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.

Morning Headlines 9/11/17

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

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

Departing Novartis CEO Sets His Eyes On Silicon Valley

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

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

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

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

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

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

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

Monday Morning Update 9/11/17

Top News

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

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

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

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

Reader Comments

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

HIStalk Announcements and Requests

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

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

This Week in Health IT History

One year ago:

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

Five years ago:

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

Ten years ago:

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

Last Week’s Most Interesting News

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

Webinars

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

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

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

Acquisitions, Funding, Business, and Stock

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

Technology

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

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

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

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

Privacy and Security

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

Innovation and Research

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

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

Other

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

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

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

Sponsor Updates

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

Blog Posts

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

Contacts

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

Morning Headlines 9/8/17

The HITECH Era and the Path Forward

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

Digital Health Entrepreneur-in-Residence Program

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

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

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

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

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

News 9/8/17

Top News

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

Reader Comments

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

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

HIStalk Announcements and Requests

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

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

Webinars

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

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

Acquisitions, Funding, Business, and Stock

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

Sales

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

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

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

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

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

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

Announcements and Implementations

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

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

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

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

Technology

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

MedAptus develops new patient assignment software for nurses.

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

Government and Politics

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

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

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

Innovation and Research

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

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

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

People

Meditech South Africa appoints Charlotte Jackson group CEO.

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

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

Privacy and Security

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

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

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

Other

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

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

Sponsor Updates

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

Blog Posts

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

Contacts

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

EPtalk by Dr. Jayne 9/7/17

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

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

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

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

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

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

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

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

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

Email Dr. Jayne.

Morning Headlines 9/7/17

Interoperability 2016-2017 Final Report

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

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

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

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

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

Tenet selling 8 more hospitals as investors debate company breakup

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

Morning Headlines 9/6/17

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

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

Cerner Announces Advisory Group to Improve Health Care Delivery for Veterans

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

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

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

Information Is Powerful Medicine

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