Morning Headlines 9/13/17

Alleged Equifax hackers demand $2.6 million Bitcoin ransom

Equifax, which suffered a cyberattack that exposed 143 million social security numbers, is reportedly being asked to pay a $2.6 million ransom to prevent the stolen data from being deleted.

Tom Frieden’s New Venture Combines 2 Disparate Health Threats

Former CDC Director Tom Frieden announces that he has accepted a new job leading Resolve, a global health initiative backed with a $225 million grant from Bloomberg Philanthropies, the Chan Zuckerberg Initiative, and the Bill and Melinda Gates Foundation. The organization will work to prevent heart disease and stroke, and to increase worldwide preparedness for fighting epidemics.

Scripps and proton center part ways

Scripps Health announces that it will part ways from the now bankrupt California Proton Therapy Center. The treatment center began offering proton-based cancer treatment options in February 2014 in partnership with Scripps, but filed for bankruptcy in March 2017, noting in its filing that Scripps management was to blame for its lack of earnings.

Tim Cook on How Apple Champions the Environment, Education, and Health Care

In an interview with Fortune ahead of the iPhone 8 release, Apple CEO Tim Cook discusses the company’s future in healthcare, explaining “the focus has been on making products that can get reimbursed through the insurance companies, through Medicare, or through Medicaid. And so in some ways we bring a totally fresh view into this and say, ‘Forget all of that. What will help people?’”

News 9/13/17

Top News

Equifax faces ransom demands from a pair of hackers claiming responsibility for the data breach of 143 million customers. The group, which some believe to be fake, wants $2.6 million in bitcoin by September 15 in exchange for not making the data publicly available. They have even gone so far as to tug at heartstrings: “We are two people trying to solve our lives and those of our families. We did not expect to get as much information as we did, nor do we want to affect any citizen. But we need to monetize the information as soon as possible.”

Equifax has its hands full in terms of more legitimate fall-out from the breach. It reversed an earlier decision that forbid customers from joining a class action lawsuit in exchange for receiving a free year of credit monitoring after backlash from the National Consumers League and lawmakers in Washington, who are already calling for hearings. The company has also faced negative repercussions for the shoddy set up of a website for affected customers that some contend looks like a scam; not to mention three executives who sold $1.8 million in shares just a few days after breach was discovered.

Reader Comments

From ACD_Fan: “Re: RAND cost-of-care study. A just released study by RAND Corp. shows the cost of hospital care in Indiana compared to Medicare payment rates. One hospital, Parkview Health, is singled out as having ‘exceptionally high prices.’ This hospital has the highest cost of any hospital in the state by a wide margin. This is the same organization that has paid $3 million to have its name plastered on the local minor league baseball stadium. I’m glad I’m out of the healthcare business. It’s hard to feel good about your mission when you have to explain away some of these excesses.”

Webinars

September 13 (Wednesday) 1:30 ET. “How Data Democratization Drives Enterprise-wide Clinical Process Improvement.” Sponsored by: LogicStream Health. Presenter: Katy Jones, program director of clinical support, Providence Health & Services. Providence is demonstrating positive measurable results in quality, outcomes, and efficiency by implementing clinical process improvement solutions in arming operational and clinical stakeholders with unlocked EHR data. Providence’s army of process engineers use their self-service access to answer questions immediately and gain an understanding of how their clinical care delivery is impacting outcomes. The presenter will describe practical applications that include antibiotic stewardship, hospital-acquired infections, and comprehensive knowledge management.

September 28 (Thursday) 2:00 ET. “Leverage the Psychology of Waiting to Boost Patient Satisfaction.” Sponsored by: DocuTap. Presenter: Mike Burke, founder and CEO, Clockwise.MD. Did you know that the experience of waiting is determined less by the overall length of the wait and more by the patient’s perception of the wait? In the world of on-demand healthcare where waiting is generally expected, giving patients more ways to control their wait time can be an effective way to attract new customers—and keep them. In this webinar, attendees will learn how to increase patient satisfaction by giving patients control over their own waiting process. (Hint: it’s not as scary as it sounds!)

October 19 (Thursday) 12:00 ET. “Understanding Enterprise Health Clouds with Forrester: What can they do for you, and how do you choose the right one?” Sponsored by: Salesforce. Presenters: Joshua Newman, MD CMO, Salesforce; and Kate McCarthy, senior analyst, Forrester. McCarthy will demystify industry solutions while offering insights from her recent Forrester report on enterprise health clouds. Newman and customers from leading healthcare organizations will share insights on how they drive efficiencies, manage patient and member journeys, and connect the entire healthcare ecosystem on the Salesforce platform.

Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.

Acquisitions, Funding, Business, and Stock

Former CDC Director Tom Frieden, MD raises $225 million to launch a global health initiative that will tackle cardiovascular disease and epidemics. Backed by Bloomberg Philanthropies, the Chan Zuckerberg Initiative, and the Bill & Melinda Gates Foundation, Resolve will aim to save 100 million lives over the next 30 years.

Apple unveils its latest and greatest devices, including the iPhone 8, Apple Watch with wireless connectivity, and the iPhone X, which commemorates the company’s 10th launch of the phone and, at $1,000, its highest price point. The product updates follow on the heels of rumors (now confirmed) that the company is working with American Well and Stanford University to test the ability of the watch’s heart rate sensor to detect heart conditions.

People

Englewood Hospital and Medical Center (NJ) appoints Ravi Koganti (New York-Presbyterian Hospital) CIO and VP of IT.

Orchestrate Healthcare hires Ed Ricks (Beaufort Memorial Hospital) as VP of the Southeast.

Dave Rodger (Spotify) joins PatientPing as head of product.

Sales

University of Illinois officials agree to spend $62 million to implement Epic at UI Hospital in Chicago.

Hospitalist group Adfinitas Health (MD) selects Continuum Health as its RCM partner ahead of a planned expansion beyond its Mid-Atlantic region of operation.

HealtheConnections opts for data cleansing, quality analysis, and reporting tools from Diameter Health for its HIE participants across Central New York.

Announcements and Implementations

Magnolia Regional Health Center (MS) integrates Nuance’s Dragon Medical One speech-recognition and CAPD technology with its Meditech EHR.

In an effort to better coordinate care between local EMS services and its ED, PeaceHealth Southwest Medical Center (WA) implements Pulsara’s PreHospital Alerting Package.

Technology

Medical Information Records USA adds automated vital sign documentation from Neximatic to its cloud-based anesthesia information management system.

Government and Politics

Health Secretary Jeremy Hunt pledges to make app-based NHS medical record access, appointment scheduling, and prescription refills available to every patient in England by the end of 2018. The digital health initiative is part of the broader $5.6 billion 2020 program announced last year. Pilot programs of the new tools are already underway.

Thus far, the digital efforts of NHS don’t seem to include getting rid of the 130,000 pages it uses to the tune of nearly $8 million in costs each year. The Guardian reports that replacing the devices could save the system $3.5 million annually.

An ONC report on interoperability at skilled nursing facilities finds that 64 percent use EHRs, and 62 percent have interoperable networks in place that ensures electronic information is available from outside sources.

Job seekers have until September 18 to submit their applications for Digital Health Advisor with the FDA’s Center for Devices and Radiological Health.

HHS deploys its first team of federal responders to the Florida Keys, where it will establish a mobile medical unit and assist local providers with healthcare services. Local emergency officials estimate that at least 10,000 residents stayed on the islands during Category 4 Hurricane Irma.

CMS threatens to end Medicare and Medicaid funding for Mercy Hospital Springfield (MO) after reports surface of a male nurse punching and tackling a combative patient, and of a female patient being held in seclusion – an area the hospital dubbed an “acute-care area” – for 15 days. A CMS investigation into patient safety practices at the hospital earlier this year found that it failed to follow up on patient grievances and to report abuse. The hospital recently fired 12 employees after their behavior in “highly tense situations” became a cause for concern. It is also bringing in an interim leadership team from other Mercy facilities.

Privacy and Security

Children’s Hospital Colorado reports that a hacker has gained access to an employee email, resulting in the unauthorized exposure of the PHI of 3,400 patients. The unauthorized access did not affect patient health data. In a savvy marketing move, the hospital re-publicizes findings from a study earlier this year that show documentation in its Epic EHR has helped it achieve a 30-percent reduction in harm for HACs over the last five years.

Innovation and Research

A JAMIA analysis of online consumer ratings of 78 physicians finds no association between a physician’s average consumer score and their specialty-specific quality scores or value-based care.

Sponsor Updates

• Agfa Healthcare releases a new white paper, “Diagnosis – Communication – Care: Hardcopy technology for the digital age.”
• Aprima will exhibit at the American Academy of Pediatrics National Conference & Exhibition September 16-18 in Chicago.
• The Tampa Bay Business Journal includes AssesURHealth’s Tori Couch in its Up & Comers class of 2017.
• Besler Consulting releases a new podcast, “Update on the Medicare appeals backlog.”
• Cumberland Consulting Group will exhibit at the Healthcare Executive Group Annual Forum September 18-20 in Nashville.
• Dimensional Insight will exhibit at the 2017 Women’s Leadership Council Conference September 14-15 in Washington, DC.
• ECG Management Consultants and Intelligent Medical Objects will present at the 2017 IHA Leadership Summit September 13 in Lombard, IL.
• Elsevier Senior Architect of Clinical Solutions Tyler Lynch showcases students building a tool to simplify prescription scheduling at MedHacks17.
• EClinicalWorks will exhibit at AAP 2017 September 16-18 in Chicago.
• FormFast publishes a new case study featuring Duncan Regional Hospital.
• HCS will exhibit at the NALTH 2017 Fall Leadership Conference September 14-15 in Washington, DC.
• Impact Advisors will present on MIPS and MACRA as part of the Scottsdale Institute Teleconference September 19.
• EClinicalWorks publishes new case studies featuring CityMD and EssenMED House Calls.
• PatientPing releases a new video on coordinating patient care.

Blog Posts

• Modernize your patient experience with PatientPop (AdvancedMD)
• Lifting a Fork for Open Source (Datica)
• Benefits of Care Coordination: A Heart of CareSync Story (CareSync)
• Winners of the 2017 CoverMyQuest (CoverMyMeds)
• MACRA MIPS Basics and What You Need to Do Now (Culbert Healthcare Solutions)
• Data Sharing – Still Crazy After All These Years (ECG Management Consultants)
• 3 Benefits of a Data-Driven Approach to Billing Integrity (Hayes Management Consultants)
• The Path Forward for HIEs, and What I Learned at the SHIEC Annual Conference (Iatric Systems)
• The Essential Rules for Data Security (Influence Health)
• Disaster Recovery: 3 Higher Standards to Hold Your Vendors to for Data Protection (InstaMed)
• The Swiss Cheese Model of Patient Safety Errors: Closing the Holes with Message Accountability (Spok)
• Benefits to Optimizing Your Electronic Health Record (Leidos Health)
• Drug Labeling Inconsistencies Abound Regarding Sulfites as Preservatives (FDB)
• Three Concepts I Wish Everyone Understood About EHR Training (Impact Advisors)

Contacts

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

Morning Headlines 9/12/17

Online physician ratings fail to predict actual performance on measures of quality, value, and peer review

An analysis of online consumer ratings of physician finds no association between a physician’s average consumer score and their specialty-specific quality scores.

Health secretary Jeremy Hunt maps out the NHS’s digital future

In England, Health secretary Jeremy Hunt outlines his vision for how digital health will improve care delivery within the NHS.

Fitbit and Dexcom to Develop Continuous Glucose Monitoring (CGM) Experience for People Living with Diabetes

Fitbit announces a partnership with continuous glucose monitor vendor DexCom that will bring real-time glucose reading results to Fitbit’s next generation activity tracker.

Data hack at Children’s Hospital may have affected more than 3,000 families

Children’s Hospital Colorado reports that a hacker has gained access to an employee email, resulting in the unauthorized exposure of 3,400 patient’s personal health information.

Curbside Consult with Dr. Jayne 9/11/17

Over the last several years, I have worked with a number of organizations that are trying to improve their corporate cultures. I have to give them full credit first for realizing that they had cultural issues, and being willing to reach out for help. I do most of my work in this area as a subcontractor for another consulting firm, which likes to bring me in because I can not only do the work but I have the MD behind my name. There are a lot of physicians who need coaching (and sometimes coaxing) who respond better to a peer with the same degree, regardless of their understanding of your level of experience behind the credentials. Some of their clients are large health systems and some are smaller, but everyone is facing similar stresses brought on by the pace of change in healthcare.

Many of the issues that we deal with are “light” cultural issues – basically having a set of rules, whether written or not, about how teams work together and how meetings are run. These are some of the low hanging fruit-type items, such as making sure meetings have agendas, that we work on scheduling policies and procedures, and that we work on managing meeting dynamics. Often, people are resistant to change for the sake of resisting change, or because they’re stressed about getting their work done. Having agendas and scheduling protocols can help reduce the overall burden of meetings. Once workers start to see that following the rules of engagement helps get them out of meetings and back to other activities, they begin to buy in to some of the larger changes that we need to make.

We typically have to get people to that place where they know they’re not going to be undergoing “death by meeting” as much as they’re used to, before we introduce some of the more challenging concepts such as device-free meetings. One has to move carefully towards that goal, especially with organizations that have been through layoffs or reorganizations. In these cases, teams may be understaffed and employees figure they’re running a hundred miles an hour and can’t keep up. They multitask during meetings, working on email and texts either overtly or under the table. Eventually we need to get rid of those distractions, but you’ve got to have some breathing room first. When people know the meeting will finish on time or early and they will have time to check email, get something to drink, and hit the restroom, they’re more likely to play along with other changes you need to make.

The goal is to get everyone to focus on the meeting at hand – not on their next meeting, or all the other things they have to do when this one is over. In other words, to be fully present and attentive to what is in front of them. It’s difficult enough to do when people are so used to multitasking or being instantly accessible to others, but it’s even more difficult to do when you try to do that kind of a transformation without a plan. I worked on an HIE project a few years ago with an organization that handed out custom challenge coins with the phrase “Be Present” to every employee without any kind of background or lead up to the initiative. The first thing that people speculated on was how much money the organization had spent on it, especially when staff hadn’t had a pay increase in several years and people had been downsized.

A couple of weeks later, when the actual initiative was rolled out, it was regarded as a joke. I would be on conference calls where people were blatantly ignoring what was going on, and rather than even try to cover with an “excuse me, can you repeat that” or “I missed the question” they’d actually say, “I’m sorry, I wasn’t fully present” as if that absolved them from being disrespectful. The first time I heard it, I was just grateful that I was also on the phone and that I wasn’t in a room full of people who could see my expression of horror. I encouraged management to address the comment directly with the employee in question, but they didn’t want to “ruffle feathers.” Since there were no repercussions, others felt emboldened to do the same thing, and the idea of “not being fully present” actually started to work its way into the corporate culture. I was glad to be working on the HIE project and that I wasn’t wearing my change leadership hat for that one. Watching their efforts implode was painful but taught me a great deal about what not to do when working on cultural transformation projects.

I hear similar tales of woe from some of my physician colleagues whose practices have been acquired by larger organizations. A couple of them are part of an organization that is focusing cultural transformation around the idea of assuming positive intent. There are plenty of leadership experts that support this philosophy as a way to help move organizations forward through difficult times. When you’re being asked to change, assuming that it is for the better can smooth the way. Groups trying to change rapidly may not have time to explain the full who, what, where, when, why, and how, so the phrase aims to encourage people to trust those that are leading them and working with them so that everyone can advance. It can be a great productivity booster as people free themselves from worrying about the ulterior motives of others.

Depending on who you talk to or whose materials you read, however, there’s another piece to the phrase: Assume positive intent until proven otherwise. This means that when negative intent is identified, people who are creating chaos need to be dealt with so that they no longer have the ability to disrupt or harm others. It’s hard to do that tough work though, and none of us particularly enjoy dealing with disruptive people. I’m hearing more and more about organizations that seem to be looking the other way or that are unwilling to deal with difficult people, asking their co-workers to just go along with it for the sake of assuming positive intent. I’ve heard stories about other organizations who have used the concept as a way to counter poorly-led or hastily-planned initiatives. Asking your employees to assume positive intent when you don’t have your leadership act together is not the way to build trust or move towards success. Changing corporate culture is incredibly difficult and it’s best when coming from both the top and bottom.

Is your organization working on corporate culture? Has your team asked you to assume positive intent? Email me.

Email Dr. Jayne.

Morning Headlines 9/11/17

Electronic Health Record Adoption and Interoperability among US Skilled Nursing Facilities in 2016

An ONC report on interoperability at Skilled Nursing Facilities finds that 64 percent use EHRs, and 62 percent have interoperable networks in place that ensures electronic information is available from outside sources.

Departing Novartis CEO Sets His Eyes On Silicon Valley

In a Forbes interview, departing Novartis Chief Executive Officer Joe Jimenez expands on his desire to return to Silicon Valley, saying “How are we going to pay for the innovation that’s coming? The only way is to get rid of the inefficiency in the system. That’s where I see digital technology starting to have a significant impact.”

MDLIVE Offers Free Virtual Care Services to Individuals Impacted by Hurricane Irma

MDLive will offer free telehealth visits to evacuees displaced by Hurricane Irma, as it did with Hurricane Harvey.

Red Cross launches first U.S. drone program for disasters

The American Red Cross will use a drone to assess damage and deliver aid in Houston following Hurricane Harvey.

Botox Maker Allergan’s CEO Defends Selling Drug Patents to Native American Tribe to Thwart Rivals

Allegran sells a key drug patent to the New York-based Mohawk tribe, leveraging its unique legal status to keep generic alternatives out of the marketplace.

Monday Morning Update 9/11/17

Top News

HHS Secretary Tom Price, MD declares public health emergencies for Florida, Georgia, and South Carolina as Hurricane Irma surges through central Florida and the Tampa Bay area. Nearly 3.3 million homes and businesses in Florida are now without power. The storm marks the first time a tropical storm warning has ever been issued for Atlanta, which is expected to feel Irma’s windy and rainy aftershocks Monday.

Vice President Mike Pence has assured state officials that the federal government will be ready to mobilize relief teams as soon as the storm has safely passed. Those teams include 300 healthcare personnel flown in Saturday by the Air Force to Orlando, where the hurricane is expected to hit early Monday morning.

As is becoming the trend, several providers – including St. Vincent’s, Florida Hospital, Nemours Children’s Hospital, and Orlando Health in Florida – have stepped up to offer free virtual consults to victims of Irma. DrFirst has made its mobile iPrescribe prescription look-up tool free to select prescribers as well.

Greenway Health CEO Scott Zimmerman cancels the company’s annual user group conference set to take place this weekend in Orlando. Verscend Technologies also made the similarly tough yet necessary choice to cancel its customer event in Miami.

Reader Comments

From Van Helten: “Re: Data silos. Here’s an exclusive photo of one being installed at a hospital in Virginia.” 

HIStalk Announcements and Requests

Cash seems to be king when it comes to why hospitals don’t freely exchange patient information. Over half of respondents believe hospitals don’t share information because the business case for sending patient health data to competitors is lacking. Print Geek contends, “There should an option here for ‘lack of government leadership and intervention supporting interoperability.’ As much as it pains me to put more of healthcare in the hands of the fed, the banking and travel businesses seemed to figure it out themselves. Healthcare’s inability to solve this themselves screams for government intervention.” Clustered points out that, “There is a business case *not* to use shared data. Facilities can bill for repeating a procedure/test, if they don’t have access to the results (e.g., if an MRI exam was performed elsewhere). They can’t bill for requesting and receiving prior medical records. While that may sound irresponsible to a clinician, it certainly makes sense to the CFO/CEO of a hospital. We’re in the business of facilitating information sharing and we see it all the time (‘yet another piece of software that will help me decrease revenues’ – sometimes we can almost see the thought bubble).” Anonymous asks, “Aren’t ‘insufficient demand by patients’ and ‘lack of a business case’ hugely overlapping? Patients need to create the business case. If we had a health system where patients felt empowered to own their data, instead of feeling like Elaine in the Seinfeld episode where she just wants to be treated for her rash, I think the business case would be obvious.”

New poll to your right or here: Has a lack of interoperability ever hindered your or a loved one’s ability to receive healthcare services in the midst of or after a natural disaster? I’m thinking especially about hurricane evacuees who’ve wound up away from their homes for weeks or months. Please leave a comment as to what happened and how you resolved the situation. Your experience may end up helping those struggling to jump through the hoops of finding post-Harvey and (eventually) post-Irma healthcare.

This Week in Health IT History

One year ago:

• The NHS names 12 health IT “global exemplars” that will receive $13 million in health IT funding to establish best practices and a new digital health academy.
• The DoJ and FTC back Teladoc in the telehealth vendor’s legal battles with the Texas Medical Board, saying that the board’s restrictive telemedicine rules are anticompetitive and were not appropriately reviewed.
• France-based consulting firm Atos will acquire Anthelio Health Solutions for $275 million.
• Cleveland Clinic files plans to build a 205-bed private hospital in London’s upscale West End.
• HHS will provide $87 million to 1,310 safety net health centers for purchasing or upgrading EHRs.

Five years ago:

• ONC publishes a Health IT Dashboard that includes six views and 250 custom dashboards for states, ONC programs, and grantees.
• The board of Allscripts approves a $1.9 million 2012 incentive for CEO Glen Tullman.
• Elsevier acquires ExitCare, LLC, an enterprise-wide solution for patient education and discharge instructions.
• PE firm Thoma Bravo acquires Mediware for $195 million.

Ten years ago:

• Google unveils an upgraded version of Google Health that includes a cleaner interface and more focus on wellness.
• Stanford’s Lucile Packard Children’s Hospital appeals the $250,000 fine levied by the state’s health department when the hospital waited 11 days before reporting a stolen, PHI-containing laptop.
• MyChart comes to iTunes.
• Outpatient imaging center operator RadNet acquires Image Medical Corporation for $10.75 million in cash and notes.
• EHealth Ontario signs a $46 million contract with Canada-based CGI Group to develop and manage a diabetes management portal.

Last Week’s Most Interesting News

• STAT investigates IBM’s failure to develop Watson into a revolutionary technology for cancer care, highlighting the fact that its marketing blitz may have over-promised on the machine’s capabilities.
• The FDA launches a Digital Health Entrepreneur-in-Residence program to help develop and launch its Software Precertification Pilot.
• Equifax informs the public that a data breach discovered in late July could affect up to 143 million people.
• Fidelity National Financial will acquire emergency department clinical documentation and coding vendor T-Systems for $200 million in cash.
• Jeanne Lillig-Patterson, founder of the First Hand Foundation and wife of Cerner co-founder Neal Patterson, dies at the age of 59 after losing her battle with cancer.

Webinars

September 13 (Wednesday) 1:30 ET. “How Data Democratization Drives Enterprise-wide Clinical Process Improvement.” Sponsored by: LogicStream Health. Presenter: Katy Jones, program director of clinical support, Providence Health & Services. Providence is demonstrating positive measurable results in quality, outcomes, and efficiency by implementing clinical process improvement solutions in arming operational and clinical stakeholders with unlocked EHR data. Providence’s army of process engineers use their self-service access to answer questions immediately and gain an understanding of how their clinical care delivery is impacting outcomes. The presenter will describe practical applications that include antibiotic stewardship, hospital-acquired infections, and comprehensive knowledge management.

September 28 (Thursday) 2:00 ET. “Leverage the Psychology of Waiting to Boost Patient Satisfaction.” Sponsored by: DocuTap. Presenter: Mike Burke, founder and CEO, Clockwise.MD. Did you know that the experience of waiting is determined less by the overall length of the wait and more by the patient’s perception of the wait? In the world of on-demand healthcare where waiting is generally expected, giving patients more ways to control their wait time can be an effective way to attract new customers—and keep them. In this webinar, attendees will learn how to increase patient satisfaction by giving patients control over their own waiting process. (Hint: it’s not as scary as it sounds!)

Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.

Acquisitions, Funding, Business, and Stock

Wellsoft enlists consulting firm MedProjects to help market and implement its EDIS at St. Luke’s Medical Center in the Philippines as part of a broader push into the region.

Technology

With help from UPS, the Red Cross will begin test flights this week of a drone that will assess damage and potentially deliver aid to areas devastated by Hurricane Harvey. The deployment, which comes a year after the Federal Aviation Administration loosened up its restrictions on using drones for commercial activities, could lead to additional flights into areas affected by Hurricane Irma.

Users of DexCom continuous glucose monitoring products will soon be able to track their CGM data on FitBit’s Ionic smartwatch.

Navicure announces integration of its automated patient payment tool with Epic.

Smart Communications will integrate its communications management technology with Casenet’s TruCare population health and care management platform for payers.

Privacy and Security

University of Wisconsin-Madison’s Department of Family Medicine and Community Health notifies select patients that it violated HIPAA when it sent information about a quality improvement survey on a postcard rather than in a sealed envelope. The postcard referred to individual patient medications and family planning services.

Innovation and Research

A Truven Health Analytics survey finds cost to be the top reason patients don’t fill their prescriptions. A third of those surveyed look at drug costs before filling their prescription – a practice that decreases with age. Looking for lower prices, twelve percent have taken to filling their prescriptions outside of the US. Strangely, those with higher incomes and levels of education are more likely to miss a dose.

Henry Ford Macomb Hospital and the AMA see an increase in patient referrals to diabetes prevention programs six months into piloting a pre-diabetes registry developed with help from Epic.

Other

The New York Times looks at the ways in which emergency relief procedures for Hurricane Harvey compare with those of Katrina, highlighting the work done by Congress and FEMA in the intervening years to make sure resources, strategies, and playbooks were in place and trusted by community leaders well before Harvey spun its way into Texas and Louisiana. The author also points out the work HHS has done to make sure hospitals and nursing homes are better equipped and trained to evacuate, with the ultimate goal of only having to move residents once.

Surgeon, author, and speaker Atul Gawande, MD places blame for the opioid epidemic squarely on the shoulders of physicians, attributing the propensity of physicians like himself to unknowingly overprescribe to medical training that encouraged such practices:

“The cause in the opioid epidemic starts with getting a prescription of opioids from physicians. We weren’t recognizing — I certainly wasn’t recognizing — the extent to which we were putting people at risk. I think the key thing that has stuck in my mind was that when you go in for an operation, and you give a supply of opioid pills, that if people are on those pills for 7 days they have an 8 percent chance of one year later still being on those narcotic pills. It is huge. It is startling. I had no idea. Basically, I was like more is better, take some.”

Sponsor Updates

• West Corp. volunteers pack 8,790 meals in under an hour for Omaha Against Hunger.
• Bernard Tyson (Kaiser Permanente) joins Salesforce’s Board of Directors.
• Surescripts will exhibit at the AAFP Family Medicine Experience September 12-16 in San Antonio.
• Verego awards Sutherland its Corporate Social Responsibility certification.
• Wellsoft will exhibit at HIMSS AsiaPac17 September 11-14 in Singapore.
• ZirMed will exhibit at the CareVoyant User Group Conference September 13-15 in Schaumburg, IL.

Blog Posts

• Healthcare Accelerators for Startups (Redox)
• 5 Pieces of Advice for Female Entrepreneurs Who Have Been There, Done That (Salesforce)
• Hospital EHR Adoption Rates Rise, Don’t Necessarily Ease Information Flow (Definitive Healthcare)
• Patient Navigators and Your Hospital Revenue Cycle (The SSI Group)
• Cultivating Your Practice’s Unspoken Voice (Solutionreach)
• Clinical Technology. Does it have to be so disruptive? (Sphere3 Consulting)
• Automated workflows, current knowledge make precision medicine possible (Sunquest Information Systems)
• Thinking inside the box with a provider decision quadrant: monitoring provider network stability (Verscend Technologies)
• CRISPR-Cas9 Trials Target Cancer Cell Research (Definitive Healthcare)

Contacts

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

Morning Headlines 9/8/17

The HITECH Era and the Path Forward

Former National Coordinators for Health IT Vindell Washington, MD, Karen DeSalvo, MD, Farzad Mostashari, MD, and David Blumenthal, MD co-author an opinion piece in the New England Journal of Medicine on the path forward for Meaningful Use.

Digital Health Entrepreneur-in-Residence Program

The FDA is seeking applications for a Digital Health Entrepreneur-in-Residence. The selected candidate will work within the FDA’s Digital Health Unit developing software test models and quality metrics.

Assessment of Remote Heart Rhythm Sampling Using the AliveCor Heart Monitor to Screen for Atrial Fibrillation: The REHEARSE-AF Study

A study published in Circulation finds that using a smartphone-enabled ECG monitor to screen at-risk stroke patients for atrial fibrillation was “significantly more likely” to detect AF as compared to routine care.

Harvey Puts One Texas Hospital’s ‘Code Brown’ Plan to the Test

As Hurricane Irma approaches Florida, the Wall Street Journal profiles preparations undertaken by Houston’s St. Joseph Medical Center in the days ahead of Hurricane Harvey’s arrival.

News 9/8/17

Top News

STAT investigates IBM’s failure to develop Watson into a revolutionary technology for cancer care, highlighting the fact that its marketing blitz may have over-promised on the machine’s capabilities – none of which have been formally documented in scientific papers. In development for six years, Watson for Oncology has been adopted by just a few dozen hospitals. HIStalk readers will likely remember MD Anderson’s decision to walk away from the technology late last year after spending upwards of $62 million on the project. Other complaints include advice that is biased towards American patients and caregiving methods; and expense, particularly as it relates to linking up the system to EHRs.

Reader Comments

From Harold & Kumar: “Re: United’s acquisition of Advisory Board. What’s United’s next move? An EHR vendor? Allscripts? Athena? If not an EHR, then Evolent? They seem to have a lot of cash and a long shopping list.” With a deal valued at a total of $2.58 billion, I’ll heartily concur that the piles of cash probably won’t lay around for long. I’ll invite readers to look into their M&A crystal balls and offer up their best predictions. It will be fun to look back and see who, if anyone, got it right.

From Just a Symbol: “Re: The state of journalism today. Typos are one thing, and we can surely forgive the occasional HER, but this headline takes the cake for lack of fact checking.” The New Delhi-based website bills itself as “a leading online news publication.”

HIStalk Announcements and Requests

This week on HIStalk Practice: Care Convene steps up Harvey relief efforts.  Vice President Pence swears in Jerome Adams, MD as US Surgeon General. The CDC doles out nearly $29 million to help states with PDMPs. Iora Health will care for WellCare’s Medicare Advantage patients. Dermatologist Jordan Miller equates the EHR’s impact on physician/patient relationships with that phone-obsessed friend who never makes eye contact. Weave Communications raises $17 million. HHS Secretary Tom Price, MD declares a public health emergency in Puerto Rico and the US Virgin Islands. HIStalk sponsors, submit your company’s details to the MGMA 2017 guide.

Welcome to new HIStalk Platinum Sponsor Lightbeam Health Solutions. The Irving, TX-based company offers end-to-end population health management solutions that reduce cost and improve patient management and coordination, including an enterprise data warehouse, analytics, risk stratification, HCC coding, quality measure optimization, physician engagement, care management, patient engagement, GPRO reporting, HIE, and cohort builder. One Texas ACO reports saving $28 million using Lightbeam’s tools and was one of just four ACOs nationally to achieve a 100 percent quality score. The company offers a free Population Health Made Simple series that describes how technology helps providers who are working under new payment models. Industry long-timer Pat Cline joined the company as CEO in 2012. Thanks to Lightbeam Health Solutions for supporting HIStalk.

Webinars

September 13 (Wednesday) 1:30 ET. “How Data Democratization Drives Enterprise-wide Clinical Process Improvement.” Sponsored by: LogicStream Health. Presenter: Katy Jones, program director of clinical support, Providence Health & Services. Providence is demonstrating positive measurable results in quality, outcomes, and efficiency by implementing clinical process improvement solutions in arming operational and clinical stakeholders with unlocked EHR data. Providence’s army of process engineers use their self-service access to answer questions immediately and gain an understanding of how their clinical care delivery is impacting outcomes. The presenter will describe practical applications that include antibiotic stewardship, hospital-acquired infections, and comprehensive knowledge management.

Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.

Acquisitions, Funding, Business, and Stock

Cognizant Technology Solutions plans to bring 75 healthcare-focused jobs to its office in Tampa, FL over the next three years.

Sales

Radiology and Imaging Specialists (FL) selects NextGate’s EMPI to reconcile over 1 million patient records.

Alliance Behavioral Healthcare selects ZeOmega’s Jiva population health management software for its 2,200 providers.

In Australia, South Western Sydney Primary Health Network opts for the dbMotion HIE tool from Allscripts to more easily exchange information between primary and acute care facilities.

Yale New Haven Health (CT) and Yale School of Medicine choose Appriss Health’s NarxCare solution to integrate their Epic EHR with Connecticut’s PDMP.

Freeman Health System (MO) signs on for CRM software from Influence Health.

LifeSpan (RI) selects cloud-based identity and access management technology from IDdriven.

Announcements and Implementations

Rehabilitation Hospital of the Pacific (HI) will upgrade its EHR from Harris Healthcare to include e-prescribing, among other features, and expand its use across ambulatory settings.

Surescripts and Allscripts partner to provide pharmacists in Texas and Louisiana free access to patient medication history data.

Union Hospital (OH) uses middleware from Iatric Systems to connect its smart infusion pumps with its Meditech EHR.

Citizens Medical Center (KS) wraps up department-wide deployment of speech-recognition tools and cloud-based image sharing capabilities from Nuance.

Technology

Meditech makes chemotherapy order templates from the National Comprehensive Cancer Network available in its Web EHR.

MedAptus develops new patient assignment software for nurses.

Casamba adds Kno2 health data exchange capabilities to its HealthWyse, TherapySource, and Smart EMR products for home health, hospice, SNFs, and outpatient clinics.

Government and Politics

The FDA launches a Digital Health Entrepreneur-in-Residence program to help develop and launch its Software Precertification Pilot. Applications are due September 29.

At the request of HHS, the National Quality Foundation issues a lengthy report on measuring EHR interoperability, as well as interoperability’s impact on “patient safety, costs, productivity, care coordination, processes and outcomes, and patients’ and caregivers’ experience and engagement,” outlining dozens of ways that interoperability could be measured and improved upon within the US.

The New York Times highlights the impact President Trump’s decision to end the Deferred Action for Childhood Arrivals program will have on the healthcare industry. Nearly 20 percent of DACA beneficiaries work in healthcare and education, filling positions like nursing assistants and home health aides – prime examples of roles that are facing a looming shortage of skilled workers.

Innovation and Research

A Health Affairs study finds that in 2016, 60 percent of the plans available on individual exchanges included provider networks where at least 25 percent of the local provider community was in network, contrary to growing concerns that network consolidation would lead to restricted access to care.

Scottish scientists develop a camera-like device that can “see” through the body. The camera, which detects sources of light in the body, was created to help physicians keep better track of medical equipment like endoscopes.

An NHS study of 444 people finds that escalating levels of severe health anxiety are placing unnecessary strain on the healthcare system, costing over £420 million in unnecessary outpatient appointments, tests, and scans. Researchers accuse Dr. Google and wearables of inciting this new state of cyberchondria.

People

Meditech South Africa appoints Charlotte Jackson group CEO.

Matt Parker (Connecture) joins HealthSparq as VP of product.

Correctional healthcare provider Corizon Health announces the immediate resignation of CEO Karey Witty. An operating committee of board members will take over in the interim.

Privacy and Security

There are just a few days left to register for Sensato’s Hacking Healthcare conference September 13-14 in Long Branch, NJ. The event will take place at the Ocean Place Resort & Spa – just steps away from the beach.

Lenovo will pay $3.5 million to 32 states that filed complaints related to the company’s preloading of advertising software onto its laptops without customer consent. The software also apparently captured personal data users shared with websites. The FTC filed a related civil complaint against the company over security vulnerabilities, and the two parties settled out of court earlier this week.

Equifax informs the public that a data breach discovered in late July could affect up to 143 million people. Stolen information could potentially include names, birth dates, SSNs, addresses, and some driver’s license and credit card numbers. Company officials point to hackers who “exploited a US website application vulnerability to gain access to certain files.”

Other

Weird News Andy says it pays to clean up after yourself: Investigators discover NIH employee Christopher Dame’s scheme to sell over $75,000 worth of stolen NIH equipment after he left an eBay receipt on the photocopier near his office. Dame admitted to stealing over 400 items from the agency over a four-year period, and has been sentenced to six months in federal prison.

This puts a new spin on the phrase “privacy breach:” Denver Health Medical Center suspends five nurses for three weeks after word spread through the hospital grapevine that the group had opened a body bag to look at a deceased male patient’s genitals. It soon surfaced that a similar incident had occurred before the patient’s death while he was incapacitated.

Sponsor Updates

• ECG Management Consultants will present at The Governance Institute – Leadership Conference September 10 in Colorado Springs, CO.
• EClinicalWorks and Healthfinch will exhibit at the AAFP Family Medicine Experience September 12-16 in San Antonio.
• Gartner includes Evariant in its “Hype Cycle for Healthcare Providers 2017” report.
• KLAS recognizes The HCI Group as the top healthcare IT consulting firm globally.
• Iatric Systems will exhibit at the HCCA Regional Conference September 8 in Boston.
• InstaMed partners with Bridge Bank to expand its credit facility.
• InterSystems will host its Global Summit 2017 September 10-13 in Palm Springs, CA.
• Intelligent Medical Objects will exhibit at HIMSS AsiaPac17 September 11-14 in Singapore.
• More than 900 healthcare professionals advance their education and network at the 2017 Aprima User Conference.
• MedData will exhibit at the Viva 17 Vascular Interventional Advances event September 11-15 in Las Vegas.
• Netsmart will exhibit at the MACMHP Annual Conference September 12 in Saint Paul, MN.
• Experian Health will exhibit at the HFMA SoCal conference September 10-12 in Los Angeles.
• FSU’s Jim Moran Institute for Global Entrepreneurship includes ROI Healthcare Solutions in its Seminole 100 list of fast-growing businesses owned by FSU alumni.
• Utah Business ranks Solutionreach twenty-fifth on its Fast 50 list of growing companies.

Blog Posts

• Predicting Readmission Risk in a Cardiac Population (ECG Management Consultants)
• Building a Denial Management System? Here’s Where to Start (Hayes Management Consulting)
• The Ecosystems That Fuel Health IT Investment (Healthcare Growth Partners)
• Functional and Handsome – Patient Instructions for Better Patient Recall (Healthwise)
• New Lessons on Patient Privacy Breaches and OCR HIPAA Settlements (Iatric Systems)
• Helpful everyday uses for SSO (Imprivata)
• Promoting a Hospital’s Best Products: Providers (Influence Health)
• The Business Value of Global Summit (InterSystems)
• Hurricane Irma Preparation (Learn on Demand Systems)
• CMS Emergency Preparedness for Nursing Homes and Long-Term Care (LiveProcess)
• Leverage data to improve healthcare consumer engagement (Experian Health)
• Opportunities for Care Coordination in the Emergency Department (PatientPing)
• How Blockchains Will Solve Healthcare IT’s Most Pressing Issues (PokitDok)
• Consultant’s Corner – Alexandra Rae (Huntzinger Management Group)
• 4 Advantages of a Consolidated Contact Center (Spok)
• Centralizing Patient Access Webinar Series – Key Takeaways (Kyruus)

Contacts

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

EPtalk by Dr. Jayne 9/7/17

I was interested to hear of Cerner’s formation of an Advisory Group “to provide insights and recommendations in support of Cerner’s work” on the VA EHR program. Although it’s “comprised of distinguished former government, military, and private sector leaders sharing a common interest in Veterans health and wellness,” it’s lacking any “regular” veterans. My former hospital was very progressive in having patients represented on a variety of steering committees and project teams – sitting right alongside the CEO, hospital board members, department chairs, service line directors, and other stakeholders as we made a variety of decisions that impacted patient care. I didn’t fully understand the gravity of having patients (and their caregivers) on those committees until I experienced it myself. Staring a patient in the face while making difficult decisions about EHRs and the management of patient data is very different than making the decision in a room of IT experts. Even though there are distinguished veterans in the group, I would submit that the electronic health needs of the “average” veteran are different from one who is a former Senator/Governor; even though Senator Kerrey does have experience receiving care in the VA system. My local VA is seriously challenged with leadership turnovers, staffing issues, and poor patient care experiences that our veterans do not deserve. Let’s get some patients in the room and see what a difference it makes as Cerner works to move their care forward.

Speaking of patients, just a reminder that all of us will be patients at one time or another. Let’s avoid being patients with influenza – the vaccination season has already started. The CDC website has information on projected strains – my employer requires all staff members to receive a vaccination by the end of next week. The best part of being vaccinated during my last patient care shift was watching my staff decide who was going to get the short straw and have to play “pin the vaccine on the physician.” The worst part was realizing several hours later that my band-aid had fallen off and I had bled through my scrubs and white coat, probably causing patients to wonder what was going on with my arm (although no one mentioned it). The paramedic who administered my vaccine was horrified, but accepted my explanation that it was much more likely due to the daily aspirin I’m taking rather than her technique.

CMS released a new fact sheet that covers mass immunization events and so-called roster billing. Most of my experience has been with traditional office-based immunizations, but I always enjoy learning something new. Definitely something to think about for organizations who provide mass-immunizations and whose practice management or billing systems will support that type of billing.

We’re struggling a little at the office with physician coverage, as several of our physicians recently relocated with spouses that were finishing medical school or residency and moving on to fellowships or other training programs. We’ve always done our own recruiting, but are thinking about using a firm to broaden our reach. Since primary care physicians are in high demand, I often receive recruiting materials and had to bring in a post card from one recruiter as an example of why we shouldn’t consider using them. Rather than lead with the usual comments about patient volume, procedures, availability of scribe coverage, and hospitalist use, it started with “features two private lakes in a wealthy suburb.” Sure, I’d love to relax by the lake between patients, but I’m thinking it’s more likely that some copy editing is in order.

If you’re on the hospital side, CMS will offer a webinar on September 12 covering the Fiscal Year 2018 Inpatient Prospective Payment System (IPPS) Final Rule. This includes clinical quality measures for the Inpatient Quality Reporting (IQR) Program and Medicare/Medicaid EHR Incentive Programs for eligible hospitals and critical access hospitals. It’s difficult to keep up with all the changes to these programs, so having someone help digest the content might be helpful.

If you’re on the vendor side, CMS has opened the self-nomination process for vendors who might want to be recognized as a Qualified Clinical Data Registry (QCDR) or as a Qualified Registry. The window closes November 1, 2017 for the 2018 MIPS performance period. Candidates have to not only submit a self-nomination but also must email CMS when their application is ready for review. There is quite an array of registries out there, and I’ll be interested to see what new organizations come to the table and whether they’re offering anything truly unique.

Things are starting to pick up in the healthcare IT world, and the user conference season is in full swing. Allscripts hosted its clients in Chicago August 8-10, followed by Aprima, which welcomed its customers August 18-20 in Dallas. Epic will host its clients on-campus September 25-28 with a theme of “World of Wizards.” The EClinicalWorks national conference will be held October 6-9 in Dallas; following that, DocuTAP will hold its User Summit in Nashville October 10-12, overlapping Cerner, which will hold its annual conference October 9-12 in Kansas City. NextGen rounds out the season with its annual user group meeting November 5-8 in Las Vegas.

Some year I would love to take a sabbatical from consulting and just go from conference to conference to conference. Pulling off that kind of a feat would require a lot of wardrobe planning and a serious amount of shoes. The other alternative would be to work with my friends at Heelusions to accessorize a pair or two and give them unique looks for the different vendors and events. I’m impressed by their Cerner-specific creation and wonder if anyone will be sporting them in Kansas City. Brand is everything, and this would certainly let employees embrace the company from head to toe (not to mention, it’s rare to see vendor-logo footwear.) HIMSS is coming, so if you’re looking to take your shoes to the next level, you might want to check them out.

What’s your favorite vendor-logo item? What’s the worst you’ve seen? Email me (and of course send pictures)!

Email Dr. Jayne.

Morning Headlines 9/7/17

Interoperability 2016-2017 Final Report

The National Quality Foundation issues a report on measuring EHR interoperability, as well as interoperability’s impact on “patient safety, costs, productivity, care coordination, processes and outcomes, and patients’ and caregivers’ experience and engagement,” outlining dozens of ways that interoperability could be measured and improved upon within the US.

IBM pitched its Watson supercomputer as a revolution in cancer care. It’s nowhere close

STAT investigates IBM’s failure to develop Watson into a revolutionary technology for cancer care.

Most Marketplace Plans Included At Least 25 Percent Of Local-Area Physicians, But Enrollment Disparities Remained

A Health Affairs study finds that in 2016, 60 percent of the plans available on individual exchanges included provider networks where at leasts 25 percent of the local provider community was in network, contrary to growing concerns that network consolidation would lead to restricted access to care.

Tenet selling 8 more hospitals as investors debate company breakup

Outgoing CEO Trevor Fetter announces that Tenet will sell eight low-margin hospitals , plus another nine in the UK, to help it reduce debt and appease activist investors that are pressuring the board to break the company into three smaller units.

Morning Headlines 9/6/17

FNFV Announces Acquisition of T-System Holdings for $200 Million

Fidelity National Financial will acquire emergency department clinical documentation and coding vendor T-Systems for $200 million in cash.

Cerner Announces Advisory Group to Improve Health Care Delivery for Veterans

Cerner creates an advisory board that will guide its VA implementation, chaired by Nebraska Governor and US Navy Veteran Bob Kerrey. Former VA CIO Roger Baker, former National Coordinator for Health IT Karen DeSalvo, MD, and Jonathan Perlin, MD and CMO of HCA, are among the experts that make up the board.

Veterans Administration Awards Diameter Health and Four Points Technology to Provide Clinical Data Quality Surveillance

The VA will implement Diameter Health’s CCD Analyzer to feed data into its clinical data quality surveillance platform.

Information Is Powerful Medicine

HHS launches a campaign encouraging consumers to access and review their medical records.

News 9/6/17

Top News

Jeanne Lillig-Patterson, the 59-year-old founder of Cerner’s First Hand Foundation, died Monday of cancer less than two months after death of her husband, Cerner Chairman and CEO Neal Patterson. She was diagnosed with metastatic breast cancer 10 years ago.

Neal Patterson died July 9 of cancer complications. He was 67.

First Hand impacted 300,000 lives in 93 countries and supported health screenings and educational programs that involve one-fourth of students in the Kansas City area.

Lillig-Patterson was Cerner employee #7, earning her the internal nickname “Double O Seven.” She got the job after responding to a 1980 ad by what was then Patterson, Gorup, Illig & Associates, which hired her for her ICD-9 coding background as a hospital admitting department employee. PGI was doing contract work for non-healthcare companies when it was hired by a pathology practice, with the founders, Lillig-Patterson, and other employees scrambling to write the COBOL code that would eventually form the PathNet laboratory information system. Lillig-Patterson suggested Cerner as the company’s name in 1984 after noticing the word in a language dictionary as a group led by Neal Patterson tried to come up with something more memorable than PGI.

Neal Patterson said of her at a 1999 company event in observing Lillig-Patterson’s planned retirement from Cerner, “She has done more jobs than any single person at Cerner. Jeanne began as our office manager and accountant. She started the account manager organization. She led the team converting our entire install base to a new platform, Classic 200 to Classic 300. She started the Cerner Health Conference. She ran professional services for one-half of the United States. She helped start the client-focused team organization, which was the predecessor to the regional branches, helping to start the client services organization. In the recent era, she started the First Hand Foundation and our community relations program. Jeanne is the soul of Cerner.”

Co-founder, board chair, and interim CEO Cliff Illig said in an internal email to Cerner employees Monday, “I would remind us all of the image of Jeanne and Neal walking through a hospital lobby carrying the bags that contained all of Jeanne’s medical records to another of her hundreds of doctors’ appointments. As Neal would want us all to recognize, it’s our job to get rid of Jeanne’s bags.”

The Pattersons had two children together – Cortney and Will – as well as Clay Patterson and Lindsey Patterson Smith from Neal Patterson’s prior marriage.

Reader Comments

From Generic Substi-Tooter: “Re: HIStalk. I’ve been a reader for six years. Just wanted to let you know that I appreciate the work you’re doing. Seems like you have a small staff helping as well, so tell them to keep up the good work. You definitely catch a lot of flak from readers about Epic or Cerner bashing, which is funny to read since I’m guessing many of those come from the company that’s had the bad press.” Thanks. People sometimes think the HIStalk team is substantial, so this is a good time to recap. I write every word on HIStalk except when I take time off, during which Jenn covers for me (she also writes HIStalk Practice). Lorre does everything that doesn’t involve writing, including webinars, with occasional help from Brianne. Lt. Dan writes the daily headlines, while Dr. Jayne’s contributions run twice each week. That’s everybody, maybe three FTEs total who each do our own thing without requiring a lot of collaboration. I started HIStalk in 2003 and have been accused nearly constantly since of bashing vendors who would prefer that health IT “news” consist entirely of their shiny, happy press releases that other sites run unchallenged. Like the industry itself, HIStalk can be rough around the edges, but I don’t push back from the computer at the end of the day until I’m reasonably proud of it.

Webinars

September 13 (Wednesday) 1:30 ET. “How Data Democratization Drives Enterprise-wide Clinical Process Improvement.” Sponsored by: LogicStream Health. Presenter: Katy Jones, program director of clinical support, Providence Health & Services. Providence is demonstrating positive measurable results in quality, outcomes, and efficiency by implementing clinical process improvement solutions in arming operational and clinical stakeholders with unlocked EHR data. Providence’s army of process engineers use their self-service access to answer questions immediately and gain an understanding of how their clinical care delivery is impacting outcomes. The presenter will describe practical applications that include antibiotic stewardship, hospital-acquired infections, and comprehensive knowledge management.

Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.

Acquisitions, Funding, Business, and Stock

Equity investor FNFV acquires ED clinical documentation and coding vendor T-System for $200 million in cash. FNFV plans “multiple acquisitions” to accelerate T-System’s growth.

In Australia, Citadel Group acquires oncology EHR vendor Charm Health from its venture capital owner.

Sales

Temple Health (PA) chooses Sectra PACS.

The VA selects Diameter Health’s CCD Analyzer to support clinical data quality surveillance.

Pharmacy benefits manager Magellan RX Management will offer its customers CoverMyMeds for electronic prior authorization.

People

Michigan Medicine names interim CIO Andrew Rosenberg, MD to the permanent role.

Christopher Rieder (Brookdale University Hospital and Medical Center) joins anatomic pathology practice company Aurora Diagnostics as CIO.

MedeAnalytics hires Kerry Martin (Cerner) as SVP of sales.

Jamie Coffin, PhD (SourceMed) joins genetic screening company Sema4 as president/COO.

Announcements and Implementations

Health Catalyst launches Data Operating System, the result of a $200 million development project that combines vendor-agnostic data warehousing, clinical data repositories, and HIEs into a single platform. Its attributes include reusable logic, real-time data streaming, ingestion of both structured and unstructured data, closed-loop EHR integration, microservice API architecture, machine learning, and an agnostic data lake. 

In South Korea, Gangnam Severance Hospital, Samsung, and virtual reality developer FNI will work together to developer virtual reality technology for mental health, including a VR-powered diagnostic tool.

Datica’s cloud platform for digital health apps earns HITRUST certification for security risk mitigation and PHI protection.

The executive clinic of The Greenbrier resort (WV) will partner with WVU Medicine, including adopting its Epic system.

Lovelace Health System (NM) completes its implementation of Epic.

Diagnostic imaging vendor RadNet partners with two Patrick Soon-Shiong controlled organizations – NantWorks and six-hospital Verity Health – with Verity Health taking over RadNet’s Breastlink business in California and all three organizations collaborating on clinical trials, data analytics, and AI-powered predictive modeling.

UnitedHealthcare announces PreCheck MyScript, which gives prescribers cost and coverage information at the point of prescribing and automates prior authorization for patients covered by the insurer’s health plans. The service being integrated with Allscripts EHRs and DrFirst.

Government and Politics

HHS OCR launches “Information is Powerful Medicine,” a campaign to let the public know that HIPAA gives them the right to view and obtain copies of their health information from their provider.

A New York Times report observes that HHS – which is legally responsible for overseeing the Affordable Care Act – is instead spending taxpayer money to oppose it in promotional videos and is constantly criticizing the law via anti-Obamacare tweets by HHS Secretary Tom Price. According to a law professor, “Here, it’s an agency trying to destroy its own program because it opposes it. It is inconsistent with the constitutional duty to take care that the law is faithfully executed.” The article also calls out the White House’s drastic cutback in insurer-paid funds for signup advertising and the removal of ACA information from the HHS.gov website.

Enteprise customer communications management solutions vendor Smart Communications will integrate its technology with Casenet’s TruCare population health and care management platform to allow health plans to deliver personalized communications to members and providers via their preferred channels.

Cerner creates an advisory group to guide its work on the VA’s EHR project, with members that include former Senator Bob Kerrey; former VA CIO Roger Baker; former HHS Acting Assistant Secretary for Health Karen DeSalvo, MD; former VA secretary James Peake, MD; and former VA Undersecretary for Health Jonathan Perlin, MD, PhD.

Privacy and Security

The Locky ransomware is being spread by a new technique in which a browser user is convincingly warned that a required PC font is missing, with the malware installing itself if the user clicks the update button.

Other

A Boston Globe report finds that rapidly expanding for-profit hospital chain Steward Health Care System has failed to file state-required financial, quality, and merger plan information and has not paid fines that were imposed for its lack of transparency. It has also stopped providing individual hospital data. A Harvard professor says the private equity-owned chain, which is going national, might be trying to hide the reality behind its claimed turnaround of its acquired Massachusetts hospitals.

A study published in Health Affairs finds that insurance company bargaining power has lowered the cost of hospital admissions and of some physician specialties (cardiology, radiology, and hematology-oncology services) in concentrated provider markets, but has not lowered PCP or orthopedist prices. The article concludes, “The policy dilemma that arises from our findings is that there are no insurer market mechanisms that will pass a portion of these price reductions on to consumers in the form of lower premiums.”

A Dallas medical testing laboratory accused by the federal government of a $100 million fraud scheme files a lawsuit to prevent state and federal agencies from revoking its laboratory licenses. Two of the principals of Next Health and Medicus Laboratories also face similar charges for their work at a now-bankrupt doctor-owned hospital chain that prosecutors say paid $40 million in bribes to generate $200 million in paid claims as an out-of-network provider. The executive of one of Next Health’s marketing contractors has been indicted in an unrelated case for giving soldiers Walmart gift cards in return for saliva and urine samples that were used to perform unnecessary tests for which Tricare paid, using a similar method to drum up business for Next Health by approaching people in Whataburger restrooms and offering them $50 gift cards for providing urine samples for a “wellness study.” One patient earned $600 for providing a dozen urine samples that were used to bill UnitedHealthcare Group $217,000, with the Next Health marketing rep bragging that he was earning $100,000 per month for brokering kickback payments to doctors. Next Health told patients they wouldn’t be billed for their part of the cost, fearing that their complaints would trigger an investigation.

In India, police are investigating the perinatal asphyxia deaths of 30 children at a state-run hospital after families complain that the hospital did not give the babies oxygen. This follows a previous incident where 60 children at another hospital died after oxygen supplies were reportedly cut off due to non-payment of the oxygen supply company’s bills.

Here’s another 30-year look back from Vince, who describes the health IT news of September 1987 and what it means today. He would love to hear stories from fellow pioneers, especially if they dig into their own closets for yellowing industry ephemera.

Sponsor Updates

• Agfa HealthCare publishes a new case study, “Hashemite University leads the way with first ‘Instant DR’ in Jordan.”
• Besler Consulting will present at the NJ HFMA Regulatory & Reimbursement Educational Program on September 12 in Edison.
• Datica releases a new podcast, “Emerging Healthcare Data Challenges from Patient-Centric Technologies.”
• Besler Consulting releases a new podcast, “Patient access strategies to improve collections.”
• CompuGroup Medical will exhibit at PainWeek September 5-9 in Las Vegas.
• CoverMyMeds will exhibit at the AAFP Family Medicine Experience September 12-16 in San Antonio.
• Cumberland Consulting Group will exhibit at the MDRP 2017 Summit September 11-13 in Chicago.

Blog Posts

• Only You Can Prevent Ransomware Attacks (Optimum Healthcare IT)
• Do You Understand MIPS? Prove It! (AdvancedMD)
• Facing down the largest breaches of 2017 with Datica’s open-source policies (Datica)
• Implementing Value-Based Care: A Top Concern of Health System CEOs (CareSync)
• What to Consider as You’re Starting to Measure Population Health (Dimensional Insight)

Contacts

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

HIStalk Interviews Rob Harding, CEO, FormFast

Rob Harding is president and CEO of FormFast of St. Louis, MO.

Tell me about yourself and the company.

I’m a resident of Franklin, Tennessee, along with my wife. I have a daughter in the area. We moved here to enjoy the benefits of the healthcare greatness in the community. I’m in the 25th year of working with my company, FormFast, which I started because I knew a great deal about hospital printing and paperwork from a previous employer.

What is the role of electronic forms as hospitals and practices are expanding their use of electronic health records?

Many of our customers and IT experts had stated that there would be no role for forms, whether electronic or otherwise, and that all of this would be handled by communicating with a database, EMR, or some other completely automated, unrelated type of departmental software. So we’ll start this conversation by saying that I’m a guy in a business that isn’t supposed to exist any more. 

We are now going through the tail-end of conversions through Meaningful Use, where the larger companies said five or six years ago that we would not have any paper forms or forms of any type. We have a 10-hospital chain on the West Coast that has 10,000 paper forms that we do for them on demand. We have in the mid-Atlantic region a client with eight hospitals and around 7,000 forms that we are generating for them. Recently one of the most prestigious institutions in the Northeast has come to us with 4,200 forms. We are now getting RFPs from large healthcare systems and IDNs saying, we need to organize and standardize thousands of forms. They are beginning to realize that these forms are still there and need to be managed.

We’ve recently been calling up medical records folks and asking, what do you think about scanning forms? Because even if you have all this data in a database and have immediate access to it, if there is a great deal of paper, these items have to be scanned into a document management system. The soonest that anybody we interviewed said that these forms were scanned and available for viewing by clinicians was 12 hours, going from there to a week. How are they operating? How are they using all this immediate information from the electronic medical record, yet don’t have any kind of access to a great deal of the clinical data? That something that we’re trying to understand.

EHR designers were initially criticized for designing screens that looked like paper forms, but nobody complains about a paper form being unusable like they do EHR screens. Is the physical paper form or its on-screen metaphor still viable?

We’ve had a lot of high-level discussions about a data-centric view of getting information — putting it in a database — versus the form- or document-centric approach.

The documents we work with have a lot of formatting. The information is presented in a sequence. A lot of the documents need signatures, either wet signatures or at least an original or electronic signature. They need to go to multiple people for approval.

The database system is a vertical system, while forms are more like a horizontal processing. We have built systems — and other companies have, also — for doing workflows that will move these forms around for signatures, approvals, or addition of data. That has not been the focus of the major electronic medical record companies. 

There was no reason that everything going on in the hospital couldn’t have been automated. When we look at piles of forms and we look at all the transactions that are taking place — some of them very specific transactions, transactions that change very frequently, you know, forms are changed very frequently – it’s a huge challenge to automate this and connect it to all these other processes.

FormFast’s solutions allow a customer to very quickly design a form, attach data elements to it, and put it into play. To be able to create it quickly and remove it quickly. That’s been one of the approaches. You have a secondary class of automated e-forms. We’re searching, and that now that our customers are asking questions about this and looking for answers, we’ll be able to get better feedback about how these problems can be addressed.

Hospitals will always have paper forms such as employment applications, invoices, and patient-completed forms that won’t be managed by their IT systems. What are examples of automating those paper forms and putting process automation or integration around them?

There has been a lot of demand for, as an example, risk management systems. The risk management paperwork is clinical paperwork, but it’s not part of the electronic medical record and it needs to be distributed to a large number of individuals for feedback. Items like that. We’ve done check approvals that have to go through several transitions — if its over a certain dollar amount, it needs to go to a certain individual for approval. Most hospitals don’t have a fully functioning human resource system, so things like evaluations for employees, collection and approval of budget data, requisitions. We have created 50 workflows covering those areas and we’re always learning more.

Where do you expect the company and the electronic forms industry to be in the next 5-10 years?

There’s a couple of directions it can go. Existing companies may expand into some of these areas, but I’ve not seen any indication that that’s a priority. We have in addition to the on-demand forms a lot folks using our form fill. Its available to fill in a form, submit the data, and put a copy of the form into an archive.

I mentioned the workflow, which is not a simple form being submitted, but a process. For the last three years, we’ve been focusing the forms, the signatures, the consents — the kinds of things needed for pre-admission processes for patients and for discharge. It started out that forms could be approved. Then we added tasks that the patients should be doing prior to admission, or things that the family needed to do after discharge.

Those have been combined into a this newer and much larger product type. There’s a requirement for huge amount of protection under HIPAA for anybody finding or looking for data. Salesforce is a platform and that seems to be something that’s moving into the healthcare environment. All the things we’re doing are on a common development platform. 

I’m sure there will be many changes in direction as the years go by. We look at hospitals that have spent 10 or 20 million dollars to automate an electronic medical record and have processes that are not part of this record that are 10 years old. There are piles of paper and thousands of forms. I’d say that we are just beginning to see those things looked at and addressed and realized. Folks in hospitals who have been so busy with other requirements are just beginning to ask that question.

Do you have any final thoughts?

I won’t say how many years I’ve been involved in paper and electronic forms in the healthcare environment, but my desire is to make things better for our customers. These problems around forms are not insignificant, with half of the data being in an EMR that is instantly available and half of it being on paper that is available days later. It’s going to be really fun to participate with our partners and customers to make that happen.

Morning Headlines 9/5/17

Jeanne Lillig-Patterson, wife of Cerner CEO Neal Patterson, dies at 59

Jeanne Lillig-Patterson, founder of the First Hand Foundation and wife of Cerner co-founder Neal Patterson, dies at the age of 59 after losing her battle with cancer. Jeanne’s death follows her husband’s by less than two months.

Moment of truth arrives for Obamacare repeal

The Senate parliamentarian has ruled that Republicans face a September 30 deadline to pass an ACA repeal bill with only 50 votes, noting that the availability of the budget reconciliation process Republicans were using to fast-track the bill will pass when fiscal year 2017 ends on September 30.

Dual Canadian/Chinese Citizen Arrested for Attempting to Steal Trade Secrets and Computer Information

A Canadian/Chinese citizen is being charged with attempted theft of trade secrets after the CEO of Massachusetts-based Medrobotics Corporation saw him sitting in a conference room at 7:30pm with three laptops open. When questioned by the CEO, the man admitted that he was not an employee or contractor of the company, and claimed to be visiting a Medrobotics employee.

Novartis names American Vasant Narasimhan as its new CEO

Swiss pharmaceutical giant Novartis announces that its CEO, Joseph Jimenez, will step down effective February 1, noting that he is “ready to return to Silicon Valley and the US.”  Vasant Narasimhan, MD, the company’s current CMO, will take over.

Morning Headlines 9/4/17

Harvey Evacuees Leave Their Belongings – and Health Records – Behind

Wired describes a frustrating situation in Texas and Louisiana, where the lack of EHR interoperability is in the national spotlight as Hurricane Harvey evacuees seek care from new doctors who have no access to their medical records.

Speech Recognition in Cardiology

A survey of 147 cardiology clinical and administrative staff finds that cardiology is lagging behind radiology in adopting voice recognition technology into clinical workflows.

Alphabet’s Verily and Google found a potential new test for heart disease using AI

Verily researchers have developed an AI-based algorithm that can analyze retinal images to calculate a patient’s risk of heart disease. The algorithm scans for key indicators in the retinal images that correlate to age, gender, smoking status, blood pressure, and blood sugar levels, and then uses this information to calculate the patient’s heart disease risk level.

How to Regulate Artificial Intelligence

A New York Times Op-Ed piece by an Artificial Intelligence researcher proposes a framework for regulating the emerging technology.

Monday Morning Update 9/4/17

Top News

An article in Wired says that despite widespread use of electronic medical records, people with medical needs aren’t faring any better after Hurricane Harvey than following Hurricane Katrina in having their medical history available to first responders and new providers.

The article blames lack of interoperability and EHR downtime caused by flooding and power outages.

The author describes PULSE (Patient Unified Lookup System for Emergencies), an HHS-funded pilot project to create a data-sharing network that can be activated in a crisis. A January 2017 HHS announcement describes the California pilot that uses technology from Audacious Inquiry:

PULSE is currently being built to facilitate exchange during a declared emergency by extending interoperability across disparate technologies to support health information exchange. PULSE will allow Alternative Care Facilities (think of these as aid stations or MASH units set up during an emergency) so that EMS and authenticated volunteer providers can quickly get access to often life-saving data, when and where they need it. In the future, the PULSE system could facilitate patient lookup capability in an ambulance.

During a recent demonstration by Audacious Inquiry, the contractor that developed the PULSE technology, the program’s benefits become readily apparent. In the event of an earthquake, or forest fire (like the one that recently ravaged Eastern Tennessee), first responders (defined under PULSE as any of six provider types, including doctors, nurses and EMTs) can query PULSE with standard eHealth exchange patient demographics—including name, date of birth, and gender.  PULSE then sends out data tendrils to California-based HIEs, health systems and hospitals, for instance, looking for a match to the query. PULSE then enables first responders to see recent care notes from treating providers – including hospital discharge summaries and the Consolidated Clinical Documents (CCDs).

As PULSE is being developed, we have tried to ensure that it can be a model for other states to use. To support future scalability, PULSE is utilizing industry standards when communicating with HIEs and hospitals.

HIStalk Announcements and Requests

Poll respondents are OK with — clinicians with or without formal informatics credentials — calling themselves “informaticists” and are equally accepting of non-clinicians who have earned a graduate degree in informatics, but draw the line at a non-clinicians whose only credential is work experience. Harry suggests calling technically focused people “informaticists” and those specializing in clinical applications and user experience “informaticians.” Kelley says a challenge in public health is separating informatics from IT.

New poll to your right or here: What is the primary reason hospitals don’t exchange patient information freely?

This Week in Health IT History

One year ago:

• CMS offers providers four “pick your pace” Quality Payment Program options for 2017.
• St. Jude Medical sues a medical security services vendor, claiming its pacemaker vulnerability testing was not only improperly performed, but also part of stock short-selling scheme.
• Apple announces the iPhone 7.
• In England, NHS announces a digital exemplar grant program for trusts.

Five years ago:

• Merge Healthcare hires an investment bank to review strategic alternatives.
• Vocera announces its public offering.
• Harris Corporation investigates potential US bribery law violations by its Carefx China division, whose employees were found to have provided gifts and payments to prospects.
• A computer hacker in Italy shares his brain cancer-related medical records on the Internet in seeking help in a project he calls “My Open Source Cure.”

Ten years ago:

• Ingenix acquires Healthia Consulting.
• Athenahealth prices its IPO.
• Allscripts announces its largest EHR sale in its history to Columbia University Medical Center.
• A UK hospital blocks employee access to Facebook after heavy use degrades its network performance.
• Health Evolution Partners, started by former National Coordinator David Brailer, MD, PhD, begins its search for investments.

Last Week’s Most Interesting News

• FDA announces a voluntary recall of St. Jude Medical pacemakers to install a firmware update to fix cybersecurity vulnerabilities.
• CHIME and DirectTrust announce plans to promote universal deployment of the Direct network.
• Advisory Board announces plans to sell its healthcare business to UnitedHealth Group.
• Texas hospitals struggled with flooding from Hurricane Harvey.

Webinars

September 13 (Wednesday) 1:30 ET. “How Data Democratization Drives Enterprise-wide Clinical Process Improvement.” Sponsored by: LogicStream Health. Presenter: Katy Jones, program director of clinical support, Providence Health & Services. Providence is demonstrating positive measurable results in quality, outcomes, and efficiency by implementing clinical process improvement solutions in arming operational and clinical stakeholders with unlocked EHR data. Providence’s army of process engineers use their self-service access to answer questions immediately and gain an understanding of how their clinical care delivery is impacting outcomes. The presenter will describe practical applications that include antibiotic stewardship, hospital-acquired infections, and comprehensive knowledge management.

Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.

Decisions

• Mercy Medical Center (MD) will replace Meditech with Epic.
• Southeast Health Center Of Stoddard County (MO) changed from Medhost to Evident in June 2017.
• Integris Canadian Valley Hospital (OK) replaced Cerner with Epic in May 2017.

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

People

Orion Health hires Terry Macaleer (Anthelio Healthcare Solutions) as president of its US operations.

Henry Mayo Newall Hospital (CA) hires Ray Moss (Cedars-Sinai) as VP/CIO.

Announcements and Implementations

A new Reaction report finds that only one in four cardiology facilities use speech recognition, with far less enthusiasm and effort than their counterparts in radiology, but cardiology use is increasing quickly. Nuance and MModal hold 89 percent of that market.

Cerner and its customer HealthSouth will work together to develop tools to manage post-acute care patients.

Privacy and Security

A university in Canada loses $12 million to scammers who impersonated an employee of its construction company vendor in requesting that checks be sent to their new address that was actually that of the scammers.

Other

Artificial intelligence researcher Oren Etzioni proposes in a New York Times op-ed piece that AI be regulated in three ways, based on Isaac Asimov’s 1942 “three laws of robotics”:

• Companies that deploy AI systems must be held accountable for any illegal behavior that results.
• The AI system, such as a chatbot, must disclose that it is not a human in any conversations with humans.
• AI systems must not retain or disclose confidential information they receive, such as background audio recorded by Amazon Echo.

Google’s Verily life sciences company develops a way to predict cardiovascular risk factors by analyzing a person’s retinal image with a machine learning algorithm instead of performing blood tests. The model showed high accuracy in using only the retinal image to predict age, blood pressure, body mass index, gender, and smoking status.

A federal judge certifies as class action a lawsuit covering all Medicare recipients who were hospitalized but categorized by the hospital as observation patients, which means that as outpatients without necessarily knowing it, they pay more for drugs, co-insurance, and nursing home care.

Sponsor Updates

Blog Posts

• Assessing Your Population Health Plan: Start with a Simple Framework (Medecision)

Contacts

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

Morning Headlines 9/1/17

Health IT Now Letter To ONC

An industry group comprised of AMIA, Athenahealth, and others asks ONC to provide guidance around information blocking.

Firmware Update to Address Cybersecurity Vulnerabilities Identified in Abbott’s (formerly St. Jude Medical’s) Implantable Cardiac Pacemakers: FDA Safety Communication

The FDA issues a voluntary recall of St. Jude Medical implantable pacemakers due to cybersecurity vulnerabilities in the devices firmware. The FDA suggests that patients coordinate with care providers to discuss the need to have their firmware updated.

Bipartisan Governors Blueprint

A bipartisan group of eight governors sends a letter to Congress with recommendations on how to stabilize the individual health insurance exchanges.

Limited Waiver of HIPAA Sanctions and Penalties During a Declared Emergency

HHS Secretary Tom Price issues a 72-hour waiver on HIPAA privacy rules for hospitals responding to the aftermath of Hurricane Harvey in Texas and Louisiana.

Regulator Wants Stronger Oversight Of Private Health IT Firm That Gets Public Funds

Vermont’s Green Mountain Care Board, which oversees the state’s medical industry, says the state’s HIE is failing to meet the needs of providers in the state and warns that it will need to improve to justify continued public funding.