Monday Morning Update 12/16/19

Top News

Hackensack Meridian Health, New Jersey’s largest health system, admits that it has paid a ransomware hacker to regain access to its computer systems.

Some of those systems remain down two weeks after the attack began.

The health system did not reveal the amount paid, but says it carries insurance for that purpose.

Meanwhile, the city of New Orleans declares a state of emergency after shutting down all of its servers and websites following ransomware threats.

Reader Comments

From Student Union: “Re: new jobs listed in the ‘people’ section. Why do some of them not include a link to the announcement?” I learn of some of them via LinkedIn notifications from my 3,000 connections and I don’t link in those cases. My criteria for mentioning someone’s new job are: (a) I only list VP and above since I would be overwhelmed with job changes otherwise; and (b) the person has to be recognizable to many readers based on their healthcare history.

From Pleiades: “Re: Monarch Medical Technologies. FDA has recalled both of their EndoTool glycemic management / insulin dosing software products. They only offer these two products and can’t implement them at any hospital because of the open recall.” FDA recalled EndoTool IV in June 2019 because of calculation errors and and recalled EndTool Subq in November 2019 because it was distributed without FDA’s approval or clearance.

From Meaningless Use?: “Re: patient portals. A recent HIStalk interviewee said they were important because they were part of the Meaningful Use requirement. How is that important? Also, where would we be today without the HITECH Act and Meaningful Use? Many of those in the industry who started pre-MU know no other reality.” My thoughts:

• The stimulus-focused MU program artificially goosed EHR demand similarly to the “cash for clunkers” program. Although to be fair, MU payments were tied to use rather than purchase – if you already had an EHR, you could get free money by simply using it per federal government requirements.
• Sales jumped for products nobody wanted when they were spending their own money, encouraging vendors to lie and providers who were anxious to lap at the taxpayer trough to buy products without due diligence or commitment to process change.
• Innovation was stifled because the industry’s collected wad was shot on the same old systems that weren’t selling before.
• Health IT was chosen as a shovel-ready project that could pump a lot of stimulus money into the economy quickly, and those involved made an earnest but fumbled attempt to give taxpayers $35 billion worth of benefit by conditioning the payouts on accomplishments (or lies about accomplishments via unverified attestation) on metrics that did little to improve patient outcomes, access, or cost. Providers were thinking only of their taxpayer welfare payments rather than the welfare of their patients when they bought these systems and attested that they were using them magnificently.
• Patient portals seemed sexy to an industry with a poor technology track record, but nobody bothered to ask patients if they wanted them or demanded that providers do more than to simply offer them to earn their taxpayer payday.
• Portals also gave providers an excuse for doing nothing else to improve communication with their patients, They could simply pat themselves on the back and cash their checks for turning on a portal that few patients signed up for and far fewer actually used. People do what they are paid to do – no more, no less.
• But as with most technology, it’s the people rather than the tools that are the problem. Providers like Kaiser embraced both EHRs and portals and have delivered pretty amazing benefits to patients, to the point that its portal is extensively used for patient-provider messaging, routine refill and appointment requests, and inquiries. They made their portal a competitive differentiator because it was profitable for them to do so.
• Patient portals are the technological manifestation of healthcare paternalism – patients are expected to use them (a separate one for each provider) even though the doctors may or may not, those multiple providers don’t exchange information, they are just as provider-protective since providers don’t promise quick or detailed responses to portal-posted patient concerns, and users still get a clipboard full of blank forms shoved in their face when they show up for a visit. You would likely change banks if the best technology they could come up with looked anything like a patient portal.
• Without MU, EHR sales would have picked up more gradually and smaller medical practices would probably have opted out. But that would have forced vendors to improve their products and encouraged new entrants to offer something better. The market was speaking before MU artificially manipulated it.
• I would be uneasy claiming in the absence of evidence that EHR adoption has improved outcomes, access, or cost to any extent, much less $35 billion worth. I would also cite endless surveys showing minimal patient use of portals and minimal improvement in any type of outcome as a result.

From Darth Vader: “Re: UnitedHealth Group. With all this talk about reducing healthcare costs, why isn’t anyone in Congress talking about UHG, and in particular, Optum? How ingrained is this organization in every nook and cranny of the US healthcare ecosystem?” We’ve societally accepted that US healthcare is a business in which patients are the widgets of production, so it was inevitable that the whole mess (or at least the most profitable parts of it) would be controlled for maximum profit by publicly traded companies, private equity firms, and profit-admiring health system executives. Those groups are also big political donors and advertisers. The track record of a constituent-focused member of Congress dismantling a hated and excessively profitable monopoly, at least in the past few dozen years, isn’t very good. One person’s excess costs is someone else’s income and the latter don’t readily give it up.

HIStalk Announcements and Requests

Most poll respondents believe that patients own the data that providers record about them. Actually I should probably say that they wish it were true, but are aware that legally (and with ownership, that’s all that counts) patients have no such claim. Reader Conflated added a poll comment that provides a thorough overview of the issue:

It seems like three concepts are being conflated in this conversation. One is ownership of the records of the services performed by a provider (“the data”). The second is rights to access the data. The third is rights to “do stuff” with that data.

It would seem the original copy of the records stored on a provider’s EHR (or the paper records in their record closet) belong to the provider. The patient doesn’t own that copy of the records. It documents the work the provider did, the observations and results the provider captured, the medical recommendations the provider made, and is the basis of mounting a legal defense if the provider is sued for malpractice. Not to mention, there are record retention requirements the provider is required to follow, another hallmark that they own those records.

However, the patient also has a right to access and copy ALL of the provider’s records about them. That copy belongs to the patient.

Taking these two points together, then, it seems like the provider and the patient both have a right to own a copy of the same data. On a right to “do stuff” with the data, this is the more complicated thing, and the area in which HIPAA most needs a refresh. Just because a provider “owns” their copy of the records doesn’t inherently give them rights to “do stuff” with it. We have also seen some legislation that the provider has an obligation to do some stuff at the direction of the patient with said data (e.g., securely transmit it to another provider), but the provider still gets to retain a right of ownership of their copy of the data.

New poll to your right or here: What data sharing issues, if any, did you experience in your 2019 provider visits?

The “like” button you see on each article tells me that the most-liked HIStalk items in the couple of years I’ve been using it (like votes minus dislikes) are, in order:

1. Pretzel Logic 9/30/19
2. Readers Write: To Douse the Flames of Physician Burnout, Target the Four Biggest Time-Wasters in the EHR
3. A Machine Learning Primer for Clinicians — Part 1
4. Book Review: Bad Blood
5. Readers Write: A Prescription for Poor Clinician Engagement with Health IT: Stop Communicating and Start Marketing
6. Neal Patterson’s Final CHC Speech — November 16, 2016
7. HIStalk Interviews Vince Ciotti, Retired HIS-torian
8. The Smokin’ Doc Celebrates a Successful HIMSS
9. Readers Write: The Big Fib
10. CIO Unplugged 3/21/18

My Anonymous Vendor Executive (AVE) offered to provide more Donors Choose matching money, but I’m stymied since I still have nearly $10,000 of AVE’s previous donation in my account. Reason: most of the larger donations I’ve received came from HIMSS-related activities, such as lunch with a CIO or other promotional event, and I haven’t done those lately. I propose that we put that money to work as follows:

• I will (since the AVE suggested it) match donations $2 for every $1, and other matching will surely increase the bang for your donation buck.
• For company donations of $1,000 or more, I’ll include a text message of your choice in an HIStalk update email in addition to the usual thank-you message on the site.

I’m open to other ideas as well. Let’s spend AVE’s money on a great cause. If you want to donate, here’s how:

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

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.

Acquisitions, Funding, Business, and Stock

Blue Cross Blue Shield of Massachusetts integrates its member app with Amazon’s PillPack pharmacy, allowing members who take multiple medications to order their prescriptions, pay for them, and schedule their delivery. The app will encourage those patients to switch their pharmacy to PillPack, in which case all of their information will be automatically transferred.

Sales

• DHR Health Institute for Research and Development (TX) joins the TriNetX global health network to improve clinical trials access to Hispanic residents of the Rio Grande Valley.

People

Rx Savings Solutions promotes Daron Sinkler to VP of sales.

Announcements and Implementations

Partners HealthCare announces a five-year digital health initiative that includes online appointment scheduling, video visits, implementation of OpenNotes, procedure and imaging cost estimates, improved interoperability, posting of ED wait times, and customized patient communications. The program also includes an incubator component. The Boston paper says the program will cost at least $100 million

Other

An article in Wired predicts the end of drug trials that use a placebo group, i.e. patients who receive no actual treatment for their conditions to determine the benefit to those who do. EHR data can identify similar patients, then compare the new product’s results with those of the existing standard of treatment as a “synthetic control arm.” The author wisely notes that this is probably why drug company Roche paid nearly $2 billion to acquire oncology EHR vendor Flatiron Health in early 2018, having foreseen the use of real-world data for drug approvals now that EHRs are ubiquitous.

I like this proposed rework of HIPAA that appeared in the Health Affairs blog last week. It calls out HIPAA’s most glaring deficiencies in falling short of broad patient privacy protection – it regulates only covered entities and those covered entities get a free pass under “treatment, payment, and operations.” Not to mention that the US lags behind in failing to protect the information of its citizens via Europe’s GDPR.

Florida pain management practice chain Korunda Medical will pay $85,000 to settle HIPAA charges that it ignored a patient’s request to send an electronic copy of their medical records to a third party, then charged the patient an excessive amount for the paper copies it sent. The patient filed a complaint in March 2019, OCR provided penalty-free “technical assistance” to the practice and closed the complaint, but the patient filed a second complaint four days later when Korunda ignored the records request again.

Cigna will implement an AI-powered medication adherence monitoring program in January. The company says knowing whether patients are taking their meds as prescribed will allow it to improve care, while privacy experts worry that the objective of insurers is always to pay less and that the “digital dystopia masquerading as healthcare” will allow Cigna to cancel policies or avoid paying claims. Cigna paid $54 billion to acquire pharmacy services vendor Express Scripts earlier this year.

A PGY-1 osteopathic resident at AdventHealth Orlando and self-proclaimed “influencer” apologizes for pitching several healthcare products on his social media accounts, one of them a sketchy nutritional supplement for rave music festival attendees that he sells as a company rep. He explains, “It makes a lot of sense that I shouldn’t be using my medical degree as a platform to sell products. But no one teaches you this stuff.” He’s also planning to use his experience to start a business that will monitor medically related social media posts for appropriateness.

An interesting New York Times article describes how Amazon Web Services “strip mines” startups by copying their software, especially open source, and then selling it themselves. AWS generated $25 billion in revenue last year and is Amazon’s most profitable business.

In Pakistan, several cardiac inpatients die when hundreds of lawyers in their customary black suits storm a hospital, angered that one of their peers told them he had been mistreated when he brought a relative in for treatment. At least 200 lawyers vandalized hospital property, damaged vehicles, set fire to a police van, and beat several doctors. Physicians and employees then fled the hospital, leaving patients unattended, and the hospital then closed when the doctors mounted a protest strike.

Sponsor Updates

• Redox releases a new podcast, “An interview with Dr. Fatima Paruk, Microsoft’s Chief Medical Innovation Officer.”
• OmniSys launches the Pharmacy Talk newsletter.
• PatientPing releases a new customer success video featuring UI Health Senior Director, Care Continuum, Rani Morrison.
• Academic Radiology features an editorial from Visage Imaging’s MingDe Lin, “Accelerating the Translation of Artificial Intelligence from Ideas to Routine Clinical Workflow.”

Blog Posts

• Seasonal Depression Awareness Month (Lightbeam Health Solutions)
• Hospital Budgets 2020: Resist the Cost-Cut Bias and Invest for Success (Loyale Healthcare)
• Helping organizations focus on care, not IT: Discussing Meditech’s cloud journey (Meditech)
• Survey Points to Major Burnout Concerns Among Clinicians (Health Catalyst)
• Enable Multidisciplinary Care with Smarter Team Tools (Mobile Heartbeat)
• Physical Therapists, Physical Therapy Assistants, Physical Therapy Aides – Looking at the Core Clinical Workforce of a Practice (MWTherapy)
• Top integration challenges in healthcare IT (OpenText)
• Five Keys to Planning EHR Go-Live Support for Providers (CereCore)
• 4 ways to boost patient engagement (Experian Health)
• What Are Millenials Looking for During Patient Payment Collections? (PatientBond)
• Three Decades of Nursing: Looking Back to Move Forward (PatientSafe Solutions)
• Satisfied Patients Say What??? (Patientco)
• #GetToThePoint: Six strategies to take action on tests pending at discharge (TPADs) and prevent potential harm. (Pivot Point Consulting)
• The Role of Patient Engagement in Remote Patient Monitoring (PerfectServe)
• Identity Goes to Vegas: Gartner IAM (SailPoint Technologies)
• Managing diabetes: High-touch, high-tech collaboration between patient and care team (StayWell)
• The Critical Importance of Patient Matching Capabilities (Summit Healthcare)
• 2018 Progress Report Myths v. Reality: How Healthcare Providers are Using Powerful Solutions to Deliver Better Care Nationwide (Surescripts)
• Beyond the Electronic Health Record: Human-Centered Design to Reduce Clinicians’ Cognitive Burden (Vocera)
• 4 Facts Every PT Should Know About Telehealth Compliance (WebPT)

Contacts

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

Weekender 12/13/19

Weekly News Recap

• Hackensack Meridian Health (NJ) brings its clinical systems back online after a downtime of several days, rumored to be the result of a ransomware attack.
• Former Outcome Health EVP Ashik Desai pleads guilty to wire fraud and agrees to cooperate with prosecutors.
• Emergency medical services technology company ESO acquires trauma registry software vendors Clinical Data Management, Lancet Technology, and Digital Innovation.
• Proteus Digital Health’s previously announced restructuring will include eliminating 292 jobs and closing several facilities by January 18.
• The DoJ will look into Google’s $2.1 billion acquisition of Fitbit for possible antitrust violations.
• Partners HealthCare (MA) will spend $100 million on a five-year digital health initiative focused on developing self-service technologies for patients.
• BJC HealthCare (MO) lays off 200 employees as it outsources some IT services to an unnamed managed service provider.

Watercooler Talk Tidbits

The DoJ charges 10 former NFL players for alleged fraud after they filed nearly $4 million in claims for medical equipment that was never purchased or received through a health reimbursement account plan set up for former athletes. Claims were filed for hyperbaric devices, ultrasound equipment used for imaging on pregnant women, and electromagnetic therapy devices used on horses.

Former debt collection agency employee Shaunna Burns takes to TikTok to share advice on dealing with medical debt collection. In just a few weeks, she has gained over 100,000 followers and over 1 million likes. “The fact that there are people out there thinking debt equals deadbeat … debt doesn’t equal deadbeat,” she says. “I’m not a deadbeat, and I have great credit, and I’m still having to deal with debt collection. I literally spent hours a week fighting with insurance companies over stupid bills that shouldn’t have been charged … having to do all that is annoying and frustrating, and I thought if I could help one person [with the TikToks], it would be worth it.”

Zuckerberg San Francisco General Hospital notifies 1,174 patients of a months-long privacy breach resulting from employees who failed to shred patient-identifying meal tray tickets, instead throwing them away in regular garbage bins.

Harvard Medical School geneticist George Church develops dating app technology designed to pair users based on their DNA. Church says the app could help wipe out inherited diseases.

Advocate Children’s Hospital  (IL) launches the Santa Connection program with help from Burwood Group and Cisco.

In Case You Missed It

• News 12/13/19
• EPtalk by Dr. Jayne 12/12/19
• HIStalk Interviews Michele Perry, CEO, Relatient
• News 12/11/19
• Curbside Consult with Dr. Jayne 12/9/19
• HIStalk Interviews Doug Cusick, CEO, TransformativeMed
• Monday Morning Update 12/9/19

Get Involved

• Sponsor
• Report a news item or rumor (anonymous or not)
• Sign up for email updates
• Connect on LinkedIn
• Contact Mr. H

Morning Headlines 12/13/19

Partners HealthCare Launches Digital Health Initiative

Partners HealthCare (MA) will spend $100 million on a five-year digital health initiative focused on developing self-service technologies for patients.

Senate confirms Trump’s nominee to lead FDA

The Senate confirms MD Anderson Chief Medical Executive Stephen Hahn, MD to lead the FDA.

Caresyntax to Acquire Operating Room Analytics Provider, Syus

Surgical automation and software vendor Caresyntax acquires OR analytics company Syus alongside a $45 million funding round.

BJC outsources IT services, cuts 200 jobs

BJC HealthCare (MO) lays off 200 employees as it outsources some IT services to an unnamed managed service provider.

NextGen Healthcare Announces Agreement to Acquire OTTO Health

NextGen acquires telemedicine vendor Otto Health.

News 12/13/19

Top News

In Boston, Partners HealthCare plans to spend $100 million on a five-year digital health initiative focused on developing patient self-service technologies including online appointment scheduling, ED and urgent care wait times, and cost estimates; virtual care via text and video; and access to aggregated medical records including OpenNotes.

Reader Comments

From Darth Vader: “Re: Optum/UHG layoffs. See UHG latest results? Talk about systemic risk. With all this talk about reducing healthcare costs, why isn’t anyone in Congress talking about UHG and in particular Optum? Just how ingrained is this organization in every nook and cranny of the US healthcare ecosystem?” Vader’s observation comes just a few days after OptumRx’s purchase of Diplomat Pharmacy for $300 million.

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

Tampa Bay Lightning owner and former hedge fund manager Jeff Vinik invests $5 million in health IT integration vendor Bridge Connector, bringing its total funding to $25 million. Vinik is also a minority owner of the Boston Red Sox.

Surgical automation and software vendor Caresyntax acquires OR analytics company Syus alongside a $45 million funding round.

Proteus Digital Health’s previously announced restructuring plans will include eliminating 292 jobs and closing several facilities by January 18. According to the local paper, the company will turn its focus from digital therapeutics for blood pressure, hypertension, and cholesterol to infectious disease and oncology, “expensive therapies that tie payments to the actual use of the drug.”

BJC HealthCare in Missouri lays off 200 employees as it outsources some IT services to an unnamed managed service provider. The health system cut about 10% of its IT workforce in July 2018 after wrapping up an Epic roll out.

NextGen acquires telemedicine vendor Otto Health.

LeanTaas raises $40 million in a Series C funding round led by Goldman Sachs. The Silicon Valley company has developed predictive analytics for optimal utilization of ORs, infusion centers, and labs.

Pharmacy benefits manager Express Scripts develops a list of recommended digital health tools for payers and providers organized into treatment categories that include depression, anxiety, asthma, and diabetes. Products and services from Livongo, Omada Health, Propeller Health, and WellDoc are among the initial group of recommended solutions.

The Chartis Group acquires The Greeley Company, a consulting and staffing firm based in Boston.

Sales

• Lakeland Regional Health (FL) will implement care team coordination technology from Andor Health.
• The NC HealthConnex HIE will use CarePort Health’s real-time care notifications and reporting capabilities to improve care coordination at UNC Health Care’s 12 hospitals.

People

CynergisTek names Tony Douglas (Symantec) SVP of sales.

Gregory Adams becomes chairman and CEO of Kaiser Permanente after serving in the interim role since the unexpected death of CEO Bernard Tyson last month.

NIH names Joshua Denny, MD (Vanderbilt University Medical Center) CEO of the All of Us research program.

Charlie Greenberg (Merck) joins PatientPoint as SVP of campaign quality and compliance.

Announcements and Implementations

Faith Regional Health Services (NE) goes live on Epic.

Government and Politics

The Justice Department will look into Google’s $2.1 billion Fitbit acquisition for possible antitrust violations related to amassing data on American consumers.

Privacy and Security

Korunda Medical (FL) will pay OCR $85,000 to settle potential HIPAA violations related to multiple complaints from the same patient that it wanted an unreasonable fee for medical records, and failed to provide the records in the requested format in a timely manner.

Other

Baxter Regional Medical Center (AR) will use a donation from community members to fund in-house development of an interface between its Cerner EHR and 400 smart IV pumps.

Avante Skilled Nursing and Rehabilitation Centers (FL) pilot the Furry Palz Program from Thrive Behavioral Sciences. Designed to rest in the laps of dementia patients, simulated breathing sounds from the robotic pets help to relieve symptoms of agitation, isolation, and depression.

Sponsor Updates

• AdventHealth Waterman and Sentara Virginia Beach General Hospital showcase reductions in hypoglycemia and glycemic practice variation utilizing Glytec’s glucose management technology and services.
• Healthwise receives a Gold Digital Health Award for a patient education video in the Health Information Resource Center’s 2019 fall competition.
• InterSystems releases a new PulseCast podcast, “Dave Menninger: Discovering the Hidden Dollars Within Your Data.”
• Vanguard profiles Intelligent Medical Objects General Counsel Charlotte Tart.
• Nordic releases a new podcast, “Avoiding common pitfalls of an affiliate extension program.”
• Arcadia congratulates its ACO customers in achieving over $423 million in Medicare Shared Savings Program savings in 2018.
• Wolters Kluwer Health adds Clinical Insights with enhanced content from UpToDate to its Lexicomp drug information resource.

Blog Posts

• Key Benchmarks for Process Improvement & Success (EClinicalWorks)
• EPSi welcomes Mosaid Healthcare, Mercy and Texas Health Resources to AWS (EPSi)
• Healthcare data exchange increases access through Intergy (Greenway Health)
• Why Troubleshooting Tools are Important to Any Citrix Upgrade (Goliath Technologies)
• This Groundbreaking Program Proves the Value of Health Literacy (Healthwise)
• Rethinking IT infrastructure in healthcare (Hyland)

Contacts

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

EPtalk by Dr. Jayne 12/12/19

My bedtime routine includes checking HIStalk for comments and doing some light Web surfing on my phone, so my attention was captured by yesterday’s JAMA article entitled “Matters of the Mind – Bedtime Procrastination, Relation-Induced Anxiety, Lonely Tweeters.” No surprise, studies linked smartphone use with bedtime procrastination. The piece also looks at how relaxation can be stressful for individuals with anxiety and depression, as well as how Twitter posts could help identify loneliness. These are areas of research many of us wouldn’t have dreamed of a decade ago. I’ve thought frequently about consumer technology (particularly smartphones) and how it’s collectively one huge experiment, albeit one without an Institutional Review Board to make sure the participants aren’t harmed. I think we’re just scratching the surface at learning what technology does (or doesn’t) do for or to us.

Jenn clued me in to this article about startups focusing on nurses as a target audience. There are 3.8 million nurses in the US, so it makes sense that companies would start designing around their needs. Clove is one of them, and their name is an inside joke as well – the C with a line over it is medical shorthand for “with” so their products are “with love.” The name is subtle but the medically-inspired design of its shoes aren’t – although they’re a running style, they have a solid smooth surface over the toe area which is great to protect from the spills and goo of the job. Ventilation holes are relocated to the sides, where splashes and drips are less likely.

The company is savvy in other ways, showing that they understand healthcare folks by shipping a three-pack of pens with every pair of shoes. The pens are marked “For Borrowing Only.” Anyone who keeps a spare (and usually crummy) pen in their pocket to deal with people who ask to use your pen and who are unlikely to give it back knows what I’m talking about. Nike also recently launched a healthcare shoe, but it’s not nearly as cool. I was a little put off by their unisex sizing as well as their use of the “star of life” logo most commonly used by emergency medical services. In contrast, Clove has both women’s and men’s sizing as well as color names that make clinicians smile: Grey Matter, Night Shift, and Pink Up.

Public health informatics is a big part of clinical informatics, and I was shocked to learn about a measles outbreak on Samoa, where measles is running rampant. The country has a population of around 200,000 and nearly 4,900 people have become ill with 71 dying. Similar outbreaks are also occurring in Tonga, Fiji, and American Samoa. Several of the Pacific island nations have vaccine rates below World Health Organization recommendations. There are numerous reasons for the low vaccination rates, but my thoughts go out to those who are sickened and their caretakers. Hopefully the outbreak is a brief one.

In other news, analytics folks must be cheering at the possibility that flu season could peak early this year. The Centers for Disease Control and Prevention’s FluSight Forecasting initiative gives it a 40% chance of peaking this month, as flu levels have been at or above the national baseline for several weeks. The chance it will peak in January is 30% and February is 20%. I’ve significantly reduced my clinical work for January and February because I loathe driving in icy conditions, so we’ll see if I played the odds right or not.

Intelligent Medical Objects has launched IMO Precision Sets, which are designed to allow clients to quickly define various value sets needed for quality work and value-based care. Based on IMO’s solid terminology and maintained by their dedicated clinical terminologists, they are available in various sets – Oncology, Reporting, Behavioral Health, Chronic Conditions, Perioperative, and Acute Conditions. I spent way too much time in a past life trying to maintain those groupings for reporting, through ICD codes and SNOMED codes. IMO’s original Problem IT product was the only solution I ever deployed as a CMIO where my providers proactively reached out to say thank you, so I’m a big fan of their work.

Congress is looking for feedback on a new bill nicknamed “Cures 2.0,” which is designed to go beyond the content of the original 21^st Century Cures Act to address topics like digital and connected health platforms. They also plan to focus on real-world evidence in the FDA’s approval process, and to speed up coverage of FDA-approved drugs by payers. Feedback is requested by December 16 at cures2@mail.house.gov if you’re interested in sharing your thoughts.

As we approach the end of the year, it’s a time for many to reflect on the months that have passed and our hopes for the coming year. Since we work in healthcare technology, we’re not immune to the influence of various trends and fads, especially where health-related tech is concerned. Like many, I’ve had my adventures with wearable tech, startups, and various apps that proposed to make my life better. Lots of people have stories to tell about how we can live our “best lives,” from tech gurus to TV personalities. In a fit of decluttering I had my Marie Kondo moment, so I giggled when I came across this article about “The life-changing magic of making do.” I’m a frugal person (as evidenced by writing this wearing 20-year old pajamas on a 20-year old sofa, watching Netflix on a TV smaller than some computer monitors), but was shocked by some of the statistics in the article as far as sheer consumption in North America.

The piece’s comments on the lack of fixability with technology resonated with me – it’s one of the reasons I hope my geriatric washer and dryer never fully give up the ghost – I don’t need something with a motherboard to control how my clothes are cleaned. (I’ve had enough of that drama with the refrigerator to last a lifetime). I’ve rehabilitated both the washer and the dryer courtesy of Repair Clinic and its videos. (Have you ever seen inside a gas dryer? It’s pretty crazy in there.) It gives me hope for what I want to do professionally in the next year – to help healthcare organizations get the most out of the resources they’ve already paid good money for and that they might not be using to the fullest. It’s a good goal, but difficult for some organizations because it often involves hard work. It’s much easier to throw out a “problem” technology when the real problem is the people or processes that govern its use. We’ll see how that plays in the New Year.

What are your reflections on the past year and hopes for the coming one? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 12/12/19

Bridge Connector Increases Total Financing to $25 Million with Investment From Jeff Vinik & Axioma Ventures

Bridge Connector will use its $25 million in financing to help scale a new integration platform-as-a-service that connects health data systems without the need for code.

Proteus Digital Health plans hundreds of job cuts, facilities closures

Proteus Digital Health’s previously announced restructuring will include eliminating 292 jobs and closing several facilities by January 18.

U.S. Justice Department to review Google’s deal for Fitbit: source

The DoJ will look into Google’s $2.1 billion acquisition of Fitbit for possible antitrust violations.

HIStalk Interviews Michele Perry, CEO, Relatient

Michele Perry, MBA is CEO of Relatient of Franklin, TN.

Tell me about yourself and the company.

Relatient is based in Franklin, Tennessee, and was started in 2014. Our name is a combination of “relate” and “patient,” relating to the patient. We are 100% focused on patient outreach and engagement, and it reflects in our name. We do this only for healthcare. We get calls all the time to see if we do this for prisons, courts, schools and everything else, but we are focused on patient engagement.

I joined in 2017. I replaced the original founding CEO. I’m a Saas software solutions veteran. I focus on high-growth companies.

I’m not a Nashville native, which you’ve probably already heard based on the lack of R’s in my vocabulary. I’m originally from Massachusetts and have spent time in New York, California, and Virginia. I was in Annapolis, Maryland for the 20 years before I took this job.

Are hospitals and practices wrong in thinking that all consumers really want is a patient portal?

Patient portals served an important purpose. They were part of the Meaningful Use requirement. But they are not addressing the needs of today’s consumers and patients. Find me a patient who thinks they are.

We compliment a lot of the work that has been done with patient portals and the investments that have been made in them. Lots of times we’ll drive people to things that are stored in a patient portal. But we’re all about using that phone and making it easy for patients.

In this day of the consumerization of healthcare, we all expect to be able to access things easily from our phone. Every day I’m making reservations, planning a flight, calling an Uber, checking my bank balance, and Venmo-ing money to my kids. You can do it with just a couple of clicks. Try to make a doctor’s appointment, check for your lab results, or register for that appointment while you actually have the medicine sitting in front of you at home. Try to do any of that stuff and it’s painful.

That’s what we’ve set out to fix. We make it easy for the patient, and if you make it easy for the patient, you make it easy for the practice. We see hospitals and clinics and everybody else wanting to engage with their patients.

What are the ones that are doing a good job doing differently from those that aren’t?

I’d love to say that it’s concentrated in different areas, but it’s not. We are seeing it across all specialties. Nebraska Cancer in the oncology area is using it to reduce no-shows by 47%. I was surprised – don’t cancer patients show up? The answer was that we need to alleviate the confusion around all the different providers and appointments people have during the cancer treatments.

We are co-presenting with Oklahoma Heart at HIMSS on driving patient engagement in a mobile-first market. We have FQHCs like Access Healthcare in Chicago, who wants to be able to message not just about your appointment, but to let you know that the food trucks that take SNAP are going to be there on the day that you are there for your appointment. Pediatrics organizations like Children’s of Colorado are doing interesting things with telehealth and remote access initiatives, reaching out into rural areas. Primary and women’s care, like Seven Hills or South Bend Clinic, are focused in gaps in care and things like that.

What percentage of hospitals and clinics are using electronic appointment reminders?

The first generation of those products was pretty basic, and it’s rare for us to run into somebody who hasn’t put in a first-generation solution. But now that they have it, they’re finding that they can do so much more with that communication. Do I need to fast before my appointment? Do I need to show up extra early for testing?

Some of our large hospitals have 120 kinds of appointment types, each of which require different messaging. They need support for multiple locations, especially now with telehealth and remote health, so they can say, “Your appointment is with Dr. Smith out of the Denver office, but you are going to be in the Grand Junction office.” The second generation of products needs these kinds of communications. But it’s really rare to find someone who hasn’t done a first-generation product, except for some small two- and three-doctor offices.

Why is patient self-scheduling uncommon?

Practices didn’t have it yet. They said, “Oh, we have a scheduler.” But people want to be able to schedule after hours, during lunch, or during conference calls. I want to quickly make that appointment off my phone or off my desktop. I want to be able to do that quickly. People hadn’t set those up.

We also found providers who wanted their front desk people to have ownership of that schedule. We’ve added to our product the ability to have a two-step acceptance. Let me make my appointment at 10:30 at night. When my kid’s not feeling well and I want to make an appointment, let me make that appointment. But let it actually have to be accepted by somebody in the office in the morning. They accept this one, accept that one, and then realize that they’re accepting all of them anyway, so they are comfortable skipping that step. But the ability to have ownership was important for a couple of our providers as we were bringing them on.

On the back end, does someone have to copy-paste from the self-scheduling application into the system that keeps the real schedule?

The way we do it is important. We actually write back into these schedules. People are sometimes kind of scared about it upfront, but then when they see that it works really well, then they give up. But yes, we don’t just send an email that someone has to then set up – we do all the write-backs right into the systems for appointment reminders, scheduling, e-registration, surveys, and all of the other components.

The culture of some hospitals and practices was built around a siege mentality, where patients aren’t allowed to communicate with a provider unless they make a billable appointment and come to the office. Is that changing?

Sometimes you can bill telehealth appointments, to have those paid for. People want to have access to their doctors, so they’re trying to make it easier to do these new types of appointments, because if I don’t make my physicians accessible to you, you’re going to go down the street to the urgent care or some other clinic. They would rather not have them go away to the Walmart clinic, the CVS clinic, or someplace else. They want you to come to their providers.

Your system offers broadcast messaging for unplanned changes to normal operating hours, like weather emergencies. Do practices who don’t have it just update their Facebook page and hope patients check there?

Some of the folks still change their websites or have a message on the answering machines. We have tremendous demand for demand messaging, or the broadcast messaging capability, when you have weather problems, like New England this week or during Hurricane Dorian. But it’s also used for non-weather things, like if a doctor will be out for the next two days on bereavement, or in OB-GYN for messages like, “This doctor was just called in for a delivery. Please call the office before coming to make sure they will be here for your appointment.” Specialists make appointments months ahead, so you have to keep up to make sure that you’re not blasting the whole patient base to get a message to the 20 patients who need it.

What about health campaigns such as disease-specific follow-up or seasonal items like vaccine availability?

There’s nothing we do that you couldn’t do manually, but it takes a lot more effort. Campaigns to close the gaps of care are important, especially in primary, women’s care, and pediatrics. Getting people back in to make sure their kids are getting the right vaccines at the right time.

We’ve learned the hard way how to actually do the notifications. Maybe 3,000 patients haven’t had this particular thing that needs to get done. If we just blast everybody, your call center gets overloaded the next Monday. We do a dribble campaign and send the messages in bunches so they don’t all go out at the same time. We pull the data from the EHR and practice management system, use the campaign to contact those people and get them to make appointments, and with patient self-scheduling, we can send them to the link so they don’t even have to call the office.

Consumers vastly prefer text message communication over all other forms for convenience, but it also offers better deliverability than email or phone calls and also gives patients a way to take action without writing something down.

What we have found, and what we recommend in our best practices, is a combination of all three. We do phone, email, and text, and we do them at a certain interval over time. We don’t want to stalk you, but we want to make sure you get the message. If you do just texts, your response rate will be lower. If you’ve heard it on an answering machine and you’ve seen it in the email, you might not have reacted to it, so it’s a combination of seeing those.

We send the final reminder at certain times of the day. Some at night, some in the morning, depending on time of your appointment. You might have accepted it and intended to go, but you drive to work and forget. But if I send you a text that morning for an appointment later that day, you’ll remember. I also can’t send them too late because you don’t want to be disturbing people at night and when they go to bed.

Do you have any final thoughts?

We’re still early on with patient engagement, how we’ll engage patients over time, and how we’ll do it within the constraints of HIPAA, GDPR, and other regulations. It will be exciting to see where this will go, with things like two-way chat. But as we do this, we’re committed to innovation. Not just product innovation, but throughout our company. We’re currently rated number one by KLAS for patient outreach, with a score of 95.6. We follow this score closely throughout the company. We believe it’s the best way to ensure that we are firing on all cylinders. We need to have great products delivered by great people to work with our customers to drive the ROI on our software.If we drive that ROI, we will help our practices have happy customers.

Morning Headlines 12/11/19

Google snaps up chief medical officer of health device maker AliveCor, weeks after buying Fitbit

Former AliveCor CMO Jacqueline Shreibati, MD joins Google Health’s clinical research team.

McKesson Appoints Nancy Flores as Executive Vice President, Chief Information and Chief Technology Officer

McKesson names Nancy Flores (Johnson Controls) EVP, CIO, and CTO.

ESO Acquires Clinical Data Management to Extend Product Portfolio in Trauma Registry Market

Emergency medical services technology company ESO acquires trauma registry software vendors Clinical Data Management, Lancet Technology, and Digital Innovation.

CommonWell Health Alliances Announces New Executive Director

Former Philips VP Paul Wilder joins CommonWell Health Alliance as executive director.

News 12/11/19

Top News

“Smart pill” medication management company Proteus Digital Health struggles to stay afloat after a $100 million funding round fails to materialize. Once valued at $1.5 billion, the Silicon Valley-based company furloughed employees for several weeks in November until it could acquire $5 million in emergency funding. Company officials say they are looking at restructuring options, while unnamed insiders point to a lack of traction with patients as a big reason for the company’s stymied growth.

Meanwhile, competitor EtectRx receives FDA clearance for its smart ingestible, which is being tested by researchers at Brigham and Women’s Hospital and Fenway Health in Boston for use with HIV medication.

Reader Comments

From Dr. Doyle: “Re: The Great NHS Heist. Interesting movie on the NHS.” Backers of the documentary make it available on Youtube ahead of the UK general election on December 12. The documentary, which aims to highlight increasing efforts to take the NHS private, has been in the works for a number of years. It made its theatrical debut in London last month.

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

Emergency medical services technology company ESO acquires trauma registry software vendors Clinical Data Management, Lancet Technology, and Digital Innovation.

Former Outcome Health EVP Ashik Desai pleads guilty to charges of fraud, admitting that, “When I was at Outcome Health, there were practices going on there that were wrong. I participated in those practices that ended up defrauding Outcome’s customers.” Three other former employees, including former CFO Brad Purdy, have pled not guilty. Former CEO Rishi Shah and former president Shradha Agarwal will make their court appearances next week.

Sales

• Hospital Sisters Health System Medical Group (IL) will implement Relatient’s patient engagement software.
• Saint Peter’s University Hospital (NJ) selects Vox Telehealth’s FemmeCare for C-Section and Hysterectomy programs to help patients better prepare for and recover from surgeries.
• Precision medicine company Astarte Medical selects commercialization services from Get-to-Market Health.

People

Paul Wilder (Philips) joins CommonWell Health Alliance as executive director.

Innara Health promotes Chris Mathia to CEO.

AI-based diagnostics vendor IDx Technologies promotes John Bertrand to CEO, replacing founder Michael Abramoff, MD who has become executive chairman. The company has also hired Seth Rainford as president and COO, and promoted Danika Simonson to the new position of chief of staff.

Announcements and Implementations

Advocate Lutheran General Hospital (IL) implements AI-enabled stroke-detection software from Viz.ai. The technology will be rolled out to the entire Advocate Aurora Health network by early next year.

Floyd Medical Center (GA) launches a telemedicine program for stroke and neurology patients leveraging providers from Erlanger Health System (TN).

IntelliGuard integrates its RFID-enabled medication tracking technology for anesthesiologists with Epic.

Wyckoff Heights Medical Center (NY) goes live on Allscripts Sunrise and FollowMyHealth software.

LogicStream Health will make its Drug Diversion App available early next year.

With help from the Medical University of South Carolina’s Center for Telehealth, Roper St. Francis Healthcare adopts tele-ICU services from Advanced ICU Care at three of its hospitals.

Privacy and Security

Hopes of returning to normal operations within a week are dashed as the Government of Nunavut in northern Canada continues to recover from an early November ransomware attack that took its computer systems offline. Health department officials still have no idea when they’ll be able to get their Meditech system and telehealth capabilities back up and running. Chief of Staff François deWet, MD says several things have made the “IT apocalypse” eye-opening:

• Having a disaster plan already in place was key to communicating needs and updates with affiliate organizations, which in turn ensured healthcare services weren’t interrupted.
• The fact that the department was in the midst of a Meditech upgrade before the ransomware attack happened resulted in more reliable backups, which are in the process of being restored.

Other

A Bright.md survey of 521 consumers finds that they trust their current providers and healthcare organizations with their health data far more than they do their health insurance companies, technology companies like Amazon or Google, or telemedicine vendors.

Sponsor Updates

• Bluetree employees impact 23 organizations by volunteering 264 hours across 13 states and India during the company’s annual Give Back Week.
• HHS expands its contract with Audacious Inquiry for the development of a national Patient Unified Lookup System for Emergencies system.
• Avaya announces that Earvin “Magic” Johnson will keynote Avaya Engage 2020 February 4 in Phoenix.
• Data Center Knowledge features Atlantic.Net in its “Trends in Data Center Network and IT Security” report.
• Wolters Kluwer Health adds machine learning and AI capabilities to its Sentri7 healthcare-acquired infections surveillance software.
• Huron will provide consulting and implementation services for Omnicell customers.
• SymphonyRM releases a new podcast, “Edward Marx and Four Pillars of Innovative Leadership.”

Blog Posts

• Reduce Wear and Tear on your Hospital’s Patient Bedside Tablets (Access)
• Optimizing Your Revenue Potential (AdvancedMD)
• 2020: What lies ahead for payers and PACS? (CarePort Health)
• #RSNA2019 – Delivering high impact care at Zuckerberg San Francisco General (Agfa Healthcare)
• 2019 #BlueleafGiveBackWeek: A recap (Bluetree Network)
• Addressing Social Determinants of Health with Technology (Collective Medical)
• 10 Things Nurses Say They Need Right Now (CoverMyMeds)
• 5 Technologies That Will Shape Healthcare in 2020 (Dimensional Insight)
• Nordic’s company culture ranks among nation’s best (Nordic)

Contacts

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

Morning Headlines 12/10/19

etectRx Announces U.S. FDA Clearance of Novel Ingestible Event Marker

EtectRx’s smart pill system receives FDA clearance after news breaks of competitor Proteus facing financial difficulties.

Alleged billion-dollar fraud scheme leads to guilty plea by former Outcome Health exec

Former Outcome Health EVP Ashik Desai pleads guilty to wire fraud and agrees to cooperate with prosecutors.

For Concussion, MS, Other Neurologic Disorders, Telemedicine May Be as Effective as Office Visit

A retrospective analysis of 101 telemedicine studies finds virtual visits may be just as effective as in-person visits for several neurological conditions.

Curbside Consult with Dr. Jayne 12/9/19

As part of the Maintenance of Certification process for my clinical informatics board certification, I have to complete a quality improvement project related to practice. Although there is quite a bit of flexibility in these projects, it’s been challenging for me to come up with something because I don’t have what many would consider a “typical” informatics practice. Many of my peers are either part of academic institutions where they have clear roles and/or titles. Others are part of healthcare delivery organizations where they have the ability to use data and processes for quality improvement. As an independent CMIO for hire, I often have a seemingly random mix of employers, ranging from startup technology vendors to large healthcare systems.

In these situations, I have contractor status. It’s a strange limbo where often you are treated like an employee but you’re actually not – you have many of the same responsibilities and are subject to the same rules as employees, but at the end of the day you don’t have the ability to direct your own work or propose new initiatives that would make sense for a straightforward project for board certification. My clinical situation is unique in that I’m employed, but very much part time and with no formal informatics role these days. My informatics influence is limited to cranky emails to our IT team asking why the system is suddenly allowing us to e-prescribe controlled substances when we do not have legitimate EPCS technology in place. My employer is reluctant to allow me to do anything with our data, since I’m essentially just an hourly physician.

I have another year or two before I have to finish this project, but I still feel somewhat adrift with it. Still, I am always on the lookout for ideas. One recently came across my desk, and I wonder if the practice would be willing to let me use their data if I could find some “what’s in it for me” for them. As an urgent care, we certainly see our fair share of trauma. Recently, JAMA Otolaryngology-Head & Neck Surgery published a study investigating a surge in cellphone-related facial trauma. Reported injuries range from being injured by a dropped or thrown phone to distraction-related falls.

The authors looked at 20 years of data from the US Consumer Product Safety Commission database looking at ER visits. They found 2,500 patients with phone-related head and neck injuries between 1998 and 2017, with a surge beginning in 2007, coinciding with the advent of smartphones. Approximately 40% of the subjects were between the ages of 13 and 29, and they were generally injured while walking, driving, or texting. Although cell phone use has also been linked to repetitive motion injuries, these were excluded from the study. The most common injuries were facial and head lacerations, followed by contusions, abrasions, and injuries to internal organs. The majority of patients were treated and released. Apparently there are more than six million patients treated for lacerations every year, with an estimated cost of $3 billion.

I’d be curious to find out how cell phones compare with other sources of trauma in our urgent care practice. We see over 300,000 patients a year so there should be a reasonable amount of data. Anecdotally, I think that sports-related injuries likely make up the lion’s share of our head trauma, followed by motor vehicle accidents, and falls. I’m betting that the causes would have to be determined by a chart audit, because many of my partners aren’t as specific with their coding as they could be. My quality intervention could be to assess whether visits were documented more accurately when physicians or scribes were doing the work, and to develop a curriculum to try to increase the specificity of coding. It’s kind of a soft project, but it at least addresses something that is clinically relevant in my practice. Still, it’s unlikely that I could talk my employers into it, since there’s not a clear return on investment for the time that would need to be spent educating clinicians and staff.

Another option for the quality project is for informaticists to conduct a 360-degree evaluation project. We did a 360-degree evaluation in residency and I’ve done it with a previous employer, and also with one of the community service organizations I work with. All three times I found it to be useful, although the episodic nature of some of my work might make this challenging. Some of my projects only last a month or two, which makes it hard for someone to get to know how you work, critique it, and then re-evaluate after you’ve completed some kind of intervention or change in how you work.

These are all part of the hoops that we have to jump through to maintain our board certification status. It’s particularly challenging in clinical informatics, since there can be such breadth in the type of work that we do. Our practice environments can be very different, and we may spend anywhere between 1% and 100% of our time doing informatics work depending on how much our employer wants to fund. I am glad that the American Board of Preventive Medicine, which is my certification body, recently approved a proposed Longitudinal Assessment Pilot as an alternative to the one-day board certification exam. It is supposed to launch in early 2021 and run for 24 months. Participants will answer 24 questions a year. This differs significantly from the longitudinal assessment pilot in my primary board, where we have to answer 100 questions a year for four years in order to replace the exam. It’s hard to imagine how the scope of clinical informatics can be distilled down to 24 questions a year, but unlike my primary board, it doesn’t seem that we have the opportunity to opt-out of this pilot.

I’m curious whether non-physicians are aware of the clinical informatics quality projects and whether your board-certified colleagues have pulled you in to help them get across the finish line. How are the projects perceived? Have there been positive outcomes? Or are they just a nuisance? On the physician side, is anyone else dreading their project? Leave a comment or email me.

Email Dr. Jayne.

HIStalk Interviews Doug Cusick, CEO, TransformativeMed

Doug Cusick, PharmD is president and CEO of TransformativeMed of Seattle, WA.

Tell me about yourself and the company.

I’m a clinician by background, although I’ve not practiced for many years. I’ve been in the electronic health industry for 35 years and I have the gray hair to prove it. I spent five of those years overseas, running a large healthcare and life sciences division for a large technology and services company.

TransformativeMed was a spinout from the University of Washington back in about 2012. It was co-founded by a practicing trauma surgeon, who continues to practice, and at that time the applications director at the University of Washington, who had overseen its Cerner implementation. The two of them together quickly saw a need to make the EHR usable, primarily for the doctors.

Does offering products that extend Cerner’s system limit the company’s opportunities?

The applications director was one of the inventors of MPages, which is used by organizations — including Cerner — to develop customizations to the Cerner Millennium software. The co-founders recognized that the EHR was just a platform, and in many cases, one that was challenging for clinicians to use. They went about inventing a series of applications that are embedded within Cerner and that have bi-directional information exchange. That allows specialty-specific workflows to be built.

By example, if you’re an endocrinologist, you need certain data at certain times in the decision-making process as part of the hospital’s overall care team. You want it in the format that is intuitive to how you practice. They developed 40 specialty-specific and subspecialty-specific clinical workflows.These are embedded in the clinical workflow, where all the action happens. Those users can manage their patient lists, the rounding and hand-off process, and care team coordination. They can also take advantage of disease-specific workflows, such as inpatient diabetes management and thrombolytics.

We continue to consume more and more of the breadth and the depth of what the clinicians need in order to make the electronic health record usable. We are moving pretty broadly across that realm.

What kind of relationship with Cerner do you need to make this work? How would that translate into working with Epic?

Our solutions are built on cooperating with the large electronic health vendors. It’s like the Salesforce model, with a great platform that is open for innovations. Cerner specifically is that type of platform. We rely on the data that is populated in the EHR. Our solutions allow that data to flow between the apps and the EHR, because it is embedded within the databases themselves.

In many cases, particularly with Cerner, the client representatives themselves come to us to help solve problems around clinician satisfaction, gaining efficiencies, and delivering on the billions of dollars that have been invested in the EHR.

It’s funny that in my 35 years in this industry, I can count on one hand how many doctors and IT people have ever said anything positive about any software solution. But in our case, what was so attractive for me coming on as CEO was that I get emails and phone calls every day from doctors and IT folks who love our embedded applications products that make their EHR usable, particularly from a specialty-specific perspective. It’s pretty amazing that for the first time in my career, we get so many kudos because doctors and IT folks love us.

How do you see the company growing? Do you hope to replicate your success in having helped other companies move up to the next level?

[Laughs] Absolutely yes, and most certainly. What was so attractive about me coming on board was that I had never seen anything like it. It isn’t disruptive to IT. Doctors and clinicians truly love us because we make their day better by delivering solutions that are intuitive to how they practice medicine. That we don’t need trainers on site speaks to the intuitiveness.

We recently went through a fairly substantial series A raise in Seattle. Before that, we were moving the company forward on customer revenue, and most of those sales had been done by word of mouth. For example, clinicians practicing at the University of Washington were moving on to other health systems and logging onto the EHR and saying, “This isn’t what I’m used to. I really need Cores,” which is the name of our product line.

When I came on board, we had a pretty nice array of clients and we’ve expanded that dramatically. I think we’re up to about 140 or so hospitals in the US. We’re selling our first international deal this week, so we’re pretty excited to expand internationally as well. Cerner has a large footprint.

We will be cautiously moving into Epic. We just closed our first contract with a health system that is moving to Epic. We couldn’t be more excited about gaining that experience, especially as interoperability and FHIR begin to take hold of the industry.

What business arrangement do you have with those EHR vendors?

We do not have a formal business relationship with them. We contract directly to the health systems. But with so many articles being published around physician burnout and lack of efficiencies and crises galore, the EHR vendors are seeing opportunity to deliver more innovation through their platform. The EHR is just data storage and the ability to move data around.

Health systems are recognizing that the EHR vendors aren’t going to deliver everything they possibly need. With the amount of true innovation that is going on across the industry, how can they add applications that make it more usable in a standardized fashion, but personalized for the clinicians who have to use it?

Particularly in this era of EHR optimization, we need to move way beyond the re-implementation of the EHR as the industry currently conceives it. EHRs need a massive overhaul to make them usable by the clinical community, and we have lots of studies to support that. CIOs are beginning to recognize, along with the clinical community, that they have a responsibility to help solve some of the problems.

It’s surprising that you can work with Epic without the company’s participation, and also that you can create add-on products without having problems when Cerner or Epic upgrade their underlying EHR.

MPages allows us to be directly embedded within the Cerner databases and all clients use it. Once we are given access to the system, it becomes our heavy lift and not an IT department burden, so CIOs love us. Plus, we are delivering huge benefits to the clinical community, namely the doctors who are finding that it is much more usable.

Epic is a different model and a more closed architecture. But we’re finding, particularly today in our first engagement, that Epic has been collaborative in terms of bringing our solutions within this health system. We’ll go live with them later in 2020. We couldn’t be more excited about the opportunity to move further into the EHR world. And not just here — the problems we face are being seen worldwide as more countries and systems purchase American EHRs.

EHRs weren’t necessarily designed for physician shift work and the resulting handoffs, such as hospitalists covering large numbers of patients for a fixed period, residents whose work hours are limited, and the use of multidisciplinary care teams. What does the market need beyond basic EHR functionality to support that model?

IT needs to become more interoperable. The 21st Century Cures Act is helping drive that interoperability forward, but health IT vendors as a whole are slow to comply.

I can use my phone to take a picture, edit it before texting it to my kids, share it on Facebook or Instagram, and my sister can download it and post it to her Nixplay electronic picture frame. This is real interoperability, and it should translate to healthcare because consumers expect it.

Doctors and other clinicians are spending so much time today away from the bedside and tied to a device – desktop or mobile – trying to get the data they need to make decisions. They need solutions that make it seamless and allow them to function as part of a care team. In the old days, you had just one doctor, like Marcus Welby, MD, but today that’s not the case. How do we continue to coordinate care across the health system to get the individual clinicians what they need immediately to make clinical decisions that positively affect the patient?

Our philosophy is about making that seamless communication and hand-off process as beautiful as possible so that clinicians can get back to the patient. They can deliver care as they’ve always wanted to. They are not tied to a computer to get the data they need in hunt-and-peck fashion. They go about doing their business and, in the process, become happier, and happy clinicians deliver better patient care.

Health systems, because they’ve invested so many billions, are now trying to figure out how to derive further value after these purchases. Companies like ours that are delivering innovation directly into the clinical workflow, where all the action happens, will be important. Because we’ve had such a substantial jump on it for the last seven years or so, we’re excited about the opportunity moving forward.

Beyond usability, EHR-related burnout seems related to the timing of system interruptions or guidance and the lack of workflow cohesiveness. Does that differ across specialties?

Absolutely. Consider the difference between what an endocrinologist may require when making a decision versus the oncologist. Although there are standards of practice, each specialty requires certain elements of data in a certain format that’s intuitive to how they practice medicine so that they can acquire that data with just one click, get everything they need, review the most appropriate and non-nuisance decision support, and then pass that on to the rest of the team.

That approach has garnered improvements in clinician satisfaction and efficiency. Instead of spending an hour and a half preparing for rounding, as some residents do, they don’t have to prepare. It’s right there for them, everything they need to do for rounding and hand-off. Those kinds of gains are making a huge difference, recognizing that some personalization needs to be done, but in a standard fashion.

Less than 1% of our solutions are ever customized because they are already intuitive to how the specialists practice medicine. That makes a huge difference, particularly with IT and the implementation process itself. Instead of taking 12, 15, or 18 months to implement a big EHR, we’re providing our applications from start to finish in less than 90 days. That’s a huge opportunity for doctors and executives to get those quick wins that deliver value immediately.

What prevents EHR vendors from using your ideas to develop competing functionality?

In the Salesforce model, these big vendors can only do so much, and they have a heavy lift across the entire system. As companies like ours begin to specialize and create niche markets, particularly for us around clinical workflows and disease-specific workflows, it’s easy for a health system just to drop it in and use it without the big lifts that they are traditionally used to with the big EHR vendors.

How will your business change as EHR vendors start using technologies from Amazon, Google, and Microsoft?

The difference is being truly embedded within the clinical workflows. The struggle in the industry is that a lot of great companies are doing a lot of great things, but they’re doing it from the outside, trying to get in. You have to toggle over to another system, or do something that disrupts the clinical workflow. We are clinicians and we are deeply embedded within the clinical workflow, where everything’s actionable. If you are using our secure messaging system, you get an alert that a particular patient’s creatinine level is high. It’s important to be able to take action from that message within the clinical workflow.

There’s much disruption and opportunity across the industry, everything from machine learning to artificial intelligence and certainly population health and analytics. Sometimes just getting the basics right around making it more usable in the clinical workflow for the clinicians is the huge opportunity. These players, Amazon included, are making huge strides in making the practice of healthcare delivery better. We welcome all of the opportunity, because it will change all of our lives, help us deliver better patient care, reduce cost, and produce better outcomes. We welcome the opportunity for companies like Amazon and Microsoft, which has now stepped back in in a dramatic fashion, because it means that healthcare will be better.

Do you have any final thoughts?

As we continue to see the industry mature, EHRs will become the platform where data is entered and stored. Companies like ours will make it innovative and useful to those who interact with it every day. This is the most change I’ve seen in 30 years, particularly as EHRs have become standard and problems had begun to arise that were never anticipated, problems that we have begun to fix across many health systems. I couldn’t be more excited to be in the industry. I still have the passion and the drive to deliver the change that we’re expecting, and it feels really good.

Morning Headlines 12/9/19

Hackensack Meridian’s ‘core clinical systems’ back online after week-long disruptions

Hackensack Meridian Health (NJ) brings its clinical systems back online after a downtime of several days, rumored to be the result of a ransomware attack.

Partners reports stellar financial results as it preps for rebrand

Partners HealthCare, soon to be renamed to Mass General Brigham, cites Epic’s more accurate coding as part of the reason it took in $484 million of operating income in its most recent fiscal year.

Digital health start-up once worth $1.5 billion is racing to keep lights on as investors flee

Once valued at $1.5 billion, “smart pill” medication management company Proteus struggles to stay afloat after a $100 million funding round falls through.

NHS gives Amazon free use of health data under Alexa advice deal

In England, NHS gives Amazon the option to use its clinical content in the development of future products and services as part of its contract for an Alexa skill that offers medical advice culled from the NHS website.

Monday Morning Update 12/9/19

Top News

Hackensack Meridian Health (NJ) brings its clinical systems back online after a downtime of several days, rumored to be the result of a ransomware attack.

The 17-hospital system, New Jersey’s largest, rescheduled 100 elective surgeries.

The health system did not post updates on its social media accounts and declined to comment other than describe the problem as “externally-driven technical issues that are affecting the performance of our IT network.”

Reader Comments

From OptumOrange: “Re: Optum / UHG layoffs. Looks like it was 1,400 people who received two weeks’ notice. March 2020 is the next round.” Unverified, but several folks said they were affected. Company executives just told investors that Optum generates more than half of UnitedHealth Group’s profit in bringing in an expected $112 billion of the parent company’s $260 billion in revenue for next year. Optum offers pharmacy benefits management, direct care via urgent care centers and physician offices, post-acute care, analytics, and population health management.

Smartfood99 left a comment about EHR vendors offering low-margin RCM services that I thought was wise enough to deserve its own spot here. It explains the hazards in adding services that are profitable, but less so than the company’s core business:

Software may be high margin, but the cost to maintain customer relationships through service and updates is low margin. While there there is a built-in revenue stream, it weakens the balance sheet for new vendor-searching hospital executives concerned about the fiscal health of the EHR company. In short, hospital executives look very closely at the bottom lines of companies they are about to make a 10-year investment with. Profitability = survival, especially when rumors of EHR vendor demise are the norm over the past few years and planted by competitor sales people like a software bug.

If you are already paying for lots of support people and development people that cut in to the bottom line, you have to be careful how you add to that mix and what it does to the balance sheet. Losing even just two or three net-new business deals a year because hospital executives base their final decision on perceived vendor long-term viability can snowball for any EHR vendor not named Epic. Such decisions that seem to make short-term sense often put the EHR vendor on the path to the dustbin of history after a slow, drawn-out death that leaves the hospital partner in a lurch.

Sure, even marginal profits and larger revenues matter, but in this business, perception of sustainability means much, much more. This doesn’t even cover the fact that having the capital to enable your business to pivot as needs change and your systems age is served in no way by being a glorified consulting company, but with all the risks that come with employing and managing larger staffs as business ebbs and flows.

HIStalk Announcements and Requests

I’m super impressed with my $480 (Black Friday special) HP laptop. It’s sleek and made of metal rather than plastic, it’s fast because of its solid state disk drive and 16 GB of memory, it makes no sound at all, the touchscreen display is surprisingly large and vibrant, and setup took just a few minutes with no bloatware to de-install. It’s been years since I set up a new laptop, so I was surprised at how easy Windows makes it – you just log on with your Windows ID and a few minutes later it’s all done. Bitdefender reminded me that I don’t have a VPN installed and I pledged to be better about using one when on public Wi-Fi, so I chose Surfshark since it was Cyber Monday priced at $48 for 27 months and it works just fine.

Thanks to the following companies that recently supported HIStalk. Click a logo for more information.

Webinars

December 10 (Tuesday) 1:00 ET. “Move on from the age of the inefficient EHR.” Sponsor: Intelligent Medical Objects. Presenters: Jim Thompson, MD, physician informaticist, IMO; Obaid Baig, product manager, IMO. The EHR seems more like transactional workflow system rather than an intuitive clinical documentation tool, creating the possibility of loss of data consistency and the need for manual workarounds. The presenters will describe how to turn an EHR into a powerful tool that can help improve workflows and documentation so that clinicians can focus on care, not coding and reimbursement.

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

Acquisitions, Funding, Business, and Stock

The best and most concise health IT investment and market report I’ve seen comes from Healthcare Growth Partners, which just posted its November highlights of M&A, buyouts, investments, news headlines, and public company performance. It notes that valuations are driven significantly by sentiment versus metrics, and both sentiment and the markets are at all-time highs. 

People

Zach Mortensen, MBA (ZM Advisors) joins pharma services provider Parexel as chief strategy officer.

Population health management technology vendor Geniq hires Jay Colfer (SSI Group) as co-CEO.

Government and Politics

The Bureau of Labor Statistics says healthcare added 45,000 jobs in November and 414,000 jobs in the past 12 months. We don’t know what those people are doing, but we know who is paying them (all of us).

Other

This is insightful. AI companies will focus on the US market because, unlike in the rest of the world, providers here can make money finding and treating undiagnosed patient conditions. That gives AI a business case.

Welcome to our American healthcare non-system. A tiny online survey finds that diabetics — most of them covered by health insurance — are buying, selling, and trading insulin and glucose strips on the black market because of lack of affordability or timely availability.

A study finds that unintentional ED ordering of duplicate laboratory and radiology orders was reduced more than 40% by swapping out interruptive alerts for a simple on-screen highlighting of the existing order in red, although no improvement was seen with medication order duplicates. The alert displays when the duplicate item is being selected instead of as a final step or after-the-fact order queue alert. The study raises an interesting point – how many duplicate orders are created because of poor visual layout or navigation of the active medication list? We assume that just because information is displayed somewhere, somehow in the EHR that duplicates are inexcusable, especially with the added layer of warnings. I speculate that clinicians are just too busy attempting to multi-task with poor keyboarding technique in disruptive environments since even smart and careful ones make mistakes.

In England former Oxford University Hospitals CIO and Chief Digital Officer Peter Knight pleads guilty to fraud for falsifying his educational credentials to get the job, which he held for two years before resigning.

Partners HealthCare, soon to be renamed to Mass General Brigham, reports earning $484 million of operating income on $14 billion in revenue in its most recent fiscal year. The CFO says the increased profit came from having sicker patients and raising its prices, along with Epic’s more accurate coding.

HIMSS announces Global Health Equity Network, which allows interested parties to support its work by (a) paying to attend HIMSS20; and (b) sponsoring HIMSS. You can also “dialogue” with leaders, probably via A and B.

Informatics troubadour Ross Martin, MD, MHA lays down “Put the Patient First*,” a healthcare protest song that Ross says he’s been contemplating writing for 15 years. The asterisk-referenced refrain is brilliant – “Put the patient first, right behind me.” I also note that Ross’s utterly amazing and complex “HITECH: An Interoperetta in Three Acts” celebrated its 10th anniversary this year.

Sponsor Updates

• StayWell contributes to the Las Americas Immigrant Advocacy Center.
• Black Book Research recognizes Netsmart as the number one post-acute technology platform for the fifth year in a row.
• CereCore collects and delivers supplies to the Tennessee Baptist Children’s Home.
• Pivot Point Consulting employees in Chicago work with Project C.U.R.E. to assemble medical supplies for delivery to hospitals in developing countries.
• Redox releases its first podcast, “An Interview with Jonathan Bush.”
• SymphonyRM releases a new podcast, “Edward Marx and Four Pillars of Innovative Leadership.”
• TriNetX expands into South Korea in partnership with EvidNet.
• Visage introduces semantic annotations for the Visage 7 Enterprise Imaging Platform.
• UASE Ministry of Health collaborates with Vocera to improve care team communication and optimize patient safety.

Blog Posts

• 3 Cs to Jumpstart Value-Based Care Programs (Lightbeam Health Solutions)
• How standardizing interdisciplinary wound protocols improves patient care at Hancock Regional Hospital (Meditech)
• Healthcare Quality Improvement: A Foundational Business Strategy (Health Catalyst)
• Welcome Recondo to the Waystar Family (Waystar)
• EHR Errors Continue to Threaten Patient Safety (NextGate)
• Key Benchmarks for Process Improvement & Success (EClinicalWorks)
• Collaboration Learnings From the PatientPing Chicago Community Summit (PatientPing)
• The Impact of the Opioid Crisis in Post-Acute Care (Netsmart)
• Early holiday comes to Southfield family through Bike-a-Thon (OpenText)
• How data-driven patient access can eliminate healthcare denials (Experian Health)
• Top Revenue Cycle Tools to Implement at Your Urgent Care Center (PatientBond)
• Holiday Arma-BILL-o’s: 5 Ideas for a Festive Holiday Healthcare Billing Experience (Patientco)
• 4 Reasons Patients Cancel Appointments at the Last Minute (Relatient)
• Methodist Le Bonheur Healthcare CISO Steve Crocker on identity governance and cybersecurity (SailPoint)
• Between the lines: Supporting women with diabetes (StayWell)
• Migrating to Epic, Cerner, Meditech? The Value of Utilizing One Vendor to Assist with All Aspects of Your EHR Migration (Summit Healthcare)
• Forces of Change: The Industry Responds to the Call for Prescription Price Transparency (Surescripts)
• TUG robot alerts are the remedy for missed medication delivers at UConn Health. (Voalte)
• 4 Common Rehab Therapy Documentation Mistakes (WebPT)

Contacts

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

Weekender 12/6/19

Weekly News Recap

• Premier is reported to be working with bankers in seeking a sale of the company.
• Waystar acquires Recondo.
• John Halamka, MD announces that he will become president of Mayo Clinic Platform in January.
• Agfa is negotiating the sale of its Europe-focused healthcare and imaging IT business to Italy-based clinical software vendor Dedalus for more than $1 billion.
• Cerner names Amazon Web Services as its preferred cloud, AI, and machine learning provider.
• A server problem causes Dexcom’s continuous glucose monitor to stop sending messages and alerts for several days.
• T-System experiences downtime from an apparent ransomware attack.
• Amazon Web Services unveils a healthcare transcription service for software developers.

Best Reader Comments

You don’t want the company distracted by a shiny new thing while the core competency is getting less attention. So it’s often not a question of “Oh, hey, let’s just do this other thing too.” If you were in a perfect world with an arbitrarily large number of qualified people to take on the job, then moving into these peripheral areas would be a no-brainer. In reality the value gained from the distraction needs to be more than the cost of the distraction. The technical economic term for this is opportunity cost. (TH)

We doctors should stop thinking about EHR as a “special thing.” It is just a tool to get the job done. I can ask the same questions that you asked about paper and pen documentation system and probably add a few more about accessibility across locations, storage challenges, etc. Why is no one complaining about that system of records and why was it not part of so-called “physician burnout?” The reason I believe, is that we all learnt how to use it during our training and accepted it as part of life. Rules of the game changed in the last decade and we need to get on with the program. (EHR is just a tool)

This should drive home the reality that the investor class isn’t comprised of smart people, just people who knew each other or went to the same universities and have consistently promoted and hired each other into positions of authority without any demonstrated qualifications. (HIT Girl)

If the digital companies would have seriously and thoroughly tested their products with MANY physicians and not only one SME, then maybe the EHRs of today wouldn’t have been the monstrosities that they are. (Been there)

I still can’t believe institutions like Goldman make these horrible investments. Between Outcome Health and Theranos, you’d think the investors involved would at some point ask some healthcare industry experts whether these companies were viable enough to pass the sniff tests. Readers on this site have called out the charade for both before. (Elizabeth H. H. Holmes)

The billing methodology in this country has gone totally out of control. Unfortunately, I’m in the middle of a medical situation and the last EOBs made me laugh. For a CT scan with and without contrast, the billed amount was $18K, allowable $18K, amount paid $400, patient due amount $0. How stupid is a system that allows this? If I didn’t have insurance and the provider wasn’t in the network, I’m sure they would have tried to collect the $18K. (David Pomerance)

The moral of the Outcomes Health story is that if you f*ck over @GoldmanSachs & friends for $500m you go to jail. But if you ARE @GoldmanSachs & friends and you f*ck over the US taxpayer to the tune of $62bn, we will hand over the money and allow you to keep doing it. (Matthew Holt)

While I’m (mostly) never delighted when a person loses his/her job, all David Duvall MBA, MPH needs to do is open up about 50 hospital leadership websites and then another 50 HIT vendor leadership pages and tell me where the discrimination lies. I promise you it isn’t against middle-aged white guys. (ellemennopee)

Watercooler Talk Tidbits

The publicly traded owner of North Tampa Behavioral Health (FL) confirms that it has reassigned the facility’s 31-year-old CEO after a newspaper’s investigative report found that he had no healthcare experience and was formerly a quarterback for a pro football team’s practice squad. A company spokesperson said it’s not unusual to recruit hospital CEOs from other industries and the attributes of B. J. Coleman  include “team leadership, situational analysis, and sound decision-making.” Inspectors found that under his leadership, just four of the 96 employees who performed lab work had proper training. The kitchen’s lead cook was covering as director of dietary services even though he wasn’t qualified, so the kitchen ignored special diet requirements and sent trays containing silverware to suicidal patients.

A Tennessee neurologist files a $25,000 defamation lawsuit against a woman who wrote a scathing Yelp review saying that he threw a tantrum when she took out her phone to record her father’s visit. She says she deleted the recording at the doctor’s request even though state law does not prohibit such recording, after which a clinic employee called her to say that phones aren’t allowed in the office. Also named in the suit is the son of the woman’s friend, who overheard her talking about it and posted a negative review on Google. Meanwhile, the negative Yelp reviews are piling up as idiots from several states who admit that they just read the online story, calling the doctor a “filthy animal” and a “nasty immigrant who is suing a real American.”

Kaiser Permanente uses text messaging to encourage 11,000 of its members to sign up for California’s CalFresh supplemental nutrition program. Kaiser didn’t have access to income data to help  choose which of its 9 million patients might benefit, so it used a census-derived “neighborhood deprivation index.”

A CMS analysis finds that the US spent more $1.2 trillion on hospitals in 2018, representing one-third of all healthcare spending. 

NICU nurses at Brookwood Baptist Medical Center (AL) dress up newborns to celebrate their first Thanksgiving.

In Case You Missed It

• News 12/6/19
• EPtalk by Dr. Jayne 12/5/19
• HIStalk Interviews Amanda Hansen, President, AdvancedMD
• News 12/4/19
• Curbside Consult with Dr. Jayne 12/2/19
• HIStalk Interviews Michelle O’Connor, President, Meditech
• Monday Morning Update 12/2/19

Get Involved

• Sponsor
• Report a news item or rumor (anonymous or not)
• Sign up for email updates
• Connect on LinkedIn
• Contact Mr. H

Morning Headlines 12/6/19

Premier considers sale with banks

Premier is reportedly arranging talks with several potential acquirers in seeking a sale of the company.

Stephanie Reel to retire as chief information officer of university, health system

Stephanie Reel, CIO/vice provost for IT at Johns Hopkins University and SVP/CIO of Johns Hopkins Medicine, will retire on July 1, 2020 after a 30-year Hopkins career.

Former Outcome Health employees plead not guilty to felony charges in alleged $1 billion scheme to defraud pharma clients

Two former Outcome Health analysts plead not guilty to charges of felony conspiracy to commit wire fraud.

VA launches National Artificial Intelligence

The VA establishes the National Artificial Intelligence Institute to research and develop AI solutions that will improve healthcare for veterans.

News 12/6/19

Top News

RCM vendor Waystar acquires Recondo Technology, which specializes in automated revenue cycle software and services.

Reader Comments

From Foundational Confused: “Re: non-profit hospital donations. You’ve said that sending money to them is a terrible use of it. How do you personally differentiate between a foundation doing good versus one just burning money?” I like supporting organizations that truly need the money and will put it to good use for a directly connected social mission. Health systems stretch the definition of non-profit (and certainly that of a charity) with million-dollar executives, vast real estate holdings, and a can’t-miss business model that allows them to charge high prices and stifle competition on the backs of people in need, not to mention that they are so adept at raking in cash that they, themselves donate to other non-profits. My paltry donation would pale to the amount of money they can print via cranking out via high patient charges and collections. I would rather help a smaller, struggling non-profit that doesn’t have the luxury of sticking it to Medicare and insurers, whose mission is in danger of disappearing without outside help and that doesn’t employ mahogany wings full of power-broking suits who spend their day plotting deeper dives into the healthcare cookie jar (I say that while acknowledging the irony that I’ve been part of that particular problem for a long time). My personal donation choices are animal rescue and sanctuary organizations, food banks, Donors Choose, and Salvation Army, where a few hundred dollars can really make a direct difference instead of covering maybe one hour of the HR VP’s time.

From Party On: “Re: HIStalk reception at HIMSS20. Wondering how to obtain an invite and which evening it will occur.” The tenth and final HIStalkapalooza was at HIMSS17, I’m sorry to say. Maybe we can all schedule a time during HIMSS20 week to simultaneously reminisce by watching the video of that final evening with Party on the Moon and several hundred industry kindred spirits. 

Webinars

December 10 (Tuesday) 1:00 ET. “Move on from the age of the inefficient EHR.” Sponsor: Intelligent Medical Objects. Presenters: Jim Thompson, MD, physician informaticist, IMO; Obaid Baig, product manager, IMO. The EHR seems more like transactional workflow system rather than an intuitive clinical documentation tool, creating the possibility of loss of data consistency and the need for manual workarounds. The presenters will describe how to turn an EHR into a powerful tool that can help improve workflows and documentation so that clinicians can focus on care, not coding and reimbursement.

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

Acquisitions, Funding, Business, and Stock

Premier is reportedly arranging talks with several potential acquirers in seeking a sale of the company, with reports of its interest sending share price and trading volume up this week.

Clinical surveillance and data visualization company Decisio Health closes a $13 million Series B funding round.

Sales

• Seminole Hospital District in Texas will implement CPSI subsidiary American HealthTech’s post-acute EHR at Memorial Health Care Center.
• In England, Birmingham and Solihull Mental Health NHS Foundation Trust chooses Hyland Healthcare’s OnBase content services software.
• Integris Health (OK) and Woman’s Hospital (LA) select Health Catalyst’s Corus Suite of patient, departmental, and equipment utilization and cost analytics.
• Cleveland Clinic London will use Vocera’s care team communication and workflow technology when it opens in 2021.
• In California, Natividad and the Monterey County Health Department will implement NextGate’s Enterprise Master Patient Index across its 19 clinics and other agencies.
• American Oncology Network selects PatientPoint’s patient and provider engagement solutions for its community oncology practice network.

People

Stephanie Reel, CIO/vice provost for IT at Johns Hopkins University and SVP/CIO of Johns Hopkins Medicine, will retire on July 1, 2020 after a 30-year Hopkins career. She says that she’s channeling Elton John in announcing her “Love Mondays World Tour” and sent me her Thanksgiving letter that outlines her future plans to enjoy family, travel, life in general, and a move from Baltimore after 25 years to Falls Church, VA. Few CIOs have had her tenure and breadth of IT responsibility over one of the country’s highest-ranked health systems as well as its correspondingly highly-ranked university through the impressive growth of both as an unfailingly steady hand on the IT tiller. I’m not saying I “know” her personally, but a couple of interviews and some private conversations about personal issues in which she was generous with her time and offers to assist make her #1 in my book.

Change Healthcare EVP/CIO Alex Choy will retire early next year.

Cletis Earle (Kaleida Health) joins Penn State Health and Penn State College of Medicine as SVP/CIO.

John Halamka, MD will join Mayo Clinic (MN) as president of its Mayo Clinic Platform, an initiative he describes as a “portfolio of new digital platform businesses focused on transforming health by leveraging artificial intelligence, the internet of things, and an ecosystem of partners for Mayo Clinic.” Halamka has spent the past 25 years in various positions, including CIO at Beth Israel Deaconess Medical Center in Boston, now part of Beth Israel Lahey Health.

Patient transfer solution vendor Central Logic promotes Barry Dennis, RN, MBA to the newly created position of SVP of clinical operations.

Google co-founders Larry Page and Sergey Brin will step down from their respective roles within parent company Alphabet as part of management streamlining that will see Google CEO Sundar Pichai take on the additional role of Alphabet CEO.

Announcements and Implementations

PatientPing enhances its collaboration network with Callouts (sharing member information with point-of-care providers using multiple EHRs) and Spotlights (a performance dashboard for readmissions, hospital utilization, and post-acute network management).

PMD makes patient-to-provider messaging and multi-provider group messaging with patients available through its app’s secure messaging capabilities.

Kindred Healthcare (KY) implements Netsmart’s Referral Manager software across its 70 LTAC hospitals.

A Surescripts report finds that the use of EHR-integrated prescription price tools more than doubled in 2019, also noting that prescriptions represent 17% of spending on goods and services that are provided directly to patients and are projected to increase 6.3% per year.

A KLAS report on ERP implementation consulting finds that among software vendors, every Infor consulting services client that was contacted is dissatisfied because the company’s consultants don’t understand the software or how to apply change management. PwC earns high marks from clients; KPMG performs well and Deloitte poorly on Workday and Oracle implementations; and for Infor implementation work, ROI Healthcare Solutions delivers high value while Avaap delivers strong outcomes.

Government and Politics

The American Hospital Association and other hospital groups file a lawsuit challenging HHS’s proposed requirement for hospitals to publicly post confidential pricing information. The plaintiffs say that disclosure of negotiated insurer charges would confuse patients about their out-of-pocket costs, adding that the rule is unlawful anyway because it exceeds CMS’s authority. 

Other

Physician services firm TeamHealth, which was acquired by investment firm Blackstone for $6.1 billion in early 2017, tells the Senate that it didn’t send surprise, out-of-network ED bills to thousands of patients in 2017 to generate revenue – their real purpose was to pressure insurers into signing more lucrative contracts. It also says that most of the public griping about balance billing comes from patients who don’t understand their coverage and mistake their co-pay, co-insurance, or deductible as a balance billing. The company suggests that Congress require insurers to immediately pay out-of-network providers at 125% the average allowed amount; require them to send the provider a check for the full amount that includes patient responsibility and then let the insurer rather than the provider collect the patient’s portion; cap ED patient cost-sharing at $1,000; and offer arbitration for dispute resolution.

UC Davis will offer an online course titled “The Health and Wellbeing of Medical Providers,” which will be taught by UC Davis Health Chief Wellness Officer Peter Yellowlees, MD, MBBS (yes, he did earn both degrees years apart even though they are basically equivalent). The 20-CME, $800 course begins on February 24. The course text, “Physician Suicide Cases and Commentaries,” was written by the instructor.

Cerner loses a $600,000 lawsuit that was brought by an air ambulance company after Cerner’s health plan refused to pay for a toddler’s air ambulance transportation after initially authorizing it.

In Australia, a women is sentenced to 25 months in prison for falsifying her application for a high-paying government CIO role. She lied about her education and work experience, gave herself a glowing recommendation in posing by telephone as a former employer, and used a supermodel’s photo as her LinkedIn headshot. Her attorney blames her actions on being “off with the pixies” due to stopping her weight loss drug.

Sponsor Updates

• Ensocare will exhibit at the National Veterans Small Business Engagement December 9-11 in Nashville.
• First Databank’s Meducation medication adherence solution wins Cerner’s first Open Developer Experience Program Member Adoption Award.
• Glytec will exhibit at the IHI National Forum December 8-11 in Orlando.
• EClinicalWorks publishes a new customer success story, “Compass Medical: Growing a Practice, Saving Lives.”
• Gartner has recognized InterSystems as a leader in its “2019 Gartner Magic Quadrant for Operational Database Management Systems.”
• Kyruus Executive Assistant and Office Manager Lisa Marie Rosson Guidi wins the Spirit Award from The Admin Awards.
• PCare leverages cybersecurity services from By Light Professional IT Services as it pursues HITRUST certification.
• PatientPing adds enhanced member information sharing capabilities and real-time network utilization dashboards to its enterprise care collaboration technology.

Blog Posts

• Advancing the medical imaging field with cloud-based solutions at RSNA (Google Cloud)
• Top 3 Ways to Identify Root Cause of Poor Performance Issues in Your Citrix or VMware Horizon Deployment (Goliath Technologies)
• The Art of Maintaining Prescription Renewal Protocols (Healthfinch)
• 6 signs of a quality EHR optimization partner (Nordic)
• You can’t spell radiology without AI (Hyland)
• Social Determinants of Health: Data Drives Lasting Health Improvements (Imat Solutions)
• Data Conversion Scope Best Practice (Impact Advisors)
• Value sets: Supporting the goals of outcomes-based care (Intelligent Medical Objects)
• Integrated Robotic Process Automation – The Fastest Growing Trend in Healthcare Technology (Summit Healthcare)

Contacts

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