Morning Headlines 9/10/18

Notable Health Closes $13.5 Million Series A Financing to Expand Artificial Intelligence Powered Physician-Patient Interaction Platform

Notable Health raises $13.5 million to further develop its physician-patient interaction software delivered via Apple Watch.

Medical Records Co. Reaches $4.9M Deal To Resolve OT Suit

Optimum Healthcare IT settles a class-action lawsuit related to unpaid overtime filed last year by two employees for $4.9 million.

Top cancer researcher didn’t list corporate ties when he published studies

Memorial Sloan Kettering Cancer Center (NY) CMO José Baselga, MD comes under fire after media outlets report he failed to disclose his financial ties to research journals in which he was published.

Monday Morning Update 9/10/18

Top News

Memorial Sloan Kettering Cancer Center (NY) CMO José Baselga, MD comes under fire after media outlets report he failed to disclose his financial ties to research journals in which he was published. Baselga has served on the boards of and performed consulting work for dozens of pharma and healthcare companies, yet has systematically failed to report the millions of dollars in payments received when speaking or writing about sponsored clinical studies.

Adding insult to injury is the fact that Memorial Sloan Kettering has not yet censured Baselga in any way, other than to call for its staff to do a better job of disclosing their corporate relationships.

Baselga’s lapse highlights not only a lack of ethics on his part, but the slippery slope prestigious research publications like The Lancet and New England Journal of Medicine must walk when deciding to publish research. Most rely on an honor system, and for some, it’s simply a matter of not enough background-checking resources to go around. While publications like the American Association for Cancer Research have never barred an author from publishing, many are now reviewing their submission and review processes. 

Reader Comments

From Vaporware: “Re: VA CIO nominee’s remarks on speeding up the Cerner project timeline. Summary: ‘We can do this faster,’ says someone who has never implemented an EHR. ‘You’ll be held accountable,’ says someone who never held anyone accountable. ‘LOL. $10 meeeellion dollars!’ says Zane on his way to the bank.” VA CIO nominee James Gfrerer told a Senate hearing committee last week that getting the Cerner switch flipped in under 10 years is definitely on the table. Nominated by President Trump at the end of July, Gfrerer spent two decades in the Marine Corps before serving as a senior military advisor in the State Department and then moving to E&Y’s cybersecurity practice.

HIStalk Announcements and Requests

The majority of respondents would have no qualms about sharing their medical bills with media outlets in hopes of getting them reduced, though my use of the word “resort” implies that it would be a last-ditch effort after all other avenues have been exhausted. Greg points out that, “If the healthcare organization is not responsive or unwilling to work with me on the bill, the media is one outlet I’d consider reaching out to. Any business should expect what they say to their customers to end up in the news or on TV. With the laws in the US so skewed towards powerful interests, public shame in the media is one of the only options an average person has to fight with.” Lisa admits that it would “definitely not be my first choice, but as a last resort it’s better than bankruptcy. So far, I’ve been able to challenge and remove billing items that are clearly inappropriate, but what do you do if the billing folks refuse to clean up errors?” Mark says he’s “already used that approach and leveraged it effectively. Know your facts, prepare your facts, and share them with others so that all can benefit. When my wife had a hip replacement, without complications, and the net charges were 2x of the local competition, 2.5x what the facility accepts for a Medicare patient, put the the pen and paper (keyboard and email) to the task. Bottom line – fees reduced, perhaps humbled the facility, for a moment.”

New poll to your right or here: Would you purchase a “premium” genetics testing service from at-home kit companies like 23andMe?

Webinars

September 26 (Wednesday) 12:30 ET. “How to Ensure Patient Records are Always Available.” Sponsor: Goliath Technologies. Presenter: Goliath Technologies engineering staff. This webinar will discuss how an early warning system can help your organization ensure your EHR systems and patient records are always available. You’ll also learn how to proactively anticipate, troubleshoot, prevent, and resolve end user experience issues before users or patients are impacted.

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

People

Lisa Johnson (Legacy Health) joins Bluetree’s executive leadership team.

Acquisitions, Funding, Business, and Stock

Quality Systems changes its name to NextGen Healthcare. Quality Systems created NextGen in 2001 through the merger of Clinitec and Micromed.

Notable Health raises $13.5 million to further develop its physician-patient interaction software delivered via Apple Watch.

Optimum Healthcare IT settles a class-action lawsuit related to unpaid overtime filed last year by two employees for $4.9 million plus $1.6 million in legal fees.

Healthcare Growth Partners recaps investment activity over the last year in RCM markets that include patient financial responsibility, complex claims from non-traditional payers, and coding and claims as they relate to connecting providers and payers.

Sales

• University of Louisville Hospital and Physicians (KY) select Health Catalyst’s Data Operating System and outcomes improvement professional services.
• Conway Regional Medical Center (AR) chooses post-discharge automated messaging software from CipherHealth.

Announcements and Implementations

Personalized cancer treatment company Driver develops an app that offers patients treatment options and follow-up care within its network of 30 cancer centers. The membership-based service includes medical record and tumor sample collection, appointment scheduling, and virtual consults.

OnlyBoth adds hospital performance to its line of consumer-friendly healthcare comparison websites.

Ciox Health announces GA of HealthSource, AI-powered software that locates, acquires, digitizes, and manages health data.

Nuance makes voice-enabled Dragon Medical workflows available through Epic’s mobile Rover documentation and barcode validation app.

Mobile Heartbeat develops a new user interface for its MH-Cure care team messaging software.

A new KLAS report on patient financial access finds that AccuReg ranks highest in customer satisfaction across categories, while Experian Health sees similar rankings from broad adopters. Recondo Technology leads the way in automated preauthorizations, but lags other vendors when it comes to customer perception of its positive impact on patients, staff, and billing. Experian Health’s customers, however, are the most likely to share patient access success stories. Change Healthcare wound up being the only vendor whose customers have all realized the benefit patient access solutions have on back-end billing.

Privacy and Security

British Airways suffers another privacy black eye after hackers breach its website and app, compromising personal and financial information tied to 380,000 passenger transactions. The airline came under fire in July when its social media team asked passengers with service complaints to post personally identifiable information on Twitter to help resolve their issues, claiming it was necessary to comply with GDPR. 

HITRUST introduces a Shared Responsibility Program to help organizations and their service providers clearly understand their roles regarding ownership and operation of security controls.

Other

CNBC survey-takers believe controlling costs to be the top reason companies like Apple and Facebook are bypassing third parties like Premise Health to set up on-site clinics for their employees.

Sponsor Updates

• LiveProcess will exhibit at the SONAR Safety Healthcare Conference September 14 in North Platte, NE.
• MDLive will present at the Healthcare Analytics Summit September 13 in Salt Lake City.
• Waystar will exhibit at the Mediware Conference September 10-12 in San Antonio.
• Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the AWHONN Ohio Section Conference September 13-14 in Sandusky.
• OmniSys will exhibit at the PDX Pharmacy Forum September 16-18 in Fort Worth, TX.
• Experian Health will exhibit at AAHAM MD September 11-13 in Ocean City, MD.
• Sunquest will exhibit at Precision Medicine for Hospital CEOs September 12-13 in Nashville.
• Visage Imaging will exhibit at the SIIM Conference on Machine Intelligence and Medical Imaging September 9-10 in San Francisco.
• Philips Wellcentive publishes a new white paper, “How rising risk impacts value-based care.”
• Voalte will exhibit at the Texas Health Association 2018 Quality and Patient Safety Conference September 13-14 in Georgetown, TX.

Blog Posts

• 5 Ways Healthcare Communication Technology Fosters Staff Connections (LiveProcess)
• Improving care coordination with a transition care center (Meditech)
• 5 Considerations When Designing Software for Clinicians (Mobile Heartbeat)
• Arming front desk staff with the tools for success (Waystar)
• Electronic Visit Verification (EVV) Requirements on the Horizon (Netsmart)
• Why secure messaging isn’t enough (PerfectServe)
• If It Ain’t Broke … Do You Need to Fix It? (CloudWave)
• Healthcare administration revolutionized (Experian Health)
• Thumbs Up: The Surprising Link Between Patient Satisfaction and Revenue Cycle (Patientco)
• 2019 is about Efficiency, Opportunity and Execution – Start Planning Now (Pivot Point Consulting)
• Contemporary Job Description for the Future of HR (ROI Healthcare Solutions)
• Founder Letter: Is Insurance Really the Enemy? (WebPT)
• Electronic Validation Saves Manual Steps in Emergency Medicine Billing to Help Providers Get Paid Faster (Lightspeed Technology)

Contacts

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

Weekender 9/7/18

Weekly News Recap

• Athenahealth prepares to take second-round bids as inside sources report that Cerner and UnitedHealthcare have passed on buying the EHR vendor.
• Theranos tells shareholders it will dissolve and will work to pay off its creditors with remaining cash on hand.
• Atul Gawande, MD taps former Comcast digital health GM Jack Stoddard to be COO of the still unnamed joint healthcare venture of Amazon, Berkshire Hathaway, and JPMorgan.
• Verity Health (CA) files for Chapter 11 in an effort to survive the health IT missteps of Patrick Soon-Shiong, MD who acquired the health system in July 2017.
• Tabula Rasa Healthcare acquires EHR vendor Mediture and its third-party administrative services subsidiary EClusive for $22 million.

Best Reader Comments

Methinks the emperor has donned new clothes ~ Argonaut Project -> Da Vinci Project (Clarence)

The travesty of the new normal known as outpatient procedures begins when the patient shows up at the crack of dawn to begin the process and extends through the point where, barely awake from anesthesia, the patient is thrust from curbside wheelchair onto waiting vehicle having been expected to digest postop instructions just reviewed. . . . Reminds me of medical care in a third world hospital where family provides food, bedding and nursing. (Kevin)

Watercooler Talk Tidbits

Readers funded the DonorsChoose teacher grant request of Ms. M in North Carolina, who asked for STEM craft materials related to the Winter Olympics and flexible floor seats. She says, "Students were excited when they opened the boxes and saw all the materials that our classroom received. They wanted to use the flexible seating right away. They also wanted to start on our Olympic projects right away and couldn’t wait until the next today to come to school. We have set up a rotation schedule for students to use the flexible seating. Our next step for using the materials is to create bobsleds that the students can race. We are always creating STEM projects in our classroom that connect to our math and science standards."

Nestle attempts to pivot from a peddler of sugary treats to the frontrunner in nutritional wellness with its Wellness Ambassador program. Initially rolled out in Japan, participants send pictures of their food via an app that then recommends special supplements and lifestyle adjustments. The program also offers a home DNA and blood testing kit to give users a more in-depth health and wellness workup. Campbell Soup made a similar move when it acquired Habit, a meal delivery service that combines DNA and blood profiles to make dietary recommendations.

Road warriors beware: Scientists determine that luggage trays at airport security checkpoints harbor more cold viruses than do any other areas within the facility, including toilets. It’s a timely observation given the spate of news this week pertaining to flights with sick passengers. A New York-bound flight from Dubai was quarantined after 100 people on board complained of feeling ill. Public health officials tested all 549 people on board for MERS; none tested positive for the syndrome, though nearly a dozen were sent to the hospital with flu-like symptoms.

CMS mistakenly sends Medicare termination letters to 38,000 Blue Cross and Blue Shield of Minnesota beneficiaries, blaming the mix up on bad data from the health plan.

IBM is developing a drone that, when paired with a companion app, could monitor a user’s health data to determine if they’d benefit from a cup of coffee, which it would then deliver.

In Case You Missed It

• News 9/7/18
• EPtalk by Dr. Jayne 9/6/18
• News 9/5/18
• Curbside Consult with Dr. Jayne 9/3/18
• Monday Morning Update 9/3/18

Get Involved

• Join my Rolodex to provide occasional news reaction or ideas
• Contribute regularly as a provider CIO, IT director, or informatics nurse (anonymous or not)
• Be interviewed (providers)
• Deliver an educational webinar (providers)
• Sponsor
• Report a news item or rumor (anonymous or not)
• Sign up for email updates
• Connect on LinkedIn
• Contact Mr. H

Morning Headlines 9/7/18

23andMe is gauging interest in a $749 ‘premium’ service that would offer deeper health data

Home DNA testing kit company 23andMe revisits the idea of rolling out a premium service for more in-depth genetic sequencing.

Cerner and UnitedHealth pass on athenahealth; shares down 1%

Athenahealth prepares to take second-round bids as inside sources report that Cerner and UnitedHealthcare have passed on buying the EHR vendor.

Da Vinci Project to Advance Value-based Care through the Use of HL7® Data-sharing Resources

Providers, payers, and vendors like Epic, Cerner, and Allscripts pledge their allegiance alongside HL7 to The Da Vinci Project, an initiative that will work to improve data sharing in value-based care using FHIR standards.

Meditation app Headspace bets on voice and AI with Alpine.AI acquisition

Headspace acquires digital voice assistant development company Alpine.AI to add more vocal interaction to its flagship meditation app.

News 9/7/18

Top News

Theranos investigative reporter John Carreyrou breaks the news that the scandal-ridden blood-testing company will dissolve. CEO David Taylor, who took over from founder Elizabeth Holmes after she resigned in June amid criminal allegations, told shareholders that time had run out to find a buyer for the company before it defaulted on a $100 million loan from Fortress Investment Group.

Fortress co-founder Wes Edens has a history of making counterintuitive investments that include $3 billion towards a private rail line in Florida, and stakes in struggling sports teams like the NBA’s Milwaukee Bucks and English football club Aston Villa. Fortress will likely walk away from the deal with a handful of presumably worthless Theranos patents – assuming it can help the company pay off the $60 million it owes to other creditors. The company has just $5 million cash in hand.

Webinars

September 26 (Wednesday) 12:30 ET. “How to Ensure Patient Records are Always Available.” Sponsor: Goliath Technologies. Presenter: Goliath Technologies engineering staff. This webinar will discuss how an early warning system can help your organization ensure your EHR systems and patient records are always available. You’ll also learn how to proactively anticipate, troubleshoot, prevent, and resolve end user experience issues before users or patients are impacted.

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

Acquisitions, Funding, Business, and Stock

Home DNA testing kit company 23andMe revisits the idea of rolling out a premium service for more in-depth genetic sequencing. The company, which toyed with the idea in 2016, has hinted at a $750 price tag, putting it several hundred dollars below the offerings of whole genome sequencing competitors like Veritas Genetics.

Mount Sinai Health System spinoff Rx.Health raises $1.8 million. The New York-based startup has developed software that gives providers the ability to prescribe apps and other digital health tools from within their EHRs.

The US patent office awards Glytec two patents describing interactions between its insulin titration software and connected diabetes technologies related to blood glucose measurement, insulin delivery, and patient messaging.

Tech-enabled kidney care company Cricket Health raises $24 million in a Series A round led by Oak HC/FT.

Athenahealth prepares to take second-round bids as inside sources report that Cerner and UnitedHealthcare have passed on buying the EHR vendor. Elliott Management has teamed up with Bain Capital, which owns Waystar, to remain a contender. Ousted CEO and company co-founder Jonathan Bush stands to gain $4.8 million if the company is sold.

Headspace acquires digital voice assistant development company Alpine.AI to add more vocal interaction to its flagship meditation app.

Catholic Health Initiatives (CO), HCA Healthcare (TN), Intermountain Healthcare (UT), Mayo Clinic (MN), Providence St. Joseph Health (WA), SSM Health (MO), and Trinity Health (MI) band together to form a nonprofit generic drug company called Civica Rx. Led by former Amgen executive Martin VanTrieste, Civica will initially focus on the production of 14 generics that the founding health systems have committed to purchasing. VanTrieste has said he will forego a salary, and expects Civica’s first drugs to be on the market by 2019.

After being acquired by Midmark in 2016, Versus Technology officially rebrands to Midmark RTLS.

People

New Jersey Hospital Association SVP Sean Hopkins will lead the association’s new Center for Health Analytics, Research and Transformation.

Jesus Delgado joins the Community Foundation of Northwest Indiana, parent company of Community Healthcare System, as CIO and VP of IT.

Cambia Health Solutions hires Faraz Shafiq (Verizon) as chief artificial intelligence officer.

Sales

• University Hospitals (OH) selects Jvion’s Cognitive Machine software to better prevent sepsis.
• Western Connecticut Medical Group chooses patient engagement consulting services and technology from Formativ Health.
• Pharmacy benefit management company EmpiRx Health selects ZeOmega’s Jiva 6.1 population health management technology.
• Johns Hopkins Medicine (MD) will use Patient Flow Optimization software from MidMark RTLS at its Sidney Kimmel Comprehensive Cancer Center.
• Hartford HealthCare (CT) will implement ESO’s Health Data Exchange technology for EDs across its six hospitals.

Announcements and Implementations

Vocera develops care team communication analytics in an effort to reduce alert fatigue and improve response times.

Hiawatha Community Hospital (KS) replaces McKesson’s Paragon with Athenahealth.

Government and Politics

Connecticut Governor Dannel Malloy announces the state will use a $12 million grant from CMS to launch an HIE early next year. The state’s first HIE sputtered out in 2014 after a $4 million investment and a four-year run at attempting to develop a reliable revenue stream.

Other

The Open Source Electronic Health Record Alliance will develop a global version of VistA compatible with different languages. The project, dubbed Plan VI, will also create a reference implementation guide.

This analysis finds that 53 percent of hospitals mark up the cost of prescription drugs for patients and payers by between 200 and 400 percent. One in six jack up prices by as much as 700 percent, while one in 12 feel justified raising prices by 1,000 percent.

Providers, payers, and vendors like Epic, Cerner, and Allscripts pledge their allegiance alongside HL7 to The Da Vinci Project, an initiative that will work to improve data sharing in value-based care using FHIR standards. Initial test cases will include workflows for 30-day medication reconciliation and coverage requirements discovery.

Scripps Research Translational Institute and WebMD develop the Healthy Pregnancy Research Program, an ongoing study leveraging ResearchKit data-capture capabilities within the WebMD pregnancy app. Researchers hope that the predominantly passive collection of pregnancy data will inform future studies geared towards reducing maternal death rates, give women a better understanding of their pregnancies, and arm them with more data to share with their providers.

In North Carolina, Broughton Hospital’s opening day is finally in sight. Construction on the $130 million facility began seven years ago, suffering numerous setbacks due to weather, ongoing litigation with the contractor, and bureaucratic mismanagement along the way. The hospital will be paper-based once it opens in March 2019, despite being billed as “state of the art.”

A survey of CMIOs on medication management initiatives finds that varying departmental workflows and a lack of process buy-in, compliance, and ownership are top areas of patient safety concern. Incomplete medication histories and the misinformed care team decisions that result are also top issues, as is a lack of pricing transparency that often results in patients forgoing medication.

A Healthgrades study shows that consumers are twice as likely to visit a doctor when they can access a physician search tool from within a prescription drug company’s website.

Sponsor Updates

• Compression therapy product manufacturer Absolute Medical selects FormFast’s Connect digital forms solution.
• Carilion Clinic (VA) renews its agreement with LogicStream Health for its clinical process improvement and control software.
• NextGen Healthcare adds electronic prior authorization capabilities from CoverMyMeds to its cloud-based Office EHR.
• Healthfinch will exhibit at the Healthcare Analytics Summit September 11-13 in Salt Lake City.
• Imprivata will present at the Massachusetts Health Data Consortium’s meeting on September 12 in Waltham.
• Influence Health CEO Rupen Patel speaks to the Metro Atlanta CEO about the company’s consumer experience platform.
• Meditech dedicates September to sepsis awareness.

Blog Posts

• Trouble Ahead: The Unintended Consequences of the Proposed E/M Changes (Hayes Management Consulting)
• Notes from the Road: 4 Stops and Our First KLAS Rating (HBI Solutions)
• 4 Best Practices for Securing EHR Data in a Consumer-Centric World (The HCI Group)
• The Coming Convergence of Healthcare and Financial Services: Patient-Centered Financial Engagement (Loyale Healthcare)
• Scottsdale Institute CIO Summit Examines Technology Innovations in Healthcare (Impact Advisors)
• How to improve patient care starting at registration (Imprivata)
• IT’s New Role in Content-Driven Healthcare (Influence Health)
• How to become an EHR consultant (Nordic)
• Most Heroes Don’t Wear Capes: How 4 Hospitals Improve Patient Outcomes With Spok (Spok)

Contacts

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

EPtalk by Dr. Jayne 9/6/18

Part of being a clinical informaticist is understanding how to lead organizations through change, especially complex and transformative change. Culture is a big piece of that, and I’m often amazed at the disparities in culture among organizations that feel they are high-performing. I see entirely too many people who are burned out from lack of work-life balance, and who feel that they need to be constantly connected in order to stay afloat at work. It used to be that the after-hours email crew was either trying to get ahead or using remote work strategies to accommodate a flexible work schedule, but now it seems to be the status quo. I see a lot of parents missing out on their children’s activities because, although they are physically present, their thoughts (and eyes) are turned to laptops and phones. I’m sympathetic to the parent who is camped out at a four-hour track meet to watch their child run a  10-minute race, but I’ve also seen parents spend an entire event working email, not seeing their child participate.

The New York Times ran a piece that covered the idea of employees working during their commutes. According to researchers, half of workers addressed work email or documents as they commuted. One researcher commented that those studied “didn’t see it as official work time, but something to make their lives easier.” The piece goes on to detail efforts in other countries, such as France and Norway, to either limit the length of the work week or to allow employees to count their commutes as working time due to being under the relative control of their employers during those hours. A recent court case in France addressed after-hours, on-call compensation. My observations from not only the healthcare provider side but also the vendor side are that many workers are required to be “on-call” nearly 24×7 without any additional pay. Since they’re classified as “exempt” employees, there is no overtime, and no limit to the work they can be expected to do. The only protections for those workers is for them to vote with their feet.

The comments on the piece are worth a read, with some making the point that workers are forced to be available at all hours and others pointing out the amount of time that workers spend surfing the Web and doing non-work tasks during the traditional work day. One commenter noted the number of people who are expected to be on conference calls while commuting, and I’ve definitely seen an uptick in that. People are trying to take calls from the train (sometimes in the quiet car) and even on planes, using VOIP to try to connect when they’re in the air. There were several negative comments directed towards those seeking work-life balance, one trying to make the point that working email isn’t “work” and insinuating that family leave or bereavement days are an indulgence. They do paint a compelling picture that many employees feel their workplace culture is broken – and although I see companies paying lip service to the idea of work-life balance, they don’t always make good on their stated intentions.

In many situations, rendering providers aren’t paid overtime – even when we do shift-work such as in the emergency department or as a hospitalist, we’re expected to spend whatever time is needed to wrap up patient care or complete documentation after our scheduled hours end. In my hospital career, I was never paid past my scheduled shift even though I spent many hours in the ED getting patients transferred to other units, writing incident reports, or handling other tasks that couldn’t be done while I was actually seeing patients. My current organization has wrestled with this for the last several years, and recently agreed to pay physicians for the hours actually worked, even though it’s not overtime per se. Physician Assistants and Nurse Practitioners were already paid for actual hours worked, but physicians were only paid based on their scheduled shifts. It’s not a perfect solution – the physician has to work at least half an hour past his or her scheduled end time before the extra payment provision goes into effect, and we’re only paid as long as patients are physically in the building, not for any resulting documentation or follow-up. Still, it’s gone a long way towards physician satisfaction, especially when you have patients walking in the door as the staff is trying to lock it.

When I’m wearing my clinician hat, I don’t ever have to worry about not hitting my daily step goal. As healthcare IT workers, though, we have known for a long time that our sedentary lifestyles place us at risk for unhealthy outcomes. Now the World Health Organization has issued a report showing that there has been little progress in getting people to be more active. WHO estimates that more than 25 percent of people worldwide don’t get enough activity on a daily basis. That’s approximately 1.4 billion people and the percentage hasn’t changed much in the 15 years where data was available. Not surprisingly, high-income countries were more sedentary. The UK and USA had inactivity percentages that increased from 32 to 37 percent, where low-income countries stayed steady at 16 percent. Inactivity was defined as less than 150 minutes of moderate exercise (or 75 minutes of vigorous exercise) weekly. The authors noted decreased exercise in women compared to men for most countries, which they attribute to cultural factors and family responsibilities (such as child care) that reduce the time available for exercise. Other factors impacting activity include sedentary jobs, use of motorized transportation, and sedentary hobbies.

I’ve made a conscious effort to try to be more active even when I work from home. I’ve got my printer on another floor of the house, which forces me to get up if I need to get documents, and I make a point of going to the kitchen when I need a drink rather than always keeping something on my desk. I intentionally park far from the door when I go shopping, and I’m hoping that those little factors add up. I also hit the treadmill when I’m on a listen-only conference call or attending an educational presentation, so that helps not only with cardiovascular fitness but with avoiding somnolence during certain presentations. I really logged the miles when I was listening to quarterly earnings calls and recordings of the ones I couldn’t attend in real time.

What’s your favorite strategy for increasing activity? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 9/6/18

Blood-Testing Firm Theranos to Dissolve

Theranos tells shareholders it will dissolve and will work to pay off its creditors with remaining cash on hand.

Cricket Health Announces $24 Million Series A Funding Round to Provide Personalized, Cost-Effective Kidney Care

Tech-enabled kidney care company Cricket Health raises $24 million.

Plan VI – OSEHRA Launching Internationalized Version of VistA

The Open Source Electronic Health Record Alliance will develop a global version of VistA compatible with different languages.

Morning Headlines 9/5/18

The Amazon-Berkshire-JPM health venture led by Atul Gawande has a COO: Jack Stoddard

Atul Gawande, MD taps former Comcast digital health GM Jack Stoddard to be COO of the still unnamed joint healthcare venture of Amazon, Berkshire Hathaway, and JPMorgan.

TRHC Acquires Mediture and eClusive

Medication risk management vendor Tabula Rasa Healthcare acquires EHR vendor Mediture and its third-party administrative services subsidiary EClusive for $22 million.

Persistent Systems Acquires Alum of 1st PULSE@MassChallenge Cohort Herald Health

Global technology services company Persistent Systems acquires Herald Health for $5.2 million.

News 9/5/18

Top News

Atul Gawande, MD taps Jack Stoddard to be COO of the still unnamed joint healthcare venture of Amazon, Berkshire Hathaway, and JPMorgan. Stoddard was formerly general manager of digital health at Comcast, where he devoted some of his time to developing digital patient engagement and education tools for a (presumably defunct) program with Independence Blue Cross. Stoddard’s time in the healthcare trenches also includes stints at Comcast-backed Accolade and Optum.

Reader Comments

From Savoy Special: “Re: Medhost’s customer count. Down to 180 hospitals? That number cannot be correct since they still have their platform in most of the 119 CHS hospitals, plus a large number of LifePoint, Acadia, and Select hospitals. Plus they recently won a multi-entity deal at the end of last year. And then there is all of their EDIS business. The Curae bankruptcy was not unexpected. There was actually a lot of buzz about Medhost at Health:Further18.”

Webinars

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

Acquisitions, Funding, Business, and Stock

Global technology services company Persistent Systems acquires Herald Health for $5.2 million. Herald’s software helps surface relevant EHR data in real time across hospital departments. The Boston-based startup came out of Brigham and Women’s Hospital (MA), which, through its Partners HealthCare network, tapped Persistent last year to develop a SMART on FHIR digital platform for sharing best clinical practices.

Redox raises $3 million, bringing its total raised to $18 million since launching in 2014.

Medication risk management vendor Tabula Rasa Healthcare acquires EHR vendor Mediture and its third-party administrative services subsidiary EClusive for $22 million. Both cater to Program of All-inclusive Care for the Elderly markets. The businesses will be incorporated into Tabula Rasa’s new PACE-focused CareVention HealthCare technology and services division.

Following in Apple’s footsteps, Amazon momentarily hits the $1 trillion mark during day trading, focusing analyst’s eyes even more eagerly on its push into healthcare. The Internet retailer went public in 1997 at $18 a share, a figure that has skyrocketed to $2,050 and made founder and CEO Jeff Bezos the world’s richest man with a net worth of $167 billion.

People

Patrick McGill (Community Health Network) will join primary care management company Primaria Health as CEO in December.

Announcements and Implementations

Greenville Health System (SC) goes live on Agfa Healthcare’s enterprise imaging system.

The Brooklyn Hospital Center (NY) implements Epic at its ambulatory sites.

Other

Following on-campus protests and obvious malcontent amongst its staff, Providence Hospital management fires the majority of its Board of Directors via email after tensions mount around parent organization Ascension’s decision to stop offering acute care services at the hospital by the end of year as part of its transition to a “health village.” (It announced it would close its obstetrics and behavioral health departments last August.) A former board member claims a vote on the acute-care decision was snuck in at the end of a regular meeting, after several other members had already left. Ascension claims the shuttering will better enable Providence to focus on “care coordination, telehealth/virtual care, primary and urgent care, home care, community-based behavioral healthcare, senior care, and more.”

In Australia, Victoria’s Dept. of Health and Human Services begins migrating 12,000 users from Lotus Notes to Office 365. Lotus Notes was first implemented in 1998, making the number of applications that have been spawned around it too numerous to die a quick death.

Researchers develop an iPhone app capable of measuring blood pressure with the press of a finger. Readings were found to be similar to those from traditional blood pressure cuffs.

The Cincinnati business paper profiles Cincinnati Children’s Hospital surgeon Victor Garcia, MD and the predictive analytics software he has developed with Israeli researchers to stave off shock in ICU patients.

Sponsor Updates

• AdvancedMD publishes a new e-guide, “In or Out-Source: Your Value-Based Care (VBC) Revenue Cycle Management.”
• Aprima will exhibit at the Patient-Centered Medical Home Congress September 14-15 in San Diego.
• Gartner recognizes Arcadia as a representative vendor across five categories in its latest report, “Healthcare Payer CIOs, Leverage Vendor Partners to Succeed at Clinical Data Integration.”
• The University of Wisconsin-Madison profiles Bluetree Network founder Ted Gurman’s work with the Madison Entrepreneur Resource, Learning, and Innovation Network.
• Datica will present and exhibit at HITRUST 2018 September 11-13 in Grapevine, TX.
• The Chicago Tribune profiles Burwood Group Senior Director of Sales and Marketing (and Renaissance man) Greg Bueltmann.
• CarePort Health will exhibit at ACMA New York September 8 in New York City.
• Carevive Systems will exhibit at the 2018 ACS Cancer Programs Annual Conference September 5-7 in Chicago.
• Collective Medical partners with the Hospital Council of Northern and Central California.
• CoverMyMeds will present at the CBI Hub and SPP Model Optimization event September 12-13 in San Diego.
• CTG will present at the Patient-Centered Medical Home Congress September 14-15 in San Diego.
• Cumberland Consulting Group will sponsor the HealthCare Executive Group Annual Forum September 12-14 in Minneapolis.
• The Connecticut Technology Council and Marcum LLP include Diameter Health on their list of the fastest-growing technology companies in Connecticut.
• Yuma Regional Medical Center (AZ) expands its use of Vocera technology to include its entire enterprise.
• Long-time Meditech customer DCH Health System (AL) will implement the company’s Expanse EHR across select hospitals and clinics.

Blog Posts

• Genomic medicine marks a new era for health care. Here are the 3 questions pharmacy leaders should ask – and answers they need. (Advisory Board)
• 3 Reasons Why IT Implementations Fail (Casenet)
• Another Success Story: Crossings’ Insulin Management Advisors (Crossings Healthcare Solutions)
• AHIP CEO Matt Eyles on Value-Based Care and Evolving Healthcare IT (Change Healthcare)
• How Risk Screening Ultimately Reduces Overall Health Costs & Improves Results (ChartLogic)
• Five Takeaways from the Xavier AI Summit (CTG)
• 7 Ways to Make the Most of LinkedIn in 2018 (Direct Consulting Associates)
• 4 Reasons Why You Need to Upgrade Your ERP (Optimum Healthcare IT)

Contacts

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

Curbside Consult with Dr. Jayne 9/3/18

I spent some time this week learning about the patient/family side of the changes that value-based care is bringing us. A close friend of mine had a hip replacement and got to experience the “new normal” in some dimensions of healthcare. He chose a surgeon at one of our local academic medical centers; since he is young (under 40) and otherwise healthy, he was offered the option of an outpatient procedure. As a physician who has been out of the primary care flow for a while, I wasn’t really aware that outpatient hip replacement was even an option. Of course, early ambulation is a good thing, but sending someone home the same day is relatively new.

It’s great to get people out of the hospital early – certainly not being in the hospital is a great protector against hospital-acquired infections. One can also think of the potential for higher-quality sleep at home, without having your vital signs checked or having IV pumps beeping at you. On the other hand, there may be children and pets at home, so quiet time is no guarantee. I’m sure one of the factors influencing a change to outpatient status for many procedures is the sheer cost of days in the hospital. As I learned more about my friend’s arrangements for his post-hospital care, one might begin to think twice about that cost equation. Certainly, there’s a smaller payment to the hospital, but there’s the reciprocal cost of having a spouse or family member take off work for a period of time because someone has to be home with the patient 24×7. Home health, home physical therapy, and other services may be substituted for the inpatient versions, and not having seen a bill for either of those services in a while, I’m not sure how much of a savings it truly is.

There’s also a psychological cost – for most of us used to western-style medicine, there may be comfort in knowing that if something “bad” happens, there are professionals close by. It’s easier to run laboratory tests if new symptoms or side effects develop; if the patient falls, there are trained staffers who know what to do and how to help. At home, there’s that shade of uncertainty about what might happen if things don’t go as planned, such as if the patient begins to run a fever or is having pain that isn’t controlled by the medications available at home. At an academic center there’s typically a “house officer” resident physician who can assess a patient if the nursing staff identifies a potential risk or worsening condition. At home, you have your telephone, and your own ability (or inability) to describe what is going on.

My friend is taking his recovery in stride, although figuratively rather than literally. He quickly figured out how to lash his portable, deep venous thrombosis compression pump to his walker so it didn’t strangle him when he was trying to make his way around the room, and shared his expanded knowledge of Netflix with the rest of us. Can’t Pay? We’ll Take It Away! is an interesting look at rather genteel British repo men and their work. I’m sure we’ll have some laughs when the surgery and home care bills start rolling in – we’ll see how long it takes to get everything paid and reconciled. Depending on how that goes, it might be the most frightening part of the entire procedure. Until then, he’ll have to be entertained by a parade of friends dropping by to sit with him so his family can leave the house, and endless card games playing Uno.

Labor Day Weekend is a fairly low readership environment, so I’ll keep this Curbside Consult brief. Whether you’re barbecuing, visiting with friends, packing away your white shoes, or using the long weekend to catch up, take a minute to remember what Labor Day is all about. It’s been a federal holiday in the US since 1894, and is also celebrated in Canada. Spend a few minutes thinking about the work people do and how much we all need each other to keep things going, especially the folks that are outside the C-suite. Be sure to thank the people in facilities engineering, sterile processing, dietary, custodial, and so many other departments that keep our healthcare world turning.

Email Dr. Jayne.

Morning Headlines 9/3/18

Los Angeles billionaire’s hospital system declares bankruptcy

Verity Health (CA) files for Chapter 11 in an effort to survive the health IT missteps of Patrick Soon-Shiong, MD who acquired the health system in July 2017 with promises of achieving the Triple Aim using Allscripts technology, which he seemed to favor as a company investor.

HCA Healthcare to buy North Carolina’s Mission Health for $1.5 billion

HCA Healthcare buys Mission Health for $1.5 billion and pledges to invest $25 million in an innovation fund for the North Carolina-based system.

You’ll Never Guess Which Company is Reinventing Health Benefits

Comcast invests in companies like Accolade and Grand Rounds to help keep employee deductibles surprisingly low.

Monday Morning Update 9/3/18

Top News

As predicted, California-based Verity Health files for Chapter 11 bankruptcy in an effort to survive the health IT missteps of billionaire Patrick Soon-Shiong, MD who acquired the health system in July 2017 with promises of achieving the Triple Aim using Allscripts technology, which he seemed to favor as a company investor. Implementation efforts have been put on hold as the frustrations of local officials mount. “It has become crystal clear by the bankruptcy announcement that he virtually had no intention of keeping these hospitals open and to continue to serve the poor like the Daughters of Charity [the past owners] did,” says city official David Canepa. “The whole thing seems like one big lie.”

Reader Comments

From Vumcit: “Re: CIO departure at VUMC. Vanderbilt operating revenue down 68 percent after Epic implementation. CIO leaving. Unofficial hiring freeze in place.” It appears CIO Ken Letkeman will be heading to Houston Methodist after overseeing Nashville-based VUMC’s $200 million switch to Epic last November. The hospital’s latest financial statement says that while the drop in revenue was planned for, the implementation caused “muted” procedural volume, though future gains are expected.

From Savoy Special: “Re: Teladoc. Teladoc Rx ordering suffered widespread outage for over 36 hours between 8/29 and 8/31. After hours on the phone with Teladoc getting multiple stories, with the only consistent theme being ‘It’s not us, it’s them’ in a vague reference to a downstream integration or e-prescribing vendor platform doing an upgrade or emergency fix. Messages are flowing in a FIFO manner as of 9 a.m. ET on 8/31.” Unverified. Teladoc uses e-prescribing services from Surescripts.

HIStalk Announcements and Requests

Blockchain’s potential impact on healthcare seems to be minimal at best, which makes me wonder if an emperor-with-no-clothes mentality has swept investors (and other media outlets) off their feet. Clarence says, “The biggest impact is the cost of time and energy spent exploring this fruitless and wasteful expenditure.” Former CIO explains that, “It’s a database, a really slow database. What database has ever impacted cost or quality? When has a slower technology ever improved anything in healthcare?”

New survey to your right or here: Would you resort to sharing your medical bill with the media in hopes of getting it reduced?

Webinars

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

Acquisitions, Funding, Business, and Stock

Virtual care software vendor Zipnosis raises $3 million in a Series B round, bringing its total funding to $22 million.

The New York Times profiles Comcast and the surprisingly savvy investments it has made to keep healthcare costs down for its employees. (Most employees have a $250 deductible.) Through its Comcast Ventures investment arm, the much-maligned cable company has developed financial relationships with startups like Accolade, which helps employees navigate their health benefits; and Grand Rounds, which helps patients find second opinions. Comcast offers their services to its employees, plus virtual care from Doctor on Demand. It’s next admittedly self-serving play is to ensure the financial health of its employees through a startup it has created and funded call Brightside. Accolade co-founder Tom Spann made his debut as CEO of Brightside at the HLTH conference in Las Vegas.

HCA Healthcare buys Mission Health for $1.5 billion and pledges to invest $25 million in an innovation fund for the North Carolina-based system. Coincidentally, HCA is part owner of St. David’s Medical Center in Austin, TX, which slapped patient Drew Calver with a $109,000 bill for heart attack treatment, but then ultimately slashed it to $332 after receiving negative national media coverage it couldn’t “neutralize.”

People

Todd Hoisington (Huron Consulting) joins The Chartis Group as principal and partner.

Announcements and Implementations

Meritus Medical Center (MD) and physician practices go live on Epic.

In Australia, Chris O’Brien Lifehouse implements Meditech’s 6.x oncology and pharmacy software.

Sales

• Mt. Washington Pediatric Hospital (MA) selects Meditech Expanse EHR implementation services from CloudWave.

Other

An interop enthusiast reflects on Epic CEO Judy Faulkner’s UGM comments on the benefits of “One Virtual System Worldwide.”

The integration of new devices for better communication tops the list of call center process-improvement goals, according to Spok’s inaugural survey of 400 providers involved with call-center strategy. Pagers are still going strong as a top communication method for staff, nearly tying with smartphones. Smart watches seem to be high on everyone’s wish list.

Sponsor Updates

• Liaison Technologies releases a new video, “The State of Data Privacy and Security Compliance in Healthcare.”
• LifeImage’s network now connects 1,500 hospitals and has facilitated the exchange of 7 billion image files.
• MedData will exhibit at the Texas MGMA Fall Conference September 6-7 in Houston.
• PatientPing releases a new success story video featuring Karen Yakabowskas of Saint Francis Healthcare Partners.
• Surescripts recognizes nine EHR companies as finalists for the 2018 White Coat Award.
• Vocera will exhibit at the 2018 Kansas Hospital Association Conference and Tradeshow September 6 in Topeka.
• Philips Wellcentive publishes a new case study, “Eastside Health Network overcomes integration challenges.”
• Meditech adds PDMP integration from DrFirst to its Expanse EHR.

Blog Posts

• Mental Health Affects Us All: A Conversation with Jason Hooper of KVC Health Systems (Netsmart)
• Are you caring for your patients’ financial health? (Parallon Technology Solutions)
• Stay in sync with Patient Estimates … (Experian Health)
• Data-Driven Case for Medical eBill Reminders (Patientco)
• Leveraging Telemedicine – Pivot Point Consulting’s Jon Melling Presents at North Carolina HFMA Summer Conference (Pivot Point Consulting)
• It’s time to ditch the fax machine (PreparedHealth)
• Excessive Healthcare Costs Burden Hospitals (The SSI Group)
• How Can I Use My Engine or Scripting for Alerting Specific Activities in My Hospital? (Summit Healthcare)
• Healthcare’s Next Best Action CRM in Population Health: Q&A with Dr. Kirsten Anderson (SymphonyRM)
• Yale New Haven Health Go-Live (Visage Imaging)
• How to Create a Patient Invoice (WebPT)
• Improved ED Wait Times, Advanced Data Reporting, and the Role of Wellsoft EDIS at KHSC (Wellsoft)
• SHIEC Conference Reflections 2018 (Zen Healthcare IT)

Contacts

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

Weekender 8/31/18

Weekly News Recap

• The first FDA-approved digital pill will soon be offered to Medicaid patients in certain markets suffering from schizophrenia and bipolar disorder.
• At Epic UGM, CEO Judy Faulkner sheds more light on the company’s One Virtual System Worldwide initiative, which would give health systems across the globe the ability to share data across a single network.
• Debt-ridden Verity Health System, acquired by Patrick Soon-Shiong last year, will file bankruptcy in the next few weeks thanks in part to poor health IT decision-making.
• Harris Computer Systems acquires Iatric Systems, which it will run as an independent business unit.
• 23andMe will turn off API access to its anonymized data sets, telling developers that they can access company-generated reports but not the underlying data.
• Two key leaders of the VA’s Cerner implementation have turned in their resignations – Chief Medical Officer Ashwini Zenooz, MD and Chief Health Information Officer Genevieve Morris.

Best Reader Comments

The Politico story about Verity Health and Patrick Soon-Shiong is depressing to read, he drove a stake into the heart of that company. I looked back at my comment after the original sale and did a double take at the date, it only took him a year to bring it down. People need to stop agreeing to work with this guy, he’s a con man. (DrM)

Watercooler Talk Tidbits

Readers funded the DonorsChoose teacher grant request of Mrs. H from North Carolina, who asked for a laptop and case for her high school class. She reports, "The laptop you gave my students is helping them in numerous ways. For example, we used it when they were learning about permeability and porosity. They were able to research ideas about what they were observing and then post their results and comments on Google classroom to share with other students. We have also taken the laptop on a recent field trip to an aquarium to post comments and pictures about the student’s new discoveries and unique experiences. We made bottle rockets from recycled 2-liter bottles, then went outside and tested their bottle rockets. At that point, the students also created a live data sheet to record hang time, rocket mass, and general weather conditions. The data sheet was then shared online with the entire class. As a result, no paper or time was wasted and everyone could give positive feedback. Thank you for your generosity in helping my students to use technology in learning and doing real science!"

Indiana University Health updates its dress code, giving staff the option to display tattoos, sport non-natural hair dye, and even choose their own socks. (Tongue piercings are still verboten.) The hospital decided to make the changes in an effort to encourage employees to be themselves while still maintaining a professional image. “We knew that many of our caregivers had tattoos that they were hiding and that just didn’t feel genuine to us,” says Chief Nurse Executive Michelle Janney, RN. “Actually what we’re saying is use good judgment and we trust you.”  

Cerner co-founder Cliff Illig and members of the late Cerner co-founder Neal Patterson’s family attend a ribbon-cutting for Neal Patterson Stadium, Oklahoma State University’s renovated soccer venue. Patterson, an OSU graduate, donated $10 million to the stadium’s renovations before he passed away last year. Patterson and Illig seem to be big soccer fans, having bought the Sporting Kansas City football club in 2006.

In Missouri, Burwood Group Senior Account Executive and cover band lead singer Stephanie Varone experiences a homecoming of sorts when she returns to Kauffman Stadium – home of the Kansas City Royals – to sing the national anthem. Varone first sang the anthem there 31 years ago, and has performed for similar crowds at Wrigley Field and Fenway Park.

In Case You Missed It

• News 8/31/18
• EPtalk by Dr. Jayne 8/30/18
• News 8/29/18
• Curbside Consult with Dr. Jayne 8/27/18
• HIStalk Interviews Mike Linnert, CEO, SymphonyRM
• Monday Morning Update 8/27/18

Get Involved

• Join my Rolodex to provide occasional news reaction or ideas
• Contribute regularly as a provider CIO, IT director, or informatics nurse (anonymous or not)
• Be interviewed (providers)
• Deliver an educational webinar (providers)
• Sponsor
• Report a news item or rumor (anonymous or not)
• Sign up for email updates
• Connect on LinkedIn
• Contact Mr. H

Morning Headlines 8/31/18

Otsuka Announces First Collaboration Agreement to Bring the ABILIFY MYCITE® System to the US Market

The first FDA-approved digital pill will soon be offered to Medicaid patients in certain markets suffering from schizophrenia and bipolar disorder.

Philips acquires Air Force technology for mobile patient monitoring

Philips Healthcare acquires patient monitoring technology from the US Air Force, with an eye towards further developing it for civilian telemedicine uses.

Centra launching new electronic health record system, anticipating increased wait times

Centra Health (VA) will go live on Cerner at each of its hospitals and 50 ambulatory and long-term care facilities September 1.

News 8/31/18

Top News

The first FDA-approved digital pill will soon be offered to Medicaid patients in certain markets suffering from schizophrenia and bipolar disorder. The Abilify MyCite regimen, which will come with a monthly price tag of $1,650, includes a sensor-embedded pill, wearable sensor, user app, and provider portal. Manufactured by Otsuka America Pharmaceutical, the pill is a digital version of the 16 year-old antipsychotic drug Abilify, which is now available as a generic for $700 a month.

Reader Comments

From CB: “Re: Curae and Medhost. Remember that Curae-Medhost deal earlier this year? Curae has filed for Chapter 11 after incurring ‘higher-than-expected costs for electronic health records.’ Rumor is Medhost is down from a high of 450 clients to less than 180.” Rural healthcare operating company Curae Health actually signed on with Medhost last September at two of its hospitals. Curae filed for bankruptcy earlier this week, citing an inability to pay vendors in a timely manner. Medhost insiders are welcome to comment on the unverified client count.

Webinars

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

Acquisitions, Funding, Business, and Stock

The US Patent & Trademark Office grants health data integration company Redox a patent for digitally translating messages between providers and vendors for smoother data exchange.

Workforce management and analytics software vendor API Healthcare will move from GE Healthcare’s campus in Wauwatosa, WI to its former headquarters in nearby Hartford. GE sold off API, along with its enterprise financial and ambulatory care management units, to Veritas Capital in July for $1 billion.

Malvern, PA-based FluidEdge Consulting receives a strategic investment from CitiusTech.

The USPTO issues Monarch Medical Technologies a patent related to providing patient-specific insulin dosing recommendations for its EndoTool Glucose Management System.

Philips Healthcare acquires patient monitoring technology from the US Air Force. The Battlefield Assisted Trauma Distributed Observation Kit was designed to help medics monitor casualties in the field via smartphone or tablet. Philips plans to further develop the technology, with an eye on telemedicine offerings for civilians.

Berkshire Hathaway CEO Warren Buffett tells Bloomberg that Atul Gawande, MD is hiring for unnamed positions within Berkshire’s joint healthcare venture with Amazon and JPMorgan Chase. Buffet added that the venture, of which Gawande has been CEO since early July, is in no hurry to upend healthcare. “We’d like to be in a hurry,” he added, “but we’re not going to try and do something faster than it can be done.”

Chicago-based Tempus raises $110 million in a Series E round that brings its total funding to $320 million and valuation to $2 billion. The oncology-focused precision medicine company was started in 2015 by Groupon co-founder Eric Lefkofsky, who plans to use the investment to expand its focus to cardiovascular disease and diabetes, and its reach to foreign markets.

People

Nashville General Hospital names Eric Stephens (Vanderbilt University Medical Center) chief analytics officer.

Jim Clifford (Philips Wellcentive) joins Rimidi as VP of strategic sales.

Sales

• Woman’s Hospital (LA) selects Health Catalyst’s Data Operating System.
• Oregon Health and Science University chooses Passport electronic forms from Access for surgical consents and safe opioid agreements.

Announcements and Implementations

UMass Memorial Medical Center (MA) implements real-time patient messaging software from HealthLoop to better support total joint surgery patients.

Definitive Healthcare announces GA of commercial medical claims data on 210 million de-identified patients.

In the UK, Great Ormond Street Hospital deploys Elsevier’s Arezzo clinical pathways software in its endocrinology and metabolic unit.

First announced in April 2016, Centra Health (VA) will go live on Cerner at each of its hospitals and 50 ambulatory and long-term care facilities September 1. Four hundred Cerner trainers will be on site to help with the culmination of what has been dubbed “Project Unison.”

Government and Politics

VA Secretary Robert Wilkie tells American Legion national convention attendees that customer service will be a top priority within the agency, as will transitioning to Cerner and working with the DoD to help patients navigate from active-duty to veteran status. He stressed that no veteran should have to endure what his father, Army Lt. Col. Robert Leon Wilkie Sr., went through when he carried 800 pages of medical records to VA appointments.

Other

Epic’s annual user group meeting brings an influx of end users and staff to company headquarters in Verona, WI. Locals bemoaned the crowds (made worse by the University of Wisconsin at Madison’s move-in week and exceptional rains), while conference-goers griped about the lack of an agreed-upon hashtag. CEO Judy Faulkner made her typical opening remarks, with even the local press picking up on her vision for a global health data sharing network. A few images from the event:

Weird News Andy says this California couple’s first kiss was definitely one to remember: Max Montgomery suffered a heart attack and collapsed on the beach during his first date with anesthesiologist Andrea Traynor, MD who quickly administered CPR. EMTs revived Montgomery in the ambulance and admitted him to the hospital for bypass surgery. The couple – and Montgomery’s heart – are still going strong 10 months later.

Sponsor Updates

• EClinicalWorks will exhibit at CASA 2018 September 5-6 in Huntington Beach, CA.
• The Healthcare Business Intelligence 2018 report from KLAS Research gives HBI Solutions an overall score of 91.3 for advanced analytics.
• Iatric Systems will exhibit at HCCA Regional September 7 in Boston.

Blog Posts

• What are MACRA and MIPS? (EClinicalWorks)
• How to Proactively Ensure End Users Always Have VDI Access (Goliath Technologies)
• Deep Cuts: PAMA’s Impact on Clinical Laboratory Reimbursement (Impact Advisors)
• Getting authentication right – considerations for medical device security (Imprivata)
• Can Healthcare Get Better Results from Lead Generation Services? (Influence Health)
• Increasing Patient Involvement: 4 Rules of Engagement (InterSystems)
• Can Technology Save Our Healthcare Payment System? (Loyale Healthcare)
• Beyond the Call: Messaging with Patients in Health Care (PMD)
• What the proposed 2019 MACRA changes mean for you (Meditech)
• Care in Motion: 5 Benefits of Healthcare-Grade Mobile Devices (Spok)
• Rethinking Your HCAHPS Score Strategy: Part 2 (Access)

Contacts

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

EPtalk by Dr. Jayne 8/30/18

Thousands of health system leaders have descended on Epic’s headquarters this week for its annual Users Group Meeting. I’m even more curious about the upcoming, first-annual, Un-Users Group Meeting, slated for September and specifically inviting groups that don’t use Epic. The meeting is designed to review options for connecting with Epic-using facilities and for attendees to understand patient-driven mechanisms of data sharing. The Epic-using hospitals in my area have zero interest in connecting with anyone who isn’t part of their respective systems, so I’m not sure that hearing from the vendor would be that helpful. If you’re in an area where everyone plays nice, registration is $100 and the meeting is only one day, so you might be able to fit it into your schedule.

Speaking of vendor user group meetings, I’ve attended quite a few in my time and beyond the educational and networking components there is typically a bit of fun. As we’re in the swing of the user group season, let’s all take a moment to review an analysis of alcohol consumption and health risk recently published in The Lancet. Although mainstream media has picked this up as a warning that there is no amount of alcohol that is safe to consume, the facts of the analysis need to be considered. Researchers looked at data on alcohol use and the risk of alcohol-related conditions from people in almost 200 countries and used it to create a global risk profile for alcohol. The authors kindly note that they adjusted for tourism and “unreported” consumption, which is an interesting concept to consider.

Not surprisingly, alcohol-related harm was less where no alcohol was consumed, and the risk increased with a rising number of daily drinks from 0 to 15. Because the study used previous data rather than being a new clinical trial, researchers weren’t able to control for other health risks such as smoking or low socioeconomic status. The New York Times brings some sanity to the data in its review of the study. Author Aaron Carroll notes: “Consider that 15 desserts a day would be bad for you. I am sure that I could create a chart showing increasing risk for many diseases from 0 to 15 desserts. This could lead to assertions that “there’s no safe amount of dessert.” But it doesn’t mean you should never, ever eat dessert.” As someone who indulged in a spirit-bolstering piece of gooey butter cake this afternoon, I fully agree. Much appreciation to my Midwest client who introduced me to the delicacy.

HIMSS19 registration is open, and they’ve upped the early bird price by $35 to a base of $825 for HIMSS members. Fees are extra for the Health 2.0 VentureConnect offering and various pre-sessions, receptions, and the SeaWorld event. I registered early so I could check one more thing off my ever-growing “to do” list, and was happy that I had booked my hotel weeks prior because my hotel of choice is already sold out.

I completed my registration while waiting on a conference line for a client who is chronically late. As a consultant, my meter starts running at the scheduled meeting start time, and the client is on the hook for any wasted time. Of course, if a client has an extenuating circumstance I will typically make an exception, but not for a client who does it all the time and has been reminded often about the time she is wasting. While I was productive, the other people waiting on the call engaged in some fairly un-professional, pre-call banter, despite being able to clearly see that an outside person was connected to the Web conference via both audio and video. I’m cool with chit-chat about weather, sports, weekend plans, kids, and what’s for lunch, but complaining about your boss probably isn’t the best thing to do on an open conference line. Especially when your boss hired the consultant who is chuckling to herself while on mute.

A friend clued me in to Paladina Health, which delivers integrated care in a medical home model. Like other offerings, its goal is increasing value while reducing healthcare spending. However, it leads with a high-touch primary care setting –  think concierge medicine as an employee benefit. There’s plenty of technology going on with population health management, risk stratification, and outreach, but the primary physician is empowered to truly build a relationship with the patient, with appointment slots ranging upwards of 30 minutes. Physicians are paid a salary and receive bonuses based on outcomes, patient satisfaction, and cost management. Patients can be seen without paying a co-pay, with the intent of encouraging them to seek care when they need it and not having cost be a barrier. I’m not sure exactly what the physician compensation piece looks like, but it was enough to convince my colleague to leave her part-time, family-friendly position and take on being available to patients 24×7. I’ll add Paladina Health to my watch list and see how they do over the next year or so.

For those of you in healthcare IT who don’t have to deal with the revenue cycle piece, think kindly if you encounter stressed-out colleagues who do. There are so many steps needed with appeals, resubmissions, and more, it’s enough to make someone lose their mind at times. CMS is one of the biggest offenders, although I’m currently working with a client who has several payers that are taking more than 52 weeks to pay, leaving the practice holding the bag. HHS filed a brief this week estimating that it will be able to clear the Medicare claim appeals backlog by Fiscal 2022 – but unfortunately, that’s a year longer than stipulated by a US District Court. The issue goes back to a 2014 lawsuit by the American Hospital Association against HHS, claiming that the Recovery Audit Contractor (RAC) program’s slow appeals process violates the Medicare Act’s 90-day appeals requirement. HHS has long claimed that administrative judges are overwhelmed and it doesn’t have the budget to hire more. There are over 600,000 appeals pending, and it’s expected that the number will be over 950,000 by the end of Fiscal 2021. To solve the problem, HHS plans to use over $180 million in additional funding to hire enough judges and staffers to more than double the number of appeals it can process annually. I’d love to see some provider-side data on what those appeals and delays cost those who are providing care. I’m betting there could be some serious savings if healthcare organizations didn’t have to hire staff to chase their payments.

What’s the longest delay in payment you’ve seen? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 8/30/18

Mississippi hospitals and owner seek bankruptcy, to be sold

Hospital and physician practice operator Curae Health (TN) files for Chapter 11, citing higher-than-expected EHR costs and an inability to pay its vendors (likely including Medhost) in a timely manner as contributing factors.

Groupon Cofounder’s Health Startup Hits $2 Billion Valuation With Latest Funding Round

Oncology-focused data analytics company Tempus raises $110 million, bringing its total raised to over $320 million.

Epic Systems CEO Judy Faulkner shares vision of single global network for patient data

Epic CEO Judy Faulkner sheds more light on the company’s One Virtual System Worldwide initiative, which would give health systems across the globe the ability to share data across a single network.