From HIMSS 3/8/18

Newsy Items

DoD doctors and software technicians tell Politico that the Cerner rollout at four pilot sites is plagued with system bugs, inadequately trained users, and login times of up to 10 minutes. Problems reported by those interviewed and in a previous internal DoD assessment of the pilot project include:

• Doctors can’t treat as many patients.
• Software-related patient safety incidents are being filed almost daily and some doctors have quit over fears that patients will be harmed.
• Interfaces are problematic.
• Documentation is outdated.
• Training, especially for clinical specialties, was inadequate or non-existent.
• Users complain that workflows are more cumbersome than with the system Cerner replaced.
• The pilot site has no failover capability.
• Extensive cybersecurity vulnerabilities mean the system could not survive a cyberattack.

DoD officials acknowledged the problems in a hastily arranged conference call, but say the rollout will continue as scheduled. As it should – the laundry list Politico ran is from just a handful of users and , other than the last two items, you could copy and paste it into any EHR implementation project that’s just a few months in.

Singapore decides to use two EHR vendors instead of make a single-vendor selection, initially causing Allscripts shares to drop to the point that the company files an SEC 8-K form indicating that while it didn’t get the single-vendor bid, at least its existing Sunrise business in Singapore isn’t at risk.

From Not So Scientific: “Re: KLAS. I just pulled ten of our last deals and seven of them stated that they looked at KLAS as part of their decision-making process. They are no Consumer Reports — wish there was a different option.” I suppose there’s a second question – did they look at KLAS reports just to validate their choice, or did it actually change their minds?

From Jemima: “Re: women. Al the acutely ill ‘patients’ in the Masimo beds are women, heavily made up. I guess men don’t end up in the hospital?” I wanted to interview one of those ladies to see what it’s like lying in a bed all day, trying to look sick with people staring at you. The job description must include “strong bladder.”

From Emily Peters: “Re: women. My worst encounter was when a HIMSS attendee asked if we had ‘any executives at the booth, or just women?” a few years ago. ARG. A younger colleague of mine posted photos of putting on a fake diamond ring to ward off creeps this year. Some things never change at HIMSS, it seems.” Next conference I’m arming an attractive female attendee with a hidden audio recorder to capture inappropriate comments for memorializing on HIStalk. I’m actually not joking about that. I don’t think we males understand what it’s like to receive unwanted attention or to be demeaned individually or collectively, intentionally or otherwise.

From Come Again?: “Re: women. Cerner CFO Marc Naughton during the HIMSS investor briefing, and on International Women’s Day, no less: ‘Instead of teacup rides and ‘It’s A Small World’ soundtrack at Disney, Vegas has crack and hookers. So basically the same. Speaking of hookers, I heard this morning that this year at HIMSS represents the first time ever that investment bankers have outnumbered prostitutes in the city, and that’s pretty amazing. Actually, I should probably apologize for comparing bankers to prostitutes. After all, that’s really unfair to the prostitutes.” Unverified. Although to be fair, some prostitutes are male, so to assume otherwise from his comments is in itself ironically sexist.  

The past several days have led me to detest the Sands Expo, which opened nearly 30 years ago (eons in Las Vegas implosion years) as an overflow space for the Las Vegas Convention Center. It feels outdated and I suspect it was not designed to hold a mega-booth exhibit the size of HIMSS, although it hosts larger conventions. The odd layout (especially the upstairs / downstairs) means full-paying exhibitors get fewer visitors than they should, it’s almost impossible to orient yourself to even leave the hall, and the too-few concession offerings are pathetically poor. I also found the restrooms inside the hall to be small and primitive and I’m not a fan of the congested hallways outside the hall and throughout the complex. About the only positive is the attached hotels that replaced the old Sands Hotel in 1999. Orlando is light years better and so were the convention centers in HIMSS-abandoned cities like New Orleans and Chicago. Las Vegas has always been my least-favorite city in the world and the convention center holds a similar spot in my heart.

Despite the choice of venue, kudos to HIMSS for developing and running a hugely complicated conference while making it look easy. I realized as I wrote my convention center critique that I have nothing bad to say about the event itself. I can’t even imagine the work required years before the first attendee shows up.

The announced registration through Thursday (since the HIMSS link for Friday’s numbers doesn’t work) was 43,857, up 4 percent from HIMSS17 but about the same as HIMSS15.

My favorite giveaway this week: cool socks. Thanks, Geneia. I may steal the idea for next year.

Lorre is still offering her “Cellar Dweller Special” for our Hall G neighbors who want to sign up as a new sponsor. A year online is better than three days in the basement.

It was cool to see software groups from Bavaria, Austria, and Israel down in Hall G. These candies were so pretty that I didn’t take one – it would have felt like defiling and art display.

Germany-based Future-Shape makes a capacitance-powered sub-flooring that turns any room into a touchscreen-like tracking system that can detect falls, issue warnings for unusual movement (like someone who’s been in a hospital bathroom for a long time), and track movement for workflow redesign.

Learn on Demand Systems helps vendors set up large-scale training and testing environments for their software, with options for cloud-based demonstrations and labs that can be used anywhere (proof is their 24-hour training activity hotspot video). They also offer cybersecurity training. 

I don’t drink hot tea, but if I did, I’d want this.

I like this booth design – the layout and lighting were well done.

This magician does an amazing vanishing act.

I was shocked that vendors were still offering refreshments on Thursday, the last (and shortened) exhibit hall day. The best item of the whole week was the doughnut bar of InterSystems, where you choose a doughnut type, pick which warm sauces you want, pick a fruit glaze if you want, and then decide what toppings would best round it out. My personal doughnut chef recommended a chocolate cake doughnut with warm dark chocolate sauce, large candied pecans, hunks of real bacon, and whipped cream, when he then garnished nicely. It was as fabulous as it looks.

What goes great with a doughnut? A mimosa.

What is it about these people that screams, “I’m not really a clinician?”

Walking through this ugly passageway between the halls is like car washes that finish up with a hurricane-like blast of drying air, except this particular blast was icy cold.

TigerText has renamed itself to make sure people understand that they move all kinds of data around, not just text.

Dell EMC’s booth was so large that they offered audio tours like you see at museums. I sat through their theater presentation, which was spectacularly uninteresting.

Alert Medical was global before it was HIMSS-cool, showing up every year in their red-and-white suits even though I don’t think they’ve ever sold a US customer and maybe aren’t even trying. This demo was being done in another language.

I got a demo of ClearSense, which offers a “Mission Control for Healthcare” dashboard that has a lot of smarts and good UI in presenting an intelligent view of just about every type of data you can throw at it. A user from Meharry Medical College said they’re doing cool things with it, with their next step being to create a data science institute.

That’s the HIMSS18 wrap-up unless I think of something else. It’s back to the usual Monday Morning Update next week. Let me know what you thought of the conference and any life-altering takeaways it provided. It’s back to Orlando February 10-15, 2019.

Jenn’s HIMSS 3/8/18

My last day at HIMSS kicked off with a pit stop for breakfast in the press room, which was refreshingly free of sugar-filled pastries (or perhaps they were just all gone by the time I got there). The Sands was decidedly quieter than Tuesday and Wednesday, with more than a few attendees exhibiting that glazed-over look that comes from too little fresh air and sunlight, and too much caffeine and alcohol.

Many female HIMSS-goers wore purple in honor of International Women’s Day, which, according to the IWD website, is an homage to the purple, green, and white worn by members of the Women’s Social and Political Union in the UK in the early 20th century. Purple represented justice and dignity, green hope, and white purity. Today, the color purple reflects the day’s goal of celebrating women’s social, economic, and political achievements and the need for gender equality.

Madhuri Kudrimoti, director of clinical informatics at Froedtert & Medical College of Wisconsin, proudly sported the color during the morning’s Mentoring Meetup, which paired over female 100 attendees with table moderators to discuss topics like work/life balance, networking, and salary negotiation. I had the chance to chat with Kudrimoti about her organization’s health IT needs before the meetup got into full swing. Froedtert recently hired its first chief analytics officer – a woman, no less – who has tasked Kudrimoti with looking for analytics solutions that can help their organization aggregate their four or five data warehouses into one. Analytics are part of a five-year strategy Froedtert has just started to embark upon.

Karen Marie-Wilding, table moderator and senior director of quality and value-based care at The University of Maryland Medical System, was quick to tell me that E&M (evaluation and management) coding needs to be retired when I asked her what topic or theme seemed to be prevalent at HIMSS. “Provider documentation needs to change in a big way,” she added, telling me that  topic had come up in nearly every session she attended. Nuance solutions seemed to have also generated some buzz among her documentation circles.

Fun fact on IWD: The name of the new Allscripts EHR, Avenel, does in fact have a story behind it (despite booth reps telling Mr. H it had no known provenance), as the tweet above can attest.

I didn’t see much purple as I made my way into the exhibit hall. Trick shots from Chef Anton (who was in fact a chef) were in abundance at the Iatric Systems booth, though. Just after I snapped this pic, the man on the pool table reached into his pocket and grabbed his phone for a selfie.

RTLS vendor CenTrak seemed to have decent traffic for the last day of HIMSS.

Clinicspectrum CEO Vishal Gandhi always looks sharp on the show floor. He had on a different but equally eye-catching jacket every day of the conference.

The LogicStream Health team is always welcoming when I stop by. This time around I got to meet founder and CEO Patrick Yoder, who happened to be chatting with friend and former colleague Ray Wolski, VP of strategic solutions at Wolters Kluwer.

Zebu Compliance Solutions had a friendly blowup of the South Asian domestic cattle the company is named for.

I had a great conversation with the folks at Fitbit, who showed me some of the compelling ways its users are sharing their personal health success stories using the new social sharing feature on its app. A first-time exhibitor, the company was touting its recent acquisition of Twine Health and the deeper dive it hopes to take into health management.

By the last day of HIMSS, I’m pretty immune to booth stunts, but the get-up above definitely got my attention. Paessler System Engineer Greg Ross donned his lederhosen to attract attendees to the German IT infrastructure monitoring company’s booth, and it seemed to work given the regret he had over not wearing the outfit Tuesday or Wednesday.

While vendors were scurrying out of the shuttered exhibit hall, I headed over to the session on physician suicide and clinician engagement tools presented by psychotherapist and StelliCare CEO Melissa McCool and Lifely Insights Chief Strategy Officer Janae Sharp, who shared a very personal story of her physician husband’s suicide several years ago. Between 15 and 20 hands went up in the audience when Sharp asked who had known a physician that committed suicide, and nearly everyone acknowledged knowing someone that had attempted or committed suicide.

Health IT came up, of course, but the ladies emphasized that EHRs and the like aren’t as much of a contributor to physician burnout and suicide as headlines would have us believe. Data from KLAS backed up their point. Solutions offered include changing licensure requirements so that mental health issues don’t have to be reported for re-licensure – a change that would hopefully result in MDs being more likely to seek proactive help, less burdensome interactions with EHRs, less burdensome federal regulations, and offering physicians more coping tools and support (like mental healthcare via telemedicine) without any stigma attached.

One sobering session led into another, with my last of the day – Lessons Learned from the Boston Bombing – proving to be my absolute favorite. Former Boston Chief of Police Dan Linskey took attendees through the day of the bombing, showing video footage and playing audio to help us understand the way in which emergency services from all sectors of the city came together in a crisis. We laughed, we cried, and we finally gave him a standing ovation. It was a far more compelling session than any HIMSS keynote I’ve ever seen. I couldn’t help but think HIMSS-goers would have been more inspired by Linskey’s experience and lessons on strategic planning and leadership than any tune from a Voice contestant or buzzword uttered by Eric Schmidt.

I took one last walk through the Venetian and called it an early night. Thanks to everyone who stopped by our booth. Your words of gratitude and encouragement keep us going year round. HIMSS18 is in the books. See you in Orlando for HIMSS19!

Dr. Jayne at HIMSS 3/7/18

Today was undoubtedly the busiest day of HIMSS for me, and my trusty Garmin certainly agrees with my assessment since it shows 22,212 steps. I started my day at the Edifecs booth (1674) chatting with them about their #WhatIRun campaign to elevate the visibility of female healthcare leaders and to inspire young women to pursue STEM careers. They’ve partnered with Ryka to give away some outstanding pink suede slip-ons while promoting the initiative. I’ll be sporting a pair tomorrow in the hall since my feet definitely need some TLC after today.

Healthcare IT remains male-dominated across many domains and it’s important for girls and young women to see women who code and women who lead. This is the third year for Edifecs to lead this charge at HIMSS and I’m grateful. I’ve been the recipient of a couple of sexist comments this week – things that people would never, ever say to a male CMIO – so we definitely have a long way to go. Stop by and say hi, grab a tee shirt, pick up a Ryka discount card, and enter to win a pair of sweet treats for your feet.

Speaking of treats for your feet, today was a target-rich environment for great shoes. Since we didn’t have a HIStalkapalooza shoe contest this year, I’m sharing my picks:

In the “Best Comfort Shoes for Women” category, I spotted a sassy marketing staffer getting ready to change into these as she transitioned from day to evening.

The “Best Total Footwear Ensemble” category, I spotted Drew Madden with blue laces to match his striped socks. The gents from Lightbeam Health had been in the running until Drew knocked them out of contention.

Since we’re giving out awards, “Best Booth Snack” goes to Bonny Roberts at Diameter Health in the Interoperability Showcase. Yesterday she was giving out Girl Scout Cookies, although I didn’t see any today.

Medicomp Systems always has a game in their booth (3616) and this year’s Quippe Virtual Experience game could win you $100. Cheers to their neighbor Blackbox, reflected in the image, who hosted a happy hour and was inviting everyone who passed by to partake with them, whether vendor or attendee.

“Best Booth Décor” goes to LRS Output Management with this phenomenal ice sculpture. They have a different one every day.

“Best Promotional Item” goes to Jeff at Grammatech (12144) with what every developer needs: a bug-removal device. Jeff was engaging and caught our attention.

“Most Organized Merchandising” goes to CTAC in booth 11616. I’ll forgive them the accessory Diet Coke because the person working on the merchandising set it down to step out of the photo.

“Best Jacket” goes to OnRamp, who had several booth staffers sporting this look.

There was plenty of sartorial splendor on display today, with these chaps from MD EMR Systems.

I’m a sucker for exhibitors that are doing good for the world, including Connection (3828), who invited attendees to fill a bag with art supplies for donation to children. On Thursday, they’ll be making no-sew blankets for charity as well.

Lots of positive vendor engagement today, with Hanna from Zayo Group catching our attention during my annual BFF booth crawl with the incomparable Evan Frankel. Effective strategies: catching someone’s eye, asking them what they do, asking what they are interested in at HIMSS, and figuring out how to tie it to your company. I’m going to track them down next time I’m in Boulder, Colorado.

Blackbaud was giving out faux script pads.

More anatomic body painting today, although the guy was wearing a shirt and shorts where yesterday’s model was wearing the equivalent of a bikini swimsuit.

Plenty of sponsor signs out in force today. I loved Optimum Healthcare IT’s astronauts. Signs were also spotted on prominent display at Meditech, Waystar, Access, Iatric Systems, and Redox.

I bumped into Jenn at the Strata Decision Technology booth and had a chance to talk to CEO Dan Michelson about the challenges of helping healthcare organizations truly understand cost accounting and what they need to get a handle on if they’re going to try to lower costs and increase value. He sent me on my way with some in-flight reading material, in case I don’t have Wi Fi on the way home.

I stopped by the Vocera booth to get a look at their Collaboration Suite, which integrates with AirStrip patient monitoring. Being able to view the rhythm strip of a telemetry patient from my family medicine clinic would have saved me a lot of heartburn when I cared for hospital patients.

I finished out the day with Zynx Health, looking at their Knowledge Analyzer solution. It allows organizations to update order sets and perform a gap analysis of their current implementation against best-available medical evidence, guidelines, and performance measures. I’ve got some battle scars from trying to harmonize order sets across various groups of attending physicians and across hospitals within Big Health System and I wish I had a solution like this years ago.

The evening was full of adventure, starting with the New Media Meetup at Senor Frog’s at Treasure Island. I enjoyed connecting with other bloggers, vloggers, and social media personalities while trying to juggle my drink, grab some snacks, and stay anonymous. From there it was on to the Nordic reception at Caesar’s Palace at the Mr. Chow restaurant. The main dining room features a large kinetic sculpture that raises, lowers, splits, turns, and rejoins itself. The best part of the event was the pool-view balcony, where I eagerly took in the fresh air I had been missing most of the week.

Thursday is my last day at the conference, so it’s off to pack and get some rest before I cram in the last round of booth visits.

Jenn’s HIMSS 3/7/18 (Part 2)

The second full day of HIMSS dawned with overcast skies and a slight chill in the air. As the week wears on, I grow happier that I decided to book a room next to the Venetian. My morning commute clocks in at around 10 minutes on foot. It’s been nice not having to wait in taxi queues or shuttle bus lines.

A quick check-in at our booth found our pile of Smokin’ Doc Polaroids growing larger. (Stop by booth 11228 for the inside scoop on what we’re doing with them.) The cameras – $99 from Best Buy – have been conversation starters all by themselves. They are indeed more novelty than anything else, given their cost and the time it takes for the image to develop (longer than the original Polaroids, I’m told).

I try every year to show my home state some love, and so stopped by the Georgia Pavilion to hear Atlanta-based Rimidi founder Lucienne Ide, MD present on the way FHIR is powering the chronic disease management company’s technology. The company’s solution, which right now is focused on diabetes and heart failure, is aimed at helping physicians close care gaps.

Clinical communications company Doc Halo, along with Waystar, splurged for a digital billboard that greets travelers as they leave the airport and head toward the strip. I’d be interested to know what kind of ROI they expected (increased foot traffic at their booth?) and what they got out of that type of signage.

HealthTap pulled me in with its unique Lego theme and surprisingly tasty kale-based juice. Product Manager Subarna Mitra patiently walked me through a demo of their “Query to Care” capabilities, which offer patients personalized care plans and algorithm- and text-based triage – all of which a provider can purchase as a white-label solution that feeds a patient’s app activity into their EHR.

Nordic’s booth seemed to have steady interest. I noticed they weren’t giving out branded coffee beans this year.

I had a chance to chat with Strata Decision Technology CEO Dan Michelson (right) as I was dropping off their booth sign. He tells me they are using the same booth as they were five years ago. “Why spend money on a new booth,” he asked, “when you can spend it on giving your customers what they want?” I don’t think they need to change a think. The water wall was particularly soothing amidst the exhibit hall hustle and bustle.

The ladies of VitalHealth were sporting such brightly hued sneakers that I just had to stop and snap a pic. Apparently their entire booth staff are similarly shod. This type of footwear makes so much since. I have literally winced after seeing women walk by in high heels, knowing the agony their feet will be in by the end of the day.

I loved the mod look of these Protenus meeting pods. I’ve noticed many booths seem to have upped their furniture décor this year, particularly in the seating area. Even the HIMSS Living Room looks like it was inspired by Magnolia Home.

PatientSafe Solutions had the biggest iPhone I’ve ever seen on display.

This ice sculpture literally stopped me in my tracks. I didn’t even think it was ice at first, until I noticed the dripping bottom. LRS provides document output management services for Cerner, Epic, GE, and Siemens.

I liked the way Stanson Health had its HIStalk sign cozily tucked amongst its awards from HIMSS and Black Book.

Redox drew me in with its tennis ball dog toys. Its office is so dog friendly that it has created a company calendar featuring the dogs of its employees. I suggested they add a canine-focused charitable effort to next year’s edition.

Liaison Technologies had one of the most creative giveaways with its blood bag ice packs. It just goes to show that you don’t have to go big to grab people’s attention. (Plus, I’m always running out of ice packs.)

AssessURHealth seems to be making important headway in generating awareness around the need to end mental health stigmas. Its “Shock Wall” highlights the number of people who have died from suicide, opioid overdose, and alcohol abuse since HIMSS opened at the beginning of the week. It’s a pretty sobering statistic, reinforced by the fact that every employee I spoke with had a personal story to tell of a friend or family member who has suffered from or succumbed to mental health-related conditions. Kudos to them for their #EndTheStigma campaign.

I popped in to their conference room to attend an intimate talk with McKinsey Senior Expert Jessica Kahn (left). As a former CMS director of data and systems for Medicaid, she had unique insight to share on the challenges Medicaid providers and their patients face when it comes to implementing and accessing behavioral health technology. She is a big believer in the role telemedicine has to play in bringing much-need mental health services to Medicaid populations.

Another round of booth time found me chatting almost non-stop with readers and sponsors like Reaction Data Marketing Director Taylor Madsen and Gwinnett Medical Center (GA) SVP and CIO Patty Lavely. They seemed to like the shirts we’re giving out at the booth (112288).

Last year’s Miss HIStalkapalooza winner Bethany Miller-Urroz stopped by to see if her reign was technically over. I say, if the sash still fits, wear it! She was bummed she didn’t think to bring it to HIMSS this year.

I’ve noticed several exhibitors using paper to highlight their digital processes. One company several rows over from ours seemed to be having fun luring attendees in to bash open its fax machine piñata.

My last foray into the exhibit hall gave me a chance to catch the Healthfinch team accepting an innovation award from Jonathan Bush at the Athenahealth booth for its Charlie Practice Automation Platform, which makes refill management and visit planning in EHRs more efficient.

Afternoon happy hours got started around 4:30. Arcadia had by far the fanciest appetizers – in both presentation and ingredients – I’ve ever seen at a tradeshow.

I find myself running into friends and colleagues like Starbridge Advisors Principal Sue Schade and Datica CEO Travis Good, MD who, unbeknownst to me, already know one another. Health IT can seem like a very small world at times, especially when surrounded by 43,000 of your closest colleagues.

NextGen’s newly rebranded booth looked nice.

The CoverMyMeds end-of-day soiree was busy. Company reps were no doubt bringing customers up to speed on their new, real-time prescription benefit solution developed with RelayHealth Pharmacy Solutions.

Tomorrow promises a slightly quieter exhibit hall, given that many vendors will start packing up early to head home. I hope to stop by the Interoperability Showcase and Connected Health Pavilion, though HIMSS has a habit of pulling us all in a million different unexpected directions. Feel free to email me with your suggestions of can’t-miss exhibits or sessions for Thursday.

From HIMSS 3/7/18

Newsy Items

Analytics vendor Inovalon will acquire competitor Ability Network for $1.2 billion, doubling the 2015 investment of the latter’s private equity owners. 

The Wall Street Journal reports that Cigna is close to buying Express Scripts for at least $50 billion as industry consolidation runs rampant. Wow.

HHS Secretary Alex Azar lays out – in an admirably direct manner – his vision of the transition to value-based care in a speech to a hospital trade association, of which I’m paraphrasing. Note that he’s basically throwing down the “no more business as usual” gauntlet to the people who will be most resistant to the planned changes. He previewed some of the the items covered in Tuesday’s presentation by CMS Administrator Seema Verma and White House Senior Advisor Jared Kushner. High points:

• The hospital industry has dragged its feet on being paid for value and health systems are charging too much without delivering good outcomes.They also haven’t done enough to manage chronic diseases.
• The White House and HHS are not afraid to disrupt the status quo “simply because they’re backed by powerful special interests.”
• HHS will emphasize giving consumers control of their health information via interoperable, accessible health IT. He said, “Patients ought to have control of their records in a useful format, period. When they arrive at a new provider, they should have a way of bringing their records, period. That’s interoperability. The what, not the how … Too often, doctors and hospitals have been resistant to giving up control of records, and make patients jump through hoops to get something as basic as an image of a CT scan. The healthcare consumer, not the provider, ought to be in charge of this information.But we do know that the barrier is not always the provider’s decision to shield that information. Sometimes it’s that there aren’t systems for easily disseminating it, and we aim to work with the private sector to open up avenues that will empower patients.”
• He calls for transparency in drug pricing at all levels.
• Azar bluntly concludes, “Our current system may be working for many. But it’s not working for patients and it’s not working for the taxpayer … This won’t be the most comfortable process for many entrenched players. But those who are interested in working with us to build a value-based system will have the chance to take advantage of a market where consumers and patients will be in charge of healthcare.”

Today was overcast and cool, not that it matters much when you’re inside a windowless casino complex jam-packed with way too many people. 

From New Health IT Investor at HIMSS: “Re KLAS. On the first day of HIMSS, I inquired about KLAS and three times got the same word from vendors – extortion. I asked Epic’s competitors and they say Epic pays nearly $6 million a year. Tonight I looked up KLAS’s public declaration of income to the VA in March 2017 and they stated $12M in annual revenue. So half of KLAS’s income is from Epic?” I disagree that it’s extortion. Vendors make a business decision to pay KLAS what amounts to advertising fees expecting to make a return on that investment in the form of sales. KLAS also claims to be the voice of the customer, but only an incompetent vendor would need a third party to tell them what their customers think. No major vendor has had the nerve – so far – to break ranks and stop supporting a system they complain about, so KLAS just keeps happily minting money. I would be shocked if KLAS only makes $12 million per year and even more so if Epic pays them $6 million. I’ve asked a few folks to guess at KLAS’s revenue and they usually say maybe $20-30 million, with those same guessers thinking Epic pays maybe $1 million. But’s all speculation since, unlike the “Consumer Reports” to which KLAS is often inappropriately compared, KLAS is for-profit, is not financially transparent, uses statistical methods that range from unstated to unscientific, and makes most of its revenue from the same companies it claims to objectively review. KLAS is not evil, they’ve just created a great business based on vendor insecurity that paying KLAS increases sales, which I would argue is more perception than reality. In fact, it would be fun to commission a truly independent and statistically valid survey to determine if providers actually used KLAS services as a major factor in their most recent system purchases.

From Kodak Moment: “Re: HIStalk booth Polaroids. Saw those in a tweet – what are you doing with them?” I really don’t know – Lorre and Brianne are always full of surprises, some of which I like.

The Oneview Healthcare folks confirmed that HIMSS did indeed shut down their live Irish band and dancers in the exhibit hall Tuesday. They told me they had done the same performance for the past five HIMSS conferences without any problems, but I’m sure someone with a bigger booth complained about the noise (or that they were losing visitors to a more interesting booth). The company was pretty funny in tweeting out a doctored-up invitation in which the band and dancing references were redacted, but reminding everybody that the Guinness would still be flowing (which I confirmed in having one Wednesday afternoon).

A reader complained that the pictures I run are too small. It seems simple to just make them bigger, but I guarantee I’ve thought of all options and their pluses and minuses. I’ll explain after HIMSS and open it up to a reader vote. In the mean time, I’ll make the pictures bigger for the HIMSS posts and that will probably trigger an immediate minus – more scrolling will be required and people hate that, especially on mobile (which is why I sometimes but not always make the pictures bigger, depending on what’s in them). Part of the problem may be that I’m working from a laptop and my screen captures might not be as crisp as usual. I admit that I have no idea how that works.

Lorre said three new HIStalk sponsors have signed up in my “Cellar Dweller Special” bonus offering. Thursday is the last chance for those who could use more, less-expensive exposure over a full year than a three-day downstairs booth can provide. We have a good time with our sponsors, and while they don’t get influence over the editorial side of what I do (screw up and I’m going to say so), a some companies were unknown before their introduction as a new sponsor.

This will be the high point of the week for me. I was puzzled to see an elderly man walking slowly but ramrod-straight down the aisle by our booth wearing a “World War II Veteran” cap. I caught up with him and asked about his service. Bruce was a US Navy Seabee deployed to the Pacific theater, serving as part of the construction team that was tasked with building the structures required for the planned invasion of mainland Japan. I thanked him for his service – choking up a little bit thinking about what he has seen and done in his long life – then asked him what he was doing at the conference. He said his daughter is the academic VP of the college of health professions at Western Governors University (exhibiting in Hall G) and she brought him along as her guest. What an honor to have him at the conference – it was heart-warming to see people who were working the booths come out to shake his hand. I don’t know how old Bruce is, but I’m sure the memory of being shipped out as a young man for an assignment he almost certainly wouldn’t survive remains vivid even 75 years after the fact.

Optum was making donations for each attendee who colored in a section of their graphic, although I got so engrossed with trying to say inside the lines that I forgot to write down the details.

It seems like half the booths are, at any given moment, stuffed with video and/or audio recording equipment and people. You couldn’t walk 50 feet without trying to dodge tripods, stay out of a camera’s line of sight, or watch two people sitting on stools conversing on camera. I don’t know who will watch all that video (not me, I guarantee), but maybe I’m just out of touch with those who can’t consume content unless it’s dumbed down to short videos. I’m also questioning whether there’s enough people who have useful wisdom to fill up all that airtime, given the skimpy resumes some of the folks who couldn’t wait to start tweet-bragging that they had been asked to share whatever it is they know. 

Cerner used the outside walls of their booth for promotional posters a la Epic, but instead of KLAS excerpts, Cerner instead highlighted customer successes.

Cerner also took off the gloves inside its booth, deviating from never referring to Epic by name (“our primary competitor”) to even copying Epic’s logo.

I asked this guy if he was having a good show, but he told me to beat it.

The hall has all kinds of nooks and crannies devoted to special interest tracks. I accidentally ran across this Innovation Live stage and listened in to someone’s case study (I think it was Albuquerque-based Twistle, which offers a patient engagement app).

Stuck back in one of the innovator areas was Neurotrack, which uses a mobile device’s camera to track a user’s eye movements when various kinds of photos are displayed over a few minutes. It’s apparently good at identifying people who may be more likely to have dementia 3-5 years down the road, giving them enough time to implement lifestyle and mental exercise changes. The company has an investor from Japan and has made some inroads there, since insurers there pay twice for Alzheimer’s (once upon diagnosis and again at death) and thus will pay for early detection that may support prevention.

Think all the cool kids are in the upstairs exhibit hall? We got Uber in Hall G, y’all.

Another great ice sculpture, provided that you see the point of making ice sculptures (and I admit I kind of don’t, especially when they are made like a giant, shaped ice cube instead of hacked from a block).

Athenahealth Chairman Jeff Immelt and CEO Jonathan Bush were hanging around the rather dead Athenahealth booth that’s about as far from the main exhibit hall thoroughfares as you can get.

I stopped by the booth of South Korea-based Bestcare, which is always an interesting experience (“from Korea, like K-Pop,” one of their folks explained with an attempt at humor last year). This is the best-looking product on the floor as far as I’m concerned, with a slick UI and innovative ideas like a graphical patient journey timeline. I would show you what I’m talking about, but like last year, they turned me down cold when I asked to snap a picture and their handouts don’t show screens. Anyway, they’re trying to get into 13 US hospitals, but I see challenges that go beyond language and culture – they don’t have a billing system, the terminology is not always US standard (like “ward” instead of “nursing unit”), and they brag that they will modify the source code to accommodate a customer’s needs, which creates an upgrade nightmare.

Harris Healthcare’s person who engaged me was friendly. I asked if Orlando Health was still using the former QuadraMed Affinity and she said yes – it will be 20 years upcoming. I didn’t mention that they’re planning to replace it (and Allscripts Sunrise and whatever they use for ambulatory) with what I assume will be Epic or Cerner.

Some company had a guy pouring chilled wine at 10 a.m.

I visited AssessURhealth, which offers a five-minute patient mental health screening questionnaire usually given in a physician office’s waiting room. Patients respond more honestly to questioned asked by an app rather than a person, and the physician practice is notified if their answers suggest immediate further questioning about any intentions to harm themselves or others. I asked the crass question of who pays for the service and it’s the doctor’s office, since they may generate more billables even while doing a good deed.

I strolled by the Aprima booth just as our sponsor sign fell over on the table, after which I noticed one of the company’s employees rushing over to reverentially place it back in place like the Mona Lisa had just crashed to the floor.

The best booth person I’ve seen was Hanna from Zayo. I care very little about bandwidth provider and to be honest I’ve never heard of the company, but Hanna’s sparkling repartee got my interest. She’s a pistol down there in Hall G.

I had to watch Bob Garner in action at the Cantata Health booth again. Within 60 seconds of my arrival, he had described in considerable detail how an attendee’s brother-in-law had passed away, even giving his full name. She basically froze, unable to comprehend what she had just experienced, and I saw her wiping tears. Bob immediately told another attendee how his brother had passed away and he also just stood there dumbfounded.

I signed up for an impressive AI presentation by Nuance CMIO Reid Conant, MD. He showed how a doctor in an exam room outfitted with a wall-mounted speaker-microphone can conduct a complete patient session using their voice alone just like when you talk to your Amazon Echo or Google Home device and it speaks back to you. The virtual assistant technology integrated with an EHR is fantastic – it can fill in discrete data fields and answer questions such as “has the patient had a flu shot?” The doctor can say, “Hey, Dragon, show me the two most recent chest X-rays,” then say, “Read me the radiologist’s impression” and then say, “Add to Susan’s task list to recheck the lungs.” The PCP can say, “Call the on-call hospitalist” and have it launch a VOIP call to create a handoff. Nuance developed the virtual assistant / virtual agent technology years ago for the auto industry. It was impressive and seems to be available now. It’s the best hope I’ve seen for letting the doctor focus on the patient, skip the effort and distraction of typing, and create a satisfying EHR interaction instead of clicking without gaining useful information (even scribes can’t give machine-generated suggestions). Epic is apparently demonstrating its Nuance integration this week and Meditech is on deck.

Tomorrow is my last day at the conference, so my last recap will be Thursday evening. Safe travels, especially those who left the Northeast in winter weather and now have to return in equally bad conditions. Feel free to send me any conference observations as we tie a bow around HIMSS18 and call it done.

Jenn’s HIMSS 3/7/18

Yesterday’s HIMSS was, for me, about interoperability in all its many forms. Health data exchange and its impact on physician satisfaction and patient outcomes were mentioned in every session I attended, the first of which was a phoned-in pre-brief with CMS Administrator Seema Verma ahead of her live session introducing the new MyHealthEData Initiative. The initiative aims to put patients at the center of their care by putting policies in place that will ensure they have control of their shareable health data. Verma shared her own frustrations with lack of access to her husband’s health data during his heart attack event last year. When pressed, his providers finally gave her five pieces of paper and a CD-Rom. “Why are we giving patients their records in these formats,” she half-jokingly asked, “when Tesla is sending sports cars into space?”

She stressed that putting data into the hands of patients will help the industry transition more quickly to value-based care. “Many of you have heard this all before,” she said, “but I’ve always been struck by how seldom patients are mentioned in talks of value-based care. We will not achieve value-based care until we put the patient at the center of our healthcare system – until they can make decisions based on quality and value.”

Though she didn’t offer any concrete timelines, she did lay out a number of related efforts:

• CMS will overhaul Meaningful Use and the Quality Payment Program’s Advancing Care Information Performance Category (which got a round of applause from the audience) to help reduce clinician burden and burnout.
• Privacy and security will be at the center of the intiative’s efforts. Ensuring security will be required to avoid penalties and receive incentive payments.
• Blue Button 2.0 is in the works to give patients easier access to their digital data.
• Payers will be strongly encouraged to ensure their members have access to digital claims data.

Given the recent HIStalk reader back-and-forth over CommonWell, it’s lack of market penetration (a founding company left and a friend in the HIE space tells me it’s expensive to become a member), and upcoming partnership with Carequality, I thought it might be a good idea to attend the afternoon session on how HIEs, CommonWell, and Carequality can work together. Led by Indiana Health Information Exchange executives John Kansky and Keith Kelley, it followed Mr. H’s rule of only attending HIMSS sessions with zero vendor presence. The hour-long presentation did a good job of bringing me up to speed on the important role HIEs play in making nationwide interoperability happen (some day), and the challenges they face when it comes to selecting their method of doing so based on the needs of their regional members. As one would expect, there’s no silver bullet; HIEs will ultimately need to leverage a combination of CommonWell, Carequality, the Strategic Health Information Exchange Collaborative’s Patient-Centered Data Home model, and the Trusted Exchange Framework and Common Agreement, which is still in draft form awaiting comments.

“The truth is it’s complicated and confusing,” Kansky said. “We don’t even have one common definition for interoperability. There’s an unsupported belief that one approach is the best approach. That’s not the case. Don’t believe your vendor when they tell you you only need one interop solution.”

My favorite part of the presentation came during the Q&A, when an audience member – presumably a vendor – asked if blockchain has any role in the HIE/interoperability conversation. The presenters didn’t mince words with their negative reaction, pointing out that FHIR, which the industry has been talking about for the last four or five years, is only just now being piloted by various organizations across the country. Not one person in the several-hundred member audience raised their hand when Kansky asked if anyone was using blockchain, and just one – from Humana – admitted that their organization was contemplating it.

The interoperability theme continued during my last session of the day, a fireside chat between HIMSS North American Board Chair and Executive Director of the Georgia Health Information Network Denise Hines and National Coordinator Don Rucker, MD. As one would expect, the conversation was fairly high level and I frankly had a hard time paying attention given what I assumed was noisy casino activity on the other side of the wall. Topics ranged from ONC’s renewed dedication to open APIs and the evolving smartphone revolution in healthcare, patient-centered care, and the need to eliminate info-blocking to move interoperability along. Rucker also addressed some of the 250 comments ONC has received on TEFCA, which should be finalized in late spring. Top of mind on the comment pile are the issues of consent, how the framework will address differing state regulations, and what coordinating entity or collaborative will be put together to oversee it.

All that talk of frameworks, APIs, and info-blocking had me in need of some Vegas frivolity, so I stopped by Pivot Point Consulting’s party for a quick sec to enjoy some time with Elvis and the Rat Pack. Where else but HIMSS can one sidle up to Sammy Davis, Jr.? More to come tomorrow.

Dr. Jayne at HIMSS 3/6/18

As is usual when I go from East Coast to West Coast, I woke up insanely early compared to local time. It allowed me to head out to the strip for a good walk to check out all the changes that have happened since the last time I was here without a crush of people and without having to deal with people handing out stripper cards. Back in the room, I tried to log into my EHR to check messages and see if there were any charts from mid-level providers that needed signing, only to find that the system is down. I’m sure they’re having heart failure at the office since we’re still in the throes of flu season.

My hotel room has a lovely view of the roof of the expo center and I was glad to see some solar panels as well. After my usual HIMSS breakfast of a Clif Bar and Diet Coke, it was off to sessions. I hate fighting the coffee and breakfast lines at most conferences and HIMSS is always the worst. I’ve learned to bring my snack stash and especially so for this conference, since there won’t be any MedData scones.

I waited until the expo hall opened and it was still gridlocked when I headed down the escalator from the faux St. Mark’s square. Claustrophobic people should not attend HIMSS since the aisles were packed today, even in Hall G. I did spend a fair amount of time there today, mostly because the vendors were more enthusiastic and actually acted like they wanted to talk to you rather than seeing you as a distraction from their internal conversations.

Not every vendor was avoiding customers, however. I had some issues with vendors upstairs being overly aggressive, straying way outside their booth boundaries and actually stepping in front of attendees and blocking their way to try to talk to them. There were also lots of people shooting video in the aisles, even up on ladders taking pictures of their booth, which didn’t help the crowding.

Cheers to sponsors that had their signs out front and center: Aprima, Dr. First, Elsevier, Forward Health Group, Health Catalyst, and Fortified Health Solutions / Santa Rosa Consulting.

Jeers to Imprivata’s scrub-clad demo team, members of which were also wearing lab coats. No one is fooled by the fact that you’re not actual clinicians. I was surprised to see how many people were watching their demo.

I had a great chat about Office 365 with this gent from Tech Data, who humored me with a photo of his cloud suit. He promises a shorts version for next year in Orlando. There’s so much going on at HIMSS that you really have to have something to grab attendee attention – I’m not sure the “same old, same old” attention-grabbers in the booths such as golf swing analyzers and cheap giveaways are cutting it. NextGen showed off in Booth 3821 with a four-panel screen printing machine making tote bags on demand – for every bag given away, they’re donating food to needy youth.

In Touch Health had a soft serve bar, but they’re located in a far corner of the hall. I only ran across it because I was turned around and couldn’t figure out how to get out of the hall. Juniper Networks had their oversized Operation game. MedData had a vintage candy shop complete with Wax Lips, which I haven’t seen for decades. Kudos to them for finding something to (hopefully temporarily) replace the scones we all love. Edifecs had some super cute pink shoes on display as part of their #WhatIRun campaign.

I found these folks painting away in Hall G, in a mostly-anatomically correct way. You never know what you’re going to see at HIMSS, and so far, this is the weirdest thing.

I was gifted with some pink socks today and must say I am thrilled!

Towards the end of the afternoon, I ran into an old friend outside the Logicalis Healthcare Solutions booth in Hall G. We were chatting away and they were kind enough to let a couple of weary travelers enjoy their comfy chairs late in the day. We talked about marketing campaigns and sales tactics with one of their client executives, who was gracious and engaging. They seem to have a lot to offer, so stop by and check them out.

From there it was off to visit various booths for cocktails and then head to the Holon Solutions reception at the Venetian. I was excited to learn about their success at Banner Health, surfacing gaps in care within the EHR. I joined some old friends for dinner, and by the end, my feet were giving out, It’s going to be a relatively early night for me.

From HIMSS 3/6/18

Today started with a traffic jam near the Treasure Island in trying to take a Lyft to the convention center, followed by a deadlocked mass of humanity simultaneously navigating the convention center halls. I seriously worried that we might have crush-related injures or deaths like at the Hajj, where too many people and too few crowd control experts create situations in which you are first carried along helplessly by the Brownian-type collective movements of everyone around you, then smothered when your chest doesn’t have room to expand to allow breathing.

The big news of the day came in a scheduled session with CMS Administrator Seema Verma that included a surprise guest in White House Senior Advisor Jared Kushner. They vowed to address EHR interoperability by using CMS payments to punish information blockers; to streamline EHR incentive payments; and to expand the Blue Button project (which you don’t hear much about these days) to an API-powered 2.0 version that gives patients greater control. The Kushner-led MyHealthEData effort will focus on giving patients access to their own data.

The Ellkay folks were giving away honey harvested from their rooftop hives. They brilliantly package it in jars of a size that pass TSA checked luggage restrictions. I had a fun chat with co-founder Kamal Patel over an delicious afternoon “Ellkay special” drink made from bourbon, the honey, peach schnapps, sweet and sour mix, and probably other ingredients I didn’t notice (lots of booths had happy hours today). Ellkay (“Healthcare Data Plumbers”) is a great success story, started when Kamal got laid off from his programmer job and had to figure out how to cover his family’s bills.

I noticed that the Voalte folks have progressed from their early-day pink pants to pink shirts. They said they still enjoy wearing pink whenever the occasion calls for it. I also learned that the name Voalte comes from Voice, Alarm, and Texting, the platform’s original capabilities.

An interesting jacket choice from NextGate.

Splunk is a great company name. I assume they do something that might conjure a vision of “spelunking,” but the clever name was wasted since I couldn’t get their booth people to come up for air from talking to each other to give me a glance.

Change Healthcare’s booth was imposingly massive. So much so that I didn’t really want to enter their soft-carpet space.

I hope this poor girl was OK, brought back to health by all the doctors and nurses who, surprisingly, looked like salespeople wearing scrubs. Surely nobody would pass themselves off as a clinician knowing that real clinician attendees (and thus prospects) won’t appreciate having their profession reduced to an exhibit hall costume. I’m at least happy that I didn’t see any provocatively clad women straying into booth babe territory.

The most personable booth rep I met all day was Sohail from Google Cloud. We had a nice chat and then he disappeared to bring me back a surprise gift of these cool socks.

GE Healthcare did a five-minute overview stage presentation, then invited audience members (of which I was the only one) to try a hands-on demo. Unfortunately it was really confusing, and neither the booth person nor I could figure out what we were supposed to do. Maybe that says something. They did mention “digital twin,” a problem detection concept I keep hearing more about.

The Epic rep who engaged me was really friendly. As a reader predicted, the company’s non-marketing team had already turned the just-released (and controversial) KLAS interoperability report into a big wall poster. They get mileage out of the large sums they pay KLAS.

More Epic posters. The second company family tree one shows how Allscripts and Cerner have grown by acquisition and product integration, while Epic has acquired nobody and developed all its own software. I asked the Epic guy how they got so good at posterizing competitive information and he said they just developed internal expertise with practice. They even had images of all of the several posters on their walls collected into a handout. Those strong visuals are the most effective items I’ve seen at any HIMSS conference.

Epic art, of which there was a lot, was all wacky.

MedData can’t bake scones in Las Vegas, so they had retro candy like Necco Wafers and wax lips.

This was a real (and real big) ice sculpture.

Allscripts finally unveiled the former Care Otter skunkworks EHR project that is now named Avenel (the name means nothing, according to the booth person I asked). It’s a tablet-only EHR (and IOS-only as well) that connects to the cloud-based back end with a single desktop used to maintain the system. The “machine learning” claim refers to the system’s “surfacing” of relevant information and workflows as driven by observed user behavior rather than by creating a rigid user template. It was quite tablet-y in a way that doctors will likely enjoy once they get used to the idea that an open encounter is not required to bring up a task list or perform maintenance. It’s pretty cool, but it’s early in its life cycle and I guess it would need to be paired with a locally hosted PM system. At least they’re building something new and it looks like something docs would love – it reminded me of Medicomp’s Quippe, which had the same friendly, intuitive tablet-powered documentation system running several years ago.

A reader asked if Allscripts was demoing Paragon and Paragon Ambulatory. I asked the company’s booth desk people and they didn’t seem to know what Paragon is. They claimed unconvincingly that it was being demonstrated somewhere this week, but offered no particulars.

Someone at the EClinicalWorks booth gave me a demo of 10i, the company’s new hospital EHR that costs $599 per bed per month. I’m impressed – I took the rep off script in asking to see functionality with which I have a lot of experience (pharmacy, lab, etc.) and it was remarkably deep and broad. It shares a single database with ECW’s ambulatory solution and will provide even hardcore modules such as LIS, blood bank, RIS, and anesthesia documentation and OR management. They have around 20 hospitals that have signed letters of intent to get in line once the initial sites shake out the inevitable problems. ECW 10i looks like a potentially strong competitor to small-hospital systems and has been architected to handle larger ones. Worth watching.

Someone asked me who’s giving away sunglasses. Talk to Vyne Medical down in Hall G.

I was truly happy that Cantata Health lured the semi-retired but still magnificently entertaining Bob Garner back to their booth. I’ve seen his sessions at least a dozen times, and while he makes me laugh harder than just about anything, some of his shockingly accurate and personal insights (he says he’s not psychic, but I wonder) cause tears from attendees who weren’t expecting to be so profoundly affected. I urge you to trust me and go see what he does. He is always the high point of my HIMSS experience.

Ireland-based Oneview Healthcare had the best themed entertainment I’ve ever seen at a HIMSS booth – a good Irish band, a local Irish dance troupe, and Guinness on draft. The HIMSS police wasn’t happy with the band’s volume, however, and was threatening to shut them down as I moved on. I like that the company proudly embraced their heritage with a fun program.

I’m not exactly sure what was going on right around the corner from our Hall G booth. I averted eye contact since I can’t imagine this is a job that either of the folks pictured would go home and tell their kids about.

Our booth neighbors Nihon Kohden were pouring sake, which was a HIMSS first for me. Brilliant, and as in Oneview’s case, culturally relevant.

Kudos to NextGen Healthcare for a cool booth idea. They brought in local artists who imprint goodie bags with your choice of design. Inside is a card from Las Vegas’s Three Square Food Bank, to which NextGen donates a matching bag filled with food for underprivileged children. 

Grahame Grieve is one of our favorite people, the humble father of FHIR who isn’t really a health IT cheerleader as much as he just wants to do the right thing for patients. Lorre said he was being approached constantly like the rock star he is, yet he just went about his business like he wasn’t worthy. I think she was rejuvenated by his altruism that is refreshing among a glut of glory-seeking behavior.

Hall G is actually a fun and easily navigated space, much better than I cynically predicted. The challenges are (a) the absence of anchor tenants, who are all upstairs; and (b) the nearly invisible stairwells that lead down from the main hall level. It’s easy to find Hall G if you are on the ground level of the lobby (it’s near HIMSS Bookstore), but it’s maddeningly hard to find the down escalators from the upstairs exhibits (hint: look between the Cerner and Allscripts booths). I also felt like a rat in a maze upstairs when trying to find the exit doors – like the casinos, they don’t make it easy to walk away.

I strolled Hall G and here’s why it’s worth the trip downstairs. It’s really easy to navigate, with mostly straight aisles that aren’t broken by huge booths. The booths are modestly sized and you see more vendors in fewer steps while still seeing giveaways, happy hours, etc. The people seem friendlier and less frantic, both exhibitors and attendees. Best of all, the companies there have more focused product lines and it’s easy to decide which ones to visit purely from their signs. It’s like HIMSS conferences used to be before they got out of hand. 

Thanks to the many attendees who dropped by to say hello at our little Booth #11228 even though it was not the easiest to find. I’m rethinking the idea that our location is super important since today’s experience suggests people will seek us out, a luxury that vendors don’t necessarily have.

I’ve had a long day, and since it’s after 11 p.m. as I write this, I suppose I should go to bed in preparation for another long day tomorrow.

Jenn’s HIMSS 3/6/18

Tuesday dawned bright and rather bleary-eyed. After a thankfully restful night’s sleep, I woke up this morning to the realization that last night’s itchy left eye was probably developing into something more acute. I’m on the mend after an early-morning MDLive consult (a perk of my MediShare plan) from my hotel room and a prescription pick-up at the Venetian Walgreen’s. I had to laugh when the tele-doc suggested I visit the MDLive booth after I told him I was here at HIMSS. I’ll likely keep a low profile at the conference today, popping in briefly to say hi to Lorre at our booth, 11288, in Hall G. I’ll be using copious amounts of hand sanitizer, so will pick up one of Arcadia’s handy HIMSS18 Survival Kits they’ve so kindly supplied us with as giveaways.

But let me back up … Arriving a full day ahead of exhibit hall hours has been a thoroughly enjoyable experience aside from my health issues. I spent most of Monday morning wandering around the Venetian and Sands to reacquaint myself with the lay of the land. Much like my time in Venice years ago, it took me longer than I expected to orient myself. That time, though, was not lost, as it gave me a chance to chat with attendees like Orchid Webb, director of clinical transformation at GMP Network (MI), a physician-based organization that helps independent MDs with technology, payer relationships, and the overall move to value-based care. Webb had good things to say about EagleDream Health, a cloud-based analytics company acquired by NextGen last fall that has assisted GMP physicians with upping their population health efforts. Though she wasn’t at HIMSS to shop for anything in particular, Webb told me she does have telemedicine on her radar, validating my comment in yesterday’s write-up that attendees are looking more for immediate-impact patient care tools than the razzle dazzle of evolving concepts like blockchain.

I also had the chance to talk with a trio from St. Jude Children’s Research Hospital (TN), who had gathered outside of Starbucks to get their pre-conference symposia game plan together. Senior Clinical Analyst Jon Jernigan (left) and friends will be hitting the exhibit hall today to look at products related to interoperability and analytics. Vendors on their stop-by list include PatientSafe Solutions and Health Catalyst.

The foot traffic seemed slower, of course, than it will be today. I’ve read somewhere that HIMSS expects 50,000 folks to descend on the Sands, with that figure later being adjusted to 43,000. It might not be too far off the mark if standing-room only events like the first-timers orientation are any indication.

Several conference-goers found time to escape the escalating attendee rush near this fountain, which is surrounded by very tranquil Chinese décor. I love the fact that every coin tossed in is donated to The Dr. Miriam and Sheldon G. Adelson Clinic for drug abuse treatment and research here in Vegas.

I was happy to get off my feet for a bit in the media room where I caught up with Wellpepper CEO Anne Weiler and Mayo Clinic Global Business Solutions Senior Director Shayn Carlson. They brought me up to speed on Wellpepper’s new care plan partnership with the clinic. The organizations will launch Mayo Clinic care plans for cardiac rehab, headaches, and sports medicine on the Wellpepper Marketplace in the coming months, with additional plans in the works for later in the year. Wellpepper has developed a patient engagement platform that enables hospitals to deploy their own treatment plans within an app that guides care delivery outside of a provider’s four walls, and then collects outcomes data providers can use for analysis. The two organizations have known each other since 2015, when Wellpepper won Mayo Clinic’s first Think Big Challenge.

After some afternoon R&R at the hotel, I headed back to the conference for round two, which included a guided tour of Athenahealth’s new art installation, the keynote, opening reception, and an intimate dinner hosted by the AMA and IBM Watson. The 5,000-pound stack of paper above will surely drive traffic to their booth (plus they’re right next to the restrooms in Hall A, which is always a good spot to be near). Coupled with a pretty cool augmented reality experience, the artwork tells the story of paperwork’s burden on physicians in terms of cost and burnout. The company’s talking points this go-round will be expanded, machine-learning based services for document management and coding that will help physicians reduce paperwork and data entry. They’ll also be demoing a new, more EHR-friendly Epocrates app – a move that Chief Product Officer Kyle Armbrester is pleased about given the company’s heretofore lack of focus on that brand.

As expected, the keynote overflow room was filled to capacity and so I joined my colleagues in the press room to watch what passes for an Olympics-like opening ceremony at HIMSS. As Mr. H alluded to in his write-up, the vocalists from The Voice that preceded Eric Schmidt of Alphabet were certainly talented, but an odd choice. I couldn’t help but wonder how much money HIMSS could have saved, or diverted to other more patient-facing causes, had they passed on the opening act. I saw most of the keynote, but only heard the last 10 minutes thanks to audio issues in the press room. Eric Schmidt essentially told the audience to hurry up and catch up so that Google and other consumer-facing companies can put their technologies to good healthcare use.

The post-keynote opening ceremony was unusual in that it was held downstairs in Hall G (a ploy to get people down there today, perhaps?). I can’t remember a HIMSS where the opening reception was held in the exhibit hall. The theme was fun – 80’s nostalgia with a focus on arcade games and music, courtesy of a high-energy DJ. I didn’t stay long. But the vibe became too weird. I knew it was time to go when Baby Got Back started playing. All attempts at legitimate health IT-focused convo had to be abandoned.

I happily headed over to a far more intimate gathering hosted by the AMA and IBM Watson. It was nice have a sit-down meal with 40 of my closest peers to hear from AMA CEO James Madara, MD, IBM Watson Health Chief Health Officer Kyu Rhee, MD and Mayo Clinic CIO Criss Ross, who had many stories to tell of the positive impact Watson technology is having on Mayo Clinic point-of-care processes. (Ross is one of 60 Mayo staffers here at HIMSS, and considers himself to be a rookie among his Mayo colleagues, given that he’s been at the organization for only five years.) He made it clear amidst all the talk of AI and machine-learning, that, at only three years old, Watson is still learning and Mayo is still realizing its capabilities. It was refreshing to hear him say he’s more interested in “little AI” than “big AI,” meaning that’s he more likely to use it for simple utilities than big moonshots. Fun fact I didn’t know: Eric Schmidt is on Mayo’s Board of Trustees. After a delicious piece of tiramisu, I called it a night.

Dr. Jayne at HIMSS 3/5/18

I was on the schedule to see patients yesterday, so I had to catch an early flight to Las Vegas. The gate area was full of people also headed to HIMSS, by virtue of this being the first non-stop flight to Las Vegas for the day. Plenty of logoed backpacks and polo shirts made it easy to pick out people headed to the show.

I normally avoid flying on Monday mornings because it’s such a zoo and today was no different, although it was possibly more challenging than normal. The TSA Pre-Check line was as long as I’ve ever seen it and TSA kept routing people out of it into other lines, causing tension and some line-jumping that led to angry words. My Southwest flight had plenty of people trying to save exit row seats despite the no-seat-saving policy, and I thought two passengers were going to come to blows at one point. Fortunately, cooler heads prevailed.

Travel seems to losing civility with every trip I take. On this flight, one man yelled at the flight attendant for touching his arm as she passed (his arm was hanging out into the aisle, making it nearly impossible for anyone to get by). Although we were on a nearly new aircraft, the wireless wasn’t working, which I’m sure raised anxiety for people who had planned on doing work during the flight. Regardless, a gentle note to travelers: if you have company logo apparel and luggage tags, you might want to behave accordingly. I made a couple of notes to try to see if some of the less-well-behaved passengers turn up in their respective companies’ booths.

There were plenty of in-flight conversations about the need for comfortable shoes and where people were staying – lots of people off the strip and several companies renting houses rather than being in the HIMSS room blocks. The general tone is that HIMSS has become all about the exhibit hall and networking and that the keynote speakers are largely irrelevant. Most of the people who were chatting around me on the flight are from the vendor side of the house and didn’t have opinions about sessions or the educational value of HIMSS because they’ll be stuck manning their booths or doing coffee runs.

I was reading some continuing medical education materials during the flight and my seat mate asked whether I was a physician. He was curious as to what I thought about Uber’s new foray into healthcare. I have mixed feelings on the offering, considering that the physicians, hospitals, and care providers are expected to foot the bill. Sure, it’s cheaper than an ambulance and cheaper than noncompliance, but for small practices that are not in risk-sharing arrangements, it’s going to be one more thing to pay for and less likely to happen. These practices are already paying for translation and interpreter services that usually negate any profit they would make from a given visit, so when you throw transportation in the mix, it only works when there is a larger entity at play to absorb the costs. I did note that if patients have the regular Uber app, the visit isn’t billed – it’s not clear however how the drivers will be compensated in that situation.

It will take a special group of drivers to care for the Uber Health population, drivers who are aware of the needs of medically complex patients who may have difficulty getting out of the house, who may have accompanying medical equipment, or who may have challenges related to their medical conditions. I assume Uber has this figured out since Uber Health has been tested for more than six months by a group of 100 hospitals and physician offices. Patients can be scheduled by the practice up to 30 days in advance, which certainly can help patients keep their visits. I was interested to see that the Uber tools are “compliant with HIPAA,” which makes me wonder whether name and address are the only PHI elements they’re tracking.

There are also liability questions. When we have patients at our practice who require transportation, we provide contact information for various community and commercial services. Our contact sheet has a disclaimer that we are not affiliated with or recommending these services and are simply providing it as a convenience. If the physician office schedules transportation and an accident occurs, do they share the liability? What if an office sends an Uber but an ambulance was really more appropriate? We’ll have to see how things shake out over the coming months.

I finally arrived in Las Vegas late morning, and although check-in at my hotel was quick, they didn’t have a room ready for an early arrival. I spent some time tidying up some project plans and people watching at the Palazzo shops before meeting a former colleague for dinner. We hit some of the shops afterwards and then made our way to the opening reception in Hall G. This year’s reception had a Pac-Man theme that I didn’t quite get, although I did get a kick out of seeing the arcade games scattered around the subterranean Hall G. There was a crush of people trying to find the buffet tables that were scattered around the hall, leading to long bar lines and questions about what was being served. Even though there was a map of offerings at the entrance, I never saw half of the options that were listed. Although many booths were fully manned, some were still being set up and still others were totally empty. I’m sure this is the largest influx of people into the basement level for the week, so if you weren’t trying to grab attention, you missed out.

LogicNets was building an oversized Jenga game in its booth.

Lightbeam Health Solutions wins my prize for being the first booth I saw that had our sponsor sign proudly displayed. I was pleased to see that the HIStalk booth with its smoking doc is ready to greet attendees tomorrow, just down the aisle from not only the Philippine Trade and Investment Center booth, but also behind the Nihon Cohden America booth, which wins my prize for some of the creepiest imagery. They have a 3-D female figure that has pictures of organs project onto it, I think they’re responsible for a guy who was wandering around with medical tape and electrodes on his head. I tried to get a picture of that, but he got away.

I felt sad for the empty “first time exhibitor” booths where perhaps the exhibitors ran out of money before they made it to the show. It looks like there are plenty of things to see in Hall G – I will have to go back and investigate what looked like a large slot car track and also a couple of interesting booths. Optiv is a first-time exhibitor, and although I didn’t have time to stop by to see what it is they do, the booth was well put together and the team seemed to be ready to talk to people. I saw one booth whose tables were covered by leftover buffet trash even though there was staff present, giving it the air of the aftermath of a college party.

I closed out the night with my first martini of the year (!) with a friend and am off to bed so I can be well-rested for tomorrow. Who knows what HIMSS Tuesday will bring?

Email Dr. Jayne.

From HIMSS 3/5/18 Part 2

HIMSS18 Day 1 is on the books. I’m not really sure if it’s Day 1 or Pre-Day 1, but it’s over regardless. There wasn’t a moment today where it didn’t feel like Sunday instead of Monday.

From Ulterior Motive: “Re: Fujitsu. They are exiting the healthcare vertical business even though they claim to focus on B2B with an emphasis on verticals. This aligns with the pending acquisition from Lenovo. That leaves the industry with Lenovo, HP, and sometimes Dell for mobile computing devices. Guess it is now time for Apple and potentially Microsoft if they can fix Surface.” Unverified.

Newsy Items

Cerner and Salesforce will collaborate to integrate to offer their combined population health management and CRM solutions, respectively.

We’re surrounded by grotesquely Americanized phony views of the real world and the worshiping of excess, debauchery, and conspicuous consumption. Sorry, wrong picture – I was looking for one from the exhibit hall.

It’s kind of like the running of the bulls in Pamplona, except that the slower-moving targets of rage are the health IT nerds thinking that they are expert multi-taskers in being able to screw around with their phones while walking and failing to notice that they’ve almost stopped mid-walkway due to lack of CPU cycles to smoothly accomplish both. They deserve to be trampled by tailgaters who are locomoting more decisively to their destination.

Change Healthcare has installed these cool device charging stations all over the convention center. You use your credit card to lock your charging device in its own little compartment and then retrieve it later. I brought external batteries saved from previous HIMSS conferences, so I should be set.

Cerner and Epic finally agree on something.

Hey, look at the HIMSS-provided free refreshment bar! I actually grabbed a few pens and notepads since those are hard to find (the latter, especially) in the exhibit hall. And an ice water.

Here’s our magnificent tribute to cost-effective exhibiting: two new pull-up signs ($75 each, free shipping), a new Smokin’ Doc standee ($75), and our old table cover and banner (which frankly could have used a touch of the iron after being hauled around for years in a duffel bag). Still, I’m excited that we at least accomplished something – a nearby Hall G booth neighbor caught Lorre before our booth was even set up and asked for the “Cellar Dweller Special” new-sponsorship bonus special I mentioned the other day. They’ll benefit for a full year at a fraction of their exhibit hall cost and we’ll feel a little bit better about squandering money on a booth. I’ll be sweating tomorrow that I’ll hear that our booth is dead.

A witty welcome gift – a sort of “found objects” art display — was awaiting us at our empty booth from our old HIStalk friend, Medicomp CEO Dave Lareau, who clearly understands our bifurcated feelings about the conference.

Actually, Hall G is much nicer than I remember, with reasonably high ceilings. Our aisle is pretty wide an inviting, with the only real negative being that it’s like a mall that has lost its anchor tenants and thus its foot traffic. I’m sure some great companies are down there with us, so show your discriminating taste in seeking out vendors that the hoi polloi can’t appreciate, like boutique wineries that aren’t interested in selling to the masses.

I caught my booth crew (both of them) wearing tee shirts I hadn’t seen, finally extracting their eye-averting confessions that they have a bunch of them with plans to use them for unstated purchases. I suppose I should overlook their lack of transparency, applaud their self-directed management,  and at least be happy that they chose to memorialize The Smokin’ Doc. I’ve already bet money that at least one person who feels gifted with unusual insight will loudly question why a doctor is smoking a pipe. It’s called intentional irony, humorless people of the world.

Lorre struggles every year trying to hang up our booth stuff by herself since the drape holders are taller than she is. Stepping in chivalrously to help was booth neighbor Bill Schriver, a US Navy veteran and senior manager from Atlanta-based consulting firm Avelead. Lorre wants to thank Bill in this way – show up at their Booth #11325, ask to meet Bill, and tell him Lorre sent you. The first three people that do that will get one of the tee shirts you see above. We apparently have both the usual men’s version as well as more flattering ones designed specifically for women, which isn’t always the case with giveaways. You might as well thank Bill for his service while you’re visiting.

Another booth neighbor is displaying this thought-provoking item, which I like to think is an abstract, wry commentary on the exhibit hall – the de-humanized protagonist has his mouth wide open talking loudly while carefully covering his eyes and ears to avoid being distracted by listening. Maybe I’m overthinking it.

The entire convention center now resembles the gambling machines that surround it, replete with ad-displaying monitors that feature eye-catching bright lights.

The first word I heard upon entering the convention center today was “blockchain,” part of too-fast, too-enthusiastic pitch some guy was delivering via his phone.

Great job on the backpacks, GE Healthcare. It’s a keeper – large, lightweight, and featuring nice straps and a magnetic closure. They chose well in designing it purely to work as a backpack, with symmetrical straps and a single, centered top handle that doesn’t try to emulate a handbag or briefcase and thus failing all possible use cases.

Hall WiFi was free and pretty good at 25 Mbps, although that will get dragged down significantly Tuesday when it gets overloaded by attention-deficit geeks desperate to mate with their electronica.

Food was a bit hard to find near the action today since most of the concessionaires operate only from stands inside the still-closed exhibit hall. I didn’t want to pay $30 for lunch, so I headed up to the Grand Canal Shoppes food court that had a lot of options for under $12. I had a pretty good Indian lunch from Curry Pot, whose naan and cumin seed basmati rice that came with the chicken tikki masala making the temporary carb loading worth it.

I attended the first part of the lackluster opening keynote session that didn’t start until 5:00. It led off with dull singing from TV talent show winners backed by pre-recorded tracks in singing irrelevant songs that ranged from “Hallelujah” to the retch-inducing “Don’t Stop Believin’” and finishing with the puzzling “Somewhere Over the Rainbow,” all of it embellished with gratuitous vocal gymnastics, background slides that missed “inspirational” while hitting “cliche” in trying to tie together with an emotional thread disasters both natural and intentionally caused, and the absence of the original songwriters or performers (it was karaoke, basically, and not in a “like Leonard Cohen sang it” sort of way). I can’t decide if I was more embarrassed when a few people cheered and clapped as though Better Midler had just belted out a number vs. the stern, besuited guys shown on the projection screens who seemed to fear that any show of emotion might burst their tightly buttoned collars. I guess it’s tough to program music for the older, button-down crowd that attend HIMSS, but I would rather have just skipped the music entirely to get us all out to dinner earlier.

They said in the opening session that the room was full at 7,000 people and that 43,000 people had registered for the conference, although I don’t know if those were official numbers.

Eric Schmidt, who has held (and lost) all the key positions at Alphabet/Google while amassing $14 billion, got off to a good keynoter start before I had to leave (HIMSS wasted a ton of stage time before he was allowed to start at 5:45). He talked about technology in medicine, calling AI-powered image analysis “a solved problem” in which machines performs far better than humans. He mentioned the new Google Cloud API and urged the industry to “run to the cloud” and get off their poorly managed and secured local servers (he sells the other kind, of course). I had to scoot and missed the rest of his talk, so let me know if he said anything interesting. The most interesting thing was how odd I felt seeing an actual person from Google – unlike Microsoft’s ever-present Bill Gates and Steve Ballmer, I had no idea what anyone from Google looked or sounded like despite my close, constant relationship with its products (Chrome, Mail, Android, search, and so on).

Tomorrow is the first day the exhibit all is open, so I’ll be cruising and possibly attending some educational sessions that I’ve highlighted. Email me if there’s something I should see or if you hear interesting news or rumors that I can use.

From HIMSS 3/5/18

The HIMSS war has begun, where the wide-eyed newbies huddle together in chattery excitement while the grizzled veterans with far-away stares trudge off to fight the latest of too many ugly battles.

Jenn, Dr. Jayne, and I will post as we have time and anything interesting to report. Experience has jaded me so that I don’t get wrapped up, as many people do, into cramming events into every waking hour. I’ll choose drifting peacefully with the health IT current instead of swimming hard upstream.

Reader Comments

From School Me: “Re: KLAS report on interoperability. It is painfully thin on actual details and is almost reckless in painting a misleading picture. Epic and ECW are routinely censured by industry associations, investigators, and the like for data blocking and KLAS gives them the highest scores for interoperability? It’s probably not a coincidence that this report landed one business day before HIMSS starts — I’ll bet you a Bellagio buffet that Epic has that report on 20-foot signs in its booth this week.”

From Skeptical: “Re: KLAS report on interoperability. I wonder if it’s an FTC violation that KLAS doesn’t disclose the financial relationships with the vendors they’re rating? Plus, wouldn’t it be valuable for CIOs to know how much each ranked vendor pays KLAS?” That’s always the question with KLAS. I suggest that KLAS implement a star system to indicate their relative income level from each vendor. They don’t have to tell us the exact figure ,but it would be nice to know when reading a report about Epic and Greenway that they’ve earned 10 KLAS payment ranking stars vs. two, respectively, although that gives vendors incentive to pay less instead of more.

From Gettin’ Jiggy: “Re: Allscripts. Elation, CareCloud, and Athenahealth will win business as the company starts charging for Practice Fusion without plans to enhance it. We still don’t know what will happen with the Care Otter product that’s being developed within a siloed organization that has shunned help from more experienced Allscripts resources. If it flies, they will surely sunset some of their reliable, stable EHRs, although client-server systems – especially for small practices – need to die. The company’s big product gap is not having a cloud-based PM product, which is needed to stem their customer losses over the past few years.” Allscripts has two problems with Practice Fusion: (a) most practices implemented it only because it was a free way to cash in on Meaningful Use money, and (b) whatever percentage of its users who are willing to pay for an EHR won’t necessarily find Allscripts products more attractive than the ample alternatives. I’m not sure any level of enhancement would help since the Practice Fusion customer base didn’t seem to care about functionality gaps enough to replace it. I also don’t know how Allscripts will mobilize a sales force to reach out to Practice Fusion customers before they start looking or digging back out the manila file folders. I’ve had one visit to a Practice Fusion-using practice and they only lightly used the online portal part – it was all paper forms otherwise even though they look like a “customer” to the company.

Newsy Items

Allscripts CEO Paul Black pens an editorial criticizing the just-released KLAS report on plug-and-play interoperability, which noted that Allscripts doesn’t participate in the highly-used Carequality or the lightly-used CommonWell. He says KLAS should have considered other available interoperability options such as point-to-point interfaces, HIEs, and APIs. Cerner is also apparently unhappy with the report, which said its CommonWell-centric approach has limited the connectivity options of customers until the CommonWell-Carequality connection opens up access to Epic-using sites.

VA Secretary David Shulkin convinced reporters last week that he had squelched VA insiders who were conspiring with White House officials to get him fired, but new reports suggest otherwise. VA OIG previously said Shulkin took a family Wimbledon vacation at taxpayer expense and an upcoming report will say he used his security detail to run personal errands. The Daily Beast cites several sources who said Shulkin is now “extremely paranoid” in posting an armed guard outside his office, cutting off access to his floor by those VA staffers he suspects of being disloyal, and attempting to fire several political appointees who were saved by White House intervention. He’s on the HIMSS agenda for Friday if he makes it that long.

CHIME CEO Russ Branzell will receive a Baldrige Leadership Excellence Award for his work in cybersecurity.

HIMSS Notes

Every year I write several times right before the HIMSS conference that companies are unwise in holding off their announcements for this week, when they are sure to be missed in the mayHIMSS, yet most still do.

This tip is courtesy of my Lyft driver last night. If you rideshare to or from the Sands, use the Venetian’s pickup and drop-off area since it’s a lot easier for drivers to get in and out. I used it last night and was impressed that the Venetian places a uniformed guy there to keep things moving and to remind people to choose the Venetian pickup option instead of the other two locations that Lyft also shows from that spot.  

Today will be the coolest of this Las Vegas week, with a high of 63 that runs up to 77 by Thursday. It got chilly quickly last night, making me glad I’d worn a long-sleeved shirt but sorry I didn’t bring a jacket.

Today we will set up our tiny booth and maybe check out the afternoon keynote and opening reception. More to come.

Jenn’s HIMSS 3/5/18

I’m up before the day has even dawned thanks to a stuffy hotel room and an inability to instantaneously adjust to the time difference here in Vegas. This will be at least my sixth HIMSS (not including the few hours I spent at the last HIMSS in Atlanta as a complete newbie both to the conference and industry), and I’m glad I got here a day early so that jet lag will hopefully wear itself out by the time the conference truly opens for business on Tuesday. I am so glad HIMSS will be in Orlando for the next several years.

Aside from connecting with readers and sponsors, which might be hard to do given the dungeon-like location of our booth, 11228, in Hall G, I don’t have a list of must-see sessions or exhibit hall meetings this go-round. The big keynotes hold little thrill, and I’ll unfortunately be on my home when the one session I do truly want to attend – It Takes a Community: Deliverying 21st Century Coordinated Care for Those in and Out of Uniform – with VA Secretary David Shulkin, MD takes place. When it comes to themes for this year’s show, I have a feeling we’ll all be playing plenty of buzzword bingo. (I’m kicking myself for forgetting to print out the card Mr. H put together last week.) I also predict that while vendors will be touting concepts and capabilities like AI, precision medicine, and [insert your buzzword of choice here], attendees will be shopping for far less sexy things like telemedicine and behavioral health add-ons.

I will admit that my interest will be piqued by companies touting blockchain capabilities, despite the fact that HIStalk readers voted blockchain the most overrated technology. (Check out HISsies winners here.) I received at least 25 press releases from companies touting such capabilities ahead of the show. I’m tempted to give my time only to those exhibitors who have solid use cases on hand, of which I predict there will be few. Companies like Change Healthcare, PokitDok, SimplyVital Health, and Patientory come to to mind as companies that may have customer success stories.

I should add that my interest in blockchain isn’t strictly tied to healthcare. Several family members have decided to invest in a cryptocurrency mining rig, and so the attendant blockchain concept has lately been a hot topic at family gatherings. I don’t understand all the ins and outs, but want to learn more. I find the evolution of the whole subculture fascinating. (As typical with tech, it’s dominated by “blockchain bros,” as this New York Times article points out.)

Perhaps the folks at Reaction Data can shed some light on how blockchain best fits into healthcare. They don’t have a dedicated market research report on the subject, but I bet it’s coming.

I do plan to highlight as many vendors as I can that have incorporated charitable giving into their show-floor activities, so please let me know via email or tweet if you come across any that I should check out. Datica Chief Data Officer Mark Olschesky will donate $1 to HIStalk’s Donors Choose efforts for every person that attends his 30-minute presentation on HIPAA/GDPR for developers on Tuesday at 12:30 pm in the Developer Innovation Lab on Level 1.

On my dance card today – ambling around the Venetian/Sands to get a feel for where everything is and hopefully run into a few familiar faces. Athenahealth has invited me to an opening-night event that will somehow incorporate VR, which I’m excited about for the novelty factor alone. Plus, I’m hoping to corner some of the top execs for their personal take on what’s going on with the company right now, especially given the activity of competitors like EClinicalWorks, which is making no bones in the pre-HIMSS media blitz about its intent to enter the hospital market.

I did get the chance to bend new Athenahealth chairman Jeff Immelt’s ear about the company’s trajectory. He says that, “In terms of storms that I anticipate Athenahealth and all players in the HIT industry will weather – it’s a going to be a ‘value game.’ In a market landscape post-government incentive, vendors will need to showcase and prove the value they can bring to the markets they serve.”

When it comes to growing the company, Immelt believes it will come down to listening to customers and delivering on that aforementioned value. “At GE, I was constantly trying to make a big company act smaller,” he explains. “Now Epic and Cerner are the ‘big guys.’ They’re the long-time incumbents and they’ve been masterful in navigating and establishing themselves in healthcare during the first wave of digitization. However, the companies that sustain market position or find new ways to gain market traction are those that deliver value and unleash the industry to fundamentally better ways of operating, sharing information, and collaborating.”

When it comes to HIMSS – and health IT – Immelt has been there since the beginning: “I’ve had a twenty-year love affair with healthcare and have watched the formation of healthcare IT from the beginning and seen HIMSS since it could’ve been held in a high school gym. I’ve seen firsthand from the likes of doctors, care staff, and healthcare leadership teams that they’re largely dissatisfied with the industry’s operational and technological current state. This is especially true when I compare healthcare with other industries. Healthcare has experienced its first wave of digitization and is primed for the next wave. I fundamentally believe that the companies that will have the most impact on an improved future for healthcare are those that combine a platform infrastructure, with a set services enabled by technology, and then sell their offerings in a way that are clearly aligned with delivering actual results and measurable value. I see this in Athenahealth’s model.”

I have a few other evening engagements planned after the VR fun, some of which may be curtailed depending on my level of fatigue. I doubt I’ll make it to the Pub Night hosted by Emids/Encore, but you never know. HIMSS has a way of making one footloose and fancy free with evening schedules. I tend to RSVP for far more activities than I could possibly attend, deciding on what events to attend based on how far away venues are from each other and whether I can coerce a buddy or two into party-hopping with me.

I’ve never had personal safety issues in Vegas – or at any conference for that matter, but I know they occur far too frequently, as the results of Mr. H’s latest poll can attest. Alcohol-infused networking events may be a contributing factor, as this article points out. I learned a long time ago – by watching several supremely drunk co-workers make fools of themselves at a company outing – that drinking while on the job, or even amidst co-workers during non-working hours – can lead to watercooler stories that take a long time for everyone to forget.

That being said, stay safe, have fun, and enjoy the #HIMSSanity.

Contacts

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

Monday Morning Update 3/5/18

Top News

For those living on other healthcare IT planets who aren’t already aware, HIMSS18 kicks off this week. The screwy Las Vegas schedule has the full conference starting on Tuesday (since hotels won’t give up their weekend casino revenue for the usual Monday morning start), so the week looks like this:

• Monday: pre-conference programs, opening keynote at 5:00 p.m., opening reception to follow
• Tuesday: education sessions 8:30 to 5:00, exhibits 9:30 to 6:00
• Wednesday: education sessions from 8:30 to 5:00, exhibits 9:30 to 6:00
• Thursday: education sessions 8:30 to 2:30, exhibits 9:30 to 4:00
• Friday: education sessions 10:30 to noon

I will abandon the usual HIStalk format this week and instead will post daily reports from Jenn, Dr. Jayne, and me about what we see or hear. Email me if you see something I should check out.

Please visit us in Booth #11228, which can be reached by descending with justifiable trepidation down the well-disguised stairs to the lower level that looks like an IRS cubicle farm and then trying to find our microscopic booth by number in the bizarre layout. You won’t get rewarded for your trouble other than with gratitude and friendly conversation among our magnificent furnishings (total cost: $300, dragged in a beat-up, garage-stored duffel bag from one HIMSS to the next). That is, unless you want to take a selfie with the life-sized Smokin’ Doc, which people love to do for some reason (including the 18th Surgeon General of the United States, Regina Benjamin, MD, at HIMSS17 – the pipe must have puzzled her).

I made it a point at HIMSS12 and HIMSS16 to spend a full day cruising Hall G and writing about what I saw there because I felt sorry for the companies whose HIMSS hopes and dreams were crushed by low booth traffic for which they paid dearly. There’s likely quite a bit of innovation happening down here in the catacombs, so give those companies a look and wish them the success that will allow them to pay the necessary financial homage to HIMSS to get promoted to the main show floor in the HIMSS21 return to Las Vegas. 

Actually, we are giving away one pretty cool thing in our microbooth – the ever-popular Conference Survival Kits that we always make available with the folks from Arcadia (Booth #4221). The tastefully understated black bag contains essentials like Wet Ones, antiseptic cleaning pads, antacids, Band-Aids, breath mints, and Blistex. Perhaps we should play Arcadia Bingo to see whose misadventures cause them to use the highest number of the items before leaving Lost Wages. 

Our booth, almost drawn to scale. I’ve never heard of any of our booth neighbor companies and they probably haven’t heard of HIStalk. I’m secretly hoping that we get a lot of visitors while they’re standing around wondering what exactly we do.

I challenged Lorre to come up with something (anything) to put a positive spin on what I expect to be a lackluster HIMSS18 exhibiting experience. She’ll offer a first-year deal to any of our fellow Hall G outcasts that sign up as new sponsors, which gives them full-year exposure for a fraction of the cost of three days in the HIMSS basement. I decided to call it the “Cellar Dweller Special.”

My HIMSS guide describes what my sponsors will be doing there, including stuff they’re giving away and anything special they’re doing for HIStalk readers.

The Meditech folks seem to always run into Boston weather-related travel delays that cause them to arrive late to the conference. This year looks like more of the same, as severe weather has caused thousands of flights to be cancelled in Boston, Philadelphia, and New York. Hopefully the flight backlog will be cleared for Sunday and Monday HIMSS18 travelers. It’s stressful enough to arrive early as I always do, so I can’t imagine getting there later than expected.

Reader Comments

From Unconscious Power: “Re: HIMSS18 opening reception. First timer. Should I go?” I’m not qualified to opine since I almost never go – it’s too early in the week to be crushed in the wave of glad-handing humanity. I’m at least glad that HIMSS did away with drink tickets and upped the food game a bit, although the entertainment is always generic Disney-grade. It will surely be better than the first return to Chicago, when it was a half-mile hike to what looked and sounded like an airplane hangar as the blizzard raged outside. The best opening receptions were always in San Diego, out on the convention center’s patio overlooking the bay.

From Sheetal Shah: “Re: your tiny HIMSS booth. Be proud of that 100 square feet! As a startup, we went for the 0x0 booth this year and decided instead to become an HIStalk sponsor!” Sheetal is VP of SymphonyRM and I appreciate the support. It’s a struggle for me to decide between 10×10 and 0x0 since our little booth will end up costing something like $7,000. We’ll see what locations are available at HIMSS19. We usually end up, at best, by the restrooms and loading dock.

HIStalk Announcements and Requests

Seventeen percent of male poll respondents and 38 percent of females say they’ve experienced unwanted sexual attention or comments during a HIMSS conference. Here is my personal challenge to you for next week. If you see someone behaving badly, observe an attendee being made uncomfortable, or see someone who has over-imbibed in a compromising situation, don’t just walk away – get involved as tactfully as possible. I would also suggest that women consider downloading one of the personal safety apps that allow them to send their location to a friend, send a message with a single tap asking a friend to call them to get themselves out of a situation, or issue an SOS if they don’t get to their destination by the expected time. Get a handful of HIMSS colleagues in your circle and these apps will provide peace of mind and maybe more. Remember that unlike Orlando and former HIMSS cities, we’re sharing the Strip with a lot of shady people who know we’re tourists from our badges. I would also enjoy having someone who makes a gender- or sex-related comment within earshot of a bystander get taken down a notch for their boorish behavior, so tell me if you get to see that.

New poll to your right or here: What OS does your most-used smartphone have?

Thanks to those who responded with insightful answers to  “What I Wish I’d Known Before … I Quit My Job to Go to Work for Myself.” I’m saddened that folks who love working for themselves are being pushed back into working for someone else because they either can’t get health insurance at all or it’s too expensive as a one-person company. It’s ironic that even health IT experts are having their entrepreneurial ambitions dashed by our screwed up health system.

This week’s question: “What I Wish I’d Known Before … Taking my First Hospital IT Executive Job.”

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

Thanks, too, to long-time HIStalk supporter PeriGen, which has upgraded its sponsorship level to Platinum. They just announced that Qualcomm Life will resell their AI-powered Vigilance early warning system for OB.

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information.

Acquisitions, Funding, Business, and Stock

HIMSS acquires Chicago-based business accelerator and venture fund manager Healthbox in its never-ending and sometimes puzzling expansion. Healthbox’s CEO is Neil Patel, who used to work with HIMSS President and CEO Hal Wolf at The Chartis Group. Patel joined the company in September 2016 after founder and CEO Nina Nashif left for unstated reasons (one might be that healthcare IT has too many poorly run startups being pursued by a surplus of underachieving accelerators that offer them little value). This is another example where some vendors that pay a lot of money to support HIMSS now find themselves competing against it.

I missed this earlier: global payment and receivables solutions vendor Flywire acquires OnPlan Holdings, the parent company of patient portal and payment solutions vendor OnPlan Health.

Sales

Comanche County Memorial Hospital (OK) will implement EClinicalWorks Acute Care EHR and RCM, replacing Allscripts Paragon for its 283 inpatient beds.

Rhode Island’s HHS chooses IMAT Solutions to implement a centralized ECQM reporting and feedback system.

Decisions

• South Peninsula Hospital (AK) will go live on an Evident (CPSI) EDIS this month.
• Tift Regional Medical Center (GA) will go live on Cerner on July 1, 2018.
• UPMC Pinnacle Lancaster (PA) will go live on Epic in April 2018.

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

Announcements and Implementations

A new KLAS report on plug-and-play EHR data-sharing capabilities concludes that it’s: (a) automatic for Athenahealth and Epic customers; (b) nearly so for EClinicalWorks; (c) limited for Cerner because of poor CommonWell adoption, at least until the CommonWell-Carequality connection is in place; (d) uncommon for GE Healthcare and Greenway Health users; and (e) not offered by Allscripts, Meditech, and NextGen. Epic and Athenahealth offer the highest likelihood of being able to connect to important partners, while Epic and Cerner offer the best doctor usability of the retrieved patient records. KLAS did the report because CommonWell’s hype that downplays its poor adoption has created distrust:

Most CommonWell EMR vendors require their customers to onboard one at a time, and only Athenahealth has driven adoption in mass. This is even true if you are using Cerner, who has been one of the most valiant and prominent CommonWell promoters. Because sharing among Epic customers is already universal, when CommonWell connects to Carequality, the entire Epic base will become available, creating instant value for most areas of the country. CommonWell will likely see a significant adoption increase with a solid Carequality connection. Since its launch five years ago, the tendency to overmarket the level of adoption of CommonWell has created apprehension and a lack of trust among potential participants and prompted this report, showing a snapshot of providers’ success.

Government and Politics

HHS will hold its free Startup Day in Boston on Friday, March 30, offering government speakers, breakout sessions, and “Shark Tank”-like pitches.

Other

A study led by the co-creator of the Bedside Pediatric Early Warning System (which was commercialized by Toronto’s Hospital for Sick Children) finds that use of the system did not decrease mortality or ICU resource utilization. An accompanying editorial by Memorial Sloan Kettering’s critical care medicine chief says that perhaps holding the system to an all-or-none mortality standard is unreasonable. He concludes with an appeal for AI-powered hospital informatics systems:

Now is the time for hospital leadership executives, medical informatics departments, interested clinicians, informatics vendors, and governmental-certifying bodies to move forward and apply artificial intelligence systems to the hospital setting to enhance processes of patient care and outcomes. Such informatics systems, which are broad in their data capture, analysis, learning, and therapeutic recommendations, are being developed … These programs should be welcomed into inpatient and ICU care to allow investigations to move away from single intervention-based studies, with simplistic but easily accessible primary outcome measures such as mortality, to a more technologically based approach to understanding health care data and studying therapeutic interventions.

Chorus, the fitness app and group encouragement tool started by former Twitter CEO Dick Costolo, shuts down after just eight months. The company ran into the Abstinence Violation Effect, in which people stop participating in their support group after they fail to meet its agreed-on expectations, such as missing a planned exercise session. He also found that people lost interest in motivating each other. Maybe Dick should have learned about dubious Internet comradeship from Twitter, whose never-ending stream of trolls, bullies, bots, and psychopaths similarly drive users away.

Without the usual HIStalkapalooza pomp and circumstance, here are your 2018 HISsies winners. Congratulations and/or condolences to those that were chosen by my readers.

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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What I Wish I’d Known Before … I Quit My Job to Go to Work for Myself

How much you need to understand your strengths and weaknesses, and that just because you are great at a particular skill in your industry, it doesn’t you’ll be great a running a business in that industry.

That I would work harder and longer for myself than for any other boss or company. And that I would have more fun and freedom! Too bad healthcare insurance availability and costs for small businesses are pushing me back to working for an employer.

That I haven’t done it yet. “I don’t have an idea, what if I fail?” Fear is a shitty thing. For those who have, give those of us who haven’t hope, but don’t sugarcoat it!

I knew the cost of health insurance would be a large expense. However, I didn’t project that the cost would more than double from one year to the next.

I should have done it SOONER!

I wish someone would have hot me over the head making sure I comprehended the true cost to do business. Business registration at the state and local level, general liability insurance including automobile insurance, you’re your own technology shop, meaning you will have to buy and install all your software and hardware and configure it so it works. It is probably 25 percent more expensive than you think to start a new company.

Before I quit my job to go to work for myself, I wish I had known that 30+ years later I still would be happy having made that important decision.

That my finances were going to take a larger hit than I expected not because my business didn’t take off (always a known risk), but because it took me longer to get back into the job market than I had expected. Although I had very competitive job opportunities, my personal situation had changed while working for myself, precluding most travel or moving out of the metro area I was in.

That I had the skills, knowledge, expertise, and professional network to quit an established position and start our own firm. Wish that I’d had the confidence to do it a few years earlier.

That it doesn’t matter how successful you are right out of the gate — hire a salesperson. I didn’t because a series of old clients signed with me just after starting my new company and I became overconfident in my success. I know now that selling while you are successful sure beats trying to catch up when those early contracts start expiring. Also, as the owner, president, and chief guru, it takes a full time salesperson and you won’t have time to be that if you’re doing everything else, too.

Nothing. If I’d not been naive and ignorant, I probably wouldn’t have started the company. My ignorance allowed me to ignore the risks and take the leap.

Everything takes longer than you think. It is not easy for organizations to decide to work with small firms, even if the individuals at those firms have stellar resumes. The security blanket of a big brand name drives revenue, even if the quality of services from small firms is generally substantially better.

The sheer terror of the roller coaster ride of income and no income. It’s debilitating and drains every last ounce of downtime from what is already an oversubscribed schedule. Say goodbye to relaxing at the weekend or even on Sunday — you spend 24/7/365 working or thinking about work and where the next penny will come from. As for the clients and choices, it’s amazing how cheap companies can be when considering payment. They all seem to forget that at least 50 percent of any fees go directly to basic costs that are not covered when you are not an employee (billing rate vs. take-home rate).

Chasing after unpaid invoices is definitely one of the most unpleasant aspects of being self-employed. One positive impact I didn’t anticipate, however, is the way it makes you think about time and making every minute count, whether you’re working or not. Also, the sense of satisfaction gained from building your business and knowing you’re helping your clients is extremely gratifying.

You wind up being put in the tough position of actively having to sell your services simultaneous to having to wind down your existing assignment. That puts a strain on you, and for those of us who got into being solo to do more as opposed to sell more, it could be awkward to have to wear both those hats. It also reinforces the message that, as a solo practitioner, when you are not working, you are making zip. No PTO, nothing like that. A little extra pressure!

In a startup of one employee, I loved setting my own schedule, driving to my own goals, and working from home. But I realized I missed the interaction of other co-workers, being part of a team, and having my home be a home. If i was building a product, I would have stuck around longer to foster it, but I was doing consulting and contracting, which is hard to scale.

How much happier I’d be. I’ve observed two kinds of consultants – those doing it to stay in the flow (and make some money) while waiting for their next real job and those for whom it is their real job. No right answer, but it helps to know which you are. Today’s technology (Google Apps, Dropbox, VOIP, Upwork, and more) make it easier than ever before. A few pointers: Get a domain name – Gmail suggests you’re not committed. Consider forming an entity like an LLC or S-Corp. There are great retirement benefits available such as solo 401(k), if your revenues allow it — remember that any savings match comes from you, so need to take it seriously. If your business can support it, a virtual assistant can give you great leverage for scheduling, invoicing, and other routine tasks. Take advantage of the flexibility it provides in your life, though the flipside is you can always be on call.

The cost of being self-employed. There are direct costs, such as self-employment taxes and insurance benefits: life, health, disability, and professional liability insurance, and indirect costs, such as handling business development for the next assignment while executing the current assignment. And handling contracts is brutal. I once had a government organization ask me to sign an 80-page contract for a job that was worth a couple of thousand dollars. We eventually got it down to three pages because I refused to sign a document that would cost me more in legal advice than the job would pay for my services.

You will need an accountant. You will pay for an accountant. Even if you think you can do it yourself or fall victim to the “QuickBooks will do my taxes for me” idea, you will need an accountant.

Weekender 3/2/18

Weekly News Recap

• Intermountain Healthcare launches a virtual hospital that brings its 35 telemedicine programs under one roof
• EClinicalWorks announces a cloud-based hospital system whose cost starts at $599 per bed per month with no upfront capital cost
• R1 announces that it will acquire Intermedix’s healthcare division for $460 million
• Apple’s plans to create an employee wellness clinic are disclosed by CNBC
• The Wall Street Journal describes OurNotes, the follow-up project to OpenNotes that will allow patients to share their own notes with their doctor
• Researchers find no relationship between hospitals implementing a new EHR and their credit ratings afterward

Best Reader Comments

These wellness ventures strike me as little more than internalization of the wellness programs bundled in with insurance products that work very poorly today. Per the article, Apple seems to be working with Stanford. If my goal was pop health/wellness, I wouldn’t take my advice from an academic medical center, particularly not one that’s currently trying to buy its way into the primary care market. The branding is interesting because it almost sounds more like part of Stanford’s strategy to put clinics on tech campuses (I believe they have a few in the works already). (Midwest User)

One positive of a travel-heavy job is that you have a chance to meet healthcare execs and leaders from all over the country and really get to know them versus only having a network of people in a city or metro area. Over years, it does incredible things to your professional network, not to mention giving you the ability to experience many different settings and organizations rather than just a few. (HIStalk Groupie)

Inherently there are still silos within managing the different applications, competing agendas on the vendor side and organization side, lack of integration between initiatives, and more importantly, involving IT with sign-off for any device and EHR enhancements or changes. (Sandy Walker)

Watercooler Talk Tidbits

Readers funded the DonorsChoose teacher grant request of Mrs. M, who asked for six Boogie Board memo pads for her high-poverty elementary school third grade class in North Carolina. She reports, “My students love using the Boogie Boards. They are fun, engaging, and offer a nice alternative to paper and pencil work. My students are in third grade and are in my bottom reading group. Their eyes lit up when they saw the Boogie Boards. It is often hard to keep them engaged. We use the boards during guided reading groups, math groups, and during word work. We plan to also use the boards to take notes from research and during quick writes. I can’t thank you enough for your donation.”

Also checking in was Ms. M from New Mexico, who requested STEAM center materials for her elementary school class. She was nice to provide this update: “Unbelievable! You have simply made the start of the new year fantastic! We have new translucent, magnetic blocks to use on our new light table! The sensory options are endless. We have new math games to collaborate with that cover all four operations. They are more than drill and skill – they involve problem solving. It’s been a great review station. We also received two Whack-a-Mole type of games that involve NOISE and LIGHTS and SOUNDS! Most teachers hers would cringe. Not this teacher! We are soooo excited. The bottom line is, you are changing our classroom. We have supplies such as dice for multiple review stations. We have rubber bands (seems so simple) to create geometric shapes on our geo-boards. We have a light table with manipulative to create patterns, work fractions, and all of it is bright, sensory, exciting, and engaging. We have amazing new wobble stools that allow my students to wiggle and move. All of this is because of you and your amazing generosity! Nothing we write can explain how sincerely we thank you or appreciate this gift. You have a lot of choices when donating and we are grateful you found us.”

An anonymous CIO reader working in United Arab Emirates made a very generous donation to my DonorsChoose project, to which I applied matching funds from my anonymous vendor executive and other sources to fully fund these classroom projects:

• A tablet, case, charging station, and 3D building blocks for Ms. B’s elementary school class in Forest Park, GA
• A wireless drawing pad, math games, and basic classroom supplies for Ms. W’s high school class in Houston, TX, which lost all of its classroom items during Hurricane Harvey
• Math and art supplies for Ms. Y’s elementary school class in Naples, FL, which was impacted by Hurricane Irma
• Two tablets and learning aids for Ms. W’s first grade class in Moscow, KS
• Math centers and games for Mr. M’s elementary school class in Northglenn, CO
• Math tools and games for Ms. S’s elementary school class in Denver, CO
• A trip to the state aquarium on Saturday Deaf Day for the deaf students of all 15 county schools by Ms. M in New Bern, NC

Federal authorities arrest two Southern California weight loss doctors who they claim cheated insurers and patients out of $250 million (!!) by falsifying test results to get insurers to pay for lap band surgeries. An unrelated newspaper investigation found that five patients died after having weight loss surgery performed there.

Every year we get the dregs of the HIMSS exhibit hall booths since we don’t spend enough money with them to earn HIMSS points, so I was too depressed until yesterday to look at the exhibit hall map knowing that we’ll be in Siberia. We certainly are – we’re in the low-ceilinged, cheerless basement (Hall G) among companies I’ve never heard of, with our tiny 10×10 space sitting next to what passes for an anchor tenant down there, the Philippine Trade and Investment Center. Hall G was so dead at HIMSS12 that HIMSS hastily posted signs practically begging people to head down the easily missed staircase and they even gave out a free lunch coupon that was good only in the Hall G food court thinking that might drive traffic (it didn’t, except to the food court). This might be the year in which I’m convinced that exhibiting isn’t worth the significant cost since booths aren’t any cheaper downstairs. I implore you to bring your miner’s lamp, descend with trepidation into the labyrinth of poorly-numbered booths, and soothe our shattered self-esteem that will be on full display at Booth #11228. We exhibit only to say hi to readers and we don’t really have anything to sell, so I’m trying to convince Lorre that she should offer a new-sponsor bonus of some kind to reward companies that are brave enough to seek us out in the catacombs.

The biggest booths at HIMSS18 in terms of square footage are:

• IBM (15,400)
• Cerner (14,200)
• Epic (10,610)
• Change Healthcare (9,000)
• Skipping a zillion more, HIStalk (100)

Things I’ll miss at HIMSS18:

• MedData’s amazing scones, since Sands Expo Center doesn’t allow baking on the show floor
• Bistro HIMSS, the moderately-priced, decent-quality buffet where we’ve held our CMIO lunches, since they don’t run it in Las Vegas
• The chance to breathe air not infused with cigarette smoke
• HIStalkapalooza

Also note that Daylight Saving Time (I just realized that the first two words should be hyphenated since they form a compound adjective) starts the Sunday morning after the conference.

Definitive Healthcare lists the top 50 hospitals by annual revenue, in which $2 billion doesn’t even get you into the top 20.

A Medgadget editorial says the site is struggling financially despite doing the right things journalistically – paying skilled writers, not running obnoxious ads, and not publishing clickbait or time wasting listicles. It blames Google (“an evil monopoly”) and Facebook, which control 70 percent of digital advertising even though they produce no content and use privacy-invading techniques to place ads everywhere you travel on the Web. 

Microsoft co-founder Paul Allen will invest $125 million to fund Project Alexandria, which will work on AI that exhibits common sense. Possible applications include medical diagnosis.

A Georgia pediatric cardiologist who admits he allowed a drug company sales rep to use his EHR password to find pediatric patients for the company’s $295,000-per-year specialty drug will get off with probation for the misdemeanor charge of wrongfully disclosing PHI.

CNBC covers the “positive stress” movement embraced by young Silicon Valley tech workers who hope that cryotherapy chambers, hot yoga, fasting, and extreme workouts will allow them to work more hours and/or to live longer.

A startup’s dating app matches people by assigning a compatibility score based on results of a cheek swab DNA test, the fourth company over several years to try to make a business of shaky science paired with sifting through the social media accounts of users trying to quantify love. I worry about “The Onion” since headlines like these are as goofy as any they could make up.

Apple is working with police near its Elk Grove, CA repair center to figure out why they’ve received 1,600 calls to 911 from phones waiting to be fixed.

My increasing frustration with my PCP’s incompetent office staff and the lack of alternate decent doctors who accept both my insurance and new patients led me to try concierge medicine. I’m delighted with it so far. I get unlimited access to my well-credentialed, mid-career doctor (his practice is solo), appointment scheduling is online, I have his personal cell phone number, he makes house calls when needed, and his panel is just 500 patients. Just about everything is covered in the annual fee: all visits, minor procedures such as wound repair and mole removal, EKG, flu shot, labs drawn right in the office with common labs either free or cheap ($5 for HbA1c or lipid profile), inexpensive imaging ($35 for an X-ray, $225 for a non-contrast CT scan), and he even provides maintenance medications at his wholesale cost — my 90-day supply of blood pressure med cost me $6 with no extra trip to Walgreens. All of that costs just over $500 per year, which is probably even cheaper than co-pays and deductibles. My new patient session lasted nearly 90 minutes as he took a thorough medical and social history and had me sign forms so he could retrieve my medical records from the other practice (assuming the incompetent people over there can find them). I was the only person in the tiny waiting room when I arrived, and when I went back to the exam room, he was waiting for me rather than vice versa. The only aspect of concierge medicine that I don’t understand is the pricing – other similarly credentialed doctors offer pretty much the same services for up to $7,000 per year, so I like to think I’m getting a deal. 

Vince digs through his March 1988 health IT archive with fond memories of the 1988 HMSS conference (that’s not a typo), Meditech winning the color monitor wars, and household names in laboratory information systems such as Antrim, Medizinische, Rubicon, and Hex FF. The big song then was Rick Astley’s “Never Gonna Give You Up,” which is entirely forgettable except for one thing – it later spawned the Internet meme “rickrolling,” a prank in which someone publishes a link to a video claiming to be one thing that instead launches the “Never Gonna Give You Up” video. I think I would prefer the link to launch a ransomware attack.

In Case You Missed It

• News 3/2/18
• EPtalk by Dr. Jayne 3/1/18
• HIStalk Interviews Colin Konschak, CEO, Divurgent
• News 2/28/18
• Curbside Consult with Dr. Jayne 2/26/18
• HIStalk Interviews Tom Borzilleri, CEO, InteliSys Health
• HIStalk’s Guide to HIMSS18
• Monday Morning Update 2/26/18
• What I Wish I’d Known Before … Taking a Travel-Heavy Job

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Morning Headlines 3/2/18

Healthcare Consulting and Services 2018: Which Firms Deliver a True Partnering Experience?

A new KLAS report that asked providers to rate consulting firms they’ve worked with finds that Nordic and Deloitte were most often perceived as true partners, while Advisory Board was by far the firm providers would not use again because of disappointing outcomes and use of inexperienced consultants.

The SSI Group Announces Acquisition of ICA

The SSI Group acquires Informatics Corporation of America and its CareAlign clinical data aggregation and exchange platform.

Uber, but for Getting to the Hospital

Uber stirs up the healthcare hype with the launch of a HIPAA-compliant service that will enable providers to arrange rides for patients to and from appointments.