Monday Morning Update 6/12/17

Top News

Cork University Maternal Hospital and University Hospital Kerry in Ireland report significant added expense as a result of their implementations of the nation’s first Maternal and Newborn Clinical Management System. The initial $39.2 million price tag has increased by $785,000 in Deloitte consultancy fees, with millions more expected as 17 additional hospitals prepare to go live on the Cerner-powered system over the next several years. Ireland’s Health Service attributes the over-budget, delayed implementations to a lack of expertise on the part of its clinical and business staff.

Ireland experiences similar woes with its eHealth project, which is “not in a good place,” according to Chief Scientific Adviser Mark Ferguson, adding that the project is moving forward with several initial pilots to help alleviate patient concerns about  the digital storage of PHI. The project will ultimately include the launch of a nationwide EHR, unique identifiers for patients, and capacity for genome-sequencing.

Providers at University Hospital Limerick are particularly depressed with projections that eHealth implementation at their facility could take up to 10 years. The hospital uses a number of different data-sharing systems, and is still plagued by an inefficient paper record-keeping system. “We have many, many computer systems in the health service,” says the hospital’s founding president, Ed Walsh, “but they don’t talk to each other. [The health service is] consumed by inefficient bureaucracy, which is based on a Victorian paper system. And until we move that, we won’t be able to move the resources necessary to provide the healthcare that the patient requires.”

Reader Comments

From Kiwi: “Re: Orion Health’s financials. It seems to be letting an error by HCIT go uncorrected. Their Healthcare Informatics 100 listing cites $193 million in revenue in 2016, but reported financials show a different story (and the company is publicly traded). If my math is correct, the New Zealand dollar has moved between being worth about $.68 to $.74, making their earnings anywhere from $140M to $152M in 2016 and even less this for FY 2017.”

HIStalk Announcements and Requests

The anonymous vendor who donated $500 to my project to fund DonorsChoose teacher grant requests in return for mentioning a survey they’re interested in tells me they’ve almost hit the 100-response mark, which will trigger a second donation even bigger than the first. Providers, please click here and spend just a few minutes to help a classroom in need. Thank you.

Over 75 percent of survey takers would consider switching systems if their vendor became involved in a situation akin to that of EClinicalWorks. It’s All Good contends, however, that “the basis of the allegations/settlement is not a reason to switch. There were defects. They’ve been fixed. But …  a switch could be considered because such a settlement could force the company into insolvency. Or at least support and innovation will suffer as the company tightens its’ proverbial belt so it can pay the fine.” Ross Martin wonders if this will be the tip of the health IT iceberg – one that’s similar to finding out VW wasn’t the only carmaker to game the emissions compliance system. He suspects that, “in the context of the Great Meaningful Use Land Grab of 2009 and the spend-stimulus-fast development of certification criteria, we will find a good amount of fudging among the vendors. Even vendors who complied with the letter of the reg are nowhere near enabling the plug-and-play level of interoperability we need.”

New poll to your right or here: Do you take research studies into consideration when making health IT purchasing or clinical programming decisions? Given the Washington Post’s piece last week on the tendency of journalists to make headlines out of studies they don’t truly understand and/or that are poorly designed in the first place, I’ve been wondering if hospital executives look at them with the same skeptical eye that I do. Your comments, as always, are appreciated.

I decided early on to have only two HIStalk Founding Sponsors, spots held by Medicity and Nuance since around 2007 or so. Nuance’s new marketing crew has decided that sponsoring HIStalk doesn’t interest them, meaning that their Founding spot is therefore available to the first company who commits to taking it over. Contact me at mrhistalk@gmail.com to grab Nuance’s premiere ad position on the page along with the usual Platinum sponsor benefits. Thanks to Nuance for supporting HIStalk for 10 years.

Welcome to new HIStalk Gold Sponsor ZappRx. The Boston-based company solves the inefficient workflow and time drain involved with prescribing specialty drugs. Its platform modernizes the multi-step, manual prescribing process – often involving multiple platforms – to automatically populate prior authorization information, obtain digital patient consent, track prescriptions, and communicate bi-directionally with the specialty pharmacy, reducing administrative burden and improving team collaboration without resorting to phone calls. Patients get their critical therapy faster and more accurately with complete transparency. Practices can estimate their time savings using the company’s online calculator – the average prescription order requires just three minutes of provider time with ZappRX. Thanks to ZappRx for supporting HIStalk.

This Week in Health IT History

One year ago:

• Connecture, a technology company that builds online health insurance marketplaces, acquires ConnectedHealth, a benefits technology platform that helps employers choose health plans.
• Cerner launches a one-year pilot study that will help determine whether patient’s genetic data can play a motivating role in promoting behavior change.
• The VA fires three more administrators within the Phoenix VA Health Care System for “negligent performance of duties and failure to provide effective oversight.”
• In light of voided test results and potential CMS sanctions, Walgreens ends its relationship with Theranos, closing all 40 of its Theranos Wellness Centers in Arizona.
• South Australia looks for a spokesperson to reassure the public that its over budget, behind schedule 80-hospital Allscripts EHR implementation is still a worthwhile investment.

Five years ago:

• Private equity firm TPG Growth acquires critical care systems vendor iMDsoft.
• NIH and the National Cancer Institute announce grants to fund development of tools that empower consumers, patients, and/or their providers.
• A CareFusion site from which medical equipment firmware updates are distributed is found to be loaded with malware, triggering a Department of Homeland Security investigation.
• Steve Larsen, the federal government’s most powerful health insurance regulator responsible for consumer protection and insurance exchanges, quits to become EVP of Optum.

Ten years ago:

• IBA is considering suing CSC and Connecting for Health after CSC blocked its bid to acquire ISoft.
• The Northeastern Pennsylvania RHIO shuts down.
• DoD’s AHLTA EMR system (formerly CHCS II) is running in 138 military treatment facilities.
• Henry Schein tries to expand its medical software line with an offer for Australia’s Software of Excellence International.
• The South Australian Department of Health launches big upgrades of its patient and nursing systems.

Weekly Anonymous Reader Question

Last week’s results: Would you recommend to someone that they switch careers to health IT?

This week’s survey: What characteristics made the worst doctor you’ve ever had so bad?

Last Week’s Most Interesting News

• The VA announces it will shut down its VistA EHR and join the DoD in implementing Cerner Millennium.
• HHS appoints Bruce Greenstein CTO.
• Athenahealth acquires Praxify Technologies for $63 million.
• The Health Care Industry Cybersecurity Task Force releases its report to Congress.
• HHS alerts providers that the WannaCry ransomware attack is still causing problems for several US hospitals.

Webinars

June 22 (Thursday) 1:00 ET. “Social Determinants of Health.” Sponsored by Philips Wellcentive. Presenter: David Nash, MD, MBA, dean, Jefferson College of Population Health. One of the nation’s foremost experts on social determinants of health will explain the importance of these factors and how to make the best use of them.

June 29 (Thursday) 2:00 ET. “Be the First to See New Data on Why Patients Switch Healthcare Providers.” Sponsored by Solutionreach. As patients pay more for their care and have access to more data about cost and quality, their expectations for healthcare are changing. And as their expectations change, they are more likely to switch providers to get them met. In this free webinar, we’ll look at this new data on why patients switch and what makes them stay. Be one of the first to see the latest data on why patients leave and what you can do about it.

July 11 (Tuesday) 1:00 ET.  “Your Data Migration Questions Answered: Ask the Expert Q&A Panel.” Sponsored by Galen Healthcare Solutions. Presenters: Julia Snapp, manager of professional services, Galen Healthcare Solutions; Tyler Suacci, principal technical consultant, Galen Healthcare Solutions. This webcast will give attendees who are considering or in the process of replacing and/or transitioning EHRs the ability to ask questions of our experts. Our moderators have extensive experience in data migration efforts, having supported over 250+ projects, and migration of 40MM+ patient records and 7K+ providers. They will be available to answer questions surrounding changes in workflows, items to consider when migrating data, knowing what to migrate vs. archive, etc.

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

People

Michael Hyder, MD (Southcoast Health) joins Clearsense as president. He will also take on the role of EVP of healthcare delivery at sister company Optimum Healthcare IT.

Apple hires Sumbul Desai, MD (Stanford Center for Digital Health) to join its healthcare team in an unidentified role.

Arik Anderson (Terumo Cardiovascular Systems) joins smart inhaler company Adherium as CEO.

Government and Politics

In a first for the FDA, it asks Endo Pharmaceuticals to stop selling Opana ER – an opioid that has become a favorite among drug users who have taken to crushing it and injecting it or snorting it. If Endo fails to withdraw the drug voluntarily, the FDA will force its removal by revoking its market approval. “We will continue to take regulatory steps when we see situations where an opioid product’s risks outweigh its benefits,” says FDA Commissioner Scott Gottlieb, MD “not only for its intended patient population but also in regard to its potential for misuse and abuse.”

The Secretary of the Navy recognizes Naval Hospital Bremerton (WA) sailors for the parts they played in an ongoing process-improvement program that has so far reduced the Patient Administration Medical Records Division workload by 40 percent, and saved $156,400 and 7,300 man hours a year. In their downtime and with little prior coding know-how, the sailors developed a Medical Records Data Automation Program that now automates the daily operations of the hospital’s medical records department. MRDAP will soon serve as a transition program between the hospital’s Composite Health Care System and the forthcoming Cerner-powered MHS Genesis system. Cmdr. Robert McMahon, Director for Administration, refreshingly adds:

“What is most impressive is these young sailors had no fear of failure and despite no personal or monetary gain they continued to capture the ideas of their coworkers to improve workflows in their department that benefited everyone. Promoting innovation is like growing grass. Sometimes you already have the soil, water and sun. All that is needed is a safe and supportive environment to grow.”

Technology

Healthcare app development company Medable creates Synapse, a cloud-based tool that enables providers to launch CareKit apps for their care teams.

Privacy and Security

After Bronx-Lebanon Hospital Center (NY) and its contractor IHealth sent threatening cease-and-desist letters to the author of DataBreaches.net (who let them know that their PHI was exposed due to an improperly configured server), the hospital tucks tail and asks her to go through the 500 mb of data she used in her original investigation to let them know which patients were affected. The audacity of the request, which did not come with an apology and with which she refuses to comply, prompts her to offer this advice:

• Don’t rush to send legal threat letters. What your mother taught you about catching more flies with honey than vinegar appears true here, too.
• If you wouldn’t send a legal threat to the New York Times over their reporting, don’t send one to me. This site may be small, under-funded, under-staffed, and under-appreciated, but with the support of great law firms like Covington & Burling, this site will always fight back against attempts to erode press freedom or chill speech.

Decisions

• St. Mary Corwin Medical Center (CO) switched From Meditech to Epic in April 2017.
• Perry Memorial Hospital (OK) will switch from Evident to Athenahealth in August 2017.
• Jefferson Regional Medical Center (PA) is switching from Omnicell to BD Automated Dispensing Cabinets. The conversion process started last month.

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

Innovation and Research

A survey of executives from 104 healthcare organizations points to AI as the next big thing when it comes to transforming the way the industry interacts with patients: 84 percent believe AI will “revolutionize” their encounters with healthcare consumers, while 72 percent report already using virtual assistants. Their interest in AI will likely fuel their near-term efforts to better understand what consumers want even before they articulate it. Eighty-one percent feel organizations should shape digital health tools based on patient preference rather than their own. A similar percentage believe those that understand the motivations behind consumer behavior will ultimately win the day.

Other

McKesson CEO John Hammergren drops the price of his $22 million compound in San Francisco by $6 million after watching it sit on the market for a year. The solar-powered estate consists of a main house with six bedrooms and 10 bathrooms; a sports complex with tennis, bocce, racquetball, and squash courts, plus a gym, rock climbing wall, steam room, sauna, yoga center, and spa; and a carriage house with a five-car garage, car wash station, and banquet hall. The accompanying pool and spa have their own pool house.

Sponsor Updates

• QuadraMed, a division of Harris Healthcare, will exhibit at the MaHIMA Annual Conference June 11-13 in Boston.
• Salesforce publishes its “2017 Connected Patient Report.”
• Kyruus wins the “Best Healthcare Big Data Platform” Award from MedTech Breakthrough.
• CRN names Impact Advisors to its 2017 Solution Provider 500 list.
• Senator Cory Booker (D-NJ) helps to christen Conduent’s new global headquarters in New Jersey.
• Gartner names AdvancedMD a leader in its FrontRunners for Mental Health Quadrant.
• Encore publishes a new white paper discussing the role of data governance in the shift to value-based care.

Blog Posts

• Why you shouldn’t delay your EHR upgrade (Nordic)
• 2017 Healthcare Revenue Cycle Management Challenges Met by Technology (The SSI Group)
• Why Group Messages are Better Than Mass Messages (Solutionreach)
• Why providers burn out on EHR documentation – and how to fix it (Nordic)
• How surveillance tools help nurses to focus on their patients (Meditech)
• Better Actionable Intelligence Means Better Healthcare for All (Surescripts)
• Better healthcare in Boise. (Voalte)

Contacts

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

Reader Survey Results: Would you recommend to a relative or colleague that they change careers to health IT?

I asked if readers would recommend to a relative or colleague that they change careers to health IT.

As I approach retirement, I enjoy having this debate with colleagues my age and with 30-somethings. I was initially involved in healthcare delivery, graduating to healthcare IT over time. My observation is that most of the senior workers recall what we would call a "good job," where you left work at a reasonable time, valued your home life, and were active enough that you didn’t have to pay huge fees to a gym in an effort to stay in shape.

It does not appear the majority of younger staff have ever experienced a job where they felt valued, where the company invested in them, where there were true career paths. Few report a job where a sense of loyalty was engendered. At a certain point, healthcare IT (and IT in general) evolved into this organism that demands 24/7 availability and accessibility, freely doles out periods of excessive hours, covertly considers a commitment to family an impediment to success, provides minimal mentoring and training, and where the management mantra boils down to "do more with less," "work smarter," or some similar analog. The question we deliberate: Which of the groups is happier with their career?

I would not recommend a career in health IT, with a few specialized exceptions.

Why: growth industry. Also the ability to be creative. Room to innovate, or coast or dabble, whatever fits your interests.

My wise old Italian immigrant father told me long ago when I started this crazy ride in healthcare IT that "people will always be sick and people will always need computers". Job security, there’s that. Although the ride has been bumpy at times, I look back fondly at my 25+ year career in this industry. I’ve met some fantastic people (and some not so fantastic people), and some really smart people. I’ve learned a lot, travelled a lot, and am passionate about what I do.

Went to school for finance/accounting and made the switch myself after chatting with a neighbor who was a healthcare IT guy. I thought he was pretty smart and he got me my first interview, and off I went from there. So yes, I would, but only if people were looking for something new.

An IT career professional needs to transcend any primary allegiance to IT and become a healthcare professional with an IT specialty, and become customer-focused. Depending on the person, that may be a stretch – especially mid-career.

Yes, I would. There are significant opportunities for those, particularly with a healthcare background, to contribute to on-going needs of health IT. As a licensed pharmacist who worked in retail for 18 years, then moved to the IT space, I’m finding much more satisfaction and sanity in working in the IT space than I ever found working the bench in McPharmacy. As data sharing continues to develop, it will be amazing to see what population health details will develop over the coming years.

Maybe. I enjoy working in the field because I love feeling like I can make a difference in peoples’ health even though I am not a clinician, and of course, it’s exciting to be in a growth industry. That said, it can be frustrating that not having a clinical background can mean always being seen as less credible, no matter how long you’ve been in the industry.

I just did, actually, to a friend who’s studying to be a software engineer (and who had previously considered healthcare). I told him it was an interesting and ever-changing field with enormous breadth, and that it was a way to be paid well while still doing something truly important.

My caveats: It will also make you want to rip your hair out, and possibly ruin most of your faith in doctors. (#NotAllDoctors)

No – I got in 22 years ago and having been trying to get out ever since! It’s like The Godfather III …

No. The demands are outrageous, the funding for IT initiatives takes the back seat to clinical initiatives, and healthcare is in the middle of a major upheaval based on budget and governmental initiatives. I would suggest something more stable.

Yes, absolutely. Health IT is and will continue to grow. Given how behind the times we are with regards to so many of the technologies available, there is ample room to jump in and make a big difference. Also, it just feels good to know you are making a meaningful difference to people doing good work. I’m not just clocking in to help people find a good restaurant, respond to the latest Internet meme, or play the cool new game. We are making a difference in the health of our communities.

I don’t know that I would recommend a career change, but I would encourage recent graduates to explore health IT as a career option. My own daughters have had the pleasurable (torturous) experience of my 20 years in HIT, they aren’t so impressed with my career choices. I remind them that it kept a roof over their heads, and computers in their rooms.

There is nothing wrong with changing careers to a specific industry. It’s not like it hasn’t been done before with other industries. We all at one point reinvent ourselves. Why should healthcare be any different?

YES: You will always have a job/career where you know it matters whether or not you come to work. You will be busy beyond your wildest imagination. And if you are good, there is never a day when you will be unemployed, wonder where you will work next, or not have the ability to be challenged.

NO: In the 30 years I have worked in this industry, I have had few days “off.” The pace is grueling, the management short-sighted or not focused on the mission, and the initiatives are always under-resourced.

Nope. It’s just a negative, stressful industry. Doctors resent EHRs and hate being forced to use technology, practices are overworked and understaffed, vendors haven’t been able to add too many cool features because they need to keep up with government regulations, and now all the hacking and ransomware scares …

Not in a traditional health IT role because of the constant pressure to cut costs and shave corners. One area I would recommend as a viable opportunity would be any position related to health analytics, artificial intelligence, and machine learning.

Morning Headlines 6/9/17

athenahealth Agrees to Acquire Praxify Technologies to Advance Cloud Platform and Mobile Innovation

Athenahealth acquires Palo Alto-based EHR optimization vendor Praxify Technologies, which analyzes the way doctors interact with EHRs and uses machine learning to optimize workflows.

One Person-One Record Clinical Information System

Nova Scotia narrows the list of vendors that will compete to implement its province-wide “one person-one record” system to Cerner and Allscripts.

Epic, Allscripts and Cerner Signal Paradigm Shift in Population Health Management

A Black Book Report lists Epic, Cerner, and Allscripts as mindshare leaders in the growing population health software vendor marketplace.

Bruce D. Greenstein: Chief Technology Officer

HHS names Bruce Greenstein as CTO. Greenstein leaves his role as President at Quartet, a data integration company working in behavioral health.

News 6/9/17

Top News

Athenahealth acquires EHR optimization vendor Praxify Technologies for $63 million. The six year-old company employs 80 at its office in Palo Alto, CA and maintains a development presence in India. Athenahealth CTO Prakash Khot is enthusiastic about the benefits Praxify’s machine learning and natural language-processing capabilities will bring to the company’s cloud-based products. Praxify is perhaps best known for its Mira voice-enabled charting technology.

Reader Comments

From AirStrip Technologies CEO Alan Portela: “Re: Rumored NantHealth acquisition. AirStrip has not been acquired and continues to gain momentum in the industry. AirStrip has formed a strategic alliance and commercial agreement with NantHealth that leverages synergies between the AirStrip One mobile interoperability platform and the Nant platform, particularly in the areas of data aggregation, normalization, real-time data streaming and visualization. Our alliance will focus initially on supporting clinical workflows in acute-care settings, with a gradual move toward post-acute and community-based care settings.”

From GraySky: “Re: Athenahealth/Medhost deal. Athenahealth is in due diligence conversations to acquire all or part of the Medhost products. It’s looking to get access to the small community and rural hospital market that Medhost has access to with its inpatient and ED solutions. Cerner officially passed up Medhost late last year after doing due diligence. Valuation was too high in the area of $200M-$400M. Shrinking customer base that includes only a few large customers that are evaluating conversion to Cerner or Epic. Aging product suite.” Athenahealth declined to confirm or deny.

HIStalk Announcements and Requests

This week on HIStalk Practice: Siemens Healthineers finalizes its acquisition of Medicalis. Merritt Hawkins releases its annual physician recruitment/salary report. Mindcotine hopes to use virtual reality to help smokers kick the habit. Brad Boyd outlines ways to leverage MACRA to support long-term strategic goals in the Consultant’s Corner. Plaintiff dismisses lawsuit against MDLive. Hematology-Oncology Associates of Central New York nearly suffers a $250k loss due to clerical error. Salus Telehealth finds an untapped telemedicine market in summer music tours. EClinicalWorks adds telemedicine capabilities to its app. Thanks for reading.

Webinars

June 22 (Thursday) 1:00 ET. “Social Determinants of Health.” Sponsored by Philips Wellcentive. Presenter: David Nash, MD, MBA, dean, Jefferson College of Population Health. One of the nation’s foremost experts on social determinants of health will explain the importance of these factors and how to make the best use of them.

June 29 (Thursday) 2:00 ET. “Be the First to See New Data on Why Patients Switch Healthcare Providers.” Sponsored by Solutionreach. As patients pay more for their care and have access to more data about cost and quality, their expectations for healthcare are changing. And as their expectations change, they are more likely to switch providers to get them met. In this free webinar, we’ll look at this new data on why patients switch and what makes them stay. Be one of the first to see the latest data on why patients leave and what you can do about it.

July 11 (Tuesday) 1:00 ET.  “Your Data Migration Questions Answered: Ask the Expert Q&A Panel.” Sponsored by Galen Healthcare Solutions. Presenters: Julia Snapp, manager of professional services, Galen Healthcare Solutions; Tyler Suacci, principal technical consultant, Galen Healthcare Solutions. This webcast will give attendees who are considering or in the process of replacing and/or transitioning EHRs the ability to ask questions of our experts. Our moderators have extensive experience in data migration efforts, having supported over 250+ projects, and migration of 40MM+ patient records and 7K+ providers. They will be available to answer questions surrounding changes in workflows, items to consider when migrating data, knowing what to migrate vs. archive, etc.

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

People

Former CMS Chief Data Officer Niall Brennan joins the Health Care Cost Institute as president and executive director.

Digital diagnostics services company Analyte Health appoints Kevin Weinstein (Valence Health) CEO. Former CEO Frank Cockerill, MD will take on the position of CMO.

Announcements and Implementations

Einstein Healthcare Network (PA) selects Teladoc to help it jumpstart a telemedicine program that will initially focus on the health system’s 8,500 employees.

Rush University Medical Center (IL) starts a three-month pilot of Proteus Digital Health’s Discover smart pill sensor, one that is added directly into traditional pills. The sensor detects when the pill has been ingested via a patch worn on the patient’s stomach, and then sends a signal updating an app with medication adherence data.

Humber River Hospital in Toronto works with GE Healthcare to build a 4,500 square-foot digital command center that will aggregate and analyze real-time data from systems across the hospital to help improve staff workflows and patient care.

Technology

Meditech adds MModal’s Fluency Direct speech-recognition dictation capabilities to its Web EHR.

Apple updates the ResearchKit app to include new tests related to range of motion, and selective and visual attention.

Cerner will integrate CareVive’s care planning software with its PowerChart Oncology EHR.

Nuance adds PowerScribe Workflow Orchestration and PowerScribe Lung Cancer Screening to its line of screening program tools for radiologists.

Nuance seems to have quietly acquired San Mateo, CA-based radiology solutions company Primordial, its partner in developing the aforementioned technologies.

Privacy and Security

From DataBreaches.net:

• Southwest Community Health Center (CT) notifies patients of a potential data breach resulting from two separate break-ins during which burglars took several computers. No mention is made of whether or not the devices were encrypted. The center is offering affected individuals free identity monitoring and restoration services.
• Mississippi’s Medicaid Division alerts 5,220 people of potential PHI exposure stemming from six online forms managed by a third party that were sent to staff via unencrypted emails for nearly three years.
• Public school guidance counselor and West Carolina Counseling Services owner Joseph Korzelius admits to using information from his sessions with elementary students to file $450,000 worth of false Medicaid claims. He faces up to 10 years in jail and a $250,000 fine.

Innovation and Research

A team of researchers from MIT and Harvard develop a proof-of-concept tattoo ink that changes color based on metabolism changes in the body, allowing the tattoo to act as a low glucose or dehydration indicator.

Healthcare researchers call out the tendency of journalists to create headlines out of health studies that are “deeply flawed,” citing several articles related to the tenuous (and later debunked) claim that EHRs do in fact lead to improved outcomes. “Health care already consumes almost a fifth of America’s GDP — two or three times every other nations’ costs despite our often inferior outcomes,” they write in their conclusion. “It is vital that all stakeholders — journalists, scientists, policymakers, editors and the public — have a better understanding of basic research design and data interpretation. During this unusual moment in history, when politicians seek out whichever facts suit their ideology, the role of good science — and good reporting — could not be more vital.”

A Black Book survey finds that an overwhelming majority of hospital executives and managers will ultimately look to population health management-focused IT as patient accounting systems as they continue to shift their organizations to value-based care. Allscripts, Cerner, and Epic seem to have the most mindshare of those surveyed.

Government and Politics

President Trump decides to keep Francis Collins, MD on as head of NIH, a position he has held since 2009.

A VA spokesman confirms that Cerner will replace only the agency’s EHR, and that Epic’s $624 million contract to implement an appointment scheduling program for the VA is not in jeopardy.

HHS appoints Bruce Greenstein CTO. Greenstein was most recently president of behavioral health tech company Quartet Health, and served under Louisiana Governor Bobby Jindal as secretary of the Dept. of Health and Hospitals.

Other

The Government of Nova Scotia narrows the field of contenders for a “One Person, One Record Clinical Information System” to Allscripts and Cerner. Based on the procurement listing sent over by HITGeek, it looks like they beat out Evident, Harris Healthcare, and Meditech in preceding rounds that began last December.

In other northern health IT news, the provincial auditor of Saskatchewan recommends the Ministry of Health replace its 50 year-old IT system with one that can better screen the billing activity of physicians that are still paid on a fee-for-service basis. The auditor also recommends the development of standard criteria to more efficiently identify physicians whose billing practices should be investigated.

E-prescribing of controlled substances increased year over year by 256 percent, according to the latest progress report out from Surescripts. Nearly 75 percent of prescriptions in 2016 were electronic, totaling 1.6 billion.

Sponsor Updates

• Meditech customers lead lists of five-star and double five-star hospitals.
• Liaison Technologies will exhibit at the Cerner North Atlantic Regional User Group June 12-14 in Springfield, MA.
• MedData will exhibit at the Ohio Hospital Association Annual Meeting June 12-14 in Columbus.
• Medecision, NTT Data, RelayHealth, Surescripts, and ZeOmega will exhibit at AHIP Institute & Expo June 7-9 in Austin, TX.
• Meditech releases the latest installment of its video series, “EHealth Partnership Unites Ontario Hospitals on Meditech.”
• Frost & Sullivan recognizes Medicomp Systems with the 2017 Enabling Technology Leadership Award.
• National Decision Support Co. adds Society of Nuclear Medicine and Molecular Imaging Appropriate Use Criteria to its CareSelect Imaging system.
• Navicure will exhibit at the NJ MGMA conference June 14-16 in Atlantic City.
• Experian Health will present at the HIMSS Brand IT Marketing Conference June 15 in Las Vegas.
• YourStory.com profiles GE Healthcare’s efforts to bring healthcare accessibility and skills to rural areas in India.

Blog Posts

• Rockin’ the Suburbs and ESignatures (Access)
• Are You Ready for a Chief Data Officer? (Liaison Technologies)
• Aligning Technology, Leadership and Organizational Culture in Healthcare Providers (NetSmart)
• Defining a Legacy EMR/PM Strategy (Mica Health)
• Meditech 6.x Implementation Phases part 8: Post-Live (Parallon Technology Solutions)
• DocRank: Computer Science Capstone Project with the College of Charleston (PokitDok)
• The 7 health IT presentations you won’t want to miss in 2017 (Advisory Board)
• Are you Investing Time in an Exceptional Training Program? (Optimum Healthcare IT)

Contacts

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

EPtalk by Dr. Jayne 6/8/17

There has been quite a bit of reader feedback about my recent Curbside Consult addressing the ECW settlement. Several readers agreed with my assertion that multiple vendors have gamed the certification process, with one mentioning “extraordinary actions” taken to pass the testing, but that the product was “replaced by corrected code before the production code was released.” Given the way testing occurs, I bet that type of maneuver occurs more often than we’d like. Technically that would be fraud, regardless of how they try to mitigate it. Unfortunately, other vendors haven’t been caught (yet) and/or didn’t allow the products of their deception to go into general release. Hopefully those companies are on notice and will toe the line.

Other readers called for zero tolerance for ECW and other vendors who cheat, including jail time or outright closure of the company. Some felt I was soft on ECW, even “tender.” Let me go on record as saying what they did was despicable – however, I’m a firm believer in the American justice system and we have a couple of things called the law and due process. Whether you think entering into a settlement is tantamount to pleading guilty, there has not been an admission of guilt and no criminal action has been filed that I can find, and trust me, I’ve been looking. My lack of a torch and pitchfork should not be construed as acceptance or approval of what was done. Still, I was surprised by the number of emails I received that attacked me personally or suggested I don’t respect patients. As much as I believe in justice, I also believe in redemption and this is an opportunity for ECW to make things right. As one reader said, “No one benefits if an EHR is litigated into bankruptcy.” Let’s not forget the vendors who have closed their doors abruptly in the past, holding their clients (and the data of tens of thousands of patients) hostage.

Another reader who is in the vendor space mentioned that his employer has already received calls from clients threatening to file whistleblower actions unless specific defects were fixed, regardless of whether they had anything to do with certification or not. Product liability law is a specialized discipline and I don’t think adding potentially hundreds of suits to the environment will result in positive change. Look at how healthcare has dealt with harm in the past: Until you get past the culture of fear and penalty, people are reluctant to report issues or to be part of the solution. Another vendor reader mentioned his company is considering being less transparent with their “known issues” lists because of fear of escalation to frivolous lawsuits. That would be unfortunate as well.

One reader offered an interesting thought around analyzing the percentage of budget that top vendors devote to R&D. There could certainly be some interesting data there and you could come up with some conclusions from annual reports and shareholder documentation. Unfortunately, privately held companies don’t have to disclose anything, so we’d be relying on their report. We’ve heard self-reported statements about this over the last year and many felt they were inaccurate, so it’s not likely that we will get “real” numbers anytime soon. I’d personally like to see the R&D budget compared to support compared to marketing and sales. There are several vendors I work with who spend entirely too much on the latter while shortchanging the former.

Others mentioned my lack of attention to the potential impact on clients. Frankly I think it’s too early to discuss, as we don’t have a full picture of whether those practices will be asked to repay incentive money. Any mandatory repayment would almost certainly create the potential of a class action suit against ECW. That’s precisely why I advised my colleagues on the system to sit tight and see how it unfolds and what remediation is offered and how it actually plays out. They’re in an incredibly vulnerable position right now and it would be easy for another vendor to try to take advantage of their situation. Anyone who predatorily goes after these practices should be ashamed, and I know they’re already out there. The last things these practices need is a hasty move or a poorly considered replacement decision.

Regardless of your position on the guilt or innocence of a vendor and whether the punishment was appropriate, this event has the potential to change the healthcare IT landscape in uncertain ways. I hope that other vendors take the advice of one reader and revisit their compliance programs. Ensuring a culture of honesty, accountability, and understanding of the fact that you hold people’s lives in your hands needs to be at the forefront of thought as corporate decision-making occurs. It’s unfortunately not as common in the US today as we would like, whether in healthcare, the automotive industry, or just about anywhere people are trying to make a profit.

Other readers offered answers to the question of what they’d do with the whistleblower payment, with several noting that legal fees will consume a good portion of it. One mentioned that he would donate to non-profits promoting expansion of EHR systems to practices serving indigent patient populations and that cannot afford to buy them. Or to scholarship funds for computer science students willing to commit to working with those practices to help them implement those systems. Both are great ideas, although I’d like to see vendors contributing to those kinds of initiatives outright, rather than having someone do it as a result of a legal action. Or how about scholarships for patient safety training to ensure caregivers and technology professionals know how to spot these kinds of problems? The reader also noted he’d reserve a few dollars to buy a good bottle of bourbon as a reward for a job well done. Based on the level of documentation and time spent by the whistleblower, I’d suggest more than one bottle would be in the offing.

I don’t think this is the last time we’ll see something like this, and the problem isn’t just on the vendor side. I’ve seen plenty of “creativity” and shortcuts from hospitals and health systems with homegrown systems or with vendors outside the CEHRT space, and although they won’t be caught for fraud during the certification process, they are eventually going to run afoul of patient safety. The question is whether organizations will find the settlement motivational and will clean up their houses voluntarily, or whether more headline-generating actions will need to occur to move the industry where it needs to be. The other possibility is more consolidation in an already shrinking industry, which could have unpredictable effects on innovation and emergence of new vendors. The one thing I can say for sure is that only time will tell.

Email Dr. Jayne.

Morning Headlines 6/8/17

Epic Systems’ $600-plus million contract with VA will hold, officials say

A VA spokesman confirms that Cerner will replace only the agency’s EHR, and confirms that Epic’s $624 million contract to implement an appointment scheduling program for the VA is not in jeopardy.

Health Inequalities in the U.S.: A Good Target for our Work

Former FDA Commissioner Robert Califf, MD discusses his new role at Verily and his perspective on how to consistently translate the potential of new technology into better health

This new smart pill reminds you to take your medicine

Rush University Medical Center (IL) pilots Proteus Digital Health’s smart pill sensor, one that is added directly into traditional pills. The sensor detects when the pill has been ingested, and then sends a signal updating an app with medication adherence data.

MIT and Harvard’s Biosensing Tattoos Will Change Color When You’re Dehydrated

A team of researchers from MIT and Harvard develop a proof of concept tattoo ink that changes color based on metabolism changes in the body, allowing a tattoo to act as a low glucose or dehydration indicator.

Morning Headlines 6/7/17

WannaCry Ransomware Continues to Cause Problems for U.S. Hospitals

HHS issues a cyber notice alerting healthcare organizations that the WannaCry ransomware attack is causing major operational issues for two large, multi-state hospital systems, and reiterates that the virus continues to pose a threat.

ONC announces winners of Privacy Policy Snapshot Challenge

ONC awards a combined total of $35,000 to the three winners of its Privacy Policy Snapshot Challenge, a contest that asked developers to create new Model Privacy Notices generator that helps software vendors create consumer-facing privacy and security policy.

The Tower Of Babel In Clinical Research: PCORnet’s Common Data Model Cracks The Foundation

A Health Affairs article discusses the research potential that EHR interoperability and data analytics will have on generating clinical evidence, saying “the ability to harness good quality, usable data from EHRs will likely be as revolutionary for health care as the Internet was to other industries.”

News 6/7/17

Top News

VA Secretary David Shulkin, MD announces the VA will shut down its VistA EHR and join the DoD in implementing Cerner Millennium, explaining, “The VA’s adoption of the same EHR system as DoD will ultimately result in all patient data residing in one common system and enable seamless care between the Departments without the manual and electronic exchange and reconciliation of data between two separate systems.”

HIStalk readers (who predicted the Cerner decision in a reader survey earlier this year) didn’t waste time weighing in once the news crossed the wire yesterday – nearly a month before Shulkin’s self-imposed decision deadline. VA Worker says, “Here we go again. VA wants to replace VistA with Cerner but will never be able to afford it.” USA First? points out that, for all the Trump Administration’s efforts to keep American jobs on American soil, they’ve chosen a vendor that has sent 3,000 software jobs overseas.

Epic also shared its reaction via a presumably non-marketing rep: “As the largest electronic health record vendor in the United States, covering two-thirds of the nation’s patients, we are proud to serve our veterans both through the VA scheduling project and through our customers that care for millions of veterans across America. These customers are the top health systems in America and we stand with them, committed and eager to ensure veterans get the very best medical care regardless of where they receive it.” 

My thoughts are these: Cerner was the only reasonable choice since the DoD had already selected it, but it’s still surprising they went without bidding and named Cerner before negotiation with them began (that’s more of how Epic customers buy software). The company will presumably have more control over naming its price than it did with DoD, where it was a subcontractor under Leidos, and it may be that Cerner gets to keep all the money this time. It’s also to the company’s strong negotiating advantage that both Congress and the President have publicly cheered the VA’s choice of Cerner, making it unlikely that the VA wants to rule out Cerner over price negotiations. The VA has previously suggested that its price tag will be multiples of the DoD’s, perhaps well over $10 billion to $12 billion.

The systems will be theoretically interoperable, but there’s still a lot of work to be done to standardize terminology and functionality to make even the same system talk to another user whose workflows and use cases are different. There’s probably still a lot of consulting work required. It will be interesting to see which firms attempt to feed at the trough of this contract, as well as whether or not the VA and DoD will truly work as a single customer. Will Cerner and the inevitable consultants get stuck trying to broker agreements on major decisions so they don’t end up creating dissimilar systems?

It’s also worth noting that project timelines will need to be synched to avoid temporary interfaces to the legacy systems. Ironically, having the same system may require more VA-DoD cooperation than running separate ones. On the flip side, it’s also important to recognize that the VA and DoD have vastly different needs, and that in the case of the VA (unlike the DoD), its VistA system contains a lot of VA-specific non-clinical functionality, such as management modules for departments that aren’t involved in patient care. VistA is not just an EHR.

Reader Comments

From Mighty Med: “Re: Walnut Hill Medical Center closure. The self-touted hospital of the future abruptly shuts its doors after being open for less than three years. It’s just another example of healthcare disruption gone awry.” The $100 million, 100-bed Dallas hospital did indeed cease operations as of June 1, citing only it’s decision to no longer participate in the Medicare program. A former employee wrote a Facebook farewell message (later taken down) praising his colleagues for working without the “unlimited resources” of traditional hospitals, implying that it was struggling in some way. Officials touted the facility as being designed “completely from the patient’s perspective to create a stress-free atmosphere for healthy recovery.“

From Just Wondering: “Re: John Fleming’s desire for a single unified EHR. Is he as stupid as he sounds?” Hardly. The former Louisiana representative, businessman, and MD has done stints at the Navy Regional Medical Center (CA) and in private practice. He implemented his first EHR in 1997 and went fully paperless two years later. Fleming’s belief that “every American should have a single, unified electronic health record system that resides in the cloud and is under full control of the patient, of the individual, of the American” is the same pipe dream that dozens, if not hundreds, of health IT companies and venture capital firms have been throwing millions of dollars at for years. As the new deputy secretary of health technology reform, he’s becoming privy to the many public- and private-sector interests that will keep that pie-in-the-sky patient record from being developed anytime soon.

HIStalk Announcements and Requests

An anonymous vendor has graciously donated $500 to my project to fund DonorsChoose teacher grant requests in return for mentioning a survey they’re interested in. They’ll also donate a bunch more money if the survey gets at least 100 responses. Providers, please click here and spend a handful of minutes and together we’ll to help a classroom in need. Thanks.

Webinars

June 22 (Thursday) 1:00 ET. “Social Determinants of Health.” Sponsored by Philips Wellcentive. Presenter: David Nash, MD, MBA, dean, Jefferson College of Population Health. One of the nation’s foremost experts on social determinants of health will explain the importance of these factors and how to make the best use of them.

June 29 (Thursday) 2:00 ET. “Be the First to See New Data on Why Patients Switch Healthcare Providers.” Sponsored by Solutionreach. As patients pay more for their care and have access to more data about cost and quality, their expectations for healthcare are changing. And as their expectations change, they are more likely to switch providers to get them met. In this free webinar, we’ll look at this new data on why patients switch and what makes them stay. Be one of the first to see the latest data on why patients leave and what you can do about it.

July 11 (Tuesday) 1:00 ET.  “Your Data Migration Questions Answered: Ask the Expert Q&A Panel.” Sponsored by Galen Healthcare Solutions. Presenters: Julia Snapp, manager of professional services, Galen Healthcare Solutions; Tyler Suacci, principal technical consultant, Galen Healthcare Solutions. This webcast will give attendees who are considering or in the process of replacing and/or transitioning EHRs the ability to ask questions of our experts. Our moderators have extensive experience in data migration efforts, having supported over 250+ projects, and migration of 40MM+ patient records and 7K+ providers. They will be available to answer questions surrounding changes in workflows, items to consider when migrating data, knowing what to migrate vs. archive, etc.

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

Acquisitions, Funding, Business, and Stock

Learning management systems vendor Relias Learning acquires WhiteCloud Analytics for an undisclosed sum. Reliance has been on a bit of a spending spree since March of last year, acquiring six other companies including analytics firm Care Management Technologies.

Aegis Health merges with digital marketing firm Clariture to form Trilliant Health. The companies will retain their brands as separate business units.

Announcements and Implementations

Mayo Clinic (MN) will use 2bPrecise’s clinical genomics solution to add genomic information into its Epic EHR. The organizations will also work together to research and develop genomics-based care protocols, particularly for patients with cardiovascular genetic disease.

Aprima announces record growth for the fiscal year, including revenue, customer retention rate, and the relocation and expansion of its headquarters.

Technology

Apple announces new devices and features at its developers conference – none of which are all that earth-shattering and only some of which are relevant to healthcare. The company will attempt to keep up with the virtual assistant Joneses with the introduction of a Siri-powered HomePod. It has added AI capabilities to its Watch, giving it the ability to serve up motivational fitness messages when steps are down. Users will also be able to link their devices to Dexcom’s glucose sensor via a new API. Perhaps the most potentially life-saving enhancement is the Iphone’s forthcoming “do not disturb while driving” feature, which shuts off all distracting notifications when the phone is connected to your car.

Casenet develops a prior authorization submission and tracking tool.

PointClickCare adds Ability Network’s claims management capabilities to its EHR for long-term and post-acute care providers.

Safety Net Connect releases an enterprise version of its Converge referral and care coordination technology that brings together behavioral and physical health, and social services.

ICare adds order sets and care plans from Zynx Health to its EHR for acute care providers and SNFs.

Government and Politics

ONC announces the winners of its Privacy Policy Snapshot Challenge, the aim of which escapes me as the number of these contests seems to increase in direct correlation to the market-worthy usefulness of their winning ideas.

Sales

Tufts Medical Center (MA) chooses ZappRx to automate the ordering of specialty drugs, expecting to reduce the average prescribing time from 20 minutes to three minutes.

Children’s Hospital of Wisconsin selects CRM software from Healthgrades.

Privacy and Security

HHS alerts providers to the “significant” challenges two unnamed multi-state hospital systems are still experiencing as a result of WannaCry malware, noting that the virus can live on a machine that has been patched, and that its repeated attempts to scan can disrupt Windows operating systems.

Innovation and Research

Early performance data on IBM Watson for Oncology shows that Watson-generated treatment plans for 362 cancer cases were found to be in line with oncologist recommendations in 96 percent of lung, 81 percent of colon, and 93 percent of rectal cancer cases.

People

Michael Caponetto (West Health) joins government healthcare program services company SynerMed as CFO.

Other

The New York Times addresses the “virtual velvet rope” creeping into healthcare – one that is moving beyond celebrities and sheikhs taking over hospital wings and turning the more mundane world of direct primary care into one of ultra high-end concierge practices. Private Medical, for instance, charges between $40,000 and $80,000 per year per family for round-the-clock physician access and near-immediate access to specialists and hospitals across the country. Launched by HealthLoop founder Jordan Shlain, MD in 2002, the company has almost no Web presence, gaining new patients almost exclusively through word of mouth.

Sponsor Updates

• Direct Consulting Associates donates fabric and stuffed animal kits to help middle-school students make stuffed animals, blankets, and pillows for local charities.
• ClinicalArchitecture partners with OpenAirWare to more easily integrate patient data from standard clinical information exchange formats with its Advanced Clinical Awareness Suite.
• Software Advice names AdvancedMD a 2017 Mental Health FrontRunners Quadrant Leader.
• Agfa HealthCare successfully completes the recertification audit cycle for its information security management system.
• Aprima Medical Software will exhibit at the NJ MGMA meeting June 14-16 in Atlantic City.
• Bernoulli Health will exhibit at AAMI Conference and Expo June 9-12 in Austin, TX.
• Besler Consulting releases a new podcast, “Looking at price data on local healthcare markets across the United States.”
• Kyruus will host its ATLAS Conference on patient access September 19-20 in Boston.
• Casenet, Cumberland Consulting Group, EClinicalWorks, InstaMed, and InterSystems will exhibit at AHIP Institute & Expo June 7-9 in Austin, TX.
• Dimensional Insight remains a top performer in the Wisdom of Crowds 2017 Business Intelligence Market Study.
• Casenet clients and employees donate gift bags to children at CHA Cambridge Hospital (MA).
• ECG Management Consultants will present at the 2017 Science of Team Science Annual Conference June 13 in Clearwater, FL.
• Glytec will exhibit at the American Diabetes Association Scientific Sessions June 9-13 in San Diego.
• Healthwise will exhibit at the Cerner North Atlantic Regional User Group June 12-14 in Springfield, MA.
• Iatric Systems will exhibit at the NCHICA AMC Security & Privacy Conference June 12-14 in Chapel Hill, NC.
• The Atlanta Business Chronicle names Ingenious Med a “Pacesetter” for the fifth consecutive year.
• Kyruus will exhibit at the Annual Conference of Healthcare Call Centers June 7-9 in Salt Lake City.
• Inc. Magazine includes PMD on its list of best places to work.
• Definitive Healthcare CEO Jason Krantz is named a finalist for E&Y’s Entrepreneur Of The Year 2017 New England Award.
• Imprivata releases a new report, “High-value, complex clinical workflows require enhanced communications capabilities.”

Blog Posts

• Medication Adherence in the Safety Net: Where Simple Innovations Make Big Impact (FDB)
• 5 areas to focus your 2017 MIPS strategy (Nordic)
• CMS Quality Payment Program – MIPS Path (Culbert Healthcare Solutions)
• Take Action Now to Protect Your Online Information (Dynamic Computing Services)
• Key Takeaways from the 2017 Wisdom of Crowds BI Market Study (Dimensional Insight)
• Healthcare Informatics: One-On-One with CEO Jason Mabry (Optimum Healthcare IT)
• Putting ClinicalKey in doctors’ hands through Research4Life’s developing country access (Elsevier Clinical Solutions)
• Can interoperability defeat the asymmetry beast? (EClinicalWorks)
• The Art & Science of Understanding Physician Activity and Referral Patterns (Evariant)
• 5 Cool Things in Healthcare (Hayes Management Consulting)
• Three considerations when implementing two-factor authentication (Imprivata)
• A Healthcare CIO’s Consumer Experience Wish List (Influence Health)
• A quick and painless intro to rolling out your EHR (Nordic)
• 10-Step Guide to Securing Data at Your Hospital (Spok)

Contacts

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

Morning Headlines 6/6/17

Kansas City-based Cerner wins VA contract

VA Secretary David Shulkin, MD announces that the VA will shut down its VistA EHR and join the DoD in implementing Cerner Millennium, explaining, “The VA’s adoption of the same EHR system as DoD will ultimately result in all patient data residing in one common system and enable seamless care between the Departments without the manual and electronic exchange and reconciliation of data between two separate systems."

Early experience with IBM Watson for Oncology cognitive computing system for lung and colorectal cancer treatment.

At the 2017 ASCO Annual Meeting, IBM presents performance data on Watson for Oncology.  A multidisciplinary tumor board and Watson for Oncology both independently reviewed and generated treatment plan recommendations for 362 cancer cases, after which Watson-generated treatment plans were found to be in line with oncologist recommendations in 96 percent of lung, 81 percent of colon, and 93 percent of rectal cancer cases.

Dallas’ Walnut Hill Medical Center confirms its abrupt closure

Walnut Hill Medical Center, which billed itself as the “hospital of the future” when it opened in 2014 , closes suddenly. Officials declined to provide details, other than to say that the hospital’s provider agreement with Medicare had expired and it would cease operations after June 1.

Curbside Consult with Dr. Jayne 6/5/17

Quite a few people called or emailed this week to find out what I thought of the EClinicalWorks settlement. Two of them were ECW users asking for my advice on whether they should change EHRs and, if so, what I thought they should be looking at. For those practices potentially impacted by the alleged wrongdoing, it’s a very uncertain time. My advice was to pause and let the dust settle before making any decisions. Neither of the ECW physicians I talked to this week had concerns about how the system is actually performing based on their scope of use, and felt fairly confident that they’re not experiencing functionality issues that impact patient care.

As for those that reached out simply curious about what I thought, I’ll share what I had to say. There were several allegations addressed in the settlement. I say “allegations” deliberately because ECW hasn’t admitted guilt nor has it been proven in a court of law. Everyone can speculate on the fact that they settled, but given that I have a plaintiff’s attorney in the family, I understand how expensive litigation can be and how $155 million may be a bargain compared to having to mount a defense, deal with the side effects of having half your company (and your customers) deposed, and having ongoing distraction that impacts your ability to keep the lights on and the business running.

First, let’s look at the kickback issue. The suit alleged that it gave kickbacks to customers for promoting its products, including payments for reference site visits. Many of the vendors I’ve worked with would also fall into this category. During my days at Big Hospital System, we regularly received extra attention from our vendor in exchange for being a reference site, and at times we also received credits against our software maintenance payments. I’m sure that could be construed as a kickback, although our site visits were quite “tell it like it is” rather than pure attempts to induce anyone to switch to the vendor. We always insisted that the vendor reps stay out of the discussion and sit in the back of the room or outside the room altogether. It looks like ECW also paid a bonus when prospects actually signed, and paid individual physicians to do references, which is a little murkier.

The way it’s described in the actual filing, any “manufacturers of products paid for in whole or in part by federal healthcare programs may not offer or pay any remuneration, in cash or in kind, directly or indirectly, to induce physicians or hospitals or others to order or recommend products paid for in whole or in part by Federal healthcare programs such as Medicare and Medicaid.” If you take that at face value, then the medical device reps need to stop wooing the cardiologists and orthopedic surgeons, regardless of whether they’re reporting their meals and tchotchkes in compliance with Open Payments. The language also applies to services, so the people from hospice that bring lunch while they explain the services they offer are guilty as well, even though they’re a nonprofit.

Next, let’s look at the issue of cheating on certification. Although some of what they did (such as hard coding the RxNorm codes for the test scripts rather than having the system access the entire library) is pretty egregious, anyone who’s been part of a certification process knows that there’s a gray area between complying with the test scripts and complying with the spirit of the requirement versus the letter of the requirement. There’s plenty of functionality out there that passes the test scripts but isn’t user friendly or sometimes isn’t even usable.

Let’s also look at the allegation that ECW “released software without adequate testing and overly relied on customers to identify bugs and other problems. Some bugs and problems – even some identified as ‘critical’ or ‘urgent’ – persisted on ECW’s bug list for months and even years. ECW lacked reliable version control, so problems addressed in one version of the software or for one particular user could reappear in other versions or remain unaddressed for other customers.” I’m currently working with half a dozen vendors who could fall into that description, and can name a few more to round out the group. Nearly every vendor I’ve worked with is guilty of this to some degree.

As a customer, I’ve been part of beta testing programs that are more like alphas, and have seen code that doesn’t seem to have been tested by anyone conscious. Sure, the coded functionality may have met the technical requirement specifications, so it passed, but when deployed to the field it’s broken or simply useless. I heard from a couple of friends who work for vendors that they were taking joy in ECWs pain. I challenged them to think about their own situations, and whether they’ve ever let a regression error go out the door. It sobered them up pretty quickly. Developers who live in glass houses definitely should not throw stones, because they could be the next ones in the spotlight.

That takes me to looking at the whistleblower component. There was quite a bit of buzz around the fact that the software technician who filed the original suit will receive $30 million. I’m wondering if this is going to be an incentive for individuals to try to prove wrongdoing across the industry in exchange for a potential windfall. Hopefully, this will spur vendors to pay more attention (and devote more resources) to defect resolution as well as defect prevention, since most vendors likely have a backlog of issues needing remediation. On the other hand, it could lead to a lot of rock-turning during which plenty of creepy crawlies will come to light. If vendors have robust systems to manage their issues they’ll persevere, but if not, potential whistleblowers could create a lot of noise that will create distractions that may ultimately harm customers.

Hopefully this settlement will be a call to action for vendors to get their houses in order, and bring greater transparency to the sausage-making that is the certification process. It’s been interesting, though, to see the number of people putting the blame on the certification process itself. The bottom line is that there are rules; if we think they are unfair, we should seek to have them changed in an orderly way rather than just flout them. It will be interesting to look back on this in six months or a year and see whether it’s changed anything or whether it just goes down as another footnote on corporate wrongdoing.

What would you do with a $30 million whistleblower settlement? Email me.

Email Dr. Jayne.

Morning Headlines 6/5/17

The Health Care Industry Cybersecurity Task Force Releases Improvement Report

The Health Care Industry Cybersecurity Task Force, per a Cybersecurity Information Sharing Act of 2015 mandate, releases its report to Congress, detailing six high-level directives over the course of 88 pages.

Health Insurance Startup Bright Health Raises $160 Million

Led by former UnitedHealthcare CEO Bob Sheehy, Minneapolis-based Bright Health closes a $160 million round of financing it will use to expand into new markets via private health insurance exchanges and health system partnerships.

23andMe Asks Customers to Conduct Pain Research at Home

23andMe for the first time enlists customers to help it conduct at-home research on pain tolerance.

OIG Highlights Data Privacy and Security in Semi-Annual Report

The HHS OIG’s Congressional report highlights challenges related to protecting the privacy and security of the data it collects and maintains, as well as those related to “effectively using data to detect and prevent improper payments and to ensure safety and quality of care for program beneficiaries.”

Monday Morning Update 6/5/17

Top News

The Health Care Industry Cybersecurity Task Force releases its slightly overdue report to Congress, detailing six high-level directives over the course of 88 pages:

• Define and streamline leadership, governance, and expectations.
• Increase the security and resilience of medical devices and health IT.
• Develop the workforce capacity necessary to prioritize and ensure cybersecurity awareness and technical capabilities.
• Increase industry readiness through improved cybersecurity awareness and education.
• Identify mechanisms to protect R&D efforts and intellectual property from attacks or exposure.
• Improve information sharing of industry threats, risks, and mitigations.

CHIME has published a far less intimidating 11-page summary of the report’s 100-plus recommendations. HHS officials have thus far been mum on the forthcoming HHS cybersecurity center’s role in fleshing out the recommendations.

Reader Comments

From Jet Blue: “Re: AirStrip Technologies. I met with a prominent venture capital firm today, and we discussed the many high-flying digital health companies that have been funded over the last few years. I learned that AirStrip Technologies has been acquired by Patrick Soon-Shiong, MD. He intends to combine AirStrip with his other companies such as ISirona and Harris CareFx. Apparently the deal is being kept under wraps.” Unverified. ISirona and Harris are among the eight companies NantHealth has acquired over the last six years. AirStrip has flown fairly under the radar this year, and issued just a handful of press releases in 2016. I interviewed President Matt Patterson, MD last March.

From HIT Apostle: “Re: Integration. We are exploring different options for how to best integrate EHR data into our analytics product suite. This would include becoming HIPAA compliant, hiring an ETL team, and adding data processes to our operating model. Have you ever asked your readers what a ballpark figure cost is for this? Are there more cost efficient options, like working with an integration vendor, such as Redox?” I don’t believe I have, so I’ll invite readers to comment with advice and experiences.

HIStalk Announcements and Requests

A HIStalk sponsor and Donors Choose supporter asked me to share this survey on EHR services. They plan to double their already sizable donation once they reach 100 responses.

It’s almost an even split when it comes to the benefits readers believe CommonWell brings to patients, a stat that MC calls into question: “Something very funny happened with this poll. When there were about 80 to 100 responses it was OVERWHELMINGLY leaning towards LESS THAN EXPECTED. Now it is 244 to 252?” April isn’t crazy about how the poll was worded: “Voting ‘less than expected’ (regardless of whether your expectations were very high) leaves the poll results looking like CW isn’t doing anything to benefit patients. ‘More than expected’ indicates you didn’t expect it to do much to begin with. I like the fact that CW is showing steady progress in addressing some of the hardest issues in interoperability. I also like the fact that they opened up the ability for patients to initiate their own record search earlier this year.”

New poll to your right or here: Would you consider switching EHRs if your vendor was involved in a legal situation similar to that of EClinicalWorks? Feel free to add write-in commentary regarding what vendor(s) you would put at the top of your shopping list and how much weight certification would carry.

This Week in Health IT History

One year ago:

• Rumors surface – again – that McKesson is considering selling or merging its McKesson Technology Solutions business unit in the face of drug pricing pressures.
• Intermountain Healthcare, Stanford Cancer Institute, and Providence Health & Services launch a genomic data-sharing network.
• Vice President Biden forms the Genomic Data Commons, an open-access cancer database that will help researchers collaborate and share information, as part of his Cancer Moonshot.
• Practice Fusion settles with the FTC over charges that it misled consumers by asking for reviews of their physicians without adequately disclosing that those reviews would be posted publicly online.
• The House passes the Helping Hospitals Improve Patient Care Act, exempting ambulatory surgical centers from MU and MIPS penalties.

Five years ago:

• Microsoft and GE Healthcare complete the formation of their 50-50 join venture Caradigm.
• Allscripts nominates a three-member board slate to settle a lawsuit and proxy fight brought by key shareholder HealthCor Partners.
• Kaiser’s Oakland hospital gets hit with a $75K Department of Health fine for a 2010 incident in which nurses ignored a telemetry patient’s tachycardia alarms.
• Data analytics vendor MedAssurant changes its name to Inovalon.
• In the UK, Brighton and Sussex University Hospitals NHS Trust is fined $500,000 when hard drives containing the medical information of patients were sold on eBay.

Ten years ago:

• Healthcare management company MED3OOO becomes a major stakeholder in Scottsdale-based InteGreat Concepts.
• Allscripts and NaviMedix announce an agreement to provide Allscript’s eRx NOW ePrescribing solution to NaviMedix’s network of more than 190,000 physician customers.
• David Brailer launches a $700 million private equity fund, Health Evolution Partners.
• Walgreens licenses kiosk and EMR software from Ethidium Health Systems for use in its Take Care Health Systems retail clinics.
• Duke Clinical Research Institute concludes that extra pay does not improve hospital performance.

Weekly Anonymous Reader Question

Last week’s results were slim, indicating that either I asked for too much or that readers don’t have much experience with mentor/mentee relationships (which I doubt given the interest in our webinar on that very topic several weeks ago). Here are the responses I received:

• I work in a company full of people who are almost all fantastic at their jobs. I try to identify the strongest skills in the people I work with most often, and then I emulate them when in relevant situations. As my assignments change, the people and skills I’m exposed to change, so I continue to develop further.
• They listen when I have a complaint – about life or work, they listen. Occasionally some wisdom comes back, but they mostly know just to listen and let me be heard.

This week’s survey: Would you recommend to a relative or colleague that they switch careers to health IT? Why or why not?

Last Week’s Most Interesting News

• EClinicalWorks will pay $155 million to settle DOJ False Claims Act allegations.
• Tablet-based patient education and pharmaceutical advertising vendor Outcome Health raises $500 million.
• Ascension-owned Seton Healthcare (TX) goes back to paper after detecting suspicious activity on its network.
• 21st Century Oncology (FL) files chapter 11 bankruptcy.
• The VA’s IT budget is reduced as it grapples with the decision to either modernize VistA or implement a commercial EHR.

Webinars

June 22 (Thursday) 1:00 ET. “Social Determinants of Health.” Sponsored by Philips Wellcentive. Presenter: David Nash, MD, MBA, dean, Jefferson College of Population Health. One of the nation’s foremost experts on social determinants of health will explain the importance of these factors and how to make the best use of them.

June 29 (Thursday) 2:00 ET. “Be the First to See New Data on Why Patients Switch Healthcare Providers.” Sponsored by Solutionreach. As patients pay more for their care and have access to more data about cost and quality, their expectations for healthcare are changing. And as their expectations change, they are more likely to switch providers to get them met. In this free webinar, we’ll look at this new data on why patients switch and what makes them stay. Be one of the first to see the latest data on why patients leave and what you can do about it.

July 11 (Tuesday) 1:00 ET.  “Your Data Migration Questions Answered: Ask the Expert Q&A Panel.” Sponsored by Galen Healthcare Solutions. Presenters: Julia Snapp, manager of professional services, Galen Healthcare Solutions; Tyler Suacci, principal technical consultant, Galen Healthcare Solutions. This webcast will give attendees who are considering or in the process of replacing and/or transitioning EHRs the ability to ask questions of our experts. Our moderators have extensive experience in data migration efforts, having supported over 250+ projects, and migration of 40MM+ patient records and 7K+ providers. They will be available to answer questions surrounding changes in workflows, items to consider when migrating data, knowing what to migrate vs. archive, etc.

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

People

Aviacode hires David Fong (Gebbs Healthcare Solutions) as VP of marketing and communications, and Jordan Stannard (IMedx) and Byron Triplett (Gebbs Healthcare Solutions) as regional sales executives.

Acquisitions, Funding, Business, and Stock

Health insurance startup Bright Health raises $160 million in a Series B round led by Greenspring Associates. Co-founded by former UnitedHealthcare CEO Bob Sheehy, the Minneapolis-based company works with health systems looking to package insurance plans with their clinical services.

Decisions

• The University Of South Alabama Health System (AL) plans To switch from Siemens Soarian to a new Cerner EHR.
• Buchanan County Health Center (IA) switched from Meditech to Epic in March.
• Girard Medical Center (KS) outpatient clinics will go live with the Prognosis Ambulatory EHR in Q3 2017.
• Platte Valley Medical Center (CO) will switch from Siemens Soarian to Epic on May 30.

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

Reaction Data publishes a new report on the UK imaging market. Carestream, Sectra, and Agfa Healthcare have the best foothold on enterprise business across the pond.

Hackensack Meridian Health (NJ) will add Cota Healthcare’s precision medicine technology to its five-month pilot of IBM Watson as a clinical decision support tool for oncologists. The trial will involve 10 physicians and up to 500 patients.

Sales

Memorial Hospital (IL) will convert from Meditech to Cerner early next year.

Lewis County General Hospital (NY) considers upgrading to Meditech 6.1. Director of Information Systems Robert Uttendorfsky anticipates that transition will cost at least $1.5 million and take 18 months.

St. Luke’s Health System (ID) will deploy Voalte’s communications technology across its eight hospitals.

The Queen’s Health Systems (HI) will integrate Recondo Technology’s ClaimStatusPlus with Epic. The organization got its start in 1859, when Queen Emma and King Kamehameha IV went on a door-knocking tour to raise funds for what would become The Queen’s Medical Center. It is the first (and perhaps only) health system in the US to be founded by royalty.

Government and Politics

HHS Inspector General Daniel Levinson releases OIG’s semi-annual report to Congress, highlighting challenges related to protecting the privacy and security of the data it collects and maintains, as well as “effectively using data to detect and prevent improper payments and to ensure safety and quality of care for program beneficiaries.”

Privacy and Security

From DataBreaches.net:

• Appthority dubs a new backend data exposure risk HospitalGown, outlining in the cheekily titled report above the havoc it could wreak in enterprise environments.
• Identity management system company OneLogin experiences a data breach, putting the information of the Stanford School of Medicine (one of its biggest customers) at risk.
• An unspecified IT issue at The Cosmetic Institute in Australia causes a private index of patient data – including pre- and post-surgery photos, Medicare numbers, and other intimate patient details –  to become publicly accessible via the surgery’s website.

Innovation and Research

MIT Technology Review reports on 23andMe’s decision earlier this month to ask its customers for help in conducting research on pain tolerance. The consumer-friendly genetics company aims to enroll 20,000 people to take surveys on pain tolerance and pain history; 10,000 of those will conduct at-home cold pressor tests, where subjects stick their hand in ice for up to three minutes. The data will likely be used to inform studies on personalized pain medication.

Other

Doctors of BC President Alan Ruddiman, MD cites a “broken culture” at Island Health and its Nanaimo Regional General Hospital as one of the main reasons for continued physician dissatisfaction with the Vancouver health authority’s $135 million Cerner implementation. According to Ruddiman, such discontent has led to physician burnout and resignations – a state of affairs that will not only affect patient care, but the community, too. “If the medical personnel are hurting and they are uncoupling from this hospital then it’s only a matter of time where this gets known as a community that’s not an attractive place to live and work and that hurts everybody …” he added.

The local paper casts Judy Faulkner-like aspirations onto VitusVet founder Mark Olcott, an entrepreneurial veterinarian working to make pet health records interoperable, and appointments and prescriptions easier to fill. Focusing on practices with four or more vets, the company hopes to pass the $1 million revenue mark this year after grossing a quarter of that in 2016.

Sponsor Updates

• LogicWorks develops a new set of DevOps tools for running applications on the AWS cloud.
• Inc. Magazine includes Nordic in its list of “Best Workplaces 2017.”
• NTT Data Services wins the “Deal of the Year” award for its acquisition of Dell Services.
• Clinical Computer Systems, developer of the Obix Perinatal Data System, PatientKeeper, and Wellsoft will exhibit at EHealth Canada June 4-7 in Toronto.
• Experian Health will host its Connect Health Conference June 6 in Chicago.
• The SSI Group will host a regional user group meeting June 6-7 in New York City.
• Surescripts and ZeOmega will exhibit at the AHIP Institute & Expo June 7-9 in Austin, TX.
• TransUnion publishes “No More Surprises: Increase POS Collections with Pre-Care Cost Estimates.”
• Versus Technology will host an open house at its new Bayside Education & Visitor Center June 7 in Traverse City, MI.
• Huron releases a video, Transforming Healthcare, featuring Harvard Business professor and author Clayton Christensen.
• ZirMed publishes a new e-book, “Leveraging Predictive Analytics to Ensure Professional Revenue Integrity.”
• Diameter Health publishes a new video featuring Chief Strategy Officer John D’Amore and Kansas Health Information Network Executive Director Laura McCrary.
• Encore, a Quintiles company, outlines what providers need to become Advanced APMs under MACRA in this white paper.

Blog Posts

• Emergency Preparedness Training and Testing: CMS Rule (LiveProcess)
• Empowering patients with digital innovation and design thinking (Meditech)
• Willow Health Care in Drivers Seat Cruising Down Road to Success (Netsmart)
• The New CISO Leader (Orchestrate Healthcare)
• The Evolution of Clinical Mobility: Unifying Communication and Workflow (PatientSafe Solutions)
• Notes from the Field: Consensus 2017 (PokitDok)
• The important role nurses play in care transition and reducing readmissions (PerfectServe)
• ROI Celebrates Annual Red Nose Day (ROI Healthcare Solutions)
• The Importance of Simulations in EHR Training (Sagacious Consultants)
• How to Know When to Quit (Salesforce)
• Consumer Impacts Patient Satisfaction: What Healthcare Providers Can Do (The SSI Group)
• Improved Patient Communication Can Help Save Lives (Solutionreach)
• Supporting Project C.U.R.E. at 2017 ASE (UltraLinq)
• From the HEDIS 2017 Trenches: The Final Countdown (Verscend Technologies)
• Picking up the pace. (Voalte)
• The Missing Ingredient to Building Healthy Communities (Conduent Health)
• Promoting Patient Engagement with Care Plans (Zynx Health)
• Human Error, Not Hacking, Most Common Cause of Data Breaches at VA Hospitals (Definitive Healthcare)

Contacts

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

Morning Headlines 6/2/17

Outcome Health Raises Financing at $5 Billion Valuation to Accelerate Growth and Transform Healthcare

Tablet-based patient education and pharmaceutical advertising vendor Outcome Health raises a $500 million investment round on a $5 billion valuation.

The ADHA wants to link up all of Australia’s health systems

The Australian Digital Health Agency releases a request for tender seeking technology vendors that will help it achieve “a digitally interoperable environment for the Australian health and care system,” over the next five to 10 years.

Accenture to Acquire LabAnswer, Expanding Its Life Sciences and Cross-Industry Research and Laboratory Informatics Capabilities

Accenture acquires LabAnswer, a laboratory research and informatics technology consulting firm, and will combine the business with its existing R&D informatics capabilities to establish the Accenture Scientific Informatics Services division.

Privacy Breach at Beverly Hills Clinic Puts Thousands of Patients, Some Celebrities, at Risk

A former employee of a Beverly Hills clinic steals 15,000 medical records, some of which belong to celebrities, after being fired for stealing from the practice.

News 6/2/17

Top News

Doctor office advertising and patient education technology company Outcome Health raises $500 million in funding, valuing the Chicago-based company at $5 billion.

Forbes estimates that the 31-year-old co-founder Rishi Shah owns 80 percent of the company’s shares, giving him a paper net worth of $3.6 billion.

Forbes also estimates that the company’s annual revenue is $200 million and it’s growing 100 percent per year, with most of the money coming from drug companies anxious to get their message in front of patients at an opportune time.

Vivek Kundra, the first US CIO, is a company EVP.

HIStalk Announcements and Requests

Tuesday’s HIStalk page views exceeded 10,000, which isn’t a record or even all that much higher than the usual daily traffic, but it’s the highest count during a non-HIMSS week other than June 28, 2016 (when McKesson announced that it would divest its Technology Solutions business) and July 30, 2015 (when the DoD awarded Leidos/Cerner its EHR contract).

I thought it would be interesting to look at the percentage of females serving on the executive teams of the top five healthcare IT companies by revenue as listed on the new Healthcare Informatics 100, which might bring to mind the old Doors song “Five to One”:

• Optum – 25 percent
• Cerner – 18 percent
• Cognizant – 16 percent
• McKesson – 25 percent
• Philips – 17 percent

This week on HIStalk Practice: Allergy Partners opts for Medfusion technology. Rhode Island practices unite as Brown Physicians Inc. Outcome Health raises $500 million in a quest to assist 70 percent of practices. Practice Fusion’s Matthew Douglass argues that America’s doctors need net neutrality. HealthTap expands to New Zealand, while Heal heads to Washington, DC. EVisit raises $2 million. US HealthWorks taps AmericanWell to power its new telemedicine service for employers.

Thoughts on the $155 Million DOJ Settlement of EClinicalWorks

I had these reactions when writing about the company’s settlement.

• I was curious about how many EPs have attested to Meaningful Use using EClinicalWorks. ONC’s Health IT Dashboard shows around 25,000, making it the #3 EHR vendor (behind Epic and Allscripts).
• The settlement amount represents 35 percent of the company’s annual revenue of $440 million.
• The settlement could be only the beginning of ECW’s problems, as it now has to deal with potential customer defections, the inevitable drop-off in sales, and potential class action provider lawsuits. It could possibly be sued by its certifying body, Drummond Group, plus it is required by the settlement terms to implement internal and external review programs.
• I assume the value of the settlement was based on the MU payments that were made to ECW-using EPs, which I’ll also assume means that HHS won’t go after the EPs individually. The complaint says the federal government is entitled to recover triple the value of fraudulent claims (presumably the MU incentives paid) plus a percentage of the company’s profits that represented “undue enrichment.” Still, as reader Debtor points out, ECW-using EPs could have been paid around $2 billion in Meaningful Use incentives, so as he or she says, “that the DOJ settling for pennies on the dollar and no criminal prosecution is unbelievable.”
• Does Drummond Group, which certified ECW’s EHR, bear any responsibility (legal or otherwise) for failing to detect that ECW was – according to the complaint – rigging its test results? On the other hand, it could argued that since the certification testing scenarios are public and static, the certification body has no easy way to detect fraud in observing only the desired scenario outputs. Certification testing is not dynamic nor comprehensive – it’s following a script to see if the expected outputs are produced.
• The $30 million whistleblower payment will surely encourage others to report any similar problems with other vendors.
• Clearly DOJ was not happy that ECW apparently charged customers for software updates, made it hard and/or expensive for them to migrate from ECW to other EHRs, and did not make it easy for its customers to exchange information with other practices.
• The kickback portion of the complaint arose from ECW giving users a $500 maintenance credit to refer a prospect who eventually signed on as a customer (those payments totaled $144,000), paying users to host site visits ($249,000), compensating customers to provide good product references, and providing consulting fees, honoraria, and gifts to influential users who pitched its product, with one unnamed doctor earning “tens of thousands of dollars in ‘consulting’ fees.” The complaint makes it clear that manufacturers can’t pay any kind of remuneration to encourage use of their products for which the federal government pays via Medicare and Medicaid. 
• It’s not clear how the settlement affects ECW-using EPs who could continue attesting under the Medicaid part of Meaningful Use for several more years. Apparently not at all since the product’s certification remains intact.
• Two ECW technical employees will pay relatively small settlement amounts over the product’s inability to process RxNorm terminology for e-prescribing. One of those employees was the developer in charge of the RxNorm software functionality and the other submitted ECW’s final certification application. The complaint says the certification body certified the product in 2013, heard afterward from ECW employees that the software didn’t really process RxNorm codes, and then re-tested the product with the same protocol in 2015, which ECW passed only because it hard-coded the expected 16 RxNorm codes.
• The complaint says ECW’s EHR did not use LOINC or SNOMED CT terminology.
• The complaint says ECW released software without adequate testing, relied on customers to report problems, allowed critical problems to remain unresolved for months or years, and reintroduced previously fixed bugs because its software version control was not reliable.
• The company’s October 6-9 user group meeting should be interesting.

The whistleblower in the case was Brendan Delaney, who was a New York City employee implementing ECW at Rikers Island for prisoner healthcare when he noticed software problems. He has also worked on ECW projects for Arcadia Solutions, HSM Consulting, and as a self-employed contractor. His LinkedIn says he’s revenue cycle manager at NYU Langone Medical Center, or at least was before he learned he’ll be pocketing $30 million (but unfortunately for him, whistleblower windfalls are taxed as ordinary income).

Interesting points from the five-year Corporate Integrity Agreement the company signed with HHS OIG:

• ECW is required to implement a quality assurance program to oversee software defects, usability problems, and any other issues that affect patient safety or product certification and to post known software problems on its portal.
• The company is required to create usability and patient safety advisory teams, consisting of at least a doctor, pharmacist, and nurse.
• ECW is prohibited from using contract language that prohibits customers from disclosing patient safety concerns and agrees that it won’t enforce that requirement in existing contracts.
• The company must help customers who want to migrate to other EHRs and can’t charge them any fees, penalties, or service charges.
• ECW is required to contact every customer with an email subject line of “Important information about your EHR software and services. You have new options free of charge to you.” The communication must start with a statement indicating that ECW has settled with HHS OIG to offer them free upgrades to the latest production version.
• The company must track any payments made to existing customers for marketing purposes and must list all of payments it makes to providers on its website.

What other vendors should do based on the settlement:

• Review the certification process to make sure nothing is being faked, talking to the technical people rather than managers anxious to avoid becoming the shot messenger.
• Don’t provide any kind of incentives for customers or their employees to help make new sales.
• Make sure customers are notified quickly of software problems that endanger patients or that can cause billing mistakes or certification shortcomings.

Meanwhile, the law firm that represented the whistleblower in the lawsuit adds a few points:

• The firm filed Brandon Delaney’s lawsuit against ECW in 2015.
• The firm’s website includes archived copies of advisories ECW sent to its customers that warned of software problems.
• Brandon Delaney provided this statement: “I was profoundly saddened and disappointed by the indifference of senior health department officials and investigators for New York City when I provided detailed information about serious flaws in the EHR software that could endanger patients. I am grateful that Phillips & Cohen and federal government attorneys recognized the seriousness of my charges and dug into the matter quickly and thoroughly.”

The Letter EClinicalWorks Sent to its Customers Thursday

Dear Customer:

Yesterday we announced a settlement with the government. As part of the settlement, eClinicalWorks paid $155 million and agreed to bolster its compliance program. The inquiry leading to the settlement primarily centered on technical aspects of the Meaningful Use program and allegations that eClinicalWorks software had technical non-conformities related to some of the criteria, all of which have since been addressed.

eClinicalWorks cooperated fully with the government. We have not admitted any fault or wrongdoing, and our goal as a company is to always make sure we are doing the right thing. We have decided to put this matter behind us and concentrate all of our efforts on our customers and continued innovations to enhance patient care delivery. Importantly, our software remains fully certified under the Meaningful Use program.

One of the technical non-conformities alleged by the government involved the use of RxNorm codes in electronic prescriptions. From 2014 to August 2016, electronic prescriptions sent by eClinicalWorks users included NDC codes rather than RxNorm codes.  During this time period, more than 500 million prescriptions were successfully transmitted and filled, and most major pharmacies did not support RxNorm codes. The failure to include RxNorm codes in electronic prescriptions was completely inadvertent on the part of eClinicalWorks, as our software used RxNorm codes in other parts of the system, such as in C-CDAs. We gained nothing by not including the codes, which are available for free from the National Library of Medicine. We resolved this issue as soon as we learned of it.

Another technical non-conformity identified by the government involved data portability. The 2014 Edition certification criteria require EHR software to “batch export” patient records. There was confusion about the meaning of this requirement, however, prompting ONC in 2015 to issue a clarifying FAQ. When eClinicalWorks was tested for certification in 2013, its authorized certification body (ACB) at the time, CCHIT, determined that our software satisfied this requirement. In 2015, our new ACB, Drummond Group, disagreed and identified this as a non-conformity. eClinicalWorks resolved the non-conformity in 2015, and our software meets all MU Stage 2 data portability requirements.

Historically, technical non-conformities with the MU Program were addressed through an administrative rather than a legal process (visit the ONC’s Certified Health IT Product List (CHPL) website for a list of EHR vendors with non-conformities: https://chpl.healthit.gov/#/search). eClinicalWorks chose to settle this matter to avoid the uncertainty of a prolonged legal dispute which could have been disruptive to our customers, our employees and our company.     

The government also alleged that eClinicalWorks’ customer referral program violated the federal Anti-Kickback statute. Under this program, called “Refer a Friend.”eClinicalWorks granted a credit, typically in the amount of $500, against existing users’ support and maintenance fees. Between 2011 and 2016, eClinicalWorks paid $392,000 to users under this and related programs. While referral programs like this are common in the industry, and while HHS-OIG has provided no guidance regarding them, the government took the position that the payments were improper. We disagreed but have nevertheless discontinued the program.     

There is a silver lining to this settlement. Today, eClinicalWorks has a more robust compliance program, and we continue to invest our resources and energy into making sure the products and services we deliver serve our customers well in the long run. We paid the settlement amount using cash on hand and have the resources to continue to grow and innovate.

It is our privilege to serve you. I am committed to enhancing our products and services. We will be releasing V11 later this year as planned and seeking certification for Meaningful Use Stage 3.   

We founded this company 17 years ago with the mission of improving healthcare together. The settlement does not change that.

Sincerely,

Girish Navani, CEO

Webinars

June 22 (Thursday) 1:00 ET. “Social Determinants of Health.” Sponsored by Philips Wellcentive. Presenter: David Nash, MD, MBA, dean, Jefferson College of Population Health. One of the nation’s foremost experts on social determinants of health will explain the importance of these factors and how to make the best use of them.

June 29 (Thursday) 2:00 ET. “Be the First to See New Data on Why Patients Switch Healthcare Providers.” Sponsored by Solutionreach. As patients pay more for their care and have access to more data about cost and quality, their expectations for healthcare are changing. And as their expectations change, they are more likely to switch providers to get them met. In this free webinar, we’ll look at this new data on why patients switch and what makes them stay. Be one of the first to see the latest data on why patients leave and what you can do about it.

July 11 (Tuesday) 1:00 ET.  “Your Data Migration Questions Answered: Ask the Expert Q&A Panel.” Sponsored by Galen Healthcare Solutions. Presenters: Julia Snapp, manager of professional services, Galen Healthcare Solutions; Tyler Suacci, principal technical consultant, Galen Healthcare Solutions. This webcast will give attendees who are considering or in the process of replacing and/or transitioning EHRs the ability to ask questions of our experts. Our moderators have extensive experience in data migration efforts, having supported over 250+ projects, and migration of 40MM+ patient records and 7K+ providers. They will be available to answer questions surrounding changes in workflows, items to consider when migrating data, knowing what to migrate vs. archive, etc.

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

Acquisitions, Funding, Business, and Stock

Medical image viewing system vendor TeraRecon acquires machine learning vendor McCoy Medical Technologies and creates a new company that will distribute trained machine learning algorithms for clinical decision support, also offering researchers and hospitals an easy way to distribute their algorithms for research or commercialization.

Accenture will acquire 250-employee laboratory informatics consulting firm LabAnswer, which it will fold into the newly created Accenture Scientific Informatics Services. 

Sales

Carilion Clinic (VA) chooses Influence Health’s directory listings management system to monitor its online presence, provide accurate online location listings, and call out unofficial social media pages.

Memorial Sloan Kettering Cancer Center (NY) and Intermountain Healthcare (UT) will use the genomics platform of Philips for cancer research and treatment.

People

Children’s of Alabama (AL) hires Bob Sarnecki (ClearData) as interim CIO.

In England, Beverly Bryant (NHS Digital) will join System C as COO.

SurveyVitals, which offers digital patient experience surveys, hires Robert Harrington, Jr., MD (Reliant Post-Acute Care Solutions) as chief medical officer.

Rob Bart, MD (LA County Department of Health Services) joins UPMC as CMIO.

Announcements and Implementations

An Ellis and Adams research report reviewing the impact of hospital acquisitions on quality finds that the average quality score of an acquired hospital slipped 5 percentage points in the first year.

DrFirst launches new solutions for Meditech users – SmartSig to manage free text prescription instructions and integration with prescription drug monitoring program databases.

Privacy and Security

The medical records (including photos) of 15,000 patients of a Los Angeles plastic surgery clinic – some of them celebrities – have been stolen by a fired employee.

In India, the Mumbai health department’s online birth and death registry is taken offline following complaints that its lack of security was allowing anyone to look up random names and print their birth or death certificates. A government official complains that only the medical health officer is now allowed to use the system and “he cannot keep printing certificates for everyone” in keeping up with the city’s daily workload of 400 births and 200 deaths.

Australia’s health department decides that the records of people who opt out of its My Health Record system won’t be deleted, but rather hidden from providers, allowing those who opt out to change their minds later.

Other

Australia’s Digital Health Agency issues a request for tender for developing a plan to connect all health-related systems over 5-10 years.

A five-sentence letter published in NEJM in 1980 concluding – without much evidence – that opiates aren’t addicting when prescribed for chronic pain has been cited more than 600 times since, with references to the article spiking after OxyContin was brought to market in 1995. The authors note that most of the citations misinterpreted the information or mischaracterized the letter’s conclusions in encouraging doctors to use long-term opiate therapy that contributed heavily to today’s national addiction, leading to their recommendation that authors cite previous studies carefully.

Facebook is hosting an invitation-only meeting next week to court drug companies as advertisers.

Sponsor Updates

• ECG Management Consultants publishes its “2017 Thought Leadership Compendium.”
• EClinicalWorks will exhibit at the California Primary Care Association Region IX Clinical Excellence Conference June 4-6 in Lahaina, HI.
• FormFast and Imprivata will exhibit at EHealth Canada June 4-7 in Toronto.
• Aprima wins Frost & Sullivan’s product leadership award for its RCM platform.
• HBI Solutions publishes a new white paper, “Turn Data Science into Value: The Four Key Requirements.”
• The Atlanta Business Chronicle profiles CFO of the Year finalist and Ingenious Med Chief Compliance Officer and CFO David Lamm.
• InterSystems’ TrakCare tops global EHR deployments, according to a new KLAS report.

Blog Posts

• Arkansas: Concerns and opportunities (EClinicalWorks)
• Go Beyond the Acquisition: Wake Forest Baptist Health Leverages Journey Mapping for Improved Patient Engagement (Evariant)
• Empowering patients with digital innovation and design thinking (Meditech)
• How to Land Top Information Security Talent (Fortified Health Security)
• 5 Common Pitfalls of Technology Strategy Development (Hayes Management Consulting)
• 3 Roadblocks to Digital Transformation (The HCI Group)
• The CIO as a Change Agent (Optimum Healthcare IT)
• The Right Alert, The Right Time, The Right Person (Impact Advisors)
• A Healthcare Marketer’s Guide to Ranking Number One (Influence Health)
• 3 Quick Tips for Refunds in Healthcare (Plus, How to Avoid Them in the First Place) (InstaMed)
• Garbage In, Gospel Out? (InterSystems)

HIStalk sponsors were listed in the Healthcare Informatics 100 highest-revenue healthcare IT companies, representing 38 of the vendors named:

• Ability Network (#75)
• Advisory Board (#19)
• Agfa HealthCare (#72)
• CSI Healthcare IT (#70)
• Cumberland Consulting Group (#95)
• EClinicalWorks (#34)
• Elsevier (#64)
• Evolent Health (#48)
• Experian Health (#45)
• GE Healthcare (#12)
• Harris Healthcare (#58)
• HCI Group (#82)
• Impact Advisors (#99)
• Imprivata (#71)
• Infor (#38)
• InterSystems (#32)
• Leidos (#9)
• Lexmark Healthcare (#61)
• Medecision (#94)
• Medhost (#67)
• Meditech (#33)
• MModal (#43)
• NantHealth (#90)
• Navicure (#87)
• Netsmart (#46)
• NextGen Healthcare (#31)
• Nordic (#59)
• Nuance (#16)
• Optimum Healthcare IT (#73)
• Philips (#5)
• Roper Technologies (#26)
• Solutionreach (#91)
• Spok (#57)
• Sutherland Healthcare (#68)
• T-System (#97)
• Verscend (#42)
• West Corporation (#41)
• Xerox (#8)

Contacts

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

HIStalk Interviews Jason Krantz, CEO, Definitive Healthcare

Jason Krantz, MBA is CEO of Definitive Healthcare.

Tell me about yourself and the company.

I’m the CEO of Definitive Healthcare. We started about six years ago. We provide detailed information and analytics on the healthcare provider market. We track data on everything from hospitals to physicians to imaging centers. Our goal is to have the best data on every facility and provider of healthcare in the US.

Does your business overlap with that of HIMSS Analytics?

HIMSS tracks a lot of data on technologies within hospitals. We do that as well. We’re much more broad. We tie the technology back to the analytics on what’s actually happening at the hospital. Things around readmission rates are very important to our clients. We track a lot of data on affiliations and how these organizations refer patients back and forth across the continuum of care.

How much of the information that you collect in having conversations with people in health systems hasn’t been publicly announced?

A lot of the really interesting stuff that we get is through conversations with IT directors and CIOs at hospitals, as well as people on the finance side. Probably 30 percent to 40 percent of our data is from a completely proprietary source that has not been announced anywhere else.

I assume a significant part of your market is vendors looking for marketing and sales data. What kind of information do they want?

The uses are changing over time. Six years ago, it was, do they have an EHR system? Which one? That is still a very important element of what they want to know, but it’s for a different reason. Oftentimes they’re trying to think about how to bolt on technology.

As the technology is becoming more sophisticated and EHR systems are becoming more ingrained with what they’re doing every day, a lot of our clients are interested in what the healthcare ecosystem looks like in a particular market. Who are the players, who owns who, who works with who and aligns with who. All of that is incredibly important to the technology players because the EHR system being at one hospital is interesting, but where it becomes really useful to healthcare is when everybody can talk to each other.

A lot of the vendors now are thinking about, how do I expand my reach beyond the hospital or the health system to link in all of the imaging centers and the most important physician groups and all of that? Our data helps paint a picture of what that ecosystem looks like and where the informal partnerships and alliances exist. That helps them think about, what is our go-to-market strategy? Who are the important players to get involved that are the influencers and can drive change within that market?

Other things they’ll think about is, depending on what their technology is, the revenue cycle guys will try to understand not only what’s in there today, but the collection process for that hospital and who the important people are for that collection process. The care coordination people want to understand the ACOs that are in partnership with the hospitals. All of that arms them with the information that they need to go have an intelligent conversation with a CIO or a CFO.

Does your conversation touch on user satisfaction with a given product or a potential system replacement?

We don’t go so far as to say somebody is unhappy. There’s some inferred satisfaction with the fact that they’re making a change or looking for a new technology, which is the type of things that our data will pick up. A lot of the people that we’re speaking to on a day-to-day basis are not going to go out on a limb and say, we’re flat-out unhappy with a vendor. Therefore, we don’t necessarily ask that question.

A lot of the product decisions must be driven by new affiliations, where a hospital or practice didn’t necessarily acquire or become acquired, but partnered with another organization in a non-ownership model.

There’s so much of that. Obviously mergers and acquisitions is a pretty tremendous trend within the market right now. We track something like one merger-related piece of news per day, a major piece of news.

Informal alliances are becoming increasingly important because there’s a limit to how far you can take the M&A game, especially as these markets become a bit more concentrated with ownership already. As everything moves to outpatient, it’s a lot less expensive to start this stuff up on your own.

Urgent care is a great example. You can have a couple of physicians who band together and create an urgent care clinic or two or three or four that can become extremely profitable very quickly. The hospitals may end up buying those up over time, but those are sprouting up so quickly that you need to create alliances with those organizations, even if you’re not in a direct ownership situation. The move to outpatient is spreading out the care so much that the need to have these informal alliances is becoming more and more important.

What other big trends are you seeing?

Something that comes up a lot that is nascent but that our clients are particularly interested in is the move towards mobile and telehealth. It’s almost like the Internet was in 2000. Telehealth is finally starting to come to its time in the spotlight. Telehealth has been around for a while and mobile health’s been around for a while, but the tools didn’t exist for it to get exciting — better phones, better cameras, and the ability of wearables that can collect information. All of a sudden all of these technologies can actually work, whereas with the Internet in 2000, it was Pets.com and in 2002, that company went out of business and everybody said, “That was the stupidest idea ever.” Now there’s Chewy, which is a billion-dollar company selling pet food online.

The mobile and telehealth stuff is finding its way now after trying to for many years. We’ve seen a lot of interest and a lot of questions around, what are people doing? What’s working? What’s not? A lot of that is just because it is still such a new market that there’s a lot of interest in how to make it work.

Are health systems forming relationships with turnkey companies like Teladoc that has their own doctors or are they more interesting in creating a service that features their own medical staff and brand identity?

Where we’re seeing health systems attacking is much more around chronic diseases. How do you manage that better? If you think about a capitated payment model where the health systems are taking some of the risk for things like diabetes care, if you can keep people out of the hospitals, obviously that’s a tremendous benefit to you. Things around wearables that can measure blood glucose and technologies like that are very interesting to them,  to be able to get that data in real time and essentially get in front of any issues before they become a big issue.

Along the same lines is medication adherence. That’s a little bit out of pure telehealth and more into apps. How do you engage that patient on a regular basis and ensure that they are taking their medications? Once you release somebody from your hospital, how do you make sure that they don’t come back in for the same reason? Payment structures are driving them to think about things like that.

The classic telehealth, the doctor on the phone, is still struggling. Where we’ve seen a lot of success is around more behavioral, psychology, and psychiatry.

Are you detecting budgetary caution around the possibility that many patients could become uninsured with Affordable Care Act changes?

There’s a lot of talk of it. We haven’t completely seen that come through. We haven’t really noticed our clients saying that budgets are getting cut or projects need to be pushed down the line. It is potentially coming. There’s just still so much unknown that nobody’s hit the panic button quite yet.

And, the need for change is so high within the healthcare system that there’s no stopping it. They need to drive down structural costs still applies, whether there’s uninsured or not. On the one hand, you don’t want to spend as much money. On the other hand, you need to change your system quickly enough to be able to deal with lower payments if that’s what’s going to happen in the future.

What’s it like running a research-based business?

The most important thing that we think about is innovation. It’s absolutely essential. How do you get information that nobody else has been able to find, do it in an efficient way, and present it in a way that people can take tomorrow and go utilize? Within healthcare specifically, there’s just so much data that’s out there that it can quickly become noise if you’re not innovating and showing clients, here’s what you should draw from the information. Here’s how you can go use it tomorrow. Here’s data that you just can’t find anywhere else.

It’s an extremely difficult business. It’s competitive. The way to stay in front of the competition is to continue to innovate and do things nobody else is doing. It changes so fast. Every day we’re rethinking about, how do we do this better? That’s essential to staying at the place that we’ve been able to get to.

EPtalk by Dr. Jayne 6/1/17

I took a break from writing over the Memorial Day weekend due to having the privilege of participating in events honoring our nation’s veterans. On Saturday, I assisted with an Honor Flight, welcoming 22 veterans and their families back from a trip to Washington, DC, where they visited the monuments dedicated to their service.

Along with active duty service members, we lined the airport terminal to salute the veterans as they were transported from the gate to the baggage claim area. There they emerged from a tunnel of American flags to greet family and well-wishers in a celebration complete with a USO-style band. These gentlemen, most of whom are in their late 80s and early 90s, helped save the world. I am honored to have been able to work with them.

Three brothers were on the flight, having served in WWII, Korea, and Vietnam. They lifted a beer at the Vietnam Memorial to honor fallen friends. The picture of that moment shares more than a thousand words. WWII veterans are passing on at a rate of 640 per day, according to VA data. Most of the veterans I’ve worked with over the years don’t want to talk about their service, but saying thank you is always appreciated.

Sunday was a little more sobering when I volunteered with a group charged with placing flags at all graves in our National Cemetery as well as on the graves of veterans buried at a dozen Jewish cemeteries. Our local post of the Jewish War Veterans of the USA provided breakfast for over 500 of us before we set out on our task. After the flag is placed, it is saluted. Each veteran’s name is read and they are thanked for their service.

Our small group placed over 1,000 of the 200,000 flags that went out that day. A small commitment compared to what those we honored have given. If you’ve never done this and have the opportunity, I would strongly encourage you to take part. Every one of those flags has a story and it’s something to think about on days when we’re tempted to complain about spotty cell service and slow lines at Starbucks.

I saw patients on Memorial Day itself since many of my partners are former military officers and having the rest of us work allowed them to participate in local remembrances. It was a busy shift due to the three-day weekend.

I experienced something I haven’t seen before, which was having a parent drop off a 12-year-old at the urgent care and then leave him in the exam room to run errands. Of course, we can’t treat a child without a parent there to provide consent, so we had to wait. After an hour, I was wondering at what point it becomes child abandonment when the parent returned, acting like his actions were no big deal. I hope the patient wasn’t too scared about being left alone. We tried to check on him regularly while waiting for Dad to turn back up.

Tuesday sent me fully back into the healthcare IT fray, mopping up after a client who decided to try to install an upgrade over the weekend despite their vendor’s support desk being closed for the holiday. While I was re-running and monitoring the upgrade scripts, I had a chance to catch up on some articles that friends and readers had sent my way.

One caught my attention with its headline that “Patients Fare Worse with Older Doctors, Study Finds.” It cites research from Harvard Medical School looking at Medicare data for over 700,000 hospital admissions. The patient mortality rate rose for each decade of physician longevity, ranging from 10.8 percent for physicians under age 40 to above 12 percent for physicians over age 60. However, physicians who saw large volumes of patients didn’t seem to have a change in mortality rates due to age, rather those rates remained consistent for higher-volume physicians. Seeing more patients may force physicians to stay current, but it could also be that lower volume physicians see fewer patients because they are less knowledgeable.

The article offers some other interesting conclusions, but I’d be interested to hear what readers think. One 74-year-old physician keeps current by reading multiple medical journals each day. That kind of volume would be hard for me to do, so I applaud him for being what he describes as “addicted to keeping up to date.” He’s a medical school dean, so I’m not surprised.

Another piece from Boston’s NPR new station chronicled one burnt-out doctor’s decision to leave medicine. The author notes that while many people ask why she left, virtually no physicians ask her that question. They instead ask how the transition worked.

I’ve had numerous physicians approach me over the last few years asking about clinical informatics as a potential way to get out of clinical practice but still be able to positively impact patient care. I would be dishonest if I didn’t acknowledge that I leveraged the move to full-time informatics as a way to get out of paying for supplemental liability insurance (so-called “tail coverage”) as well as a way to get free of a restrictive non-compete clause. In my situation, those were beneficial side-effects of the move, however, rather than incentives.

The article was sent to me by a former residency colleague who is trying to formulate her own exit strategy. She was one year behind me in training and we caught up recently for drinks. Out of the 13 family medicine residents in our two classes who we’ve kept up with:

1. Clinical informatics: 1
2. Residency faculty: 1
3. Retrained in another specialty: 1
4. Cosmetic/age-reversing medicine: 2
5. ER/urgent care: 2
6. Concierge practice: 1
7. Left medicine to care for family: 1
8. Part-time practice: 1
9. Incarcerated: 1
10. Full-time primary care: 2

Those are some sobering statistics for physicians who aren’t even 20 years out of training. They also paint a different picture of the primary care shortage, one where lack of training slots are not the problem.

I hate to see my friend consider leaving medicine, as she practices in a relatively underserved area and also serves as the medical director for a home hospice organization. Those vital services aren’t easily replaced. She has already stopped delivering inpatient care and next week marks the end of her hospice practice. Her eight-year plan gets her children nearly through college while letting her only sit for Board recertification exams one more time. I’m glad that she’s designing a strategy that lets her keep seeing patients while trying to address potential burnout. I will be supportive no matter which way she decides to go.

Are you thinking about leaving healthcare or healthcare IT? Email me.

Email Dr. Jayne.

Morning Headlines 6/1/17

Electronic Health Records Vendor to Pay $155 Million to Settle False Claims Act Allegations

eClinicalWorks will pay a $155 million to settle a Department of Justice investigation alleging that it misrepresented the capabilities of its software during the EHR certification process.

Soon-Shiong appointed to health IT committee

House Speaker Paul Ryan appoints Patrick Soon-Shiong, MD  to the 25-member Health Information Technology Advisory Committee, despite a recent STAT investigation alleging that Soon-Shiong orchestrated inappropriate financial transactions between his businesses and his non-profit research organization

Health information exchanges reduce redundant medical procedures

A Brookings Institute report, co-authored with researchers from SUNY Buffalo and the University of Connecticut, finds that the implementation of a health information exchanges in western New York was associated with a decrease in the number of repeated therapeutic procedures performed, but had no impact on the number of diagnostic procedures performed.

Swedish double-booked its surgeries, and the patients didn’t know

A Seattle Times investigation finds that Swedish Health neurosurgeons routinely double-booked themselves, running multiple operating rooms at the same time.