unrelated to OpenBeds but related to substance use treatment, the Google Doodle on October 1 honored Dr. Herb Kleber, a pioneer of evidenced-based treatment of substance use disorders and an all-around-incredible person.”

image


HIStalk Announcements and Requests

image

Welcome to new HIStalk Platinum Sponsor StayWell. The Yardley, PA-based health empowerment company enables providers everywhere to improve health outcomes using the science of behavior change. Its patient education and marketing solutions inspire change, improve outcomes, and create loyalty. Providers use its digital, video, and print educational materials for 80 million patients each year, with outcomes that have been proven in 120 peer-reviewed studies. Its Krames On FHIR solution — available in Epic App Orchard and Cerner App Gallery – delivers personalizable patient education directly into the clinician’s EHR workflow for the specific patient’s profile and encounter, allowing users to tag their favorite tools, organize folders, search by keyword, and filter by age and gender. Thanks to StayWell for supporting HIStalk.


Webinars

None scheduled in the coming weeks. Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

image

22C Capital joins Advent International and Spectrum Equity as an investor in health data marketing and research firm Definitive Healthcare’s recapitalization, first announced in June.

image

Defense lawyers for former Theranos CEO Elizabeth Holmes and former president and COO Sunny Balwani insist the prosecution is refusing to turn over documents that would clear the pair of any wrongdoing. The attorneys contend that documents from the FDA and CMS are vital to refuting allegations that the pair knew Theranos blood tests were inaccurate and that they lied to investors, partners, physicians, and patients. The Theranos saga will continue on November 4, when all parties are expected back in court.


Sales

  • The Texas Health Services Authority selects Audacious Inquiry’s Emergency Department Encounter Notifications and Encounter Notification Service care coordination technology.

People

image

Mathew Gaug (Lima Memorial Hospital) joins Memorial Hospital and Health Care Center (IN) as VP and CIO.

image

Diameter Health names Terry Boch (Machinify) chief commercial officer.


Announcements and Implementations

image

In New Hampshire, GraniteOne Health system will leverage Dartmouth-Hitchcock Health’s Epic software and telemedicine expertise once their merger is approved.

image

The George Washington University Hospital in Washington, DC implements new software that combines care coordination and communication software from TransformativeMed with clinical decision support from Crossings Healthcare Solutions.

image

Meditech will offer EHR software on Google Public Cloud, starting with its Meditech-as-a-Service subscription model. Google Cloud will also work with the company to develop native cloud products and corresponding APIs.

North Memorial Health (MN) will connect its Epic system to the state’s AWARxE PDMP, developed and managed by Appriss Health, next month.

image

Porter Medical Center, part of the University of Vermont Health Network, will go live on Epic November 1.


Other

image

ProPublica digs into the steps Newark Beth Israel Medical Center (NJ) took to keep a heart transplant patient alive for one year in order to avoid being penalized by federal regulators who could potentially shut the transplant program down. A leaked recording of a meeting of hospital administrators found that some found the situation unethical given the patient’s vegetative state and a lack of communication about palliative care with his family; but most ended up agreeing that the patient would “take one for the team” to help the transplant program survive.


Sponsor Updates

  • Engage and Gevity Consulting partner to expand their services across Canada.
  • Elsevier Clinical Solutions, Ensocare, Healthwise, and Imprivata will exhibit at CHC 2019 October 7-9 in Kansas City, MO.
  • EClinicalWorks will exhibit at the Georgia Primary Care Association conference October 9-11 in Alpharetta.
  • Glytec congratulates customer Sentara Healthcare for achieving Magnet status at its Virginia Beach General Hospital.
  • Phynd becomes a member of the CHIME Foundation.
  • CoverMyMeds will sponsor and exhibit at the IPatientCare National User Conference October 18-19 in Cincinnati.
  • CB Insights includes Kyruus, Redox, MDLive, PatientPing, and TriNetX on its list of 150 digital health startups redefining the healthcare industry.
  • Experity launches a new website to serve as the one-stop-shop for urgent care businesses.
  • Meditech announces its support for Health Records on iPhone.

Blog Posts


button


Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates. Send news or rumors.
Contact us.


125x125_2nd_Circle

EPtalk by Dr. Jayne 10/3/19

October 3, 2019 Dr. Jayne 2 Comments

image

Fall is finally here in my part of the world, although areas of the US are still near broiling. October 3 marks the start of the last 90-day EHR reporting period for those of you playing the Promoting Interoperability home game, hospital edition. Those not reporting for a continuous 90 days in the calendar year will receive a downward payment adjustment. Hospitals must also respond in the affirmative for the Prevention of Information Blocking and ONC Direct Review Attestations.

Speaking of reporting, I somehow wound up on an email list for Greenway Health customers. Apparently, there is an issue with the Greenway Patient Portal and settings that allow providers to block sending laboratory data through the portal. Originally designed to keep sensitive information from being sent, if the setting is enabled then the entire site is unable to attest to certain MIPS and Medicaid measures. Providers were advised to adjust their settings prior to October 1 so that they would have data for the 90-day collection period ending December 31. Seems like something that should have been found earlier in the year, and I’m still puzzled how I wound up on their mailing list.

image

For anyone who has worked with hospitalized patients, we know how challenging it can be when patients are disoriented or at risk for falls. I was excited to read this case study about virtual sitters in the hospital environment. Mission Hospital in Asheville, NC piloted virtual sitters in its neuroscience unit. They noted a 23% reduction in falls and a 12% reduction in fall-related injuries during the 12-month pilot. Mission Health worked with Cerner to develop the virtual sitter system, using Microsoft Kinect technology to monitor patient movement. The solution included two-way audio, voice recognition, and customizable alerts. Technicians could monitor six patients at a time, and if patient movement occurred, the technician would be alerted to the specific feed. Similar to when an in-person sitter is used, the technician could use voice instructions to try to redirect the patient if needed. If the intervention isn’t successful, the technician can alert nursing staff to intervene in person. Large hospitals can spend millions of dollars on sitters, so this technology has the ability to significantly impact the bottom line.

Despite what the folks at Apple may have us believe, the iPhone isn’t the be-all, end-all of smart phones. I always cringe when a vendor launches a solution that is only available for the iPhone, as if those of us who use Android are some kind of second-class citizens despite Android having a slim majority of market share. I ran across a press release about a non-profit industry group that is working to create an open-source version of the Apple Health tool kit that can be used by Android users. Members of the CommonHealth project team include Cornell Tech, UC San Francisco, Sage Bionetworks, Open mHealth, and The Commons Project. The plans include robust governance to review partners and apps requesting to connect through the platform. UCSF is piloting along with other academic medical centers and health systems. I’d be interested to hear from anyone who is involved in the project.

From Incognito: “Dr. J – You are on to something when you note that switching back and forth between scribes and flying solo is a bit of a thing. I am convinced that EMRs bring a very different and intense kind of cognitive load than the analog world did, even without accounting for all the ‘little things’ that have been added to the physician’s thought process (because now, ‘they’ can). Adding a scribe is really just another piece of that cognitive load, even if it does reduce some bits. Switching back and forth flies in the face of ‘standard work’ in good processes. I’m sure that there are industrial design and psychology/perception experts who can tell us what we are doing to ourselves. They see it in fighter pilots and in air traffic controllers – and in Facebook ads.” Fortunately, I had a scribe all day today so things ran smoothly. Unfortunately, it’s probably the last time I’ll work with him since he’s getting ready to travel to residency interviews. Today’s scribe is a fully qualified physician, trained and licensed in another country. He’s been a delight to work with, even though his employment is a direct result of our broken health system that doesn’t always allow international medical graduates to perform the functions they might otherwise be able to. He plans to complete a residency in internal medicine so he can practice in the US, since he’s a dual national also holding US citizenship.

There was an article in my local paper about the explosive growth of urgent care facilities in the US, and not surprisingly several local physicians wrote scathing editorial letters claiming that urgent care providers are guilty of rampant overprescribing of antibiotics. The same claims are often made of telehealth providers, even though some have better data on others on how well they avoid unnecessary antibiotic prescriptions. It can be difficult to get data out of EHRs to run those types of reports, and even more difficult to try to use technology to limit prescribing, as one reader recently wrote:

“At my facility, we get fairly regular reports on antibiotic stewardship. Oddly enough the EHR is one of the roadblocks for doing what we want and need to do in this area. Tracking antibiotic use requires substantial pharmacist and infectious disease physician time where a well-designed EHR should have easy-to-use canned modules for tracking use as compared to the latest local microbiology profile. More importantly, there is no straightforward/easy way to restrict specific drugs to be ordered only by certain specialists, on certain floors or services, or with co-signatories or approvals by another service. Oddly enough, it seemed easier to implement such restrictions in the pre-EHR era. One issue is that we don’t want to block all direct prescribing of specific antibiotics since we are very mindful of not restricting initiation of a potentially life-saving antibiotic in an emergency situation such as impending sepsis. The issue of drug-specific prescribing restrictions is not just a problem with antibiotics – we have the same issues in trying to restrict rampant prescribing of other costly drugs.”

There’s no perfect system out there that can prevent all imperfect human behavior from happening. I know providers who consistently do sketchy things regardless of the education they receive, and probably the only thing that would block those folks would either be a hard stop in the EHR or a disciplinary action. Even though the organizations I’ve worked for take a dim view of such behaviors, there’s a delicate balance between admitting volumes, revenue generation, and tolerance for those who know where their bread is buttered.

Has your organization figured out how to effectively transform physician prescribing behaviors? Was it high-tech or high-touch? Leave a comment or email me.

button

Email Dr. Jayne.

Morning Headlines 10/3/19

October 3, 2019 Headlines No Comments

22C Capital Announces Investment in Definitive Healthcare

22C Capital joins health data marketing and research firm Definitive Healthcare’s recapitalization with an undisclosed investment.

MEDITECH Announces Collaboration with Google Cloud to Bring EHRs to the Public Cloud

Meditech will offer select EHR software on Google Public Cloud, and will work with Google Cloud to develop native cloud products and APIs.

GraniteOne Health moves forward with Dartmouth-Hitchcock collaboration

In New Hampshire, GraniteOne Health system will leverage Dartmouth-Hitchcock Health’s Epic software and telemedicine expertise once their merger agreement is approved.

Elizabeth Holmes’ attorneys blast prosecution over withholding government documents

Defense lawyers for former Theranos CEO Elizabeth Holmes and former president and COO Sunny Balwani insist the prosecution is refusing to turn over documents that would clear the pair of any wrongdoing.

Morning Headlines 10/2/19

October 1, 2019 Headlines 2 Comments

Northwell, Allscripts to jointly develop next-gen electronic health record

Northwell Health (NY) will work with Allscripts to develop a cloud-based EHR incorporating voice recognition and artificial intelligence.

VA shares electronic health records

Beginning next year, the VA will automatically share health data with community providers using the Veterans Health Information Exchange.

FDA informs patients, providers and manufacturers about potential cybersecurity vulnerabilities for connected medical devices and health care networks that use certain communication software

FDA issues an alert about Urgent/11, a cybersecurity vulnerability found in IPnet third-party software that attackers may exploit to take over medical devices and hospital networks.

All 3 DCH Health System Hospitals Closed to New Patients Due to Ransomware Attack

An early-morning ransomware attack forces DCH Health System (AL) to divert patients from its hospitals.

BREAKING: Bankrupt microbiome-testing startup uBiome is shutting down

After laying off half its staff this summer and filing for Chapter 11 earlier this month, UBiome will cease operations and liquidate assets.

News 10/2/19

October 1, 2019 News 10 Comments

Top News

image

image

Northwell Health (NY) physicians and IT and operations staff will work with Allscripts to develop a cloud-based EHR incorporating voice recognition and artificial intelligence. Northwell has been an Allscripts customer (Sunrise and TouchWorks) since 2009, when the health system was known as the North Shore-Long Island Jewish Health System. It plans to implement the new software systemwide.

image

SVP and CIO John Bosco, who has been with the organization since 2004, will likely have a hand in product development.

image

I can’t recall an EHR vendor in recent memory putting boots on the ground at a single client site to design, develop, and implement a product before releasing it to the market. Perhaps that end-user accountability will result in something more tangible than the ambulatory-focused Avenel software Allscripts launched at HIMSS18, only to cease mentioning it almost immediately afterwards.

Allscripts shares seem largely unaffected, dipping slightly from $11.11 to $10.58 during Tuesday’s trading.


HIStalk Announcements and Requests

image

Welcome to new HIStalk Gold Sponsor Summit Healthcare. The Braintree, MA-based company has helped 1,000 healthcare systems take control of their integration and automation needs over its 20-year history while maintaining a 98% customer retention rate. Product suites include Exchange (interoperability platform), All Access (document distribution and display), EMPI (patient identity and demographics management), Scripting Toolkit (robotic process automation), Scheduler (schedule- and parameter-based task launching), and InSync (synchronization for data management). The company’s integration technology and professional services can help health systems lower costs, increase speed to results, improve care, and enhance compliance and control. Its EMPI Analysis Check can help hospitals that have merged, changed systems, or maintain best-of-breed ancillary systems assess the impact of duplicate records, inaccurately billed claims, and reconciliation costs. Thanks to Summit Healthcare for supporting HIStalk.


Webinars

October 2 (Wednesday) 1:00 ET. “Conversational AI in Healthcare: What About ROI?” Sponsors: Orbita, Cognizant. Presenters: Kristi Ebong, SVP of strategy and GM of healthcare providers, Orbita; Matthew Smith, AVP and conversational AI practice leader, Cognizant. Conversational AI holds great promise to drive new opportunities for engaging consumers and customers across all industries. In healthcare, the stakes are high, especially as organizations explore opportunities to leverage this new digital channel to improve care while also reducing costs. The presenter experts offer a thought-provoking discussion around conversational AI’s timeline in healthcare, the factors that organizations should consider when thinking about virtual assistants through chatbots or voice, and the blind spots to avoid in investing in those technologies.

Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

image

PDMP-focused technology company Appriss Health acquires OpenBeds, software developed by Johns Hopkins faculty member Nishi Rawat, MD that helps providers and social workers connect behavioral health patients with inpatient and outpatient care.

image

Athenahealth puts its Arsenal-on-the-Charles headquarters outside of Boston up for sale. It purchased the historic property from Harvard University in 2013 for $168 million. The company still maintains five offices in the US and two in India, and intends to remain in the area as a long-term tenant.

image

Siemens Healthineers subsidiary Siemens Medical USA will acquire Seattle-based ECG Management Consultants from Gryphon Investors.

image

Francisco Partners will buy LIS vendor Orchard Software. Billie Whitehurst (Netsmart) will become CEO of the newly acquired company. The Francisco Partners portfolio already includes Capsule Technologies, CoverMyMeds, GoodRx, T-System, QuadraMed, and ZocDoc.


Sales

  • Inspira Health (NJ) will offer telemedicine services from MDLive.

People

image

Alphabet names Robert Califf, MD (Duke Health) to head of strategy and policy for its Google Health and Verily Life Sciences Divisions. The former FDA commissioner has been a Verily advisor since 2017.


Announcements and Implementations

image

WakeMed Health & Hospitals (NC) implements PeraHealth’s Rothman Index predictive analytics software.

image

Boulder Community Health (CO) goes live on Epic.

Boston Software Systems announces GA of productivity-focused analytics.


Government and Politics

Beginning next year, the VA will automatically share health data with community providers using the Veterans Health Information Exchange.

image

ONC is looking to hire a Washington, DC-based executive director and economist.

image

FDA proactively issues an alert about Urgent/11, a cybersecurity vulnerability found in IPnet third-party software that attackers may exploit to hack into medical devices and hospital networks.


Privacy and Security

image

A ransomware attack forces several hospitals in the Australian state of Victoria to take their computer systems offline. Impacted organizations include Allscripts customer Gippsland Health Alliance and the South West Alliance of Rural Health, which seems to be an InterSystems customer. The hack coincided with an upgrade to the nationwide My Health Record PHR connecting diagnostic imaging and pathology providers to the system.

image

DCH Health System in Alabama diverts patients from all three of its hospitals after their computer systems were taken down by an early-morning ransomware attack. The system announced it was implementing Meditech Expanse just over a year ago.


Other

image

Northern Light Health administrators say they will work harder to get physicians on board with the Maine-based health system’s rebrand, which kicked off last year. Staff have questioned the value of an expensive project that has no direct impact on patient care. The undisclosed cost of the marketing project, which typically runs into the millions of dollars, has eaten into earnings as the system attempts to pay off $391 million in debt and borrow another $34 million for construction.

image

Stanford University’s Machine Learning Group works with Intermountain Healthcare (UT) to develop software that can accurately identify the presence of pneumonia from chest X-rays in as little as 10 seconds. Intermountain expects to roll out the CheXpert technology in select emergency departments this fall.

image

A small Definitive Healthcare survey of healthcare stakeholders finds that a lack of resources including health IT, gaps in interoperability, and trouble with collecting and reporting patient data are some of the biggest barriers to moving to value-based care models. Those who’ve already made the transition cited reduced medial errors as the biggest benefit.


Sponsor Updates

image

  • Dimensional Insight team members sponsor the registration table at the St. Jude run/walk.
  • AdvancedMD publishes a new e-guide, “4 Ways to Tell if Your EHR is an Adult or Teen.”
  • Bluetree names Deb May (Renown Health) and Carmen Wolf (Nuance) executive partners.
  • Burwood Group Cloud Services President Chris Pond joins the board of the Boys & Girls Club of Greater San Diego.
  • CoverMyMeds publishes a new case study, “End-to-End Support Improves Patient Access for Specialty Medications.”
  • The One Million by One Million blog features Diameter Health CEO Eric Rosow.
  • Hyland Healthcare assists in the development of NIST’s new practice guide, “Securing Picture Archiving and Communication System.”
  • Zynx Health’s new Import Manager gives customers the ability to import PowerPlans from their Cerner EHRs to Zynx Health’s Knowledge Analyzer.

Blog Posts


button


Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates. Send news or rumors.
Contact us.


125x125_2nd_Circle

Morning Headlines 10/1/19

September 30, 2019 Headlines No Comments

Francisco Partners to Acquire Orchard Software

Private equity firm Francisco Partners will acquire laboratory information systems vendor Orchard Software.

ECG Reinforces Client Focus, Joining Siemens Healthineers

Siemens Healthineers subsidiary Siemens Medical USA will acquire ECG Management Consultants from Gryphon Investors.

Alphabet taps former FDA commissioner to oversee health strategy and policy

Alphabet names Robert Califf, MD (Duke Health) to head of strategy and policy for its Google Health and Verily Life Sciences Divisions.

Athenahealth campus is for sale, but it aims to stay put in Watertown – as a tenant

Athenahealth decides to sell its Arsenal-on-the-Charles headquarters outside of Boston, but intends to remain in the area as a long-term tenant.

HIStalk Interviews Karly Rowe, VP, Experian Health

September 30, 2019 Interviews No Comments

Karly Rowe, MBA is VP of new product development, care and identity products, at Experian Health of Franklin, TN.

image

Tell me about yourself and the company.

I’ve been with Experian for eight years. I oversee all of our new product development, the processes, the teams, as well as our identity and care management portfolio. Our Experian Health business is represented by the areas of revenue cycle management, identity management, care management, and analytics. We started in the market serving a group of providers.

What are the chances of the US implementing a unique patient identifier?

Now more than ever, there’s an openness to consider a national patient identifier, especially as topics of interoperability are getting more and more advanced through things like TEFCA. There’s a new acknowledgement within the public sector, the private sector, and the healthcare industry as a whole that a lot of the things that we want to achieve — in terms of true interoperability and improvement of care for patients and care coordination – all foundationally stem from having a national patient identifier in place.

I don’t have a crystal ball to predict whether that time will be tomorrow, next week, or a year or two years from now. But I do think that there’s been a significant shift and an openness, to where we are closer now than we ever have been to getting to a point to embrace the national patient identifier.

How would that change the company’s business?

I don’t see a large pivot. Our position is that there isn’t one key-holder to this identifier. It’s more likely and more beneficial that it’s a handful of vendors, of organizations, working together to provide it. 

We collaborate with vendors across many other lines of business. Our core business is as a credit bureau. If you look at that model, Equifax, TransUnion, and Experian work together, collaborate, and share information as it pertains to individual’s credit to ensure that the information is the most accurate when going out to consumers.

For us in a healthcare setting, do we provide identity services? For sure. Would we be open and accepting to collaborate with other key leaders within the industry to make this something that could truly help transform the healthcare industry? 100%. There’s precedent that has been set across multiple aspects of our business. That credit example is just one of many.

Online services often ask people to verify their identity by choosing their previous address or a car they used to drive from a list of choices, something that they know that others would not. How is that being used in healthcare versus just taking a patient’s driver license or insurance card?

That’s a service that Experian Health has been providing to the healthcare industry for several years. We work with a lot of the patient portal systems and are integrated directly with them. We can help provide the confidence to our healthcare clients that the patient is who they say they are, before you then open up access to all of their personal health information that’s highly sensitive. 

That’s something that we have carried over. Banks and financial institutions probably paved the way and were pioneers of setting that precedent. Healthcare is adopting that, as patient information is no longer on paper and it’s all electronic records. Access to that information needs to be protected and treated with the highest degree of security and sensitivity.

Surveys have shown that consumers, wisely or not, are willing to share their private information with companies that give them something in return. How will that play out in healthcare?

Even speaking for myself as a consumer, there’s a general frustration that we all feel when we say, “I can’t access all of my health information, my historical information, anywhere.” Unlike when I go online to look at my credit card statement and I can see all the transactions and I can look across multiple credit cards. The history, credits, and debits are all there.

It is absurd in healthcare that from a consumer perspective, if I wanted to do that today, I would have to individually reach out to find every doctor, every pharmacy, every lab test that I ever got, and manually go ask for that information. There’s a convenience where I would love to know that the care that I’m getting, the decisions that the doctor who’s standing in front of me is about to make on my health, are the best decisions.

The way for that doctor to make the best decisions is for me to provide the consent to say, you have access to that information, and there’s a way to pull that all together. The only way that that really happens is if you have an understanding of who I am as a patient across all of the different encounters that I’ve had. That stems by speaking the same common language, and the problem that we have today in healthcare is that we’re all speaking different languages. Everybody’s got a different way of identifying a patient and none of them interact. It’s like one health system speaking French, one speaking German, and another speaking Italian, all trying to talk to each other about a patient. It’s impossible.

Are health systems interested in using outside consumer information for patient engagement, marketing, or other communication that doesn’t involve only what the EHR contains?

Some are, but there are clear lines of distinction. This is where the patient plays a role in what information is being shared and for what purposes. There’s that clinical aspect of saying, I just want to be able to provide the history of my health so that that doctor has seen every lab result, every test, every procedure in their hands.

There is another element where, like in many other facets of our lives, we like the customization of the ads that are being sent to us, the coupons that are targeted to services that we enjoy, or the commercials. That transcends every other part of our life. In healthcare, there is an interest in saying, “Maybe there are pieces of who I am as an individual and the likes that I have. I’m OK with you having so that you can tailor my experience when I’m a patient visiting your portal or when I’m interacting with you as a healthcare system.”

That starts to get into things that could improve the patient experience and their overall engagement. A lot of topics stem around overall care management, care coordination, and how that patient is being treated and receiving care. There are broader socioeconomic data factors that can assist in that. But I draw a line of distinction between those. For a lot of consumers and patients, clinical information is different and feels different than your lifestyle, behavioral, and socioeconomic type information. Patients may want to choose to share those things differently for different purposes.

Some of the first uses of commercial consumer information I saw in health systems were as simple as verifying a patient’s identity via the address they provided or to determine their propensity to pay. Is it a big leap from there to using social determinants of health?

We talked about having a patient identifier. Studies done by ONC on patient matching show that having reference data, knowing more about a patient than what’s present within a healthcare system, can help you get a better match. It’s the same in social determinants of health. They say 80% of health outcomes are attributed to non-clinical factors. That means the socioeconomic factors that surround someone.

If you take a step back and say, what am I willing to give to get, it is like what you said about consumers. If a consumer knows that they could receive better care or have better care decisions made for them if they allow the caregivers or the healthcare organization to have a more complete picture of who they are as an individual, I don’t know who wouldn’t sign up for that.

Protections need to be in place to make sure that there isn’t abuse. Organizations like ours take it very seriously — the types of data, how that data is being used, and adhering to all of the regulations that are set forth. One of the things that we stand by very strongly is that we’re an original source compiler, which means all the data that comes into us, we have direct relationships with all those data furnishers. That allows us to ensure the integrity of that data, how it is intended to be used, and the regulations that are involved.

Others are buying data from somebody who buys data from somebody who buys data. The further downstream you get and all those different extensions, the higher the risk goes in terms of that data being used for the wrong purposes and for purposes that wouldn’t make a patient feel good.

What trends are you seeing in the increasing number of uninsured patients and high-deductible health plans that leave them paying more?

Patients have two pain issues – paying a larger percentage of the total and wanting visibility earlier. Sometimes it’s not the total of my bill that bothers me, but rather that I don’t have visibility before I get that bill in the mail. We do a lot of work with many of our clients to put patient estimates in the hands of consumers so that they are not surprised by what a particular procedure will cost or what their bill will look like. That goes a long way in helping them have a dialogue and a conversation with their healthcare provider to understand whether they have options or flexibility. 

That becomes critical, because it ties directly to the overall amount that the patient will ultimately be burdened with. There may be things that are optional within a patient’s care plan, there may be things that aren’t, or maybe there’s a drug that’s getting prescribed where there’s the option for a generic. Having that patient visibility into the cost up front allows that dialogue to happen, and maybe downstream to reduce that total burden and allow the patient to play an active role.

What is the expected outcome of Experian Health acquiring patient scheduling vendor MyHealthDirect?

What MyHealthDirect does is synergistic with what we do. We provide a lot of services that fall into the patient access realm. Bringing in the scheduling component to our suite of solutions, providing that ability to schedule a service, combining that with our matching and the correct identification of that patient, and then being able to facilitate the registration process, which starts to include running eligibility, looking at coverage, and providing those estimates. It’s really just continuing our breadth and advancing the more holistic solution of the patient access services that we can provide to our client base. 

All of this ties around our broader vision of of helping improve the care coordination for patients on behalf of our clients. It’s a natural fit and tie-in with many of the services that we provide today, but it also allows us go back to our clients with a solution that helps them manage that upfront interaction with a patient from the point of scheduling an appointment.

Do  you have any final thoughts?

We at Experian Health are excited about how we can help transform the healthcare industry, providing services and offerings to the market that are unique to our business. How we combine those, how we help solve challenging problems. One of the reasons I got into our healthcare space is that we have unique data and unique capabilities that, when hearing the challenges that our clients are facing, allow us to provide a differentiated solution. We’re excited about where we can help take the industry as we go forward.

Subscribe to Updates

Search


Loading

Text Ads


Report News and Rumors

No title

Anonymous online form
E-mail
Rumor line: 801.HIT.NEWS

Tweets

Archives

Vince Ciotti’s HIS-tory of Healthcare IT

Founding Sponsors


 

Platinum Sponsors


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Gold Sponsors


 

 

 

 

 

 

 

 

 

 

 

 

 

 

Reader Comments

  • Ok Boomer: 👆...
  • meltoots: If Cerner received top marks for IT hospital support, then I cannot imagine how bad it really is out there. Cerner IT su...
  • TH: Everything you said in that comment is true... And it's still a voluntary choice people make. It may be the case th...
  • Fellow Ex-Epic: Echoing this sentiment. Epic threw away the goodwill they accrued from the years I helped them improve healthcare, and f...
  • Why not?: It's not about not wanting them to eventually end up at a customer. The understanding is that it's there to deter poachi...
  • Ex-Epic Chiming In: In the case of Epic, you're now limited not only by your own non-compete, but the separate agreements that Epic has made...
  • HISJunkie: Forgive me I have too say it...but: "I told you so", right here on HISTalk when they first went public...
  • Frank Poggio: Non-compete, Why would a vendor NOT want an employee to go to work for a customer/client?? Decades ago when I worked fo...
  • Collin: great interview! for anyone who's interested in seeing more about the "clever dog trick syndrome" mentioned here, I foun...
  • Associate CIO: Regarding your statement "I echo the sentiment that these are agreements which people voluntarily enter into and agreein...

Sponsor Quick Links