Reader Survey Results 2017

I do a reader survey once each year, usually right before the HIMSS conference. I then review the results along with other feedback I receive to plan the upcoming year. I always make at least a few changes that readers suggest. Thanks to everyone who completed the survey, including the person who won the random drawing for a $50 Amazon gift card.

I have a diverse and opinionated readership. Some people are interested in only a subset of industry topics. Others want a basic bullet list of headlines and nothing more. Still other readers either like or don’t like rumors, humor, or certain parts of HIStalk like CIO Unplugged or Readers Write. While I truly appreciate and will consider all suggestions, I don’t want to fall into the trap of “designing by committee,” where the quest to displease no one ends up in pleasing no one, either. So, don’t think I’m not listening just because I didn’t immediately act.

I’ve been able to stick to writing HIStalk for 14 years now only because I do it in a way that makes me happy and satisfied. I’m lucky to have found a self-selected audience that keeps coming back. I’m therefore in agreement with the most common “what should I change” suggestion, which is to not change anything significantly unless it’s a clear improvement that’s within my grasp. I have zero interest in getting bigger or slicker if it’s not fun.

I’ve also learned a big lesson over the years – everybody likes to read, but few like to write. Suggestions often involve getting new non-vendor contributors or participants, which would be fantastic, but that has failed every time I’ve tried. Writing is hard for most people and their jobs often limit their availability, so even the most eager writers often fade away after writing a handful of times. Read on below for the kinds of contributors I can use and would be willing to pay for (another lesson learned – consistent contribution requires some level of payment).

Respondent Characteristics

I received 201 survey responses this year. Some respondent highlights:

• 80 percent have worked in the industry for at least 10 years
• 28 percent work for a provider organization
• 8 percent are CIOs
• 33 percent work for providers and have buying authority greater than $10,000
• 88 percent have a higher appreciation of companies that they read about in HIStalk
• 45 percent have a higher appreciation of companies that sponsor HIStalk
• 92 percent say reading HIStalk helps them do their job better

That last stat is what keeps me coming back every day. Readers, too, probably.

Elements Appreciated

I asked which HIStalk features the respondent appreciates most. I should note that I haven’t run an Advisory Panel for a long time since I was getting fewer and fewer responses, so many respondents probably don’t recall what it is.

Suggested Changes

Here are the most frequently suggested changes, along with my responses.

Improve the search function.

I’ve added somewhat effective “search by date” capability in the sidebar. It’s not perfect, but it works well enough that even I used it when trying to find something I’ve written in a given date range.

Move the Readers Write bios to the top of the article and include that in the email notification.

Good idea. I will do that. I initially had a reason for putting the bio last, but I’ve forgotten what it was.

Create articles around questions that readers can answer anonymously.

I like that idea a lot and I’ll start that this weekend. It will fizzle out quickly if I don’t get responses, but it’s worth a shot.

Spotlight consumer digital healthcare.

I’m a hospital guy, so while I cover the topic when something interests me, it’s not a big emphasis. I would be happy to add a weekly digital health summary if someone wants to write it or help me figure out the kinds of topics it should include.

Add non-US coverage.

My non-domestic audience is about 5 percent, with the top five non-US countries being Canada, India, the UK, Netherlands, and Australia. I would be willing to add a weekly summary of non-US healthcare IT news if I can hire someone knowledgeable to write it in adding more value than I could.

Add the ability to see all of a particular type of article, like Dr. Jayne or CIO Unplugged.

That’s available now. Hover over the Archives link at the top of the page, then click Dr. Jayne or Ed Marx to see all of their posts. You can also hover over Articles and then choose Index to see a newest-to-oldest list (rather than the full articles) by category, then click on any article to jump to it.

Add Dr. Jayne-like commentary from nursing, lab, pharmacy, etc. even if only quarterly.

I’ve appealed for such writers before with no takers, but I’ll throw it out there again and offer compensation for someone who is skilled and reliable. I always ask the person for examples of similar writing they’ve done or for them to write a sample article. That’s usually where the previously enthusiastic conversation ends. As I mentioned before, I can run the articles anonymously since I know first-hand from nearly being fired for writing HIStalk that employers aren’t always supportive.

Create an iPhone app since I like to do my reading in the morning.

Bringing up the site on a mobile device should display the site in an easily navigated mobile format. If not, scroll down and you’ll see the “desktop/mobile” chooser. I’ve looked at full-fledged mobile apps, but they don’t seem to offer a lot more than the mobile-optimized theme I already have.

Do more with social media.

My personal experience is that social media is overrated for a site like mine. I’ve looked at the stats and there’s no uptick in actual site readership from a blitzkrieg of tweets, Facebook posts, and LinkedIn items. I’ll think about revisiting, but social media campaigns work best for consumer sites rather than business-related ones. I’m happy to take advice from experts who believe otherwise.

Don’t quit writing HIStalk.

This came up a bunch of times. I have no plans to quit. Writing HIStalk is a hobby rather than a job to me, so I have no motivation to stop doing it any more than someone else would to quit playing golf, going to movies, or having dinner parties.

I know a lot of fellow readers of the site who are in their 20s (thanks to Epic staff for encouraging employees to read the site regularly) who would love to see some representation outside of predominantly older, white male execs. That’s a totally valid and relevant piece of the industry, but there are also a lot of badass young leaders, providers, and technologists (not just start-up founders shilling product) who I’d love to see on this platform, too.

That would be great if I could fine someone, even if they have to contribute anonymously for work reasons.

Offer an honorarium to ongoing contributors.

I’m perfectly willing to do that. 

Get rid of the smoking doctor’s pipe.

I’ve made so much fun of newbies who think they possess rare insight in noticing that the logo of a healthcare IT site is a smoking doctor that I have to assume this was (like the logo) intentionally ironic. If not, I’ll counterbalance it with another reader’s suggestion – give the doctor an additional accessory of a martini.

Add a thumbs up/down capability to articles and comments.

I admit I cheated a bit in reading this comment several weeks ago and then buying the thumbs up/down plug-in that’s on the site now. It has been used nearly 3,000 times since I installed it over the holidays, including by me.

Dump Readers Write.

I admit I’ve considered this several times. I turn down a lot of articles that are boring, unoriginal, vendor-slanted, or not all that related to health IT, but most of what remains still has some of those characteristics because vendors pay their PR people crank out dull, inexpert prose in which a vendor pitch is not too cleverly concealed. I keep thinking that providers will step up to the minor challenge of stating their opinion (even anonymously), but that rarely happens.

Suggestions

Convert webinars into podcasts so I can listen to them on my commute.

I think that’s probably doable. I also wondered whether people would appreciate having the transcribed webinar narration available to read as a PDF so they could distribute it, mark it up, etc. But let’s hear what you think – complete my little poll of which (if either) of those options you would use.

A Facebook-like look back of the news of that day five years back.

Great idea. I’ll add that to my calendar to add to each Monday Morning Update.

Use hashtags or tags of some sort so people can follow specific topics that interest them and get a weekly digest of headlines or posts relating to this topic.

Several people suggested that HIStalk posts could be repackaged into a curated summary of some type. I would have to understand the topics, but certainly one would be all items for specific vendors, which might then create a separate post (maybe on a separate site just to keep the clutter down) or as a weekly email with its own subscriber list. Tell me what you need.

Please stay focused on what you do. Additional news or too many communications can become overwhelming.

I agree, which is why I write one consolidated news article three times per week instead of blasting out every story individually. Anything I add would most likely have its own email subscriber list.

I love the idea of an email bulletin, beyond the headlines.

I agree. Email newsletters are hot again, especially if they are pithy and sassy. About three-fourths of a small number of respondents to a recent poll I ran said they would read a daily email, although I didn’t ask about a weekly one.

Facts are appreciated more than opinion.

Not to everyone. I know it seems obvious when you’re reading a site to think that every reader perceives it the same way, but I can say with certainty that it’s not that simple. More people say they read HIStalk for opinion, rumors, humor, and even music recommendations than say they wish I would stick to the same facts (usually from press releases) that every other site runs. I try not to be heavy-handed or to pedantically pontificate, but I also don’t hesitate to interject my opinion and welcome readers to agree or disagree in the comments.

Improve the home page layout. Having three columns is distracting and makes the page feel pinched when you get further down. And I never use the sponsor quick links – they just take up a lot of space on the screen, making it look busy.

I’m considering making some changes to skinny down the items in the right columns. Most are important, but they don’t necessarily need to display with each page view – a flyover menu of some sort would make them readily available without taking up space. Stay tuned.

Add one random and/or humor related item to the summary email you send for posts.

I try to do that, although I admit that I’m usually physically and emotionally drained by the time I send the email because I’ve been heads-down in deep thought for hours.

Get a DC insider to write.

I assume that means DoD and VA, although maybe I’m interpreting too narrowly and you’re actually interested in more political topics (in which case I’ll pass). As a reader, what would you like to see?

You could seriously sell your content curation and insights, especially if they were well-indexed for research purposes.  I would buy a personal subscription.

I’m not interested in selling anything, but tell me what you would find useful.

Comments

I invited respondents to say anything they want.

• How long until you quit? I want to make sure I’m done before then; I can’t imagine doing my job without you providing the necessary information I need for my job.
• It’s still my favorite work-related read of the day.
• I love HIStalk. It’s my favorite guilty pleasure.
• I like the balance of news and fun. Also appreciate your candor when people send you unsubstantiated information.
• Love it — and you’re great, but I’ve got to say that I get downright excited to read Dr. Jayne.
• This is a wonderful service to the community.
• I think you do a phenomenal job of bringing the news and sharing your personal insight as a long-time industry observer. I’ve been reading HIStalk since I started working in the industry 12 years ago. I think the site could be even better if it stopped running unsubstantiated rumors as if HIStalk was the National Enquirer or Fox News.
• Love it — specifically feel indebted to you for your summation of various complicated government rulings and policies. Also greatly admire what you have done with your reach when it comes to DonorsChoose.
• Dr. Jayne is my favorite. I also love how Mr. H is not cow-towed by disgruntled readers. Got the balance right!
• I continue to find HIStalk a very valued resource. You also made a recent comment about death and who cares once you are dead. I hope you are thinking about who would take over HIStalk when you lose the interest in keeping up with it. I do not think this is a prepare to die exercise — rather a realization that HIStalk is a valuable resource and honest broker of information in the HIT world and very worthy of continuing. Based on your humor, your often highlighted other interests, I assume that someday you will want to spend your time on other things beyond the care you put into HIStalk.
• Conduct regional social events where readers can get together, or do it at Health 2.0 meeting.
• I was once a complainer about the pro-Epic vibes and I have to say that I don’t feel the vibe anymore so if you were trying (or maybe I was over-analyzing and grew another year older?). Thanks!
• It’s an amazing site and any criticism I have is honestly quibbling — I would hate it if you hung it up.
• I work with the DoD and VA on their interoperability and have noticed that your periodic comments about that subject are quite dated. The two departments over the past 2-3 years are far more cooperative, interactive and mutually supporting in interoperability/data sharing needs than ever before.
• Appreciate all of your hard work.  Yours is the first news site I look at every day since I get both news and humor.
• It is an invaluable part of any HIS professional’s tool box.
• Thank you for this invaluable service. I truly appreciate that you offer thoughtful commentary, and not the generic re-spewing of outdated not-news that so many other healthcare IT sites espouse. My favorite articles are often Dr. Jayne’s blogs. I love hearing about actual in-the-trenches experiences. Of course, Weird News Andy is good for a chuckle or a smh. And I appreciate the donation updates.
• I check you daily and often share articles with others in my group. I’ve attended a few webinars and found them generally useful. On a regular basis I read something I find immediately useful for what I do, or something that spurs me to look deeper into some topic. In short, you’re great!
• I have been reading since the beginning and I’m a big promoter. I have mandated that my executives subscribe to the blog everywhere I’ve worked. So many people don’t bother to look outside their own little empires to understand the broader industry. You force readers to do that, and I am really grateful.
• So appreciate this resource. Single best blog I read and have read for 10 years now.
• I’m just a lowly independent Epic consultant (10+ years) but you really have helped me do my job better. I can chit-chat with a CIO waiting in line for lunch; and when I mention something I just read in HIStalk, he/she perks up and takes notice of me and we can carry on with a well-informed conversation. I have noticed that folks can tell if one has read HIStalk. I mention your site at least three times on every gig, so word-of-mouth DOES work. I can steer clear of (or be attracted to) Epic implementations that are in trouble, depending on the mood of my checkbook and my BS tolerance at any given time. I love Dr. Jayne’s commentaries and will go back to find one if I’ve missed a week. Her perspectives from "the trenches" are very beneficial from a physician’s perspective and I enjoy her writing style very much.  Your donor matching program for kids makes my heart sing — that’s all I can say, except you are contributing to a generation of life-long learners. Ed is Ed, and I like him. Weird News Andy is a hoot — wish he’d do more, but he’s probably busy doing real work most of the time. And you, Mr. H, should be commended for maintaining a non-biased and well-written site for all of us to benefit from. You are a voice of reason (or at least, devoid of BS) in this whirlwind of healthcare drama. Your dry wit doesn’t hurt, either — I get at least one chuckle a day guaranteed, if not a belly laugh. Please keep doing what you’re doing. Peace Out and Happy 2017!!
• Thank you for all that you do, Mr. H., and I hope you benefit from HIStalk as much as your readers do. I feel that the site is at its best when it provokes disagreement between readers, as this is a good indication of a particularly sticky problem yet to be solved.

Morning Headlines 3/3/17

McKesson and Change Healthcare Complete the Creation of New Healthcare Information Technology Company

McKesson’s Technology Solutions business unit and Change Healthcare Holdings’ analytics business unit finalize their planned merger, creating 15,000 employee Change Healthcare.

InterSystems wins multi-million pound Liverpool joint-EPR tender

In England, InterSystems is selected as the next EHR vendor for three major Liverpool NHS hospitals: Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool Women’s NHS Foundation Trust, and Aintree University Hospital NHS Foundation Trust.

Judge Certifies Overtime Case Against Cerner As Class Action

A group of Cerner systems analysts and delivery consultants have won the right to file a class action suit against the company, arguing that overtime wages had been improperly withheld.

CVS Health to Adopt Epic Electronic Health Record System for CVS Specialty Care Management Programs

CVS will implement Epic across its CVS Specialty care management programs.

News 3/3/17

Top News

McKesson and Change Healthcare Holdings (the former Emdeon) complete the creation of the new health IT company Change Healthcare, which combines CHC’s software and analytics business with most of McKesson Technology Solutions.

McKesson will own 70 percent of the 15,000-employee Change Healthcare.

The company’s leadership team is listed above.

Reader Comments

From Alhambra: “Re: EClinicalWorks. The only tool available for EP MU attestation is the MAQ dashboard, which contains a disclaimer that all users must accept when they first log in. ONC is aware and investigating since a certified EHR must be able to accurately produce the required attestation reports.” Unverified as to the ONC part, but above are the screen shots provided. I’m not sure requiring acknowledgement of a standard lawyer-verbose warranty either absolves responsibility to ONC or suggests a lack of capability, so I suppose the issue is who is liable if an incorrect attestation is filed because of flawed data and whether the disclaimer is binding either way.

From Studiously Stoic: “Re: Becker’s Healthcare ‘150 Great Places to Work.’ We won and would like it mentioned.” I should stop being surprised when an organization that wins an award fails to note the worthlessness of their “win.” Becker’s employed no reasonable methodology to come with its click-baiting list – it accepts nominations, but then just lets its “editorial team” (mostly of them recent liberal arts graduates) make up the 150 winners based on unstated criteria that doesn’t seem to involve any research beyond Googling. It’s not like they actually surveyed employees or anything. This is not newsworthy.

From Banacek: “Re: ECG Management Consultants. Apparently cleaning house after last year’s acquisition of Kurt Salmon, with over 30 people being terminated. Senior partners are being targeted.” The company provided this response: “ECG recently completed a three-year strategic plan and organizational restructuring. This resulted in some departures and reassignments, primarily for our administrative function, but included a few consulting staff members as well. Overall departures have been minimal (fewer than five consultants from January 1 through February), and we have continued to make strategic hires – for example, in our revenue cycle and academic practices. Our business is strong and we anticipate continuing to grow in 2017.”

HIStalk Announcements and Requests

We provided a greenhouse and gardening kits for Mrs. M’s class of severally mentally and physically disabled students in Ohio. The students are actively participating and will present their work to their families in May and can then take the seedlings home to transplant them into their own gardens.

I’m annoyed at companies whose marketing people declare that their unchanged software has suddenly transformed into “artificial intelligence” just because it sounds cooler. AI is defined as a device that perceives and reacts to its environment in mimicking human reasoning in performing a complex, nuanced task such as solving a problem and then learning from the process to get smarter. Today’s version of AI is primitive, incapable of doing even a fraction of the intellectual processing of a not-very-bright human even when limited to a super-specialized task in a closed context. I suspect that most AI systems have a “man behind the curtain” who carefully programs the system to appear smart when it’s really not, hoping to find a profitable problem to solve without anyone digging too deeply into the methods involved. 

This week on HIStalk Practice: The Vancouver Clinic adds ActX genomic decision support. Drchrono opens its second office. CMS begins $100 million spend on helping small practices make the QPP switch. Jacksonville Children’s & Multispecialty Clinic selects PatientPay billing. The CMS Innovation Center looks for input on new pediatric care delivery models. Austin Regional Clinic adds Wolters Kluwer clinical guidelines to its Epic EHR. Coordinated care tech startup CrossTx raises $735k. Culbert Healthcare Solutions Executive Consultant Randall Shulkin shares value-based reimbursement success factors for medical groups.

Webinars

March 9 (Thursday) 1:00 ET. “PAMA: The 2017 MPFS Final Rule.” Sponsored by National Decision Support Company. Presenter: Erin Lane, senior analyst, The Advisory Board Company. The Protecting Access to Medicare Act of 2014 instructed CMS to require physicians to consult with a qualified clinical decision support (CDS) mechanism that relies on established appropriate use criteria (AUC) when ordering certain imaging exams. Providers must report AUC interactions beginning January 1, 2018 to receive payment for Medicare Advanced Imaging studies, with the CDS recording a unique number. Outliers will be measured against a set of Priority Clinical Areas and interaction with the AUC. This webinar will review the requirements for Medicare Advanced Imaging compliance and will review how to ensure that CDS tools submit the information needed for reimbursement. 

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

Acquisitions, Funding, Business, and Stock

AnalyticsMD changes its name to Qventus.

Consumer medication reminder free app vendor Medisafe, which apparently makes money by charging drug companies to nudge their patients into profitably taking all their ordered doses, raises $14.5 million. 

An employee overtime lawsuit that was filed against Cerner by delivery consultants and system analysts is certified as class action. The lawyer who represents current or former Cerner employees in several related lawsuits says that Cerner’s job titles make it sound as though learning consultants and delivery consultants are highly skilled positions, but claims that in reality, “these are folks that are entry level, straight out of college, with no real minimal requirements other than a college degree and a willingness to relocate to Kansas City.”

Tech-powered insurer Oscar, which offers exchange medical insurance policies in four states, loses $200 million in 2016. The company hopes to survive by raising prices, narrowing networks, and selling small business insurance plans to reduce its reliance on the volatile individual market.

Sales

The DoD chooses BD’s Pyxis ES automated dispensing cabinet for its 115 inpatient facilities and pharmacies in a $100 million contract award.  BD acquired the former Carefusion – which offered Pyxis dispensing technology, Alaris smart IV pumps, MedMined surveillance software, and medical supplies — for $12.2 billion in 2014. 

CVS Health will extend its use of Epic to its specialty pharmacy, which will join CVS’s MinuteClinic as an Epic user.

In England, three Liverpool trusts choose InterSystems TrackCare in a deal worth up to  $86 million.

People

Signet Accel names co-founder Peter Embi, MD, MS as chief medical officer. He remains president and CEO of the Regenstrief Institute.

Government and Politics

A federal grand jury in Texas indicts 16 people for fraudulently billing Medicare $60 million for hospice care. In addition to paying kickbacks disguised as medical director salaries and submitting false claims, the company’s CPA owner and nurses made medical decisions based on what paid the most, including placing patients on high-dose narcotics regardless of their need. The medical directors also gave their EHR log-in credentials to others to create and sign orders for services that were billed but not performed.

CDC publishes the 500 Cities Project, which allows visually comparing and downloading the prevalence of 27 chronic health condition measures between cities and down to the census tract level in a chosen city.

Other

Facebook is testing algorithms that can identify users who are having potentially suicidal thoughts, after which a company team will rapidly review the user’s posts and comments from friends and then send a message offering resources. Facebook is trying to balance its response to such incidents against the privacy issues that would arise if it automatically notified family, friends, or mental health groups without the user’s permission. It already allows users to manually flag suicidal posts, functionality that has now been added to Facebook Live streaming video. Facebook says it was working on the tools before a series of events in which people live streamed their suicides on Facebook Live, often with the encouragement of other Facebook users.

Amazon Web Services explains its four-hour East Coast outage on Tuesday: a script being run by a technician to take down a few problematic servers contained a typo that instead took a bunch of servers offline, including the one that indexes all locations for running database commands. AWS says it has updated the script tool to disallow taking servers offline if any subsystem will fall below its minimum capacity. It will also speed up an existing project to improve recovery time of the indexing subsystem.

NHS auditors find a hospital’s foreign doctor with poor English proficiency looking up medical terms on Google. The hospital says the doctor no longer works there and it will now require language checks.

A study finds that 80 percent of patient advocacy groups accept money from drug and medical device companies that sell products to people with the conditions they support, raising the question of whether the donations influence the frequent silence of those groups about drug prices. Some groups receive more than half of their funds from industry, while 40 percent of them have industry executives as board members. Even the umbrella group for patient advocacy groups took in 62 percent of its $3.5 million budget from industry. The groups claim such donations don’t affect their decisions, but the authors recommend that they be required to provide full disclosure.

A study confirms what we all suspect and fear – people are indeed peeing in public swimming pools and hot tubs, with an analysis of artificial sweetener content in two pools suggesting they contain from 8 to 20 gallons of urine. Hot tubs had much higher urine levels. Movie gags to the contrary, no blue dye exists to call out the pee-pertrators.

Sponsor Updates

• Medicity launches Community Interchange, which creates a single, de-duplicated, and normalized CCD for hospitals.
• CommonWell TV interviews LifeImage CTO Janak Joshi.
• Children’s Mercy Kansas City (KS) goes live on GetWellNetwork.
• MedData will exhibit at HFMA Utah’s Spring Alliance Meeting March 8-10 in St. George.
• National Decision Support Company will integrate its CareSelect decision support system with McKesson and Meditech. The company also announces that its client base has increased to 250 provider systems and 2,000 facilities in all 50 states. 
• NVoq will exhibit at the CHA Rural Health and Hospitals Conference March 8-10 in Denver.
• Recondo Technology releases a revenue cycle API for prior authorization, eligibility, medical necessity, and pre-service patient collection and related RCM processes.
• NTT Data and Oracle expand their existing relationship, adding cloud capabilities to Oracle’s Healthcare Foundation analytics platform.
• Netsmart extends its behavioral population health solutions to post-acute providers.
• Orion Health begins migration of its Amadeus precision medicine platform to Amazon Web Services.
• CloudWave chooses Commvault to power its backup-as-a-service healthcare offering.
• Definitive Healthcare launches a professional services team to help customers use its healthcare data to understand the market and executive plans.
• Obix Perinatal Data System will exhibit at the March of Dimes Perinatal Nursing Conference March 6-7 in Lombard, IL.
• Medicomp Systems announces Quippe Clinical Lens, a web-based, problem-oriented clinician view of relevant clinical information from EHRs and HIEs.
• Experian Health will exhibit at the FL AAHAM meeting March 8-10 in Palm Coast, FL.
• Uniphy Health releases UH4, an enterprise collaboration platform that supports patient-centric communications and provides real-time patient data at the point of care.
• Kyruus integrates ProviderMatch with Salesforce Health CLoud.
• PatientKeeper previews its new e-book, “Healthcare IT 2017-2022: First Comes Change, Then Comes Value.”
• PokitDok joins the AWS Marketplace, becoming an APN advanced technology partner.
• QuadraMed will exhibit at the ANA Annual Conference March 8-9 in Tampa, FL.
• Imprivata integrates its PatientSecure positive patient ID solution with registration kiosks from CTS, Vecna, and PatientWorks.
• The SSI Group will exhibit at the HFMA Region 5 Dixie Institute March 9 in Savannah, GA.
• The Surescripts National Record Locator Service is live at 14 health systems nationwide.

Blog Posts

• How Hospitals are Solving the Patient Experience Problem (Definitive Healthcare)
• I’ll Be Back: Return of AI and Machine-based Learning (Iatric Systems)
• Identity Theft Victimizes Businesses as Well as Consumers (ID Experts)
• Revenue Cycle Post-Implementation Support (Impact Advisors)
• How Saint Joseph Health System is making checking in more secure and accurate with biometric identification (Imprivata)
• Healthcare Consumer Experience Abounds at HIMSS17: Three Key Takeaways (Influence Health)

Contacts

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

Morning Headlines 3/2/17

Trump CMS Pick Gets Second Vote After Tie at Senate Committee

The Senate Finance Committee vote on Seema Verma’s nomination to lead CMS resulted in a 9 to 9 tie Wednesday, requiring a second vote, which will be held Thursday.

Grail Closes Over $900 Million Initial Investment in Series B Financing to Develop Blood Tests to Detect Cancer Early

Life sciences start up Grail raises an unprecedented $900 million Series B funding round to fund the development of an early detection cancer screening blood test.

Trump chooses Pence ally to lead Medicaid

President Trump nominates Brian Neale, ‎executive director at the United States Congress Joint Economic Committee and former health care policy director for Vice President Mike Pence, as the director for Medicaid.

Losses Mount for Obamacare Startup Oscar as Repeal Looms

Health insurances startup Oscar Health, which hoped to profit in the ACA’s individual marketplaces, reports 2016 losses topping $200 million.

Lorre’s HIMSS17 Summary 3/2/17

During the months leading up to HIMSS, I feel like a CPA anticipating April 15. It is a huge push to get an unbelievable amount of work done in not nearly enough time. After all, I’m the one and only HIStalk team member other than the folks whose time is fully committed to writing what you read every day.

As in previous years, I enlisted the help of a couple of my family members to help me get things to the convention center and distribute the HIStalk sponsor signs. Our booth is small and there is little to it, so it takes about 15 minutes to set up.

It usually takes a couple of hours to deliver all of the sponsor signs since we do it before the exhibit hall setup is complete. It’s hard to find the booths with just their numbers because of irregular aisles. This year, we waited until the opening day when all of the booth signs and numbers were up. We got it done in record time.

Midway through HIMSS16 a year ago, I went to my first booth selection appointment. With the help of someone there, I chose our booth location purely because it was at the top of an escalator and not in the back of the exhibit hall near the loading docks or restrooms like we usually get for our tiny 10×10 space. On Sunday afternoon when I arrived to set the booth up, our booth was the first thing I saw.

Even that first look at our pretty decent-looking spot could not prepare me for the opening of the doors to attendees at 10:00 Monday morning. People were lined up as far back as I could see. The location of the booth made up for all of the prior years combined. Our booth was busy from the time the exhibit hall opened until it closed each day.

Here are the Top 10 comments and questions I heard at the booth:

1. I love HIStalk, I read it every day.
2. Please tell Mr. H not to ever stop writing HIStalk.
3. I am new to healthcare IT and I read HIStalk because it makes me look smart. (I heard this a lot)
4. HIStalk is required reading where I work.
5. Does that really look like Mr. H? (asked while pointing at our cardboard standee of the smokin’ doc).
6. Do you know who Mr. H is?
7. Why are so many people visiting your booth? What do you guys do?
8. Would it be OK to take a selfie with Mr. H? (our cardboard standee)
9. Do you have any extra tickets to HIStalkapalooza?
10. I heard a rumor that this was the last year for HIStalkapalooza. Please tell me it isn’t so!

I am always excited to meet the guests who spend time in our booth. This year I had a chance to talk with Nancy Ham, named as one of the most powerful women in health IT. She spoke about the importance of mentoring young women in the workforce. Keep an eye out for an upcoming HIStalk-sponsored webinar where she will cover a similar topic.

It was interesting to talk with Dr. Regina Benjamin, the 18th Surgeon General of the United States. She was at HIMSS with accessURhealth to emphasize the need for tools and resources to positively impact the identification, treatment, and awareness of mental and behavioral health.

I packed up and left the booth early on Monday so I could be a the House of Blues by 4:30 to walk through the logistics of HIStalkapalooza. It was like HIMSS all over again – we were two hours from opening the door to the attendees and there was so much left to be done. None of the sponsor banners were hung and the step-and-repeat red carpet backdrop I had bought online for $250 was delivered to my feet in two big boxes. I showed the people who would hang the banners where they should go.

I know Mr. H mentioned this, but you had to be there to appreciate the ingenuity and determination Jenny and Val from Optimum Healthcare IT demonstrated. I asked the House of Blues if they could provide someone to help us assemble the frame that holds the step-and-repeat. After spending about 30 minutes on it, one of their production crew told me we were probably missing a part and it couldn’t be put together, leaving us without a backdrop and Mr. H with a wasted investment. I sighed with frustration and went on to the next urgent matter. When I returned, Jenny and Val were sitting on the red carpet with the pieces of the frame spread out, trying to figure out how to assemble it. A few minutes later, they had it standing, albeit a little bit propped up.

There were a lot of challenges with the House of Blues this year, but as always, someone trying to do a good job provided a highlight. I ordered a toast for a group of people and the bartender said a manager would need to approve. She arrived after 15 minutes and said they aren’t allowed to provide shots at events like ours. After the manager was out of earshot, the bartender decided that as long as he placed an ice cube in each glass, it’s not technically a shot. The tradition was upheld.

The result was the now-famous Longo Lemonade toast.

This is Jean, a HIMSS shuttle bus driver who also provided amazing service. I had waited 30 minutes for the shuttle to stop near where I was staying and it finally arrived just as it started to rain. As the last passenger stepped off of the bus and I took the first step to enter, Jean received a call from his dispatcher telling him to return to the garage empty since the shuttle schedule was changing from every 15 minutes to every 30 minutes. After a bit of coercion, Jean agreed to take our group of passengers to the convention center before returning to the garage as instructed. I got there on time and still dry.

We gave out our usual HIMSS survival kits, thanks to Arcadia Healthcare Solutions. Meditech gave us a supply of “Mobile Pockets” and cool green pens to give away. I managed to grab a pocket for the back of my cell phone cover, but the pens were gone before I got one.

I don’t see a lot of cool things at our booth because most companies are demonstrating in their own booths. The one exception was Blausen. It is like a collaboration of WebMD and Pixar, They claim it is the world’s largest library of medical and scientific illustrations and 3D animations, but that was an understatement. Each one has a short video that describes the condition, symptoms, and treatment clearly with visuals that are hard to stop watching.

The team from Spok stopped by for a picture and I admired their company-branded shoes. The Spok logo was subtle and the color matched the logo on their shirts perfectly.

HIMSS17 was manageable for me because of the help I received from Brianne, shown here backstage at the House of Blues with some of the Party on the Moon dancers. She spent the weeks leading up to HIMSS making sure all of the HIStalkapalooza invitations were sent and all of the (never-ending) changes were kept straight. She answered questions from sponsors and kept them on track. During HIMSS, she spent time in the booth and gave people information. She spent almost all of her time at HIStalkapalooza at the door enforcing the rules for admission. Thank you, Brianne.

My favorite part of HIMSS every year is connecting with the readers and sponsors. I interact with people on the phone and through email all year, so it is really a treat to meet people I have only spoken to and get a hug from those I have known for years.

I thought HIStalkapalooza was fantastic again this year. Thanks to the many sponsors that made it possible.

Despite the fact that Mr. H swore he wouldn’t do it again because of the work involved and the financial risk he takes in hoping he can cover the cost with sponsorships, I am already hearing him softening up a  bit. My plan is to find sponsors willing to sign up early to avoid our last-minute panic and reduce his risk. It makes sense to limit the number of sponsors to those who can commit early and thus make it extra special for them. Stay tuned!

Contact Lorre.

Readers Write: It’s Time to Bring Back the Noise

It’s Time to Bring Back the Noise
By Andrew Mellin, MD

A very memorable moment for me at one of the first go-lives for a hospital EHR was when I stood on the unit and realized there was an eerie silence. While the beeps of the monitors and the drone of the overhead pages continued, the buzz of the caregivers talking to each other was gone as everyone was staring intently at a computer monitor.

As an implementation team, we quickly learned we needed to frequently remind the caregivers to keep talking to each other as part of our go-live training for future sites. But years later, it is clear the EHR has fundamentally changed the dynamics of how providers and care teams communicate.

The impact of this dynamic is well recognized. The change in communication patterns, sometimes called the "illusion of communication," is identified as one of the key unintended consequences of implementing an EHR. With today’s EHRs, we now have all the information we need at our fingertips, yet the ability for care teams to collaborate in an ongoing, continuous dialogue is not well supported by the systems’ encounter, inbox, and order-based models.

We still have noisy hospitals, but now we hear the wrong kind of noise: the sounds that keep patients awake and require caregivers to respond to beeps emitted from devices in stationary locations that make it difficult to find a real signal that requires action.

It’s time to bring the right kind of noise back to patient care. Not the auditory noise that we hear, but the cognitive buzz that is generated when high-functioning teams are communicating in an effortless, asynchronous manner.

Think of how communication models like iMessage, WhatsApp, and SMS have changed the way we communicate in our personal lives. There’s very low effort required to initiate a simple message. We have the ability to share rich information — such as images, videos, or voice — as well as expressive notifications. We even have an ongoing transcript of the conversation and acknowledgement of message receipt.

Healthcare communications benefit from the same communications models, but require HIPAA compliance, message traceability, integration to other initiators of messages (e.g., the hospital operator), and EHR integration.

The actual messaging app, however, is simply the user window into communications technologies that not only improve care team collaboration, but more importantly, drive improved care team efficacy and patient outcomes.

For example, physicians work in shifts that are largely defined by an on-call schedule. When I worked as a hospitalist on weekends when the staff frequently changed, I needed to find an on-call schedule to determine which specialist would see my patient that day (usually I just asked the nurse or HUC to page a person for me because it was too hard to figure out who was on call.)

To solve this problem, a healthcare communications platform needs to support messaging to a role that resolves to their correct on-call individual. And secure mobile messaging is not only about person-to-person communications — rather it is a way to notify an individual of any important piece of information about a patient, whether it is generated by a machine or a human.

For example, when a CDS alert in an EHR is triggered to indicate that a patient may be becoming septic, a rapid response team can be automatically and immediately notified. When a device triggers an alarm, instead of a loud beep that has to be interpreted, the specific, detailed message with patient context is sent to the right person’s device with the appropriate sense of urgency.

All technologies have limited value unless directly leveraged to improve organizational goals, and communication tools are often an underrepresented element of process improvement initiatives due to the limited modes that exist without a modern communication infrastructure. I’ve seen dramatic operational and clinical improvements achieved when these tools are embraced, such as 30-minute reduction in admission times from the ED and material improvement in HCAHPS scores.

These tools do not eliminate the phone call that is essential in a complex situation or the need to document the care plan in the EHR. Rather, these tools augment the EHR and elevate the quality and cohesiveness of the care team collaboration. The magnitude of the value of healthcare communications is under-appreciated: One large academic medical center sends over 150,000 messages to the caregivers and support staff in their organization every week.

It’s time to give caregivers the communications tools they need to improve the patient’s care experiences and outcomes and care team efficacy while eliminating the auditory noise where care is delivered. And it’s time to bring in the kind of high-value noise where caregivers are rapidly interpreting and responding to targeted messages on the go on their mobile device.

Andrew Mellin, MD, MBA is chief medical officer of Spok of Springfield, VA.

Readers Write: Growing Contingent Workforce Benefits Both Healthcare Organizations and HIT Professionals

Growing Contingent Workforce Benefits Both Healthcare Organizations and HIT Professionals
By Frank Myeroff

There’s high growth when it comes to temporary workers, contractors, independent consultants, and freelancers within healthcare IT. New technologies, cost factors, and a whole new generation of HIT professionals wanting to work in a gig economy are fueling this growth. The rise and growth of the contingent workforce is only expected to accelerate over the next few years into 2020.

This dynamic shift to a contingent workforce makes sense for healthcare organizations and the benefits are well worth it. With a contingent workforce, healthcare organizations experience a big efficiency boost, risk mitigation, and derive a substantial cost savings in these ways:

• The rise of managed service providers (MSP) enable health systems to acquire and manage a contingent workforce. As contingent labor programs continue to grow, these partnerships will be one of the most important workforce solutions that a health system can adopt to effectively manage risk and decrease healthcare hiring.
• The use of vendor management systems (VMS) is a fast way to source and hire contingent labor. These systems make it easy to submit requisitions to multiple staffing suppliers.
• Outsourced expertise will be able to assist healthcare facilities in meeting the January 2018 EHR system requirements. In addition, they often have the extensive knowledge needed when it comes to medical coding. For example, according to the AMA, 2017 ICD-10-CM changes will include 2,305 new codes, 212 deleted ones, and 553 revised ones.
• Healthcare organizations can dial up or dial down staffing as needed without having to pay FTE benefits.
• Improved visibility and the provider stays in control through the use of structured reporting, governance processes, and dashboards.
• Internal resources are freed-up to focus on higher-priority, clinical-facing initiatives such as workflow optimization.

For HIT professionals, contingency work in the HIT space is attractive since opportunities are plentiful, the remuneration is desirable, and the work is rewarding. In addition, work is becoming more knowledge- and project-based and therefore is causing healthcare organizations to become increasingly reliant on their specialized HIT skills and expertise. According to Black Book Rankings Healthcare, this reliance will help to fuel the growth of the global HIT outsourcing market, which should hit $50.4 billion by 2018.

However, making the change from an employee to a contingent worker takes thought and preparation before just jumping in. Here are a few suggestions:

• Identify the niche where you have skills and expertise. Know your passion. Also, pinpoint what type of HIT services and advice you can offer that healthcare organizations are willing to pay for.
• Obtain the required certifications. Getting certified is a surefire way to advance your career in the IT industry. Research IT certification guidesto identify which ones you will need in the areas of security, storage, project management, cloud computing, computer forensics, and more.
• Build your network and brand yourself. It’s important to start building your network once you’ve decided to be a consultant. A strong contact base will help you connect with the resources needed in order to find work. Also, position yourself as an expert, someone that an organization cannot do without. Now combine both a professional network and social network to help you spread with word faster.
• Target your market and location. Determine what type of facility or organization you want to work with, and once decided, think about location. Do you want to work remotely or on site? Are you open to relocation or a commute via airline to and from work?
• Decide whether to go solo or engage with a consulting and staffing firm. If you have the entrepreneurial spirit and want to approach a specific organization directly for a long-term gig, you might want to go solo. However, if you’re open to both short-term and long-term opportunities in various locations, a consultant staffing firm might be the answer.

The rise of a contingent workforce and gig economy will only continue to grow, and with it, much opportunity. A consultant or contractor has more freedom than a regular employee to circulate within their professional community and to take more jobs in more challenging environments. For healthcare facilities, a contingent workforce means acquiring the right HIT skills and expertise needed without the overhead costs associated with payroll benefits and administration. No doubt, a win-win situation for both.

Frank Myeroff is president of Direct Consulting Associates of Cleveland, OH.

Readers Write: Automate Infrastructure to Avoid HIPAA Violations

Automate Infrastructure to Avoid HIPAA Violations
By Stephanie Tayengco

Every other week, news of HIPAA violations comes to light, bringing attention to the challenges of maintaining privacy in the ordinary course of doing business and providing care.

Take, for example, a recent HIPAA violation settlement. Illinois-based healthcare system Advocate Health Care agreed to pay a $5.5 million OCR HIPAA settlement in August after it was found that the company failed to conduct an accurate and thorough assessment of the potential risks and vulnerabilities to all of its ePHI. Earlier this summer, The Catholic Health Care Services of the Archdiocese of Philadelphia agreed to pay $650,000 for failing to implement appropriate security measures and address the integrity and availability of ePHI in its systems.

It is unclear in both cases whether infrastructure configurations were directly to blame. However, addressing the infrastructure-related elements of HIPAA and HITECH take considerable time and effort, time that could be spent addressing the critical application and mobile device-level security standards that result in the vast majority of violations. To refocus engineers away from time-consuming infrastructure compliance, the practices of infrastructure automation and continuous compliance are the key.

Reduce the chance for human error

The foundation for compliant IT infrastructure is implementing strong standards and having guardrails in place to protect against changes that are inconsistent with those standards at the server, operating system, and application level. This is the next evolution of compliance — building a system that can self-correct errors or malicious changes and maintain continuous compliance.

In a recent survey, IT decision-makers shared that 43 percent of their companies’ cloud applications and infrastructure are automated, highlighting that while companies already recognize the tremendous value of system automation, they can do even more.

The road to automation must begin with an IT-wide perception shift — that manual work introduces risk. Any time an engineer is going into a single piece of hardware to perform a custom change, error is possible and system-wide conformity is threatened. This does not mean replacing engineers with robots. It means tasking engineers with creating the control systems. This is an equally challenging (but far less boring) technical task for engineers, but it creates more value.

Part of this control system will be configuration management at the infrastructure level and for application deployment automation. Equally important is the operational shift to train engineers not to make isolated changes to individual machines  and instead to use the control system in place and implement changes as code. Code can be easily changed and tested in non-production environments. Code can be versioned and rolled back. Software deployment tools provide an audit trail of changes and approvals that can be easily read by auditors.

Invest in transparency

One of the main causes that can lead to non-compliance is a lack of transparency, usually in one or both of two key areas:

• Lack of transparency into where critical data resides
• Lack of transparency into current state of system configurations (i.e., how/where data is encrypted, who has access to that data, how privileges are maintained, etc.)

Many companies rely on manual processes and spreadsheets to track the configuration of their systems. In a cloud environment that changes frequently, this can be a real headache.

The single biggest change to make today is to improve the visibility of data criticality and system configurations is to implement configuration management. Rather than rely on manual documentation after the fact when changes are made, configuration management tools allow describing a desired state and creating and enforcing it across the infrastructure. Ideal configurations are coded in a single place, providing the current state of all systems at any time. This is a huge leap forward and it is applicable for operating either on bare metal or in the public cloud. Making long-term investments in operational transparency can help avoid HIPAA headaches.

Focus on mission-critical apps, not infrastructure

As healthcare companies improve IT operations, they should be focused on developing or delivering great patient-centered applications and services, not infrastructure maintenance and compliance.

Migrating to the cloud is the first step. Migrating to a public cloud platform like Amazon Web Services (AWS) provides the benefits of a government-grade data center facility that has already been audited for HIPAA and HITECH compliance. Signing a BAA with Amazon means that a portion of the physical security standards is taken care of (note: regular assessments are still required). That is a huge reduction in risk and cost burden right off the bat.

In addition, the cost of change is significantly reduced in the cloud. Adding, removing, or changing infrastructure can mean a few days of work, not months. That means systems engineers can focus on improving software delivery and the configuration management system, not on manually configuring hardware.

Just one word of caution. Beware of any cloud vendor or service provider that describes the cloud as “no maintenance.” It is true that cloud systems are more efficient to maintain, but maintenance is still necessary. The IT team will focus more of their time on maintenance tasks that are more critical to the business, like building a new testing ground for an application development team or refining the code deployment process, not on undifferentiated data center tasks.

It is only a matter of time before the industry witnesses its next HIPAA violation. Automating infrastructure can significantly reduce the cost and effort of maintaining infrastructure compliance, and can refocus IT on higher-impact areas such as device security.

As health IT evolves, expect to see these two key of technologies — cloud and automation — driving the next wave of efficiencies in health IT.

Stephanie Tayengco is SVP of operations of Logicworks of New York, NY.

CIO Unplugged 3/1/17

The views and opinions expressed are mine personally and are not necessarily representative of current or former employers.

Attitude, Not Aptitude, Determines Altitude

I have never been the smartest person in the workplace. I never will be. We all have talents, skills, and special gifts, but you won’t see my name on any Top 10 lists for brainiacs. Not even the Top 1,000.

I can’t blame genetics since my siblings are pretty dang smart. Each of my kids excelled academically as well. Our gifts are unique to each individual. I suspect what makes the difference is how we steward our gifts.

I was going through my school report cards with my youngest daughter recently. Not pretty. From first grade through high school, it was clear I was not the sharpest tool in the shed. College undergrad was the worst, starting with a wicked 1.6 GPA.

My lackluster grades made my Army Officer assignment of combat engineer all the more perplexing. I was the only non-engineer, non-math major accepted into our cohort. I barely graduated with a degree in psychology and there I was in engineering school! On our second day, we took math and engineering competency exams and I was immediately directed to the remedial section.

Out of desperation, I clung closely to the Zig Ziglar quote that, “Attitude, not aptitude, determines altitude.” I had no choice. Ziggy gave me hope that, despite my intelligence, I could still thrive by adopting a positive outlook.

As I entered the workforce and looked towards the ranks of management, I could not compete on sheer aptitude, but I could with attitude. I was astonished to surpass peers who were much smarter than I. While I worked on building my core business and technical smarts, I doubled down on ensuring an infectious attitude. I started to see that altitude was something I could control.

We all know people who are super smart, but who never realize their full potential. Clearly there are many reasons why this happens, but certainly a lackluster attitude robs many of the personal and professional heights they were destined for.

That said, it’s not only people of average intelligence that benefit from good attitudes. Everyone, regardless of aptitude, benefits from good attitudes.

I’ve shared previously my experiences of being part of strong teams that accomplished some pretty cool things. One common characteristic of each team member was attitude. I understand my success as a leader is predicated on having a good attitude, which ultimately separated me from many peers. I wasn’t better-looking or taller. I did not always dress the part. I was not the product of private schools, nor boosted by a familiar family name. I had few if any advantages.

As I said, I was not smarter. I was pretty much average, except for my attitude. Attitude is one key to a prosperous life. And you control it.

How can you change your level of attitude?

• Admit you need to change your attitude.
• Hold yourself accountable to people who will get in your face and tell you the truth when your attitude is poor.
• Surround yourself with people who have infectious attitudes and soak it in.
• Seek professional help if there are unhealed wounds that keep your attitude low.
• Practice the art of smiling and don’t stop even on bad days.
• Accept your shortcomings and move on.
• Avoid negative self-talk or putting yourself down in front of others.
• Be thankful daily for something. Anything.
• Step outside of yourself and see a different perspective.
• Remember the big picture.
• Live a balanced life, routinely taking time for yourself to recharge.
• Drop friends and colleagues who have bad attitudes.
• Surprise someone every day with something that makes them laugh.
• Pray for your haters.
• Stop feeling guilty for things you have not done.
• Address the gaps or barriers in your life that may be driving you down.
• Don’t worry about things you can’t change.
• Believe in something bigger than yourself.
• Practice random acts of kindness.
• Be the bigger person and mend broken fences.

I believe that because of a shift in my attitude, I was able to transform from college flunky to holder of multiple master’s degrees.

I believe that because of a shift in my attitude, I went from remedial Army Engineer student to graduating in the top 10 percent of my cohort.

I believe that because of a shift in my attitude, I went from average career to something beyond my dreams.

I believe that because of a shift in my attitude, I love life despite my wounds.

Simply put, not only do people with bad attitudes typically underperform, nobody wants to be with them. They are sad, mad, full of unconstructive criticism, and no fun. No wonder they are not getting promoted.

Attitude does determine altitude.

Ed encourages your interaction by clicking the comments link below. He can be followed on LinkedIn, Facebook, Twitter, or on his web page.

Morning Headlines 3/1/17

Mayo Clinic: Consolidated Financial Statement

Mayo Clinic’s will spend $1 billion for its five-year Epic implementation, according to its annual financial statement.

Shulkin proposes eliminating 40-mile, 30-day rule for non-VA care

Speaking at the Disabled American Veterans annual conference, VA Secretary David Shulkin proposes eliminating a policy that limits veterans from receiving private-sector care.

Hospital illegally overcharged patients for medical records: suit

New York-Presbyterian Columbia University Medical Center is sued after charging a patient $3,000 for a copy of their medical record.

The 21st Century Cures Act: Implications for Research and Drug Development

A panel discussion hosted by Harvard’s T.H. Chan School of Public Health covers the expected implications 21st Century Cures Act will have on the pharmaceutical industry.

News 3/1/17

Top News

Mayo Clinic’s annual report says it will spend more than $1 billion for its five-year Epic implementation.

Reader Comments

From Craptastic: “Re: McKesson’s EIS division. The likely buyer is India-based Tata Consultancy Services. They are conducting web-based video sessions between Charlotte and Mumbai. The EIS division contains dead or dying products like Star, Series, and HealthQuest, so the main target is Paragon, which was hot in small hospitals years ago, chilled down by trying to replace Horizon, then cold as hell once the divestiture rumors started.” Unverified. Publicly traded Tata Consultancy Services, part of the Tata Group conglomerate that manufactures everything from Tetley tea to Jaguars, is perhaps best known in health IT circles for being hit with a $940 million judgment in a trade secrets lawsuit brought against it by Epic.

From Quirky Queen: “Re: HIMSS17. This website lists what people thought were the dominant themes.” The website asked a bunch of people, most of them vendors, which topics dominated the conference. Not surprisingly, vendors donned their tunnel vision glasses to declare that whatever they sell (cloud computing, cybersecurity, or population health management tools, for example) is the Next Big Thing that attracted massive HIMSS17 interest. Beyond the obviously self-serving answers, even the question itself encourages bias – what if there was no big thing, or what if that person missed it? I’ll go to with the former and I’m happy that nobody waved yet another shiny object that does little to improve outcomes or cost. Cybersecurity got more attention mostly because HIMSS pushed that topic as a business opportunity, but nobody I saw had a lot of big developments or compelling case studies for population health management technology, precision medicine, and analytics. The mode seems to be more optimization than acquisition. I consider that positive – hopefully we’ve outgrown the days of providers creating their IT strategies around vendor brochures.

From UMMC IT: “Re: University of Mississippi Medical Center. Looks like staff reductions will happen and IT may get hit hardest with the largest budget on campus and staff.” The hospital says that an unexpected $35 million Medicaid funding cut will require layoffs and elimination of programs. 

From Salty Dog: “Re: marketing conference. I remember seeing that you had a discount registration code for John Lynn’s marketing conference. Do you still have that available? Also, thanks for HIStalkapalooza – I got my annual fix of dancing and enjoyable conversations with both acquaintances and strangers.” Registration for the Healthcare IT Marketing & PR Conference is open through March 6, for which using promo code “histalk” saves you $300 on the $1,395 general registration. Nearly all attendees of last year’s conference gave it at least an 8 on a 10-point scale. I’m glad you enjoyed HIStalkapalooza, where dancing is always a highlight thanks to the incredible Party on the Moon.

From WK Fan: “Re: HIStalkapalooza. I appreciate the broad coverage of HIStalk and thank you for hosting the event. Invitations and HOB being a pain to work with stinks, but the party and vibrations were positive. Band was upbeat, food not so much, but wait staff and bar was inviting. The negatives will sting and linger, but don’t forget to pat yourself and your party planners on the back since it delivered a great time.” Thanks. We did the best we could, anyway. I’m sorry the food didn’t live up to its price tag. I only had chicken, salad, and spinach-artichoke dip and it was pretty good for what it was.

From Darren Dworkin: “Re: HIMSS17. Many of us come back from HIMSS with all sorts of reflections on the industry, the show, the crowds, and of course our share of suggested improvements. But I thought I would take a minute to give a well-deserved shout-out to out going president of HIMSS, Steve Lieber. As you shared in HIStalk a while back, after almost 20 years and navigating some amazing growth, Steve is leaving an organization he did not create but that he certainly helped propel to be a foundational piece of our industry. A friend shared with me recently that building and running an organization can often look glamorous from the outside, but inside it is more akin to the work of picking up tin cans one at a time. Building and running big things is hard  since everyone has an idea how to do it better. Steve, thank you for doing the hard things for our industry and growing HIMSS to what it is today.” I agree. I struggle with the unbridled, sometimes seemingly patient-indifferent ambition of HIMSS that is fueled by a business model of selling vendors access to providers, sometimes veering into purely commercial territory (HIMSS Media, HIMSS Analytics) and orchestrating self-serving advocacy efforts, but Steve skillfully moved the organization to where he thought it needed to go and sometimes dragged the industry along with it.

From Bonny Roberts: “Re: HIStalkapalooza red carpet. Your #1 fan was a retired woman who came to Orlando only to attend the event – she didn’t even register for the HIMSS conference.” That’s pretty cool. Hopefully she found it worth whatever degree of travel was required. Bonny, in the red dress above, was our red carpet host. I don’t know the identity of the person to whom she’s referring.

HIStalk Announcements and Requests

We readers funded Ms. A’s DonorsChoose grant request in buying 30 calculators for her sixth grade math class in South Carolina. She moved me with her report about the impact of the $5 calculators: “My classroom is a much better place because of your willingness to help them in a time of need. These calculators have enhanced our classroom and my students so much … The calculators prior to these new ones were very old, and honestly, they came from the local Dollar Tree store. In the school district that I am teaching at, our salaries are below average and we extend our finances to help our students as much as possible. The need for calculators was extreme, so I purchased my own class set. While they lasted for a short amount of time, they were great for my students … They deserve the best, and they definitely got that from your donation. Again, thank you so much for these beautiful calculators! They do not seem like much, but they will impact my students and classroom so much!”

Our post-HIMSS17 cupboard is a bit bare since everybody wrapped up most things before the conference, so potential new sponsors and webinar promoters can contact me for the specials I always trot out right about now.

I’ve heard from several folks that, like me, they are a bit under the weather post-HIMSS from some combination of stress; sore throats and runny noses (maybe from rebreathed air or exhibit hall glad-handing); and possibly some element of food poisoning.

As a healthcare guy, the first things I thought of upon reading about the Oscars “wrong envelope” fiasco were the following:

• Surely just like in healthcare there was a Swiss cheese effect of multiple exceptions that lined up to allow the usually reliable system to fail. As it turns out, the PwC envelope guy above was screwing around on Twitter in a celebrity-fawning haze instead of paying attention to the job he was being paid to do. Then, a justifiably puzzled 79-year-old Warren Beatty showed Faye Dunaway the card he had been handed to see what she made of it, but then she misunderstood his intention and blurted out the name she saw. That’s pretty Swiss cheesy.
• A human factors expert would have paid close attention to the envelope’s color and labeling, which is no different than redesigning an IV label or patient wristband to prevent mistakes.
• Technology might have helped, such as discreetly barcode checking the envelope before handing it over. In fact, the entire process of relying on duplicate stacks of paper (one on each side of the stage) seems dramatic but ripe for technology improvements, such as having the complete narrative to be read – including the winner’s name – from a teleprompter whose contents are secured until the big reveal.
• Bonnie and Clyde should have taken a time-out before forging ahead with a situation that was obviously puzzling to them.
• The Oscar producers seemed afraid to speak up before the non-winners began their acceptance speeches. It was apparently a stagehand who figured out the problem and stepped in a couple of minutes later, no different than when a cranky surgeon forges ahead into blunder-dom because everybody is reluctant to challenge them.
• The brand damage to PwC (which wags are calling “Probably Wrong Card”) is incalculable.
• Unlike an actual healthcare snafu, nobody was harmed, social media were entertained, everybody was a good sport, and all who were involved lived to tell about it.
• Notwithstanding proclamations of a non-punitive culture, the two on-stage consultants will be thrown under the bus and either demoted or fired and PwC will lose its most visible client.

I strung together a sampling of HIStalkapalooza photos into a YouTube video. This is the last party-related deliverable on my list, except I think the videographer has a final video cut on its way. Here’s a fun fashion footnote: three women told me they ordered fancy dresses from the once-fabulous Rent the Runway, but all three received garments that were obviously ripped. Two spent time trying to patch them up, while the other just gave up and went back to conference wear. Perhaps the company is a victim of its own success and is wearing out its means of production. 

Webinars

March 9 (Thursday) 1:00 ET. “PAMA: The 2017 MPFS Final Rule.” Sponsored by National Decision Support Company. Presenter: Erin Lane, senior analyst, The Advisory Board Company. The Protecting Access to Medicare Act of 2014 instructed CMS to require physicians to consult with a qualified clinical decision support (CDS) mechanism that relies on established appropriate use criteria (AUC) when ordering certain imaging exams. Providers must report AUC interactions beginning January 1, 2018 to receive payment for Medicare Advanced Imaging studies, with the CDS recording a unique number. Outliers will be measured against a set of Priority Clinical Areas and interaction with the AUC. This webinar will review the requirements for Medicare Advanced Imaging compliance and will review how to ensure that CDS tools submit the information needed for reimbursement. 

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

Sales

A cross-border radiotherapy project in Republic of Ireland and Northern Ireland chooses Agfa HealthCare’s health management platform, including its universal viewer.

People

Consumer health website Sharecare — founded by WebMD founder Jeff Arnold and TV huckster Dr. Oz — hires John Solomon (Apple) as strategic advisor and Dale Rayman (Zipongo) as SVP of actuarial consulting and business development.

CompuGroup Medical promotes Benedikt Brueckle to CEO of its US division. He replaces Werner Rodorff, who will return to his previous role as CTO.

Announcements and Implementations

For-profit, five-hospital Cancer Treatment Centers of America Global will integrate NantHealth’s oncology clinical decision support with Allscripts Sunrise.

MModal launches Scribing Services, which provides medical scribes who review audio from encounters – either in real time or afterward – and document directly into the EHR.

Government and Politics

VA Secretary David Shulkin, in his first public address, outlines his priorities, which include improving access to non-VA providers when a veteran can’t get a timely VA appointment, making it easier to fire bad employees, creating new suicide prevention programs, improving coordination with the DoD, and enhancing the VA’s IT.

Meanwhile, the VA says it will increase employee drug testing and drug inspections following government reports of sloppy drug tracking, large numbers of drug diversion investigations of which few resulted in disciplinary action, and lack of consistent drug testing of new hires.

An HHS GAO report recommends that HHS encourage improved information exchange as patients leave hospitals for post-acute care settings.

A Black Book survey of 35,000 consumers who are covered by exchange-sold health plans finds a strong drop in satisfaction in the past year, with the biggest gripes being poor customer service, premium hikes, narrowing networks, reduced benefits, and too-few participating insurers to choose from. Time to resolve member complaints jumped from 12.5 days to 31 days in 2016. Overall satisfaction dropped from 77 percent to 22 percent, wile 58 percent of those surveyed said plan services declined significantly. More than two-thirds of US counties had only one or two insurers to choose from. 

HIMSS declares health IT to be “a bright spot for the US economy,” somehow missing the economic point that a swollen healthcare industry and its supporting services are mostly a drain on the economy and international competitiveness rather than something to brag about.

Privacy and Security

A patient sues New York Presbyterian / Columbia University Medical Center for charging her $1.50 per page plus an administrative fee to provide copies of her medical records, presenting her with a bill for $3,000. State law limits costs to 75 cents per page. Also named in the suit is IOD Inc., to which the hospital outsourced its release-of-information management.

The Equal Employment Opportunity Commission subpoenas TriHealth (OH), demanding that it turn over the medical records of the employees of an unnamed company that is being investigated for making unjustified disability-related medical inquiries. The company says TriHealth doesn’t give it access to the records, while TriHealth says it doesn’t own the records of the approximately 2,000 patients involved and thus can’t turn them over to EEOC.

Other

Amazon Web Services went down in the eastern US Tuesday afternoon, causing problems for websites, apps, and services that rely on its cloud computing services. Explaining to a hospital CEO that their outage was caused by someone else’s data center problems must be tough. I’m not sure which cloud-based vendors went down, but Practice Fusion was one of them.

Tech-powered home caregiver matching company HomeHero, the #1 home care provider in California, finally shuts down after an October 2015 Department of Labor ruling that home care workers must be hired as W-2 employees rather than 1099 contractors, a change advocated by labor unions and California $15 per hour minimum wage advocates. That ruling also required paying overtime rates that doubled the cost of live-in care that made it more expensive than sending a patient to a skilled nursing facility. The now-defunct company pivoted to an enterprise model to work with hospitals, signed up with the Cedars-Sinai digital health accelerator, and developed a CareKit-integrated health app, but then found that large health systems would launch pilot projects strictly for case studies with no intention of buying anything because they had no financial incentive to pay for home care (“being dragged out in the middle of an ocean and abandoned”).

In Australia, merged medical device manufacturers Medtronic and Covidien implement new supply chain systems, with conversion hiccups interrupting the flow of orders for surgical instruments, respiratory products, and sutures for six weeks, causing hospital surgery backlogs and apparently some incidents of patient harm from the use of replacement products.

Laid-off IT workers at UCSF were planning to demonstrate on campus Tuesday to protest the university’s decision to outsource their jobs to India.

A reader sent over an interesting 2015 Health Affairs article about healthcare costs that I had missed. It opines that conservatives blame patients for making bad health choices and paying too little of their healthcare costs to have adequate skin in the game; liberals blame doctors and hospitals for gaming the system to protect their incomes; while both sides ignore the comparative US under-investment in public health and social spending. It concludes, “Improving health requires changing the society itself, not merely changing individual behaviors.” 

A study finds that even though EDs are the source of a lot of inappropriate antibiotic prescribing, most pediatric EDs say they aren’t invited to the table when antimicrobial stewardship programs are being created or managed.

Former CMS Acting Administrator Andy Slavitt notes that only 2.1 percent of HIMSS17 attendees were identified as non-management clinicians and 60 percent came from non-provider settings. That’s based on job title and employer, though, and sometimes clinicians still see patients while working in IT or at a C-level job. The other slice and dice I’d like to see is how many CIOs, IT directors, CMIOs, and VPs came from provider organizations since those are the decision-makers that vendors swear are in short supply in the exhibit hall.

Sponsor Updates

• Medhost’s inpatient, ED, BI, and YourCareUniverse portal earn Meaningful Use Stage 3 certification.
• AdvancedMD will introduce a new dermatology practice model, Practice 2.0, at the ADAM/AAD meetings in Orlando this week and next.
• Sutherland Healthcare Solutions publishes a case study of its ICD-10 transition work with Palomar Health.
• CommonWell TV interviews Aprima COO Neil Simon at HIMSS17.
• The Breaking Health Podcast interviews Arcadia Healthcare Solutions CEO Sean Carroll.
• CRISP publishes a case study about PROMPT, a care coordination platform developed by Audacious Inquiry.
• Palmetto Health Quality Collaborative goes live on Caradigm’s population health management solutions.
• Casenet integrates its TruCare population health and care management solutions with MCG Health’s evidence-based guidelines to improve the prior authorization process.
• CoverMyMeds expands its RxChangeRequest Service at no cost and commits to interoperate with willing trade organizations.
• Cumberland Consulting Group CEO Brian Cahill contributes to Consulting Magazine’s cover story on “The Trump Effect.”
• Elsevier CMO Peter Edelstein shares precision medicine insights from the HIMSS17 show floor.
• EClinicalWorks successfully deploys CommonWell services.
• FormFast will provide forms automation and electronic signature technologies for the Meditech implementations of health IT service provider Engage.
• Healthcare Growth Partners publishes “Health IT Valuation Trends by HIT Subsector.”
• Two studies presented at ATTD 2017 showcase the dramatic improvements in diabetic control and patient outcomes enabled by Glytec’s personalized therapy management and clinical decision support.

Blog Posts

• Five Considerations for Implementing a Successful Disaster Recovery and Business Continuity Strategy (Optimum Healthcare IT)
• Leidos Health Ranked in 2017 Best in KLAS Awards: Professional Services (Leidos)
• Introducing the 2017 Data Gallery (Arcadia Healthcare Solutions)
• Reflections on HIMSS17: Same Same, but Different (Datica)
• Healthcare Innovation Creates Investment Opportunities (CareSync)
• Healthcare Cybersecurity Professionals in High Demand (Direct Consulting Associates)
• Is Your Online Corporate Image Attracting the Best Talent? (Dynamic Computing Services)
• 3 Takeaways from HIMSS17 (Dimensional Insights)
• Doubling Down on Value-based Care: The Ambulatory Strategy (ECG Management Consultants)
• 3 Ways Social Media can Improve Healthcare Marketing Efforts (Evariant)
• The Top 10 Reasons Transformation is the New Normal for Healthcare – Reason 7 (GE Healthcare)
• Optimizing Your EMR Project: Utilize Your Lessons Learned (Hayes Management Consulting)
• How America’s Best Hospitals Engage Patients in Their Care (Healthgrades)

Contacts

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

Morning Headlines 2/28/17

Vanderbilt hospital employees breached patient records

An EHR audit at Vanderbilt University Medical Center (TN) finds that two patient transporters inappropriately accessed more than 3,000 medical records between May 2015 and December 2016. A spokesperson for the hospital reports that the transporters were disciplined, but additional details were not disclosed.

From Machine-Readable Provider Directories, A Preview Of A Revolution

Health Affairs reports on the potential benefit machine-readable provider directories could have for researchers and regulators working to improve healthcare access.

Top 25 Women In Healthcare 2017

Modern Healthcare publishes its annual list of top women in healthcare, with Epic CEO Judy Faulkner and IBM Watson Health General Manager Deborah DiSanzo representing health IT.

VA data show low rate of discipline for drug loss, theft

An AP investigation finds that while there were more than 11,000 reported incidents of drug loss or theft at federal hospitals last year, only 3 percent of those incidents resulted in disciplinary action.

Morning Headlines 2/27/17

Message is from Island Health President and CEO Dr. Brendan Carr

In Canada, Nanaimo Regional General Hospital shuts down its Cerner CPOE system, responding to safety concerns raised by the medical staff.

In Missouri, a Showdown Over Creating an Opioid Database

Political pressure mounts for Missouri state lawmakers to establish a prescription tracking database as the state becomes a tourist attraction to drug seekers.

Excessive computer use by doctors has negative impact on patient care: study

A study of three US hospitals finds ICU staff spend an average of 49 percent of their shift on a computer.

At 95, the doctor may be out, but never forgotten

A local paper covers the career of 95 year old Woodrow Batten, MD who helped found Johnston Memorial Hospital (NC) 60 years ago and continued to work there, even earning his Epic certification, until his recently announced retirement.

Monday Morning Update 2/27/17

Top News

Six-hospital Memorial Healthcare System (FL) pays $5.5 million to settle HIPAA charges after notifying HHS that two of its employees — as well as 12 employees of affiliated physician practices — inappropriately accessed patient information that was either sold or used to file fraudulent tax returns.

An investigation found that the health system failed to review audit logs and did not properly maintain access authorization despite having noted those deficiencies in its own risk analyses for several years before the incident occurred.

The information of 115,000 patients was exposed, most of it to someone using the login credentials of a former employee of an affiliated physician practice over a one-year period. 

Reader Comments

From Pittsburgh HIT Minion: “Re: HIStalkapalooza. I just wanted to reach out and thank you for hosting a wonderful HIStalkapalooza at HIMSS. I’ve been honored to receive an invite for the past couple years, and it is without a doubt the highlight of my time at the conference. So many of us are faced daily with the challenges of delivering high-quality care to patients who are scared, confused, and just want our help navigating a difficult and expensive health system. The upbeat crowd, the humor of the awards, and the always incredible Party on the Moon are a welcome respite from the cares that our chosen career path brings. Again, thank you.” You are welcome. It’s a pain dealing with no-shows and an endless parade of self-entitled folks that drain our time and energy right when need it most (boy, could I tell you stories), but it’s nice that attendees enjoy the evening even if I don’t. The only way I would do it again is if I could figure out venue in which I’m not at financial risk (due to high buy-out costs) and if I could just open the doors to anyone with a HIMSS badge without dealing with the whole invitation process that brings out the worst in people. I will also say that I would never do another one at House of Blues Orlando – their only strong competency seems to be nickel-and-diming and saying “no” to even modest requests, which is especially galling given that I was about to write them a check for $99,000 and I couldn’t even get someone to bring me a plate of food backstage.

From Cathy’s Clown: “Re: HIMSS selling booths by volume instead of area. If that’s the case, can one company buy the space above its competitor and advertise against it?” HIMSS should sell the air rights competitively, encouraging companies to lock in the space above them to avoid being trumped by a competitor whose sign there contains a downward-pointing arrow with a legend of “I’m with stupid.” I don’t see a height surcharge listed on the price sheet, but it doesn’t contain a great deal of detail. Based on the information above, however, the largest booths such as those of Epic and Cerner cost in the $400,000 to $500,000 range for floor space alone.

From Dickie Doo: “Re: your HIMSS booth. What was the total cost for your tiny space?” Ouch, that “tiny” part stung a little, as the truth often does. I gulped hard in paying $5,300 for our booth, but I magnanimously sprang $130 for two chairs so Lorre and the 18th US Surgeon General Regina Benjamin wouldn’t have to stand all week. Then it was another $18 for a cardboard trash can, $182 for a standard conference table, and $167 for the cheapest available carpet (and if you noticed the hideous color, you’ll understand the low price, especially since I refused to pay Freeman to run the sweeper over it). We don’t ever even buy a power strip ($150 per day or something like that) or Internet access, so we’re as barebones as it gets. Our location for HIMS18 is horrible, down in the Siberian basement, so I’ll really question the value then. I should instead hit up a big-boothed vendor to donate a free corner of their space in return for a fairly regular inflow of the interesting characters we apparently draw (it’s hearsay to me since I’m not actually there to see it). 

HIStalk Announcements and Requests

Three-fourths of poll respondents think the VA will replace VistA with a commercial solution, with Cerner edging Epic as the most likely product.

New poll to your right or here: For HIMSS attendees: did you discover a product or service that you will follow up on?

Ms. W checked in from her high-poverty South Carolina school to describe how funding her DonorsChoose grant request worked out: “Thank you so much for the STEM materials. When the package arrived, my students were so excited. They felt like it was Christmas all over again. My students love building and creating with the objects, not only for projects, but also during free time. My students will sometimes choose to read or work with a STEM bin once their station is completed. They love getting to use these new materials to help them stretch their minds and build with these materials. Their creativity is really growing. I love watching them love learning!”

Fun stuff from the back of the tee shirt that Eclipse gave me at their booth.

Thanks to Jenny and Valerie from Optimum Healthcare IT for spending at least an hour assembling our step-and-repeat background for the red carpet entrance. That’s another saga in itself. House of Blues wanted $1,250 plus labor to put up a step-and-repeat, so we bought one online for $250, hauled it over to HOB, and then had to figure out how to assemble it right before the doors opened. HOB did stick us for the red carpet itself since we didn’t have an alternative – that chunk of ratty red rug cost me $1,200 to use for the evening even though they surely didn’t pay more than $500 for it and it looked like it had been used at least 1,000 times since.

I’m running my annual post-HIMSS webinar special to rebuild the freshly eliminated backlog. Contact Lorre for a deal.

Webinars

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

Acquisitions, Funding, Business, and Stock

ConsejoSano, which offers digital health tools to help Spanish speakers navigate the US health system, raises $4.9 million in a Series A funding round.

Decisions

• Watauga Medical Center (NC) and Soin Medical Center (OH) will switch from BD Pyxis MedStation to an Omnicell automated dispensing cabinet (ADC) system.
• University of Maryland Rehabilitation and Orthopaedic Institute (MD) will replace its Omnicell ADC with BD Pyxis MedStation.

People

Lucia Savage, JD (ONC) joins Amada Health as chief privacy and regulatory officer. 

Announcements and Implementations

CMS adds Audacious Inquiry to its SPARC contract.

Other

Drug seekers are arriving — sometimes by the carload — in Missouri, the only US state that hasn’t implemented a prescription drug monitoring (doctor-shopper) database that would otherwise thwart their drug-seeking ambitions. Physician and Republican Senator Rob Schaaf, who has led opposition to the database and who says he will filibuster in trying to stop any new bills that would support its creation, explains, “I have always been opposed to having our private medical data on a government database.”

In Canada, Nanaimo Regional General Hospital temporarily shuts down CPOE and goes back to paper ordering as the latest in a series of problems in its IHealth rollout of Cerner.

Healthgrades names its best hospitals for 2017, with 22 states and DC having none of them.

A small observational study finds that ICU doctors and nurses spend an average of 49 percent of their time working on the computer, with some of them hitting 90 percent of their working hours at a keyboard. The authors warn that team communication and interaction with patients and family may suffer, adding, “The job really isn’t fixing bodies and interacting with them. It’s just managing streams of data.”

The Raleigh, NC newspaper profiles Woodrow Batten, MD, a hospital doctor who has retired just months after earning Epic certification. The 95-year-old doctor co-founded the hospital 60 years ago.

Sponsor Updates

• PokitDok Launches on AWS Marketplace, Becomes APN Advanced Technology Partner (PokitDok)

Blog Posts

• #HIMSS17 CIOs discuss extending their EHR [CHIME Focus Group] (Nordic)
• 5 Necessary Steps to Protect Your Patient Data (Spok)
• Revenue Cycle Post-Implementation Support (Impact Advisors)

Contacts

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

Jenn’s HIMSS Report – Wednesday

My last full day at the conference started off cloudy and cool, which made for a comfortable, early-morning walk to the convention center. I have really enjoyed not having to rely on the shuttle this time around. I think I’ll look into booking my room for HIMSS18 within the next month. I must add, though, that I am not looking forward to heading back to Las Vegas. It’s one of the few cities I’ve visited around the world that just doesn’t agree with me (or perhaps it’s the other way around).

After catching up on email and other tasks in the press room, I sat down with Quest Diagnostics SVP and CIO Lidia Fonseca to get a feel for what the company has been up to. I’ve been keeping an eye on their patient-initiated testing pilots (check out my latest coverage at HIStalk Practice), and was eager to learn if the high-profile rise and fall of Theranos had offered any lessons learned. She was quick to tell me they don’t comment on the strategies of competitors, but did add that Theranos had “certainly created a heightened awareness of diagnostics.” It seems reasonable to assume that consumers might trust a company like Quest over a startup like Theranos, given that Quest has been very intentional about playing by the regulatory rules, and seems to be rolling out consumer-directed testing methodically.

After hanging out at our booth for a bit, I trekked over to the Nuance to meet with Ehab Hanna, MD, CMIO at  hospital management company United Health Services of Delaware. He took me through his organization’s roll out of several Nuance transcription technologies, the most recent of which includes PowerMic Mobile, and Cerner’s Document Quality Review, which includes Nuance’s CDI tech. He pointed out that the majority of his physicians (there are still a few holdouts who employ scribes at their own expense) are beginning to see the impact transcription can have on quality scores now that everyone is preparing for MACRA. Hanna added that he would spend some time in the exhibit hall looking at analytics and data warehousing for population health management initiatives, and mobility tools for providers and patients.

Walking to interviews certainly works up an appetite, and so Lorre was kind enough to hand me a HIMSS Bistro ticket left over from the HIStalk CMIO lunch. I set off on quite the adventure to find the place, which ended up being on the lower level of Hall A, tucked away in an inconspicuous wing. It was a nice excuse to get away from the multitudes and enjoy a meal that was a few steps above press room fare. I have a huge sweet tooth and was quick to take advantage of the dessert bar. I’ve tried to eat well while I’ve been here. Any slip ups have been justified by the reality that the miles I’ll walk afterward will surely burn everything off.

I found a much quicker way back to our booth, where I spent some time chatting with readers, many of whom stopped by to ask, “Was that really the last HIStalkapalooza?” Most everyone had an idea of how to save it. I found the notion of charging for tickets interesting, though I’m not sure that would actually cut down on the hassle Lorre suffers through every year. A Swiss provider on the prowl for new ideas said HIStalk could donate anything above and beyond breaking even to Donors Choose, which sounds good in theory. I was happy that everyone was so excited about the event, but I’m not sure that enthusiasm will be there seven months from now when we’d typically start canvassing for sponsors.

My last chat of the day was with CommonWell Health Alliance Executive Director Jitin Asnaani. Their booth, much smaller than in years past, was crawling with reps from their member companies. The organization now has 5,100 sites live, an exponentially huge jump from the 700 sites it was touting at HIMSS in 2015. Asnaani has been pleased by the expansion of membership beyond traditional EHR vendors. Representatives from the long-term and post-acute care worlds – long overlooked by programs like Meaningful Use – have expressed interest in connecting to the CommonWell network. Even ONC has approached the alliance about the ways in which those sectors of healthcare can tap into the care coordination benefits offered by the interoperability it affords.

When I asked what had stood out to him at HIMSS thus far, Asnaani was quick to say the lack of buzz around interoperability, which everyone seemed to be touting the last time around. He’s hopeful that providers are starting to think of interoperability as par for the course. He also noted that attendees and exhibitors seemed to be a bit subdued given the uncertainty surrounding the new administration’s ACA plans. “ONC’s sessions have never been so popular,” he joked.

Exhibit hall closing time was looming, so I took a quick walk through the exhibit hall to see if there was anything left worth seeing.

Quite a crowd had gathered to watch GE Healthcare’s "Who Wants to be a Millionaire" game.

The Nordic team was fun to chat with. They were in full unload mode, and are sending me home with quite a treasure trove of goodies.

The Bottomline Technologies team was happy to pose for a picture. I was pleased to see they had prominently displayed their HIStalk sign.

Conduent Health’s booth was booming.

I noticed quite a few exhibitors with arcade-like grabbing games. I’m not sure I’d stand in a line to try and win a T-shirt. The men at ExtraHop’s booth had no such qualms.

The Access booth seemed busy. I had a nice chat with one of their writers earlier that morning. It’s always nice to compare tips, tricks, and quirks with fellow scribes.

I had to stop by LogicStream Health’s booth to express my regret at not being able to attend their party Tuesday night, which I heard was a blast. They’ve kindly invited me several years in a row, and every year I RSVP with the best of intentions. But then #HIMSSanity overwhelms me …

The closing bell finally rang, at which point all of the remaining exhibitors cheered and clapped loudly. That didn’t stop attendees from continuing to wander the hall as sales teams boxed everything up. I finally got a chance to wander towards the Interoperability Showcase, where I passed this eye-catching setup.

The Showcase still seemed to be hopping; a presentation was even about to get underway, which surprised me. This marked the first time I’ve ever stayed until the bitter end of exhibit hall hours, and I was surprised to see so many folks still around. I did later hear that the conference center taxi queue and airport check-in lines were insane, making me love my decision to depart Thursday even more.

I began the packing process back at my hotel rather than tackling my inbox, which I don’t think I can bear to attempt until I’m back home. Two of my favorite giveaways include a full bag of coffee beans from Nordic and this messenger bag from Chilmark Research, both in the same color scheme of my favorite college football team. I would have included Arcadia’s Survival Kits, but I either used everything in mine or gave it away to friends suffering from blisters or impending colds. Note to just about everyone: Band-Aids and Emergen-C are must haves at HIMSS.

I’m going to take a few days to decompress and then get back into the swing of things over at HIStalk Practice on Monday. Thanks to everyone who took the time to chat with me, invite me to parties, and stop by our booth to tell me how much they enjoy reading. HIMSS may be crazy, but it’s definitely one of the professional highlights of my year. See you in Las Vegas!

Morning Headlines 2/24/17

Screening for medication errors using an outlier detection system

A JAMIA study evaluates the effectiveness of using outlier detection software to identify potential medication errors.  5 years worth of EHR data was screened using the system to detect potential medication errors, and 75 percent of flagged charts had confirmed medication errors.

Letter to HHS Secretary Thomas Price, M.D

CHIME, MGMA, and 14 other medical societies co-sign a letter to HHS Secretary Thomas Price, MD lobbying for an indefinite delay of Meaningful Use Stage 3.

LabCorp buying Spokane-based PAML

LabCorp announces it will acquire Pathology Associates Medical Laboratories, a national medical reference lab co-owned by Providence Health & Services and Catholic Health Initiatives.

Republican-Led States Push to Reshape Their Medicaid Programs

More than half-dozen states are seeking federal permission to reshape state Medicaid programs to impose coverage restrictions as ACA reform efforts stagnate.

Dr. Jayne’s HIMSS Report – Wednesday

I have to say, after two days of walking the halls at HIMSS and attending social functions in the evening, my feet were tired this morning. Nevertheless, I took my cocktail of four ibuprofen, two Tylenol, and a Pepcid and headed back to do it all again.

I spotted this sweet ride in the parking lot behind the Hyatt.

Today’s schedule included a couple of meetings with vendors who attend HIMSS but don’t have booths. It’s always a challenge to find quiet meeting space. We used the meeting area outside the HIMSS Bistro, which was nearly empty at 11 a.m. Speaking of HIMSS Bistro, I can’t wait to hear Lorre’s recap of the CMIO luncheon yesterday. She always takes good notes on the discussion so we can share what CMIOs and clinical informatics folks are thinking as they attend HIMSS.

I noticed lots of vendors sporting their HIStalk sponsor signs today. Thanks to all of you, especially HBI Solutions, Harris Healthcare, Wellsoft, Nordic Consulting, Kyruus, Datica, and Medicity. DrFirst also had their sign out and I stopped in to see their secure texting solution, which is configured as a patient-centered chat.

My booth crawl BFF this afternoon said she thought this giveaway pen looked like me until I pointed out that the physician doesn’t appear to be wearing a shirt.

I took a deeper look at several vendors, including Jellyfish Health, which has solutions to make anywhere the waiting room. My urgent care practice has an online registration and queuing system, but it’s not entirely reliable. I was impressed by what I saw at Jellyfish Health, but we’ll have to see what the COO thinks.

LogicStream Health was showing demos and data from their solutions, which really caught my interest since driving clinician behavior is going to be a big part of organizational success under healthcare reform.

One of my booth crawling pals today is attending her first HIMSS, and was dedicated to seeking out the wildest swag to take home to her granddaughters. She scored at CompliancePoint, who was giving out flashing LED eyeglasses.

We were more impressed by the shirt that Bonny Roberts picked up at Banyan. I wish I had seen it before the hall closed so I could snag one myself.

I also spent a bit of time cruising the hall with @techguy John Lynn. I’m sorry I missed out on the salsa dancing at the New Media Meetup last night, but I learned he knows a thing or two about country western dancing, so I’m hoping a country-themed meetup is in the works. I’ll break out my boots for sure.

He was able to talk me off the ledge when I saw this rounding cart from Omnimed, which caused some bad flashbacks to medical school. I haven’t seen paper charts in a hospital in years, but the rep told us people are still buying them, although with a better top surface to hold a laptop. They also have an IV pole that holds an iPad.

We stopped to talk to Travis Good, MD at Datica, particularly about the company’s rebranding from Catalyze. It takes quite a bit of effort to research potential names, investigate securing web domains, and starting the process for trademark protection. Travis mentioned he thought warm cookies would be a great addition to the booth, and then the discussion turned to pizza. Vendors, take note for next year — you can’t underestimate the power of pizza.

As far as other booth draws, Mimecast had Nerf guns where you could take aim at ransomware, but the line to take a turn was long, which is an interesting commentary. SecureIdeas had a great tagline about being “professionally evil” to protect systems from real evil. Quite a few vendor people were heads-down on their phones and others were just throwing their giveaways at passersby so they didn’t have to ship it home. The rep at Retarus global messaging told us to take what we wanted because “everything must go” and didn’t even ask us what we do or what we’re looking for at the show.

I traded booth crawl partners and spotted some more people in white coats at Marco Inc. and Carepoynt. Why, oh why, does that continue? On the positive fashion side, booth staff at Cerner were wearing the most beautiful orchid-colored sweaters.

The interesting giveaway of the day was at MAD Security, whose offering was a bottle of Macallan 12 scotch. Several vendors were giving out insect repellent this year, including Healthcare Informatics (lemon/rosemary oil) and Battelle with what they were calling their “Zika Pen.” They engaged us by saying, “We’re the biggest company you’ve never heard of,” and after checking out their website, I have to say they’re quite the interesting vendor.

We spotted more funny name badge ribbons at AbbaDox and I snagged a couple for next year.

As the show wound down, many vendors began tearing down their booths while people were still walking through. I headed out for a quick drink with some old friends and we ran into Nick van Terheyden @drnic1, who asked if we were headed to the Harry Potter event. Although it was pouring rain at the time, he said he really wanted to go so he could get a wand – because that’s the only thing that will fix healthcare.

On that note, I closed out HIMSS17. Back to the hotel for packing, blogging, catching up on 200+ emails, and getting a little rest before Disney’s Magical Express whisks me back to the airport.