News 9/22/17

Top News

Politico reports that HHS Secretary Tom Price, MD took five flights on private jets between September 13 and 15 “at a cost of tens of thousands of dollars more than commercial travel.” Price’s destinations included Athenahealth’s MDP event in Maine, the Goodwin Community Health Center in New Hampshire, and the Mirmont Treatment Center in Pennsylvania. Those organizations have confirmed that they did not cover Price’s travel costs. HHS spokeswoman Charmaine Yoest has said that those flights “were important for him to get outside of Washington, DC, talk to real people on the ground, and using the travel arrangements we did was the best way to get him there.”

Other Trump administration officials have come under fire for their lack of fiscally responsible flying. Officials are reviewing travel expenses for Treasury Secretary Steve Mnuchin, who used an Air Force jet to visit Kentucky in August and later requested a military flight for his honeymoon (allegedly for security reasons); and for EPA Administrator Scott Pruitt, who has spent a considerable amount of money on commercial flights to his home in Oklahoma.

Reader Comments

From Dave: “Re: Equifax post-breach customer service. From what I understand, if you go to the Equifax site and sign up for the free credit monitoring that they’re offering, the current terms and conditions that are agreed to by clicking through it, according to an attorney I was told about, say that you are hereby waiving any rights to participate in a class action suit. When the attorney called and asked Equifax about that, they told him not to worry and that it won’t apply in this case. Yet, they haven’t changed it and people are clicking on it. And it’s only there because of this very breach. Sounds fishy to me.”

HIStalk Announcements and Requests

This week on HIStalk Practice: KeyCare will implement I2I Population Health’s PHM technology across 16 community health centers. HRSA earmarks $200 million to help health centers expand mental health and substance abuse services. Bend Medical Clinic hopes to climb out of EHR-related financial troubles with help from Summit Health. Providers react to Jonathan Bush’s burning question. VillageMD launches in Georgia. CMS Innovation Center pursues new direction. Physician burnout becomes a vicious cycle. PRM Pro Jim Higgins emphasizes communication preferences in improving patient retention.

Last call: HIStalk sponsors, submit your MGMA details for inclusion in our annual must-see vendor’s guide over at HIStalk Practice. Companies that are walking the show floor instead of exhibiting are also welcome to submit their information. The guide will publish the week of October 2.

Webinars

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.

November 8 (Wednesday) 1:00 ET. “How Clinically Integrated Networks Can Overcome the Technical Challenges to Data-Sharing.” Sponsored by: Liaison Technologies. Presenters: Dominick Mack, MD executive medical director, Georgia Health Information Technology Extension Center and Georgia Health Connect; director, National Center for Primary Care; and associate professor, Morehouse School of Medicine; and Gary Palgon, VP, healthcare and life sciences solutions, Liaison Technologies. This webinar will describe how Georgia Heath Connect connects clinically integrated networks to hospitals and small and rural practices, helping providers in medically underserved communities meet MACRA requirements by providing technology, technology support, and education that accelerates regulatory compliance and improves outcomes.

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

Acquisitions, Funding, Business, and Stock

Video interpretation and telemedicine company Stratus Video opens a Center of Excellence in Dallas. The company expects to hire 200 employees from the area within the year.

Moffitt Cancer Center’s (FL) informatics subsidiary, M2Gen, will use an undisclosed amount of equity investment from Hearst to expand its cancer research efforts and data-sharing network.

The Dallas News cites unnamed analysts in an article claiming that HCA is a frontrunner to acquire some of Tenet Healthcare’s hospitals.

Sales

Christus Health system (TX) selects Influence Health’s CRM software.

People

Biomedical informaticist Neil Sarkar (Brown University) takes the editorial helm of AMIA’s new JAMIA Open publication.

PeraHealth names LeAnne Hester (Premier) chief commercial officer.

Great Lakes Health Connect Executive Director Doug Dietzman will also lead Making Choices Michigan, a nonprofit focused on advance care planning that became a wholly owned subsidiary of GLHC earlier this month.

Announcements and Implementations

University of Kansas Health System rolls out speech-recognition software and EHR services from Nuance.

Baptist Health Corbin (KY) implements tele-ICU services from Advanced ICU Care.

Technology

Intelligent Contacts develops a service that helps hospital collections staff bypass lengthy hold times when trying to get in touch with payers.

Providers can now access Doximity Dialer from within Epic’s Haiku mobile app. Dialer gives users the ability to call patients from their smart phones with one touch, while guarding the privacy of their personal phone numbers.

Amazon looks to give recently revitalized Google Glass a run for its money with Alexa-enabled smart glasses, the company’s first wearable. Users will be able to hear Alexa courtesy of a wireless bone-conduction audio system, and could wirelessly tether to a smartphone. Google Glass founder Babak Parviz joined Amazon in 2014.

LiveData launches a cloud-based version of its PeriOp Manager technology.

National Decision Support Co. works with Mayo Clinic (MN) to develop a real-time decision-support tool for laboratory testing available within the EHR via the company’s CareSelect software.

ClinicTracker end users gain lab connectivity via EHR integration with Change Healthcare’s Clinical Network. 

Privacy and Security

In its latest monthly update, Protenus reports that healthcare organizations experienced 31 breaches affecting 673,934 patient records – stats in keeping with the preceding seven months. Hackers were responsible for 55 percent of breaches, while insiders racked up 27 percent, pointing to a continued need for cybersecurity training.

Government and Politics

VA Interim Deputy Secretary Scott Blackburn will assume the role of acting CIO when Rob Thomas retires next month. Thomas took on the role in February after CIO LaVerne Council departed with the Obama administration.

The CMS Innovation Center asks for stakeholder feedback as it considers a “new direction to promote patient-centered care and test market-driven reforms that empower beneficiaries as consumers, provide price transparency, increase choices and competition to drive quality, reduce costs, and improve outcomes.” CMS Administrator Seema Verma says in a Wall Street Journal op-ed that the agency will pivot its Innovation Center to offer providers new ways of delivering care, noting that value-based programs have resulted in market consolidation and reduced competition. Comments are due November 20.

Niam Yaraghi, a fellow in the Brookings Institution’s Center for Technology Innovation, argues in a Health Affairs blog that HITECH and HIPAA are as much at fault for the nation’s EHR interoperability problems as the vendors and providers that are being blamed. He recommends enacting policies that would give providers and vendors the option of charging fees for the the exchange of medical data, a move that would “unleash the long-awaited incentives for information exchange in the healthcare industry and open the floodgates of medical data to allow patients to access, manage, and transmit their medical data as easily as their financial data.”

Other

“Where are helicopter parents when you need them?” asks Weird News Andy after learning that doctors in Wales put a two year-old’s cast on the wrong leg. After taking the child back to the clinic a day later, the child’s mother says clinic workers were “making out as if it was my fault for not checking which leg it had been put on at the time. I told them that it wasn’t my duty to be aware of that and point out their mistake.”

WNA shakes his head at the fact that Equifax linked to a fake customer support site that mocked the company’s breach follow-up for several days before realizing its mistake. The company’s Twitter account even got in on the action. Ars Technica reports that a security researcher developed the fake site to emphasize how easy it is to fool people into clicking on links and giving up personal details.

Sponsor Updates

• EClinicalWorks will exhibit at the SFMGMA Annual Healthcare Symposium September 22 in Fort Lauderdale, FL.
• Evariant makes the Marcum Tech Top 40 list of fastest growing technology companies in Connecticut.
• Healthfinch, Imprivata, and Intelligent Medical Objects will exhibit at Epic UGM 2017 September 26-27 in Verona, WI.
• Healthgrades will sponsor and present at Denver Startup Week September 26-27.
• Consulting Magazine includes Impact Advisors on its list of best small firms to work for.
• Kyruus will exhibit at SHSMD Connections September 24-27 in Orlando.
• Inc. profiles NTT Data’s wearable technology relationship with IndyCar driver Tony Kanaan.
• Black Book’s 2017 report ranks ZirMed first for end-to-end RCM for the seventh consecutive year.
• Frost & Sullivan recognizes Sunquest Information Systems for its strides in precision medicine and patient-centered healthcare.
• Forward Health Group will host the Greater Madison Chamber of Commerce – HealthTech Capitol Views & Brews event September 24 in Madison, WI.

Blog Posts

• Top Revenue Cycle Management Issues that Impact Compliance: Patient-Focused Compliance Issues (ECG Management Consultants)
• Grove Medical: Tackling Diabetes with Healthcare IT (EClinicalWorks)
• 3 Tips for Improving Millenial Patient Engagement (Evariant)
• Restoring the Joy in Clinical Practice (Hayes Management Consulting)
• HGP Closes its 100th Transaction! (Healthcare Growth Partners)
• Ignorance, Bliss, and the Zen of Risk Management (Iatric Systems)
• Streamlined Training Reporting During an EHR Implementation (Impact Advisors)
• Five Questions You Should Be Asking About Cybersecurity (Imprivata)
• Making Google Analytics Work for Your Healthcare Organization (Influence Health)
• There are No Cliffs Notes for PoS Payment Device Security in Healthcare (InstaMed)
• Managing Your Brand’s Reputation Across the Web (Kyruus)
• Aim For more: Beyond the Triple Aim in Healthcare (Infor)
• The Importance of Proper Scheduling before an EHR Go-Live (Leidos Health)
• Why 3 separate hospitals started an HIE together (Meditech)
• 8 Ways to Reduce Alarm Fatigue in Hospitals (Spok)
• The four types of struggling project managers (and how to improve) (Nordic)

Contacts

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

EPtalk by Dr. Jayne 9/21/17

I took time out from consulting this week to attend the first-ever Smartsheet user conference, held in Seattle. I’ve been a user of Smartsheet for some time, primarily because it makes it easy to share project plans and documents with clients in a way that I can control without having to deal with versioning issues. I like the ways people can collaborate and it just feels easier to me to use than other Web-based collaboration tools. When I heard a few months ago that they decided to host a client conference, I jumped at the chance to see what it looks like when a company decides to make that happen. I’ve heard plenty of tales from the EHR world about clients who attended the first user group for a given vendor, many of which take the “bunch of guys and a couple of cases of beer” story form.

I suspected Smartsheet had progressed well beyond that narrative based on the agenda, which included a wide variety of sessions and social events. The conference kicked off on Monday with a meet-and-greet at The Parlor in Bellevue, just a hop, skip, and a jump from the conference hotel. Pool tables and ping-pong competed for attention with Monday Night Football, along with a variety of snacks and drinks. For those of us who are perpetually jet lagged, it was a nice way to start a conference. The conference went into full swing on Tuesday with over 1,000 people in the audience for the keynote session. They brought in local DJ Darek Mazzone to introduce the crowd to the Seattle music scene and it definitely set the tone for the morning. Prior to the conference, I didn’t know anything about the company’s leadership, but found them engaging and passionate about the work they’re doing. Based on the staging and lighting budget, it was clear they had spared no expense in aiming for a first-class entry into the user conference space.

The company used the event to launch several new features, some of which were literally rolled out immediately prior to the conference kickoff. I hadn’t been aware of their mobile app before they discussed it at the keynote (not sure how I missed that little tidbit) but quickly downloaded and started testing it. After the pumped-up buzz of the keynote, everyone headed out to breakout sessions. The halls were crowded, which was a testament to the sold-out status of the conference, which seemed a little large for its surroundings. The first few breaks between sessions were crowded with videographers trying to capture footage of the crowd along with client interviews. I took advantage of one of the breaks to talk to one of the mobile developers, who was very interested in hearing what users think of his product and who didn’t give me any sass about the fact that I didn’t even know it existed until a few hours prior.

Breaks were also prime time to continue on the “swag journey,” which drew participants to various booths highlighting different product features. The swag was outstanding, with a high-quality messenger bag for everyone (although I was surprised that it didn’t have a Smartsheet logo). I bypassed some of it but did snag the conference survival kit with its band-aids and mints along with a tech case with some headphones that my teenage house-sitter will like. I took a pass on the fidget cube and tattoo stickers. The swag hunt punch-cards led to some jokes among attendees who had difficulty figuring out which booth had which swag (or whether a booth had swag at all) until they learned to “follow the hole punch crumbs.” We’ll see if that gets changed out for next year.

One conference element that I hope does get changed out is their preregistration and attendance scheme. Attendees had to preregister for sessions and then have their badges scanned for admittance to a session. If you were one of the unlucky attendees like me who didn’t receive the preregistration email, you had no idea you had to preregister for sessions, and were consigned to a second-class “standby” lane just outside the meeting room. Others who did preregister weren’t showing a green light when scanned, and were sent to the end of the standby line. The way it was handled at some sessions was less than customer-friendly, and I hoped that after a couple of rounds of this silliness the conference organizers would have tried something different. It continued throughout however, with room monitors ranging from just letting people in regardless of whether they scanned green or not, to being belligerent with attendees. I resigned myself to the standby line but was able to get into every session I wanted to attend. The bottom line though, is that for a company that talks a lot of about reducing wasted time and streamlining work, they added some major inconvenience (and dissatisfaction) for their attendees. Pro tip: Have people pre-register to get a feel for the room size you need for each session, then bump that by X percent and just let everyone in without a bunch of silly lines.

Some sessions featured a sketch artist creating story boards during the sessions, which was fascinating to watch if you were lucky enough to get a seat in the front. My favorite session was one on collaborative work, led by Margo Visitacion of Forrester Research. She addressed a lot of issues that I cover in some of my change leadership courses, including helping people understand the new ways that work is done today and how knowledge workers operate compared to traditional work methods. My second favorite session featured Amy Sovereign from the City of Detroit discussing how their Program Management Office uses Smartsheet in their Lean Six Sigma efforts. The presentation format was more of a fireside chat, but with vibrant photos of the city projected on the big screen as they talked. They’ve done some interesting things with the technology including end-of-shift debriefing surveys when they deployed body cameras to the police department. She got several chuckles from the audience, talking about people who are “allergic to Lean Six Sigma” and how much people love their paper. I also enjoyed her comments about making sure that you have buy-in before deploying new solutions, because you “don’t want to put technology in a catapult.” It’s vivid images like those that can captivate an audience.

I was less-than-captivated by another session where the male panelist was introduced with all of his credentials and accomplishments, and the female panelist was introduced as “the lovely Miss Jane Doe.” I’ve never heard a man in a professional setting introduced as “the handsome Mr. John Doe” so I’m not sure why that is acceptable, and I wasn’t the only person it grated on. This phenomenon has actually been studied before, and I would encourage presenters and moderators to take a gander at the paper before preparing your next set of introductions. The session was also marred by horrible feedback between the speakers and the microphones and a constant humming, so I didn’t get much out of it. Speaking of ruining the audience experience, I’m not sure why people still think it’s OK to answer phone calls in the middle of the session and talk all the way down the aisle and out the door. Nor do I understand why someone would do a conference call in the hallway on speakerphone and not with headphones, but I saw that at least twice.

The lunch breaks were designed to be networking sessions, and on Tuesday I wound up at a project management-themed table with people from all kinds of companies. I don’t want to unmask my secret identity by saying who I sat with, but people I met at various points were from Target, Centene, Oregon Health & Science University, Comcast, MGM Hotels and Resorts, health systems, hospitals, EHR vendors, Microsoft, DocuScan, local school districts, municipalities, Salesforce, and more. It was a great conversation and very gratifying to hear about the way some of these groups were solving the same problems I run into with my clients. Of course, explaining my vague-sounding consulting firm always garnered some interesting looks.

Tuesday’s client event was at the Chihuly Garden, and on the hour-long bus ride (love that rainy rush hour Seattle traffic!) I met some fun people who had some great advice for doing different things with Smartsheet. The event featured not only the glass, but food and drink from various local vendors along with seafood, pasta, and an all-potato buffet with parmesan French fries, tater tots, kettle chips, potato skins, and a baked potato bar. The dessert tables had been picked clean by the time I figured out they were in a separate little greenhouse area, so I missed out on the eclairs. The featured cocktail included moonshine from 2Bar Spirits, but I steered clear.

Wednesday’s keynote included a panel of Smartsheet leaders taking audience questions, followed by Captain Chesley “Sully” Sullenberger, who I found riveting and one of the best of the many professional keynote speakers I’ve seen over the years. If you’re looking to be inspired to greater things such as duty, honor, dedication, and service, he’s your man. He had some great insights into how people and technology interact, along with the true nature of innovation – changing before you’re forced to. I do have to say though that watching the recap of Flight 1549’s journey at the beginning of the speech was haunting. I’ve made plenty of life or death decisions in very short timeframes with patients on the table in front of me, but I can’t imagine being in his seat with 155 passengers on board and figuring out a solution that saved everyone. He recounted how hearing the flight attendants shouting “Brace, Brace, Brace” to the passengers functioned in a sort of cheerleading capacity to help him through the situation. He highlighted the performance of his team during the incident and how everything in their careers before that helped prepare them for the situation. One of his statements really resonated with me as he discussed how 208 seconds has come to define his entire career as a pilot. I thought about that several times the rest of the day – if we had three minutes that would define our careers, what would that look like?

Overall, I was happy with my choice to attend, although the registration fee plus a couple of nights of Seattle-area hotel rates put a dent in my budget. Smartsheet did a great job with their inaugural client conference and I’m looking forward to seeing things grow. They’ve certainly come a long way from their startup in a little yellow house in Kirkland, WA.

Email Dr. Jayne.

Morning Headlines 9/21/17

Medicare and Medicaid Need Innovation

CMS Administrator Seema Verma says in a Wall Street Journal op-ed that the agency will pivot its Innovation Center to offer providers new ways of delivering care, noting that value-based programs have resulted in market consolidation and reduced competition.

Cleveland Clinic CIO talks innovation, patient engagement and BYOD

In an interview with MedCity News, Cleveland Clinic CIO Ed Marx discusses his views on BYOD, and the various apps used by patients and clinicians at the Clinic.

To Foster Information Exchange, Revise HIPAA And HITECH

Niam Yaraghi, a fellow in the Brookings Institution’s Center for Technology Innovation, argues in a Health Affairs article that HITECH and HIPAA are as much at fault for the nation’s EHR interoperability problems as the vendors and providers that are being blamed.

Senate girds for final Obamacare repeal vote

Senate Majority Leader Mitch McConnell (R-Ky) will introduce the Graham-Cassidy bill for a vote by next week. The vote will likely be the GOP’s final opportunity to repeal ACA.

Morning Headlines 9/20/17

Kaiser IT union members march for higher pay at company headquarters in Oakland

Kaiser Health union members are picketing in front of the company’s downtown Oakland headquarters, demanding better pay for a group of IT desktop support staff. The employees are making an average of $72,000 per year, which Kaiser executives say is typical for the local market, but union members disagree and are seeking considerably higher rates.

Some tax-exempt hospitals are lax at providing charity care and accountability

Senator Chuck Grassley (R-IA) publishes an opinion piece in STAT highlighting recent reports of not-for-profit hospitals refusing charity care under all but the most extreme cases.

Health care giant HCA may be in the mix for Tenet, analysts say

The Dallas News cites unnamed analysts in an article claiming that HCA is a frontrunner to acquire some of Tenet Healthcare’s hospitals.

Health Benefits In 2017: Stable Coverage, Workers Faced Considerable Variation In Costs

A Kaiser Family Foundation study finds that employer-sponsored insurance plans rose four percent for single coverage, to $6,690, and three percent for family coverage, to $18,764.

News 9/20/17

Top News

The hole Equifax keeps digging for itself just keeps getting bigger and bigger. The company’s CIO and CISO (whom some have raked over the coals for her music degree) announced their immediate retirements last week as affected consumers continued to cry foul over its shoddy attempts to provide assistance in the wake of a now-infamous breach that involved the data of 143 million people. Not to be outdone by its own incompetence thus far, Equifax has also revealed that a data breach occurred in March, and may have been carried out by the same hackers.

To top it all off (though this story seems very Theranos-like in that it just keeps on giving), the DoJ has launched a criminal investigation into Equifax officials that may have violated insider trading laws when they sold $1.8 million in company stock before the initial breach was revealed.

Reader Comments

From Kiwi: “Re: Orion Health’s Singapore project. Your initial statement of the Orion Singapore project is overstated. It’s really just an expansion of the work they have already done with Accenture as prime on a national EHR awarded in 2010. Its just a Rhapsody deployment, not a national EHR. So there is not not much net new revenue. Noting about that deal would contradict potential office closings in Singapore for a company tight on cash.” Per Kiwi’s digging, this announcement from 2010 does indeed name Accenture as the National EHR contractor, along with team members from Oracle, Orion Health, Initiate Systems, and HP.

Webinars

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.

People

Welltok hires Chris Power (Paycor) as CFO.

Acquisitions, Funding, Business, and Stock

Influence Health relocates to larger office space in Atlanta. The company, which has grown its Atlanta workforce to 48 employees since acquiring BrightWhistle in 2015, plans to hire an additional 60-70 over the next two years.

Gary Fingerhut, former executive director of Cleveland Clinic Innovations, is charged with conspiracy to defraud the Cleveland Clinic out of $2.7 million. Fingerhut and an unnamed accomplice opened a shell company that Cleveland Clinic Innovations hired to develop medical charting software. The shell company was paid $2.7 million in total, but delivered no goods or services in return. Investigators found that $469,000 was funneled directly back to Fingerhut.

Text-based telemedicine company CirrusMD will move into larger office space within Denver’s new health IT-focused Catalyst HTI development next spring. It plans to add another 25 employees within the next year.

IT workers in Southern California unionize and stage a demonstration for equal pay and benefits at Kaiser Permanente’s national headquarters in Oakland, CA. The group of desktop computer support employees has been has been haggling with Kaiser over an initial contract for two years. A KP spokesman explains that, “Their average wage is $34.97, or more than $72,000 annually. The union is demanding that these 60 employees be paid at a much higher rate, which would make them much more highly paid than similar workers in the same market. We have offered a generous increase but the union is demanding considerably more.”

In an effort to emphasize its focus on AI, predictive analytics company Faros Healthcare changes its name to Raiven Healthcare.

Announcements and Implementations

Jackson Medical Center (AL) implements Evident’s Thrive EHR.

Government and Politics

Madigan Army Medical Center (WA) personnel prepare to go live on MHS Genesis next month. It will be the first multi-branch hospital to roll out Cerner’s EHR for the DoD.

Indiana partners with SAP to create a database and dashboards displaying the state’s information on “drug arrests, drug seizures, death records, pharmacy robberies, overdose-related ambulance calls, and the use of naloxone, an overdose-reversal drug.”

Privacy and Security

Sixty-three percent of physicians and 41 percent of nurses use personal devices for work even when their hospital has a no-BYOD policy, according to a Spok survey of 350 healthcare personnel. Data security was cited as the main reason some hospitals prohibit BYOD programs. Top BYOD barriers include WiFi coverage, data security, and cellular coverage.

Technology

Florida Hospital and Nemours Children’s Hospital (FL) see telemedicine utilization rates skyrocket after giving patients free access several days before Hurricane Irma hit. Nearly 2,700 patients downloaded Florida Hospital’s eCare app, while Nemours saw adoption of its CareConnect jump 554 percent. Over 100 people accessed Florida Hospital’s virtual care the Saturday before Irma – that’s 93 more than it sees on a typical Saturday.

Innovaccer develops a Care Intelligence System that encompasses data integration, analytics, quality reporting, patient and provider engagement, and care coordination.

Sales

Cuero Health System (TX) signs on with Revenue Maximization Group for practice management and RCM services.

Innovation and Research

A study finds that patients who rely on Glytec’s digital glucose therapy management software see rapid glucose control and more easily maintain long-term A1C reductions.

Other

State and federal officials put the brakes on “DNA Day” at last weekend’s Baltimore Ravens game against the Cleveland Browns over privacy concerns. Fans were supposed to receive a DNA test kit from Orig3n that would let them test for four genes, but will now have to wait until the Boston-based company receives proper approval from the Maryland Dept. of Health.

Intermountain Healthcare and University of Utah Health system personnel return from their post-Harvey relief efforts as part of the Utah Disaster Medical Assistance Team. The team initially set up a field hospital near the airport, then moved to helping evacuees at the George Brown Convention Center. “We were ready for anything,” says Scott Gardner, PA-C in Trauma Services at Intermountain Medical Center. “Some of our mission was to be available in 30 minutes to be able to go anywhere to set up a self-supporting medical treatment area. But fortunately for the people of south Texas, we weren’t needed for emergencies. It meant the first responders and hospitals were well-prepared and operational.”

Sponsor Updates

• AdvancedMD will host its Evo17 User Conference September 20-24 in Nashville.
• Besler Consulting releases a new podcast, “Caring for healthcare providers.”
• Black Book highlights consolidations going on amongst several companies in its Top RCM Software & Services report.
• CoverMyMeds will exhibit at the PCMA Annual Conference September 25-26 in Scottsdale, AZ.
• Direct Consulting Associates will exhibit at the Ohio MGMA annual conference September 22 in Dublin.
• Built in Boston profiles Docent Health CEO Paul Roscoe.
• Lightbeam Health Solutions will provide population health management solutions to members of the American College of Osteopathic Family Physicians.
• Reaction Data publishes a new report covering UnitedHealth’s acquisition of The Advisory Board.
• Meditech customer Frisbie Memorial Hospital (NH) rolls out the company’s patient portal app.

Blog Posts

• How independent physicians provide “best of both worlds” medical care (AdvancedMD)
• Agfa HealthCare celebrates 150 years of expertise and innovation at RSNA 2017 (Agfa Healthcare)
• HITRUST CSF Certification Round 3 (Datica)
• CareSync Team Members Support Each Other in the Wake of Hurricane Irma (CareSync)
• The Evolution of Continuous Testing (CTG)
• Selecting and Mentoring Your Physician Champions for Organizational Change (Culbert Healthcare Solutions)
• Immigration Update – Interviews for Employee-based Visa Holders will Begin in October 2017 (Dynamic Computing Services)
• Dispatch from the SHIEC Conference (Diameter Health)
• Numeracy: Analytical Skills for the 21st Century (Dimensional Insight)
• 4 Questions with Robert White, MD, CMIO of Allegheny Health Network (Optimum Healthcare IT)
• Why ADT feeds matter and how providers can use them to deliver better care (Lightbeam Health Solutions)

Contacts

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

Morning Headlines 9/19/17

Solon man charged with defrauding the Cleveland Clinic out of $2.7 million

Gary Fingerhut, former executive director of Cleveland Clinic Innovations, is charged with conspiracy to defraud the Cleveland Clinic out of $2.7 million. Fingerhut and an unnamed accomplice opened a shell company that Cleveland Clinic Innovations hired to develop medical charting software. The shell company was paid $2.7 million in total, but delivered no goods or services in return. Investigators found that $469,000 was funneled directly back to Fingerhut.

Transition to electronic records

The local paper on Joint Base Lewis-McChord (WA) covers the upcoming Cerner go-live at Madigan Army Medical Center, the first large, multi-branch hospital to go live under MHS Genesis.

Health Information Technology is Helping Treat and Manage HIV for Patients and Providers

On National HIV/AIDS and Aging Awareness Day, ONC CMO Thomas Mason, MD discusses various health IT projects that are improving care delivery for HIV patients.

The race is on as Senate factions vie to either fix or replace the ACA

Modern Healthcare covers several last minute efforts to repeal and replace ACA prior to September 30, when reconciliation rules, which allow passage of the bill with a simple majority vote, will expire.

Curbside Consult with Dr. Jayne 9/18/17

I recently spent some less-than-quality time at my local Department of Motor Vehicles office. Since the lines were long, I had the opportunity to observe many of the processes that were occurring, coming to the realization that some of the issues we are battling in healthcare IT aren’t unique to our industry.

The first thing I noticed was a confusing registration kiosk, which had been implemented since the last time I was there. There wasn’t any clear signage to direct people to the registration kiosk, so people came into the building and stood there looking for the old “take a number” dispenser without much luck. Eventually other waiting patrons would direct people to step up to the kiosk, and then you could see more confusion occur as they tried to figure out how to use it. When I approached the kiosk, I could see that it was designed to handle two different registration processes (titles and vehicle licenses vs. driver licenses) and the language on the screen was ambiguous, resulting in a post-it note at the bottom of the screen that provided additional instruction. Once you registered, it printed out a number slip, but the printer wasn’t anywhere near the kiosk; it was instead mounted around the corner on the half-wall supporting the service counter.

How many times in healthcare IT do we implement new technology but fail to change the physical space to maximize adoption? I have nightmarish visions of all the physicians I’ve watched juggling laptops on their actual laps, because they don’t have an adequate surface on which to use it while also facing the patient. Have you ever seen a computer on wheels that’s on a cart so big it barely fits through the doorway, leading nurses to leave it parked in the hall rather than bring it into the patient room? How often do we ask users to navigate a poorly designed system that requires external “job aids” and “cheat sheets” to know what to do because it’s not obvious from the screens?

I made it through the registration gauntlet, but then had to listen carefully to the numbers being called because they were using the same number series for both driver licenses and vehicle licenses. It wasn’t always clear whether they were calling “number 8 for titles and licenses” or “number 8 for driver licenses” and so on. As I tried to observe the flow, I was even more confused by the fact that the “titles and licenses” clerks were subdivided into those that only did vehicle and boat licenses, and those that could process vehicle licenses and titles but not boat licenses. It took me at least a couple cycles to figure out which staff members were working on which issues. It reminded me of situations I’ve seen in hospitals where patients have to visit with multiple registrars to get situated prior to a laboratory or radiology procedure, depending on what kinds of services they needed. As the patient, it makes one feel shuffled around and that your needs aren’t being met, and as a consumer at the DMV I didn’t feel any different.

I also had the opportunity to watch the clerks try to straighten out several customer service issues, where patrons didn’t quite have the right information they needed to complete their transactions. Several of them involved elderly individuals trying to obtain driver licenses in a new state of residence, who might be missing a critical form of ID such as a birth certificate or Social Security card. More than once I heard clerks asking customers if they had their “red, white, and blue” card with them, which I quickly figured out was the Medicare card. In the absence of a Social Security card or proof of SSN, they were accepting the Medicare card as a proxy. I couldn’t help but wonder if anyone was educating the DMV about the Social Security Number Replacement Initiative, which is now called the New Medicare Card initiative. Certainly DMV staff will need different scripting when the new Medicare cards hit the streets, and I’m sure there will be an uptick in customers making multiple visits to get their licenses squared away.

While waiting, I noticed that they had installed a video screen that was supposed to display helpful information about your visit, not unlike educational programming in a physician or hospital waiting room. However, they had the screens set to advance so quickly that it was difficult to read all the content on the screen, requiring multiple cycles through the information to be able to absorb it all. I’ve done similar work for medical practices, both in the waiting room context and with employee workstation screensavers. I’m pretty “DMV literate” but I still couldn’t follow all the information they were trying to impart. It got me thinking about whether organizations are adequately considering elements such as health literacy and accessibility when delivering this kind of information.

When I finally made it to the counter, I had some extensive back and forth with the clerk, who tried her best to try to convince me that I didn’t need to file the forms I was there to file. It reminded me of my recent journey through trying to get approval for a colonoscopy from my insurance, who couldn’t see past the fact that I am not yet at the “typical” age for the test. Both clerks were so stuck in policy and procedure that they couldn’t see the documentation being put before them so that they could do what was right for the patient/customer. In both cases a supervisor had to be called, with the information repeated multiple times to different staffers, only to ultimately accomplish what was asked for in the first place. How many times do we see this in healthcare, where rules often cost us efficiency and patient satisfaction?

Even though I had convinced the supervisor to file my paperwork, I still wasn’t convinced that the state would mail me what I needed in four to six weeks as promised. I wasn’t sure that the information I provided had been keyed in accurately or that it described my situation, and just had to hope for the best. It was like sitting and waiting for your Explanation of Benefits statement to see if your procedure was going to be covered after all or rejected. Barely a week later, I was pleasantly surprised to receive my finalized documentation in the mail, exactly as I had expected it. Much like healthcare, despite the barriers placed in front of us, we still get good outcomes. It’s just a shame there has to be so much chaos leading up to the end point.

What other parallels to healthcare do you see in other industries? Are they solving the problems better than we are? Email me.

Email Dr. Jayne.

Morning Headlines 9/18/17

Second review launched into IHealth

In Canada, British Colombia’s Health Minister Adrian Dix, launches an independent review of Island Health’s $178 million Cerner Millennium implementation. Island Health has faced fierce resistance from its providers over complaints that Cerner is difficult to use and a risk to patient safety.

I’m the perfect person to price shop for an operation. But the process went terribly

A Massachusetts physician and price transparency researcher recounts the difficulties she had when trying to compare prices for a procedure her daughter was having.

Indiana, Reeling From Opioid Crisis, Arms Officials With Data

Indiana partners with SAP to create a database and dashboards displaying the state’s information on “drug arrests, drug seizures, death records, pharmacy robberies, overdose-related ambulance calls, and the use of naloxone, an overdose-reversal drug.”

Ask Mayo Clinic online offers symptom assessment through Epic’s MyChart

Epic will integrate Mayo Clinic’s online symptom checker into its MyChart app.

Monday Morning Update 9/18/17

Top News

The British Columbia Ministry of Health in Canada launches an independent investigation (the second one in less than a year) into the Cerner-powered Island Health EHR – a $178 million system that has faced fierce physician criticism – including a return to paper-based records over patient safety concerns – at the two hospitals it has been deployed in. Ernst & Young will deliver a report outlining its costs, benefits, problems, and solutions later this fall. The report will likely determine the fate of IHealth, which was initially scheduled for province-wide deployment well before now.

Reader Comments

From Kiwi: “Re: Orion Health. You can notch Ian McCrae’s net worth down even further. Orion was down to about $4 million in cash as of March 31 of this year, and had to raise funds through sale of stock in July. Fifty percent of that money raised was from insiders, including about $11 million from McCrae. That was actual cash he had to pony up. Last year the company lost $24 million on declining revenue of $144 million. Coupled with the unhappiness of some key customers like CalIndex and things are not looking good in the US either. All figures are USD. Lots of folks in HIT seem to make the mistake of not converting NZD like the piece Mr. H ran on June 12 about the folks at HCIT 100 not doing the math or their Top 100 vendors.” Things can’t be all bad for the New Zealand-based company. As first reported by Iknowaguy, Singapore’s health technology agency signed a five-year contract with the company for deployment of a nationwide EHR powered by Orion Health’s Rhapsody Integration Engine.

HIStalk Announcements and Requests

It’s a resounding “no” when it comes to readers whose healthcare has been affected by a lack of interoperability during and/or after natural disaster. I assume that only those who needed care answered the poll, but perhaps that was naive of me. In any case, Deb is decidedly in the “yes” camp, recounting the very different outcome that may have occurred had health data sharing been possible during her brush with Mother Nature: “Fourteen years ago, when a hurricane was approaching Florida, my daughter who has IIH (idiopathic intracranial hypertension) experienced severe symptoms as the barometric pressure dropped. We went to a hospital that was part of the network I was working for at the time. Her diagnostic and surgical records were in Illinois. The physician in the ER refused to believe her diagnosis even though she had the shunt and multiple surgical scars. I doubt that information sharing was an option at the time, but if it were, perhaps seeing her records from a major teaching institution would have allowed the physician to get past his own prejudices and actually treat her.”

New poll to your right or here: Will you purchase the $1,000 iPhone X when it arrives in stores? If your answer is “yes,” I’d appreciate you telling HIStalk readers why you’re prepared to spend that kind of money on a smart phone. I’m sure there are folks out there who feel it’s justified, but I just can’t wrap my head – or my wallet – around it.

This Week in Health IT History

One year ago:

• 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 acquires Anthelio Health Solutions for $275 million.
• Apple releases iOS 10, which includes HealthKit support for C-CDA, which will let patients download their medical records into HealthKit and share parts of that information with other apps.
• Cleveland Clinic files plans to build a 205-bed private hospital in London’s upscale West End.
• Appalachian Regional Healthcare brings the computer systems of its Kentucky and West Virginia hospitals, pharmacies, and clinics back online after nearly three weeks of downtime caused by an attack of unspecified malware.
• HHS provides $87 million to 1,310 safety net health centers for purchasing or upgrading EHRs.

Five years ago:

• Massachusetts Eye and Ear Infirmary and its physician group pays HHS $1.5 million to settle potential HIPAA violations following the theft of a PHI-containing unencrypted laptop.
• CMS awards HP a $43 million task order to continue providing IT services for the EHR incentive program and for maintaining the Integrated Data Repository database.
• Nuance will purchase Ditech Networks, a provider of voice technologies and voice-to-text services, for $22.5 million.
• The Forbes 400 list of richest Americans includes Epic’s Judy Faulkner (#285 with a net worth of $1.7 billion) and Cerner’s Neal Patterson (#391 at $1.12 billion).

Ten years ago:

• Philips considers offering an EHR product in Europe.
• Phreesia raises $10 million.
• Demand pushes Athenahealth’s IPO price to over $35, making it the best first-day gain of 2007.
• Craneware IPOs in London.

Last Week’s Most Interesting News

• Navicure and ZirMed agree to merge their RCM capabilities, operating under both brand names in the near term.
• Tenet Healthcare shares climb 13 percent following a Wall Street Journal report suggesting it is considering a sale of the company.
• Equifax suffers major fall out from a data breach that affected 143 million customers, including ransomware demands, class action lawsuits, and impending Congressional hearings.
• The American Red Cross announces plans to use a drone to assess damage and deliver aid in Houston following Hurricane Harvey.
• Epic will give MyChart users the ability to share data with any provider with Internet access, even those without EHRs.

Webinars

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.

Decisions

• Hillcrest Henryetta Medical Center (OK) will switch from McKesson to Epic on Feb 28, 2018.
• Centra Health (VA) will switch from Sunquest to a Cerner laboratory information system by the end of this year.
• Shannon Health (TX) will switch from McKesson to Epic next month.
• Potomac Valley Hospital (WV) will switch from Evident to Epic on October 1.
• Westerly Hospital (RI) switched from McKesson to Epic in January.

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

Announcements and Implementations

Allscripts will work with vendors, payers, and pharmacy benefit managers to aggregate and embed real-time prescription prices into prescribing workflows.

In Canada, the initial phase of Alberta Health’s Community Information Integration Program goes live at a primary care clinic using Orion Health’s cloud service. This first stage will give over 50,000 PCPs across the province the ability to share health data via Alberta’s Netcare EHR, which leverages Orion Health portal technology.

Sales

Curae Health selects Medhost’s Physician Experience and Perioperative Information Management System for implementation at two of its hospitals in Mississippi.

Privacy and Security

The Arkansas Department of Human Services discovers that a former employee mistakenly emailed spreadsheets with the Medicaid information of over 26,000 beneficiaries to her personal email address. The oversight was caught when attorneys for the department were preparing for a wrongful termination lawsuit later brought by the employee. The state hospital that hired her after she left DHS has fired her for her breach-related incompetence.

Technology

Mayo Clinic (MN) rolls out its Ask Mayo Clinic symptom assessment tool to Epic MyChart users.

Innovation and Research

A telemedicine study of 120 pediatric patients at Florida-based Nemours Children’s Health System’s sports medicine clinics finds that just one visit per year saved the health system $24 per patient. The virtual consults helped patients and their families save $50 in transportation costs and nearly an hour of waiting and visit time.

Other

Cigna’s “TV Doctors of America” return to encourage yearly physicals.

Sponsor Updates

• Salesforce.org donates $12.2 million to San Francisco and Oakland school districts in support of computer science education.
• The SSI Group will exhibit at the 2017 HFMA Tri-State Fall Institute September 20 in Cincinnati.
• Surescripts will exhibit at the NASP Annual Meeting & Expo September 17-20 in Washington, DC.
• T-System and Wellsoft will exhibit at the 2017 National Association of Freestanding Emergency Centers Conference September 19-21 in Washington, DC.
• ZirMed will exhibit at the MedInformatix 2017 Annual User Group meeting September 19-22 in San Diego.
• Bernoulli Health contributes to an AAMI study, “Continuous Surveillance of Sleep Apnea Patients in a Medical-Surgical Unit.”

Blog Posts

• Counterpoint: Digital Health is Just Getting Started (Redox)
• Bay Area Students Get Code-Ready and Job-Ready (Salesforce)
• MIPS Improvement Activities – How to Choose (Solutionreach)
• Sunquest provides a complete solution for molecular diagnostics and informatics (Sunquest Information Systems)
• Improve medical record retrieval success by analyzing provider behavior patterns (Verscend Technologies)
• Overlake Medical Center transforms healthcare with technology. (Voalte)
• 5 Types of SMS Conversations for Business (West Corp.)
• A Heartfelt Thank You to PAH Clinicians and Patients (ZappRx)
• Working CME Credits Into a Busy Schedule (Zynx Health)
• The Changing Role of Healthcare CFOs (Definitive Healthcare)

Contacts

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

Morning Headlines 9/15/17

Navicure and ZirMed Announce Plans to Merge

In a deal rumored to be worth $750 million, Navicure and ZirMed agree to merge their RCM capabilities, operating under both brand names in the near term.

Investors Put 23andMe Valuation at $1.75 Billion 

Consumer genetic testing and research company 23andMe raises $250 million in a round led by new investor Sequoia Capital, bringing its total funding to near $500 million.

Epic Announces “Worldwide Interoperability”

Epic will give MyChart users the ability to share data with any provider with Internet access, even those without EHRs.

Black Book Announces Top RCM Software & Technology Companies

Black Book releases findings from its latest hospital executive survey on RCM software, technology, and outsourcing.

News 9/15/17

Top News

Navicure and ZirMed announce plans to merge, though Reuters reports it’s more of an acquisition by Navicure to the tune of $750 million. The combined RCM company will operate under both brands for the foreseeable future, maintaining offices in Georgia, Illinois, and Kentucky. The agreement comes about a year after Bain Capital Private Equity bought a majority interest in Duluth, GA-based Navicure. Louisville, KY-based ZirMed has been shedding assets over the last several months. It sold off its analytics business to Koan Health in May, and laid off 60 employees a few months before that.

Reader Comments

From ButIThoughtYouSaid: “Re: Orion Health. Orion is closing their Singapore office and letting all employees go. Fate of their Middle East operations remain to be seen. They recently decided to pull out of an EMR contract in the Gulf rather than deliver it. Ian McCrae is under tremendous pressure as share prices are just above $1 from $5 fifteen months ago. I feel for him.” I haven’t seen any news related to the company’s Singapore presence, though I did read that McCrae’s personal worth has plummeted from $225 million NZD to $125 million.

HIStalk Announcements and Requests

This week on HIStalk Practice: Government agencies rescue dialysis patients in the wake of Hurricane Irma. Pennsylvania officials see reduced doctor shopping thanks to PDMP. MGMA calls for CMS to address "hidden" EFT fees. Macro-Eyes develops predictive patient scheduling tool. AAFP swears in new president during FMX conference. Summit Reinsurance Services enlists the population health assessment expertise of XG Health Solutions. Physician satisfaction improves during year-long trial with scribes. The Pitt County Health Dept. in North Carolina allocates $238,000 to implement Epic. Parents push back on telemedicine in Austin schools. HIStalk sponsors, submit your company’s details to the MGMA 2017 guide.

Webinars

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.

People

Atlantic General Hospital names Jonathan Bauer (McKesson) VP and CIO.

Precision medicine company Cota hires Andrew Norden, MD (IBM Watson Health) as CMO.

Dan Watanapongse (Sterigenics International) joins Intelligent Medical Objects as EVP and CFO.

Kaiser Permanente appoints Harvard Medical School pediatrics professor Mark Schuster, MD head of its new medical school in Pasadena, CA. The school will welcome its first group of students in the fall of 2019.

Bruce Henderson (Navigant) joins consulting firm Navvis as president.

Acquisitions, Funding, Business, and Stock

23andMe raises $250 million in a round led by new investor Sequoia Capital, bringing its total funding to near $500 million and a reported valuation of $1.75 billion.

Healthcare business development company Marketware secures $4.5 million in a Series B round led by Epic Ventures. Alex Obbard (Solutionreach) has joined the company as CEO.

Public and private payer Centene expands in New York via its $3.7 billion acquisition of Fidelis Care.

Dallas-based Tenet Healthcare shares climb 13 percent following a Wall Street Journal report suggesting it is considering a sale of the company. Tenet shares are down 72 percent in the last three years in the face of ongoing activist investor pressures.

Announcements and Implementations

Allscripts and Surescripts offer pharmacists in Alabama, Florida, Georgia, North Carolina, and South Carolina complimentary access to patient medication history data as part of their hurricane relief efforts.

Perficient redesigns the Colorado Center for Personalized Medicine’s data warehouse, moving it from University of Colorado hosting services to Google Cloud.

FormFast debuts its Connect e-forms solution on the Salesforce AppExchange.

Government and Politics

CMS previews the SSN-less Medicare cards it will begin mailing out next April.

Irving Burton Associates signs a two-year, $11 million contract with the US Army Medical Research and Materiel Command to supply research, scientific, management, and technical support services for its Telemedicine and Advanced Technology Research Center.

Privacy and Security

Fortified Health Security partners with IoT security software company ZingBox to develop a program that will help healthcare organizations monitor and manage connected medical devices and networks, as well as potential threats.

Senator Al Franken (D-MN) asks Apple CEO Tim Cook for more details on the upcoming iPhone X’s use of facial recognition to unlock the phone, particularly in the areas of privacy and security. He points out that, “should a bad actor gain access to the faceprint data that Face ID requires, the ramifications could last forever, particularly if Apple’s biometric technology comes to be used in other devices and settings. Furthermore, Apple itself could use the data to benefit other sectors of its business, sell it to third parties for surveillance purposes, or receive law enforcement requests to access its facial recognition system – eventual uses that may not be contemplated by Apple customers.”

Sales

Sutter Health (CA) selects advance care planning software from Vynca.

Christus Continuing Care (TX), Carespring Health Care Management (OH), Cornerstone Healthcare Group (TX), and Perimeter Healthcare (GA) contract with HCS for its Interactant EHR.

Brigham Health (MA) selects Redox’s API services to consolidate and standardize EHR data for use with hospital apps.

Technology

CoverMyMeds will develop e-referral technology for speedier electronic prior authorization of specialty medications.

Epic announces “worldwide interoperability” with the November launch of Share Everywhere, which enables patients to give MyChart data access to any provider with an Internet connection, even those without an EHR. In turn, providers can send progress notes back to the patient’s care team.

Innovation and Research

Optum360, Navicure, ZirMed, and Advisory Board take top client experience honors for software and technology in Black Book’s latest RCM survey, which also found that 74 percent of respondents are reprioritizing RCM ahead of projects related to population health, patient engagement, analytics, and physician practice acquisition and recruitment.

Other

San Diego workers spray city streets with bleach in an attempt to stem an outbreak of hepatitis A that has killed 15 and infected 400 people, mostly homeless. City officials have declared a public health emergency, installed hand-washing stations and additional public toilets, launched city-wide vaccination campaigns, and passed out hygiene kits in an effort to keep the outbreak – largely spread by unwashed hands – at bay. 

Eight senior citizens die from heat-related distress after The Rehabilitation Center at Hollywood Hills (FL) loses power during Hurricane Irma. Health officials evacuated 141 residents from the facility, sending them to local hospitals and prompting the inspection of other nursing home facilities, of which dozens are still without power.

Sponsor Updates

• Medicity will host its annual client summit September 19-21 in Stone Mountain, GA.
• Dimensional Insight publishes a new white paper, “Three cornerstones for healthcare analytics success.”
• Voalte announces the speaker lineup for the Voalte User Experience conference set to take place October 11-13 in Sarasota, FL.
• Consulting Magazine ranks Impact Advisors fourth on its list of best small firms to work for.
• Over 225 Epic customers adopt National Decision Support Co.’s CareSelect Imaging Platform.
• Dimensional Insight publishes a new resource guide, “How to create a winning business intelligence RFP.”
• Allscripts certifies Elsevier’s Interactive Patient Education as part of its developer program.
• Liaison Technologies begins accepting applications for its Data-Inspired Future Scholarship program.
• LiveProcess will exhibit at California Hospital Association Disaster Planning 2017 September 18-20 in Sacramento, CA.
• MedData will exhibit at the MRCA HFMA Fall Revenue Cycle Conference September 20-22 in Mt. Pleasant, MI.
• Meditech will exhibit at the Wyoming Hospital Association Annual Meeting & Convention September 19-21 in Sheridan.
• Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the NC/SC Perinatal Partnership Conference September 17-19 in Concord, NC.
• Experian Health will exhibit at the HFMA VA-DC event September 20-22 in Virginia Beach.
• PatientKeeper will exhibit at the MUSE Community Peer Group – Ontario September 15 in Barrie, Ontario.
• Liaison Technologies achieves Payment Card Industry Data Security Standard v3.2 certification and is included in the Visa Global Registry of Service Providers.
• Black Book launches a redesigned website.
• Nordic releases a new podcast, “Using the longitudinal plan of care to drive better outcomes.”
• ZappRx will exhibit at the National Association of Specialty Pharmacy meeting and conference September 18-20 in Washington, DC.

Blog Posts

• Ever Been BeanBoozled by an IT Vendor? (Access)
• Survey Responses Can Now Be Exported From TMS (Learn on Demand Systems)
• How one hospital is preparing for Meaningful Use Stage 3 (Meditech)
• How Equifax Could Have Minimized the Impact of Their Security Breach (Liaison Technologies)
• Advisory Services – Going Beyond Population Health Management Solutions (Lightbeam Health Solutions)
• Defining Avoidable Visits to Drive Affordable Patient ED Access (MedData)
• How EHRs Can Give Time Back to Docs (Meditech)
• Pediatric Clinical Decision Support Comes of Age (National Decision Support Co.)
• Work through Billing Challenges and Arrive at the End Zone (Navicure)
• How to Survive Audits by Documenting Medical Necessity in Home Healthcare, Part 1 (Netsmart)
• The Value Equation for Customer-Centric Innovation (NTT Data Services)
• What I Did Last Summer (NVoq)
• 7 Keys to a Successful Clinical Communication Implementation (PatientSafe Solutions)
• The Emerging EHR Divide (PatientKeeper)

Contacts

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

EPtalk by Dr. Jayne 9/14/17

The Patient-Centered Outcomes Research Institute Board recently approved $97.9 million to support clinical effectiveness research. Eleven studies will compare different approaches to improving care for conditions that stress patients, caregivers, and the healthcare system. Issues addressed in the studies include opioid use for chronic pain, improvements to treatment of multiple sclerosis, and treatment for young sickle cell disease patients who are moving to adult care. They also approved $32.8 million for studies with pragmatic design; one for therapies to help patients with head and neck cancer swallow better; one to evaluate antiseptic skin washes used prior to orthopedic surgeries; and another that looks at effective prevention of dental cavities. Practical studies like this help to emphasize the need to continue spending research dollars to see how we can better improve health promotion, disease prevention, and the treatment of burdensome illnesses.

With all the intrigue around repealing the Affordable Care Act, I missed the fact that the Children’s Health Insurance Program (CHIP) must be reauthorized by Congress. CHIP covers nine million children from low- and middle-income households. Legislators are considering the duration for which they will reauthorize the program as well as whether other initiatives will be attached. There are a couple of other priorities Congress is grappling with, such as the debt ceiling, which also have to be addressed before the 30^th. The last CHIP reauthorization was for two years and was passed months before the expiration date as part of a larger Medicare package. I’m all for ‘just in time’ delivery but this is cutting it close. Some states would run out of money as early as December, although others might have enough funds to get through the spring. Since many states already planned their budgets assuming the CHIP funding would be there, a loss of funding could trigger extensive cuts.

For those of you looking for your next gig, the FDA is accepting applications for its Digital Health Entrepreneur-in-Residence program aimed at supporting and developing the Software Precertification Pilot Program. The fellows will work with the FDA Digital Health Unit at least three days per week and will work to analyze software industry processes and key performance indicators to aid in predicting product quality. The goal is to look at the technology developer rather than at the finished product, as the FDA currently does for medical devices. Fellows will work with data modeling and will interact with stakeholders, pilot program participants, and internal FDA staff. Candidates must have at least five years of experience in software design, process improvement, metrics development, clinical trial design, post-market surveillance, or other related fields. During the six-month to two-year commitment, fellows will be based on the FDA White Oak campus in Silver Spring, MD. Applications will be open through September 29.

Patient engagement is a priority for many organizations, and CMS has announced a Medicare-Medicaid Coordination Office (MMCO) sponsored webinar titled “Involving and Supporting Family Care Givers in Care Planning and Delivery.” This is a timely topic for organizations looking to involve and empower the family members who are involved not only in assisting patients with activities of daily living but also in trying to manage multiple medical conditions, ensure medication compliance, watch for deterioration in patient status, and navigate the maze of healthcare. The webinar will also cover strategies for engaging families while respecting cultural diversity and will include geriatricians as well as a family caregiver. A close friend of mine just lost his spouse after a longstanding illness, and the stress on caregivers can be significant. Involving them in the care plan can help them focus on what they are able to do to improve quality of life for their loved ones rather than feeling helpless and alone, as my friend sometimes did while navigating the system on his wife’s behalf.

As a provider in flyover country, I didn’t know there was such a thing as the CMS Hurricane website; it’s got a lot of information about exceptions and exemptions for Medicare providers impacted by storms and flooding. Exceptions are being granted under quality reporting and value-based purchasing programs for hospitals, inpatient facilities, rehabilitation centers, home health agencies, hospices, and more. Exceptions are automatic based on location in a FEMA-declared major disaster county, without the entity having to submit an exception request. Additional options for impacted organizations include waver of hospitalization requirements prior to skilled nursing facility coverage if patients are evacuated, transferred, or relocated due to hurricanes; temporary expansion of bed counts at Critical Access Hospitals; waivers to permit replacement of lost or destroyed Durable Medical Equipment; and replacement prescription fills for covered Medicare Part B drugs. Other waivers are specified by state and entity. In addition to temporary relief from administrative burdens, CMS announced that US Public Health Service Commissioned Corps members have been deployed to affected areas, including physicians, nurses, and dieticians.

In other CMS news, a recent Proposed Rule would cancel two new bundled payment programs set to begin next year, and would overhaul the Comprehensive Care for Joint Replacement model that is currently mandatory in 67 geographic areas. It would become voluntary in 33 of those areas, underscoring a plan by CMS to boost participation in voluntary programs rather than requiring participation in episodic payment models. While CMS might be reducing burdens, other governmental entities are introducing new ones, namely a proposed House bill that would require e-prescribing of controlled substances under Medicare. The Every Prescription Conveyed Securely Act (HR 3528) is largely in response to the opioid crisis and would require e-prescribing for controlled drugs under Medicare Part D. Electronic prescribing of controlled substances is legal across the US now, with some states having their own additional controlled substances requirements. Although it specifies Part D requirements, it could push a lot more physicians to adopt the technology, as many will not want to have separate workflows for controlled and non-controlled drugs.

I had a couple of client engagements that were impacted by the hurricanes, so I’m about to head out on the road for a couple of weeks. None of my clients were in the areas of direct impact, but one did have some secondary flooding and a power outage. Fortunately, their failover systems worked as planned and their downtime procedures were in place, so the business was able to get up to speed as soon as the road to the office was accessible again. The recovery from these storms will be going on for months to years, so I know those who escaped with minimal impact are extremely grateful.

Email Dr. Jayne.

Morning Headlines 9/14/17

Tenet Healthcare Is Exploring Options Including a Possible Sale of the Company

Tenet Healthcare shares climbed 13 percent following a Wall Street Journal report suggesting it is considering a sale of the company. Tenet shares are down 72 percent in the last three years and face ongoing activist investor pressures.

Connecting Public Health Information Systems and Health Information Exchange Organizations

ONC publishes a report on how public health agencies could better use existing health information exchanges to collect information from providers.

Martin Shkreli’s bail revoked, he heads to jail after Facebook post on Clinton

Former pharmacy CEO Martin Shkreli is heading to jail after having his bail revoked over inflammatory online posts about Hillary Clinton. Shkreli was awaiting sentencing after being found guilty of securities fraud.

Impact of Scribes on Physician Satisfaction, Patient Satisfaction, and Charting Efficiency: A Randomized Controlled Trial

A study published in the Annals of Family Medicine finds that  the use of scribes improved all aspects of physician satisfaction, including overall satisfaction, having enough face time with patients, time spent charting, chart quality and accuracy. Scribes had no effect on patient satisfaction and increased the proportion of charts that were closed within 48 hours.

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.