Aetna announces plans to offer an Apple Watch subsidy through large employers and select individual customers to ramp up its wellness and care management programs, and will provide its own 50,000 employees Apple Watches free of charge.
HIStalk Announcements and Requests
This week on HIStalk Practice: Dr. Gregg pontificates on the proper way for vendors to apologize for unexpected downtime. Enjoin VP James Fee, MD describes how physician engagement efforts can improve clinical documentation. Malvern Family Medical Clinic Owner Shawn Purifoy, MD offers insight into the benefits of joining an ACO and the struggle to remain independent. Medecision William Gillespie, MD lists three population health must-haves for primary care. Midwest Nephrology Associates Owner Gary Singer, MD digs into the benefits of Carequality’s Interoperability Framework.
This week on HIStalk Connect: Sirono Chief Revenue Officer Peter Longo discusses the problem with hospital billing and keys to successful patient payments.
Webinars
October 13 (Thursday) 2:00 ET. “Glycemic Control During Therapeutic Hypothermia.” Sponsored by Monarch Medical Technologies. Presenter: Tracey Melhuish, RN, MSN, clinical practice specialist, Holy Cross Hospital (FL). Using therapeutic hypothermia (TH) as a method of care can present risks of hyperglycemia, hypoglycemia, and blood glucose variability. Maintaining safe glucose levels during the cooling and rewarming phases of TH reduces the risks of adverse events. Tracey Melhuish, author of “Linking Hypothermia and Hyperglycemia,” will share best practices for optimal glucose control during TH and the success Holy Cross Hospital sees while using a computerized glucose management software.
Contact Lorre for webinar services. View previous webinars on our HIStalk webinars YouTube channel.
Announcements and Implementations
Vidyo launches a clinical design service to help providers integrate telemedicine into their workflows.
PatientPing and Vermont Information Technology Leaders deem their care coordination technology collaboration a success at the six-month mark. Since going live, 400 provider locations in New England have been “pinged,” letting them know that their patients have been seen at local hospitals. PatientPing has recorded 62,000 notifications on 12,000 Vermont citizens.
UAB Medicine will replace its connectivity software with Orion Health’s Rhapsody Integration Engine – a project that will include rewriting 300 interfaces.
Cypress Creek ER (TX) selects Wellsoft’s EDIS for its third freestanding ER, set to open mid-October. Angleton ER (TX) will go live with Wellsoft technology when it opens in December.
NewCrop adds specialty medication prescribing software from AssistRx to its e-prescribing software.
Acquisitions, Funding, Business, and Stock
Former Tuomey Healthcare (SC) CEO Ralph Cox will personally pay a $1 million fine to settle Stark Law allegations that he illegally compensated doctors in exchange for unnecessary patient referrals to the hospital.
MedWand Digital Health secures a “major investment” from sensor technology-focused Maxim Ventures, which the Las Vegas-based startup will use to work towards anticipated 2017 FDA approval of its diagnostic device for virtual consults.
People
Wendy Deibert (The VirtualEngine) joins Vidyo as VP of clinical services.
Teladoc adds the new role of COO to CFO Mark Hirschhorn’s responsibilities.
Greg Alexander (Evolent Health) joins Lumeris as national VP of market operations.
The Chartis Group promotes Michael Topchik to head of the new Chartis Center for Rural Health.
Michael Bain, MD (Qualified Emergency Specialists) will head Cincinnati-based TriHealth’s new clinical informatics department as CMIO.
Technology
Dr. Oz lends his gravitas to San Francisco-based wearables startup IBeat, becoming an investor, partner, and advisor to the company as it launches its heart-monitoring smartwatch via an Indiegogo campaign. For a mere $5,000, buyers can purchase the “Meet Dr. Oz Special,” which includes VIP access to this show, a two-night hotel stay in New York City, two watches and monitoring services, plus a signed book and scrubs. Oz was not involved in last month’s seed funding round of $1.5 million.
Government and Politics
HHS and AARP announce the winners of their “A Bill You Can Understand” contest. Designs from Los Angeles-based RadNet, which won in the easiest-to-understand category, and San Francisco-based Sequence, which won in the overall approach category, will be tested or implemented in six healthcare facilities – including Cambia Health Solutions – across the country. (Jenn talked with CHS President and CEO Mark Ganz about the challenge as part of “The Hypocrisy of a Simpler Patient Bill.”)
Hillary Clinton takes to the New England Journal of Medicine to outline her vision for universal, quality, affordable healthcare. Her short op-ed hints at healthcare IT among her four goals: “I am also committed to expanding access to high-quality data on cost, care quality, and health delivery system performance to help patients and doctors make informed choices, and entrepreneurs build new products and services.” Donald Trump has thus far declined the same editorial opportunity.
ONC awards seven organizations $1.5 million to improve the flow of health data for patients and providers, particularly data related to medication management, laboratory data, and care coordination. The funding comes via the office’s High Impact Pilot and Standards Exploration Award programs.
HIMSS presents Acting Assistant Secretary for Health and former national coordinator Karen DeSalvo, MD with the Federal Health IT Leadership Award during its National Health IT Week festivities.
Privacy and Security
HITRUST connects and begins bi-directional sharing of cyber threat indicators with the Department of Homeland Security’s Automated Indicator Sharing Program. The information exchange corresponds with HITRUST’s new CyberAid program, which helps smaller organizations select security solutions and contribute to the exchange.
The New Jersey Spine Center notifies patients of a July 27 ransomware attack that resulted in the provider paying an unspecified dollar amount to unlock all of its digital patient records. Files were reinstated on August 1.
Royal Cornwall Hospitals Trust in England suffers multiple ransomware attacks over the past year.
Australia Health Minister Sussan Ley apologizes to physicians for the accidental leaking of Medicare data, discovered after University of Melbourne researchers attempted to decrypt some of the data, thus inadvertently revealing sensitive information.
Research and Innovation
The FDA approves Medtronic’s artificial pancreas that automatically monitors a patient’s blood sugar levels and then administers the appropriate insulin dose.
An American Telemedicine Association/Wego Health survey of 429 patients finds that just 22 percent have taken advantage of video visits in the last year, with the average patient engaging in between one and four virtual consults. Of that percentage, as many patients requested telemedicine services as their providers initially offered it. I’m not sure that “strong demand,” as tweeted above, is warranted with these results.
Other
Seems like #HIMSSanity has already begun.
British researchers have created a 3D-printed replica of the human body to help train surgeons, particularly when it comes to making that initial slice.
Sponsor Updates
Fortified Health Solutions will exhibit at the HIMSS Southern California Annual Privacy & Security Forum September 30 in Newport Beach.
Frost & Sullivan recognizes Orion Health with the 2016 European Frost & Sullivan Award for Product Leadership.
The FDA approves Medtronic’s artificial pancreas that automatically monitors a patient’s blood sugar levels and then administers the appropriate insulin dose.
Aetna announces plans to offer an Apple Watch subsidy through large employers and select individual customers to ramp up its wellness and care management programs, and will provide its own 50,000 employees Apple Watches free of charge.
An AMA survey of 1,300 physicians finds broad-based optimism for digital health innovations, but note that liability coverage, data privacy, workflow integration, and improved ease of use are all issues that need to be overcome before digital health tools will deliver at full capacity.
September 28, 2016NewsComments Off on Safeguarding Smartphones in an Era of Escalating Vulnerabilities
HIPAA-related security concerns mount as smartphones become more ubiquitous across enterprise healthcare environments. By @JennHIStalk
Ransomware headlines seem to reign supreme in healthcare news, and yet industry insiders know that the greater potential for cyberattack and financial loss resides in just about every person’s pocket (or pocketbook). Catholic Health Care Services of the Archdiocese of Philadelphia’s $650,000 settlement with OCR for HIPAA violations this summer is a prime example of the vulnerability of mobile smart devices. The settlement stemmed from the theft of a smartphone containing the PHI of 412 nursing home residents. Acting as a business associate, CHCS provided IT and management services to six SNFs, and was thus responsible for protecting resident PHI under HIPAA. OCR found that, in addition to a lack of encryption and password protection, CHCS also neglected to develop a risk analysis and accompanying plan for risk management.
While the organization’s lack of cyber safeguards and subsequent fine made headlines, it’s probably a safe bet to assume that other similar entities are operating without the appropriate security safety nets.
Getting on the MDM Hamster Wheel
Smartphone security “is a moving target,” says Alex Brown, director of strategy at healthcare communications company Voalte. “Today, there seems to be two layers of what people are looking into when it comes to smartphone security – applications on the device and the content of those applications. If your application has PHI sitting in it all the time, than you have a much higher risk than with an app that has PHI on it only when it’s connected to a server.
“Not every healthcare organization has the expertise to deploy security,” he adds, “which is why providers rely so much on vendors to make sure that they’re really keeping up to date with best practices around mobile device management.”
Brown finds that in today’s world of escalating cybersecurity concerns, constant dialogue with hospital customers about the importance of up-to-date MDM is a must. Hospitals are now faced with managing almost daily updates from Apple and Google, he explains, which, for many, has taken some getting used to.
“It’s an important piece that not a lot of sites think about,” Brown says. “It’s constantly moving. I like to refer to the smartphone space as a hamster wheel of updates. It can be a little daunting to get on it, and once you’re on it, you really have to keep up. If you don’t, that’s where you can introduce risk. The CHCS settlement was a gut check for other providers in the sense that they hopefully are now asking themselves, ‘Are we checking all the boxes constantly? Are there new boxes that we can now check?’”
Great Vendor Expectations
Parkview Medical Center (CO) CIO and Vice President of IT Steve Shirley has seen his fair share of cybersecurity practices, having spent 30 years in banking IT and nearly eight in healthcare. “In banking, we were mandated and audited on our vendor management programs. I routinely went onsite at vendor locations to audit their data centers, review their SaaS70 reports, and determine the overall security posture of the firm. We looked at their financials and did a significant amount of work to ensure the vendor was not only financially strong and stable, but secure, and that our data was safe.”
Shirley adds that security in the financial industry is at a higher level of maturation than in healthcare for obvious reasons. “They have to protect identities and money,” he explains. “Now that health data is under attack, we need to raise security to a higher standard. At Parkview, we’re heavy users of smartphones. The challenge is that in the BYOD world, other than our MDM strategy and provisioning, we don’t have a lot of control over what devices come in the door. And so we expect the highest level of security from our vendors. We include vendor management in our RFPs and require BA agreements for any vendor dialing into our system in any way. This is in addition to the standard requirement when the vendor has access to our data for things like analytical activity.
“When we implement new solutions,” he adds, “we collaborate with them to plan and design for security, whether at the mobile device level or system level. When we partnered with PatientSafe Solutions to roll out PatientTouch on the iPhone for services ranging from bedside medication verification to care team texting and communications, we brought in all of the vendors involved to develop a system that was not only reliable and functional, but also secure across all connections and access points. Six companies were involved: PatientSafe, their wireless vendor, our IT team and wireless vendor, Cisco, and Apple all participated in ensuring the system worked seamlessly and securely.”
Sticks Will Get the Cybersecurity Job Done
With regard to the CHCS breach, Shirley isn’t shy about sharing his opinion. “In the banking industry, I learned that we all mean to do good, but the movement of the day is so fast and furious that things tend to fall by the wayside,” he says. “And so the government stepped in with punitive measures for not meeting security or other standards. Y2K was a great example. The FDIC threatened to close banks if they didn’t have an appropriate Y2K strategy. I pray every day my hospital doesn’t get attacked and a breach occurs. As regretful and tough as the fine is, it’s a necessity because it creates an industry wakeup call for those who haven’t realized healthcare is under attack.
“It seems that while people understand that systems like servers, desktops, laptops, etc. are highly susceptible to attack if not properly protected, there’s a perception that smartphones are different,” he explains. “We, both industry and our consumers, need to get serious about understanding that a smartphone is a device that has access through the Internet and is thus vulnerable.”
Grace Hua, director of product management, clinical communications at PatientSafe, is of a like mind in her belief that hospitals should demand that vendors provide technology support and safeguards for clinician end users. “This should be a wakeup call not only for BAs, but for the industry as a whole,” she says in reference to the CHCS news. “BAs need to fully understand the importance of the data they are potentially putting at risk, and the implications of theft or security breach, as that data now has a dollar value tied to it. Hacking is now just as profitable in healthcare as other industries.”
Increasing Staff Awareness
When it comes to safeguarding smartphones and patient PHI, Shirley and his team are taking proactive measures to keep CHCS-type incidents at bay. Higher-level efforts include membership in security organizations like the SANS Institute and making sure that new technology deployments include a project milestone for evaluating and understanding potential security risks, and then developing a plan to mitigate them.
“This seems so intuitive,” he says, “but I think it is sometimes not the highest priority in the deployment of healthcare systems. Examples of this include installation of modalities for radiology that have communications facilities onboard, or even simple things like network printers.”
Shirley is especially excited about boots-on-the-ground efforts at Parkview. “We have a network security engineer who, in addition to his technical role, is responsible for security education. He regularly visits units during their daily huddles to give security tips like how to create strong passwords or how to validate that the person on the phone is authorized to receive information. Throughout the hospital, we use our digital wallboards to deliver security messages to everyone onsite. Our employee and physician newsletters have standing articles about safety. We’re also putting together a security video that will be required viewing for all employees. The effort has been huge in the last year to increase staff awareness.”
A Rising Tide Lifts All Cybersecurity Practices
Shirley is happy to report that his colleagues at neighboring institutions are paying just as much attention to securing mobile devices. “Two years ago, I would have said healthcare organizations are not paying enough attention to cybersecurity protection,” he says. “Now, I’m seeing new and extreme efforts every single day. Recently, a competitor healthcare system went to two-factor authentication for external access, and I think that’s awesome. At Parkview, we’ve implemented MDM for all of our devices. We don’t store data on laptops or mobile devices, and we don’t deploy any mobile hardware that hasn’t been encrypted. I think the industry understands healthcare is under threat and there are many points of potential vulnerability we need to address. It’s absolutely becoming more of a focus.”
Comments Off on Safeguarding Smartphones in an Era of Escalating Vulnerabilities
InstaMed announces a $50 million investment from Carrick Capital Partners, which it says will be used to “drive the growth of the InstaMed Network, accelerate go-to-market strategy, and drive further innovation in healthcare payments technology.” The new round brings InstaMed’s total funding to $126 million since its 2004 formation.
Former Tuomey Healthcare (SC) CEO Ralph Cox will personally pay a $1 million fine to settle Stark Law allegations that he illegally compensated doctors in exchange for unnecessary patient referrals to the hospital.
InstaMed secures a $50 million investment from Carrick Capital Partners, bringing its total funding to nearly $126 million since launching in 2004. (CCP’s only other foray into healthcare IT seems to be a 2014 majority equity investment in post-acute software vendor Procura.) The Philadelphia-based company will use this latest round to further develop its healthcare payments technology and go-to-market strategy. CCP Managing Director Jim Madden will join InstaMed’s board, while colleague Chris Wenner will become a board observer.
Webinars
October 13 (Thursday) 2:00 ET. “Glycemic Control During Therapeutic Hypothermia.” Sponsored by Monarch Medical Technologies. Presenter: Tracey Melhuish, RN, MSN, clinical practice specialist, Holy Cross Hospital (FL). Using therapeutic hypothermia (TH) as a method of care can present risks of hyperglycemia, hypoglycemia, and blood glucose variability. Maintaining safe glucose levels during the cooling and rewarming phases of TH reduces the risks of adverse events. Tracey Melhuish, author of “Linking Hypothermia and Hyperglycemia,” will share best practices for optimal glucose control during TH and the success Holy Cross Hospital sees while using a computerized glucose management software.
Waycross, GA-based Salus Telehealth and Chicago-based VideoMedicine merge under the Salus brand name to offer telemedicine hardware and software, including a direct-to-consumer app. Salus CEO Paula Guy will remain in that role over the newly combined company. VideoMedicine founder and CEO Charles Butler, MD seems enthusiastic about the merger, though his role moving forward remains unclear. Fun fact: He competed at the age of 18 in the 1998 Nagano Winter Olympic Games in the sport of ice dancing.
PeriGen confirms the acquisition of Hill-Rom’s WatchChild Fetal Monitoring System. The newly combined team will be led by PeriGen CEO Matthew Sappern, while the management team will include executives from both companies. WatchChild General Manager Brian Bishop will join PeriGen as chief product officer. PeriGen also closed a corresponding investment round led by Ambina Partners, giving AP founder Greg Share a spot on PeriGen’s board.
People
Sentry Data Systems promotes Tom Tran to CFO and COO.
Cerner President Zane Burke joins the board of Truman Medical Centers (MO), which signed on to a 10-year EHR deal with Cerner last fall.
Shelby Solomon (Connecture) joins Medecision as SVP, corporate development and strategy.
Announcements and Implementations
Sunnybrook Health Sciences Centre will implement patient registration technology from Harris QuadraMed across its three facilities in Toronto.
Cigna adds virtual consults from American Well to its telemedicine offerings for 2017 employer-sponsored and individual health plans. The payer rolled out a similar service from MDLive in 2013.
Standards development organization NCPDP works with Experian Health to develop a vendor-neutral universal patient ID management tool.
Several hospitals, including Boston Children’s Hospital and Mercy Health System (WI), and a Pennsylvania-based care program for the elderly, roll out Circulation’s medical transportation technology, which takes advantage of Uber’s API to help providers and patients schedule rides that cater to specific needs and preferences.
Indiana-based HMO MDWise – a joint venture between Eskenazi Health and Indiana University Health – taps Valence Health to process its medical claims beginning January 1.
San Mateo County Health System (CA) implements NextGate’s EMPI patient-matching technology across its 10 divisions and six EHRs.
Privacy and Security
The GAO releases a “scathing” report on cybersecurity preparedness in health information technology, recommending that HHS “update its guidance for protecting electronic health information to address key security elements, improve technical assistance it provides to covered entities, follow up on corrective actions, and establish metrics for gauging the effectiveness of its audit program.”
A former Alberta Hospital Edmonton employee inappropriately accesses the records of 1,300 patients over the course of 11 years, most likely out of “personal curiosity,” making it the Canadian province’s largest deliberate breach of health data.
Technology
SnapMD adds provider-to-provider consult capabilities to its telemedicine technology.
Varian Medical Systems develops new cancer care coordination software that aggregates EHR, IS, and portal data from the patient, PCP, radiation, medical and surgical oncology, and social services.
Memorial Healthcare System partners with American Well to offer a telemedicine app for members of its managed care or consumer health plans.
Casenet rolls out the latest release of its TruCare care administration and management software.
Government and Politics
President Obama gives his stamp of approval to National Health IT Week, reminding citizens of the “billions of dollars” spent to encourage the adoption of EHRs at 97 percent of the country’s hospitals, and his efforts to launch the Precision Medicine Initiative.
Coinciding with nationwide health IT marketing push, ONC releases its Health IT Playbook, a Web-based manual that updates the Patient Engagement Playbook for Providers, offering guidance on a wide variety of health IT products and topics. The playbook includes a guide to EHR selection and contracts.
Research and Innovation
Despite past “snake oil” commentary, an AMA survey of 1,300 physicians finds that a majority are optimistic about the potential of digital health tools to improve patient care. Enthusiasm seems to outweigh adoption: Physicians cite liability coverage, EHR workflow integration, and data privacy as must-haves for successful and consistent adoption.
Sponsor Updates
Forward Health Group Founder and CEO Michael Barbouche speaks at the Wisconsin BioHealth Summit September 27 in Madison.
Impact Advisors releases a new white paper, “Realizing Clinical Benefits from EHR Investments.”
The GAO releases a “scathing” report on cybersecurity preparedness in health information technology, recommending that HHS “update its guidance for protecting electronic health information to address key security elements, improve technical assistance it provides to covered entities, follow up on corrective actions, and establish metrics for gauging the effectiveness of its audit program.”
The Wall Street Journal reports on an ECRI Institute study on wrong-patient medical errors, of which 7,613 cases were identified between January 2013 and July 2015. The report calls for an increased use of barcode scanners and patient pictures embedded within the EHR, but stops short of calling for a national patient identifier.
ONC releases its Health IT Playbook, a web-based manual that updates the Patient Engagement Playbook for Providers, offering guidance on a wide variety of health IT products and topics.
September 26, 2016NewsComments Off on Curbside Consult with Dr. Jayne 9/26/16
National Health IT Week is underway. According to the press release, “This annual celebration is a time for all of us to reflect on the progress we have made and recommit ourselves to advancing the promise of health information technology.” The newest National Coordinator for Health IT, Vindell Washington, MD will host a Twitter chat on Tuesday starting at 11am ET using the hashtag #AskVindell. Topics include the current and future state of health IT as well as questions and answers. There are all kinds of National Health IT Week activities taking place across the country. I’m out with clients this week so I won’t make it to any of the festivities. Still, I wanted to take a chance to reflect on my own time in the Health IT trenches.
I was fortunate to attend a medical school that rotated its students through hospitals that embraced technology. Looking back, some of it was pretty primitive, but back in the day we thought we were cutting edge as we navigated through the lab system with light pens tethered to green-screen terminals. One hospital had started its own EMR. Even in the early days, it had most of the data needed to round on patients – laboratory data, vital signs, medication lists, and more. It was a luxury to prepare for rounds at a single workstation rather than having to round up paper charts and dig through them.
Surprisingly, the more advanced hospital was a community hospital rather than the primary academic hospital. Looking back, it may have been easier to pilot informatics platforms on the community side since the roster of admitting physicians was fairly stable. Although residents and students participated in patient care, it wasn’t at the same volume as the academic hospital. The community hospital was progressive in other ways, building the first hospitalist program in the city and serving as a pioneer in laparoscopic surgery.
My medical school class was the first one to have email accounts issued to everyone with the expectation that we’d actually use it, as opposed to it being optional. Granted, it was Lotus Notes, but it was high tech at the time. We still did our histology coursework looking at carousel after carousel of 35mm slides, however. We had a transcription service where someone took notes at every class and distributed them; without laptops, we took old-fashioned paper notes then typed them up later, printed them, and photocopied them. No one seemed to put two and two together that we could have been emailing them around. Today, my school augments its gross anatomy program with virtual anatomy – 3D computer simulations based on CT scans taken of live individuals. Very different than the cadaver cross sections that we worked with.
Health IT really started to boom while I was in my residency training, with increased nursing documentation being done electronically, although paper copies were still printed and added to the chart. There was a lot of fighting over PCs because the hospital hadn’t really thought through the computerization piece or what it would look like from a workflow standpoint. The residents thought we were cool because we could dictate our History and Physical documents and Admission notes using Dragon. It not only helped avoid the lengthy, handwritten note process but made sure the documents were on the chart quickly compared to the turn-around time required for “regular” transcription. No one at the time thought of outsourcing transcription services to 24×7 resources in another country, and certainly no one thought much about natural language processing.
I purchased my first handheld device as a Chief Resident. While others seemed to be leaning towards the Palm Pilot platform, I went with the Pocket PC. Although I legitimized my purchase by using it to take attendance at Grand Rounds and to use Excel to track various program requirements, I secretly thought the coolest feature was the fact that you could put music on it. The ultimate mix tape was now in your pocket at all times (or at least as long as the battery lasted). I found that Pocket PC in a drawer a few weeks ago and it fired right up. The data files were gone but the music was all still there, providing a much-appreciated blast from the past.
When I opened my solo practice, I was supposed to be on an EHR from day one, but there were implementation issues, forcing me to spend a year on paper charts in an office that wasn’t built to house paper charts. When we finally got our system, we learned a lot about vendor bait-and-switch, starting when the trainer first arrived and tried to train us on a system that was different than what we actually had installed. It went downhill from there and ultimately resulted in a de-installation. That experience, however, set the groundwork for my career in health IT, as hospital leadership realized I had been through the wringer but learned quite a bit, and could be an asset to their future EHR plans. I slowly crossed over into the technology side of things and never looked back.
People occasionally ask whether I think it was a waste of time to go to medical school. They often assume I don’t see patients anymore. Being a physician first was critical to me winding up in the wild and crazy world I work in today, and I wouldn’t trade it even with the hideous student loans and the long, torturous work hours. I learned health IT on the side and on the fly, while building a practice and settling in as a young physician. We’ve gone a long way past many of the things I used to struggle with early in my career – trying to access charts in the middle of the night, dealing with pharmacies that weren’t comfortable with electronic prescriptions, and bringing faxes directly into the EHR. Now we’re moving into an age where pharmacogenomics is a reality and we have the world’s library at the tips of our fingers at all times.
I remember doing an interview for the hospital newsletter early in my career. The CMO called to blast me for saying that having computers in the office allowed me to look things up during the patient visit. He felt that my statement implied that I was inexperienced and that patients would avoid me. Quite the opposite: Patients appreciated having a physician who was willing to look things up and show them the actual literature so that we could make decisions together. Having technology in the room transformed how I practiced in a positive way, and I know it made a particular difference for many of my patients. Sometimes, as we reflect on how we work with technology today, we tend to demonize it without putting into perspective what our daily lives would look like without it.
Even though it sometimes drives me crazy, I’m grateful for healthcare IT and what it has done for me personally. I’m hopeful for what the future holds, even despite the mandates and regulations. I can’t wait to look back in another five or 10 years and see where we’ve gone.
How has health IT impacted you, personally or professionally? Email me.
BCBS of Nebraska announces that it will exit the state’s health insurance exchange, citing the $140 million in marketplace-related losses it has suffered thus far.
Providence Alaska Medical Center (AK) begins offering telehealth critical care consults to a clinic in Unalaska, the remote town that is home to Dutch Harbor, one of Alaska’s busiest fishing ports.
Care New England Health System pays $400,000 to settle HIPAA violations after OCR discovered, while investigating a lost backup tape, that it had hadn’t updated its business associate agreement with Woman & Infants Hospital (RI) since 2005.
GE Healthcare launches Five.Eight, an accelerator (not to be confused with the Athens, GA rock band) for global healthcare startups aimed at improving outcomes for the estimated 5.8 billion people in the world who don’t have access to quality, affordable care. The accelerator hopes to enroll 10 companies in its first program, each of which will work with GE on developing scalable products for potential distribution or integration into GE’s portfolio. Seed funding of up to $5 million per startup may also be available.
India-based Tricog is the first member of the new accelerator. The startup has developed technology to help ED physicians diagnose heart attack patients within minutes, decreasing time between symptoms and treatment and increasing survival rates.
HIStalk Announcements and Requests
It’s Hillary Clinton in a landslide with heavy HIStalk reader turnout. Maybe I’ll run it again after the debates. New poll to your right or here: continuing last week’s poll, which health IT salesperson LinkedIn credential would most impress you?
Welcome to new HIStalk Platinum Sponsor Ivenix. The Amesbury, MA-based company has transformed IV infusion delivery from the decades-old technology of competitors to the connected world to improve patient safety, eliminate workflow inefficiencies, and protect the hospital’s bottom line by reducing adverse events. The Ivenix Infusion Management System measures and adjusts IV flow rate in real time and supports mobile viewing of infusion status and alarms, integrating with the EHR to auto-program and auto-document. Adaptive technology eliminates the need for ongoing calibration, while software and security updates along with drug library updates are delivered without removing devices from the floors. Ivenix addresses the challenges of increasingly complex dosing regimens, the demand for EHR integration, and infusion technology-related patient safety issues. Thanks to Ivenix for supporting HIStalk.
I found this video that describes the benefits of the Ivenix Infusion Management System, including eliminating nurse time spent manually documenting IV pump information in the EHR.
Last Week’s Most Interesting News
Epic announces a number of new offerings and initiatives at its annual user group meeting, which attracted 18,000 attendees.
The Chan Zuckerberg Initiative donates $3 billion to “cure, prevent, or manage all diseases by the end of the century.”
Private GPs in England offer third-party video visits as an alternative to long appointment wait times, with NHS footing the bill.
The entire board of Cairns Hospital in Australia resigns following an unpopular and over budget Cerner rollout.
Appalachian Regional Healthcare (KY and WV) brings the computer systems of its several hospitals, pharmacies, and clinics back online after nearly three weeks of downtime caused by a malware attack.
Webinars
September 27 (Tuesday) 1:00 ET. “Put MACRA in your Workflow – CDS and Evolving Payment Models.” Sponsored by Stanson Health. Presenters: Anne Wellington, chief product officer, Stanson Health; Scott Weingarten, MD, MPH, SVP and chief clinical transformation officer, Cedars-Sinai. Reimbursement models are rapidly changing, and as a result, health systems need to influence physicians to align with health system strategy. In this webinar, we will discuss how Stanson’s Clinical Decision Support can run in the background of every patient visit to help physicians execute with MACRA, CJR, et al.
October 13 (Thursday) 2:00 ET. “Glycemic Control During Therapeutic Hypothermia.” Sponsored by Monarch Medical Technologies. Presenter: Tracey Melhuish, RN, MSN, clinical practice specialist, Holy Cross Hospital (FL). Using therapeutic hypothermia (TH) as a method of care can present risks of hyperglycemia, hypoglycemia, and blood glucose variability. Maintaining safe glucose levels during the cooling and rewarming phases of TH reduces the risks of adverse events. Tracey Melhuish, author of “Linking Hypothermia and Hyperglycemia,” will share best practices for optimal glucose control during TH and the success Holy Cross Hospital sees while using a computerized glucose management software.
Blue Cross Blue Shield of Nebraska pulls out of the federal health insurance exchange, leaving Nebraskans with extremely limited purchasing options when open enrollment starts November 1.
TierPoint will spend $20 million to build the first phase of a 90,000 square-foot data center in Dallas.
Announcements and Implementations
Canopy Health, an accountable care network formed out of an affiliation between California-based UCSF Health and John Muir Health, selects financial risk management and population health services from Conifer Health.
Sydney-based Macquarie University’s MQ Health campus partners with Emory Healthcare (GA) to launch the country’s first remote intensive care unit monitoring program using technology from Philips.
Technology
MSN Healthcare Solutions incorporates SyTrue’s NLP OS operating system and AdvancedBI’s business intelligence tools into its new NLP-based analytics offering for radiologists.
VitreosHealth adds predictive risk models for identifying gaps in care, mental health conditions, and patient motivation to its population health management analytics engine. Models for palliative care will be rolled out towards the end of the year.
Research and Innovation
AHRQ looks for peer-reviewed, patient-centered outcomes research findings related to geriatric care shown to have improved patient outcomes for potential investment in broader dissemination and implementation.
I missed this a few weeks ago: The National Science Foundation awards Rice University mechanical engineer Marcia O’Malley a $1 million, three-year grant to develop a tool that will track the movement of a surgeon’s operating tool and emit a vibration if his or her technique is deemed too rough. (No details are given as to how “rough” will be determined.) O’Malley says the tool will combine virtual reality with real-time touch feedback that will hopefully make the process of learning how to perform delicate surgeries easier.
Privacy and Security
Care New England Health System pays a $400,000 HIPAA fine for neglecting to update its BA agreement with Woman & Infants Hospital (RI), for which it provides IT system technical support and information security. The lack of updated documents came to light when WIH reported the loss of unencrypted backup tapes containing the PHI-filled ultrasound studies of 14,000 patients. WIH ended up paying a $150,000 fine for its role in the breach.
Other
Iliuliuk Family and Health Services, the only clinic serving Alaska’s extremely remote Unalaska Island (which also happens to be one of the country’s busiest commercial fishing ports), launches virtual consults via satellite technology with Anchorage-based providers at Providence Alaska Medical Center. The local news reports that the service will connect mainland ED physicians with clinic staffers to treat injuries “among the Bering Sea crabbing fleet made famous by the Discovery Channel show ‘Deadliest Catch.’”
Sponsor Updates
Experian Health will host its Financial Performance Summit October 5-7 in Nashville, TN.
Patientco releases its annual State of the Industry Report.
PatientMatters will exhibit at the Arkansas Hospital Association Annual Meeting & Tradeshow October 5-7 in Little Rock.
PerfectServe will exhibit at ANCC 2016 October 5-7 in Orlando.
Lexmark Healthcare submits a formal pledge of commitment to interoperability.
Sagacious Consultants makes a charitable donation to Tri 4 Schools to help extend its Exercise to Achievement after-school program.
The SSI Group will exhibit at the AAHAM ANI 2016 conference October 5-7 in Las Vegas.
In Australia, the entire board of Cairns Hospital resigns following an unpopular and over budget Cerner rollout. A staff survey included complaints that the system was “convoluted and time consuming, with significant adverse impacts on patient safety and care.”
Facebook founder Mark Zuckerberg and his wife Priscilla Chan, MD will donate $3 billion to “cure, prevent, or manage all diseases by the end of the century.” Zuckerberg noted that we spend 50 times more on disease treatment than prevention and says the couple’s donation will bring scientists and engineers together to build research tools and technologies.
The first project funded by the donation will be the $600 million Chan Zuckerberg Biohub, which will bring together scientists and engineers from Stanford, UCSF, and Berkeley. Its first two efforts involve infectious disease (developing a universal diagnostic test, using gene editing tools to create new drugs and monoclonal antibodies, using machine learning to mine clinical trials data for vaccine development, and deploying a rapid response team during disease outbreaks) and mapping all human cells to create the Cell Atlas for research.
It’s an impressive donation, but still only one-tenth of what the NIH spends on research in a single year. It’s trendy for tech companies (IBM, Google, Microsoft, etc.) to arrogantly think they can “solve” disease. I’m a bigger fan of Michael Bloomberg’s donations that involve public health or those efforts that involve personal responsibility or uncontrolled healthcare costs rather than chasing elusive magic bullets. At least these first projects commendably blend technology with developing a baseline of intelligence than can be built upon over the years.
Reader Comments
From Considering Further Education: “Re: your observation that salespeople typically don’t have advanced degrees. As a salesperson, how much more credible would I be with an MBA or other advanced degree? I’m young and motivated, but wondering if it would pay off.” My observation was that salespeople (and thus CEOs promoted from sales roles, as is often the case) often have no degree at all or unrelated bachelor’s degrees from universities not on anyone’s top lists, with my assumption being that they were so confident in their career path that they didn’t expect to be competing for jobs on the basis of educational credentials. I would place zero value on a salesperson having an advanced degree, but I’ll ask experienced readers to weigh in, especially as it pertains to moving from sales to executive positions.
I should mention that every time I talk about advanced degrees, I get a bunch of emails from indignant folks who don’t have them describing their personal success in a world of less-competent, less-motivated degree holders in thusly assuming they hold no value for anyone. I suspect that everyone’s ideal credentials are their own, with any more education being worthless paper-hanging and any less education failing to clear the slippery educational slope (if you don’t need a master’s, do you need a bachelor’s? What about a high school diploma?) Degrees don’t matter if you work for yourself, start Facebook, or land a CEO position, but for most people, they will elicit some reaction and affect employment opportunities at least indirectly.
From Ascetic Acid: “Re: integration report. What do you make of this gaffe?” Looks like bad strategery.
HIStalk Announcements and Requests
Welcome to new HIStalk Platinum Sponsor Sutherland Healthcare Solutions. The Clifton, NJ-based company is a leading provider of consulting, BPO, ITO, and analytics services to providers, payers, government, and ACOs, with 5,000 employees working from 15 sites around the world. It offers claims administration and adjudication, coding, technology services, end-to-end RCM, analytics, patient experience consulting, and population and payment solutions. Health IT services include product development, maintenance, and support; testing as a service; implementation; integration; clinical help desk; and training. Among the company’s 100+ clients are six of the top 25 US hospitals and three of the five largest US health plans. CEO Graham Hughes, MD is an industry long-timer, having spent time at IDX and GE Healthcare. Thanks to Sutherland Healthcare Solutions for supporting HIStalk.
This week on HIStalk Practice: Doctor on Demand CEO Hill Ferguson discusses the intersection of fintech and health IT. Health Systems Informatics launches population health management consulting services. FDA, USDA announce app development competition, telemed funding as part of Prescription Opioid and Heroin Epidemic Awareness Week. Coordinated Care Oklahoma adds DrFirst tech. Kansas City Care Clinic goes with care coordination tools from BluePrint Healthcare IT. Community Health Center selects Safety Net Connect IT as part of school-based effort in New Mexico. AAFP elects new president. Physician morale takes a nosedive.
Webinars
September 27 (Tuesday) 1:00 ET. “Put MACRA in your Workflow – CDS and Evolving Payment Models.” Sponsored by Stanson Health. Presenters: Anne Wellington, chief product officer, Stanson Health; Scott Weingarten, MD, MPH, SVP and chief clinical transformation officer, Cedars-Sinai. Reimbursement models are rapidly changing, and as a result, health systems need to influence physicians to align with health system strategy. In this webinar, we will discuss how Stanson’s Clinical Decision Support can run in the background of every patient visit to help physicians execute with MACRA, CJR, et al.
October 13 (Thursday) 2:00 ET. “Glycemic Control During Therapeutic Hypothermia.” Sponsored by Monarch Medical Technologies. Presenter: Tracey Melhuish, RN, MSN, clinical practice specialist, Holy Cross Hospital (FL). Using therapeutic hypothermia (TH) as a method of care can present risks of hyperglycemia, hypoglycemia, and blood glucose variability. Maintaining safe glucose levels during the cooling and rewarming phases of TH reduces the risks of adverse events. Tracey Melhuish, author of “Linking Hypothermia and Hyperglycemia,” will share best practices for optimal glucose control during TH and the success Holy Cross Hospital sees while using a computerized glucose management software.
HIPAA-compliant hosting and EHR integration technology vendor Catalyze raises $6.5 million in a Series B funding round, increasing its total to $12.5 million.
Hill-Rom will sell its WatchChild fetal monitoring system business to advanced fetal monitoring and clinical decision support vendor PeriGen to focus on its core growth areas of falls prevention, patient satisfaction improvement, and infection prevention. The 18 CWS employees assigned to WatchChild will be offered positions with PeriGen. I described the company’s history in responding to a June 2012 reader rumor report that Hill-Rom was shopping WatchChild even then as:
The WatchChild OB monitoring system is owned by Hill-Rom, mostly known for selling expensive hospital beds and a few other marginally related product lines. WatchChild was supposed to be a natural extension of the company’s NaviCare nurse call system. HRC shares haven’t exactly shone lately, dropping from $48 in July 2011 to $30 now [note: they’ve rebounded to $61 since], so Hill-Rom may simply see the frenzy of M&A activity in healthcare IT as a good opportunity to sell some or all of its IT holdings to focus on core business. All of this is speculation since they’ve made no announcement that I’ve seen. Hill-Rom used to be known as Hillenbrand Industries, whose humorously complementary business was Batesville Casket Company. I’ve always wondered if they might put some of their nurse call technology in those caskets as an upgrade for those who fear being buried alive.
TransUnion acquires RTech, which offers post-service eligibility solutions to maximize hospital reimbursement, for $62 million.
Sales
CHI Franciscan Health (WA) chooses Glytec’s EGlycemic Management System for real-time insulin dosing in its eight hospitals, integrated with Epic.
Adventist Health chooses Oracle Applications Cloud for ERP, human capital management, analytics, and enterprise performance management.
Johns Hopkins Aramco Healthcare will deploy Epic and Hyland OnBase in its facilities in Saudi Arabia.
People
Clinical trials software vendor Cure Forward hires Frank Ingari (NaviNet) as CEO.
In England, NHS England chooses its just-appointed chief clinical officer Keith McNeil, MB to also head up its new Digital Delivery Board. McNeil resigned as CEO of Addenbrooke’s Hospital last year just before Cambridge University Hospitals NHS Foundation Trust (which includes Addenbrooke’s and The Rosie Hospital) was placed on “special measures” for a number of patient care problems; he was also CEO when the Regulator Monitor investigated the trust’s financial challenges following its $300 million Epic rollout.
Announcements and Implementations
Bakersfield Memorial Hospital (CA) rolls out a camera-equipped security robot that patrols the ED parking lot and offers visitors a button to call a security guard.
LiveProcess announces new mobile apps for patient care and transitions, discharge, staffing, transplant, and hospital operations.
St. Luke’s University Health Network (PA) goes live with Caradigm Care Management to support its Bundled Payments for Care Improvement program.
UPMC launches Curavi Health, which will offer telemedicine equipment and software to nursing homes and provide after-hours consults from University of Pittsburgh Physicians.
Engage, the IT services division of non-profit Inland Northwest Health Services (WA), offers a NetApp-powered cloud backup and recovery solution to the 40 hospitals whose Meditech systems it hosts.
Government and Politics
An HHS OIG audit finds that the state of Washington overpaid $9.2 million to 19 of the 20 hospitals that received Medicaid EHR incentive payments in 2011-2015.
Keck Medical Center of USC notifies patients that it experienced a ransomware attack on August 1, adding that it recovered its systems without paying.
Codman Square Health Center (MA) notifies nearly 4,000 patients that an unnamed number of its employees looked up patient information on the New England Healthcare Exchange Network without authorization, with those employees since either suspended or fired. The employees viewed information of non-Codman patients whose information was stored on NEHEN, which is an interesting twist on the usual “viewed without authorization” situation.
The forever-bungling Yahoo warns users that it has become the victim of what is apparently the biggest breach in history, with the information of 500 million accounts exposed in 2014 by “a state-sponsored actor” with the announcement coming right before the company closes the sale of its pathetic dregs to Verizon for next to nothing. An interesting reader comment to that item says it’s suspicious that breached companies always scapegoat unverified “state actors” instead of “some 16-year-old kid.” At least the overused “sophisticated attack” excuse is now rare. Expect the average consumer to become even more wary of signing up for health-related apps and portals.
The information of thousands of patients whose information was stored by a now-closed physical therapy EHR vendor is exposed in a “leaky bucket” of its incorrectly configured Amazon Web Services S3 (Simple Storage Service) account.
In light of the AWS breach, DataBreaches.net suggests reviewing business associate agreements using the checklist above.
Hackers take ransomware up another notch with Mamba, which instead of encrypting files, encrypts the entire hard drive and offers to sell the password required to boot up the PC. At least some Luddite hospital might have its first laptop encrypted, although not in a good way.
A survey finds that half of IT professionals don’t understand that emptying a PC’s Recycle Bin doesn’t permanently erase the files it contains.
Other
Google parent Alphabet kicks off its carefully controlled DeepMind Health public outreach meeting with an apology that the event was held at Google’s opulent London offices, suggesting that more accessible community spaces might be more appropriate going forward. The company, which has been criticized for its lack of transparency for rolling out clinical products without the required government approval, says it has been clear since it acquired DeepMind for $500 million that intends to build a business model from its use of patient data it gets for free with use of its hospital software, but suggests that it would like to get paid for clinical outcomes rather than the traditional software vendor activity. A prototype of a patient portal app was shown, although development has not started.
In Australia, the entire board of Cairns Hospital resigns following massive budget misses following its implementation of a Digital Hospital program in which it installed Cerner Millennium. Employee surveys following the go-live earlier this year – results of which the hospital has declined to release but they leaked out anyway — found that the system was not intuitive and user friendly, endangered patients with its specimen order and collection workflow, and was brought live without adequate testing and support coverage.
The local paper says McDonough District Hospital (IL) has been live on a new EHR, Cerner Safari, for three months. I’m not sure where they got that name.
A Madison TV station runs a UGM-inspired video profile of Epic’s 90-employee culinary team led by Chef Eric Rupert (not to be confused with Chef Eric Ripert), where everything — right down to the hot dog buns and ice cream — is made from scratch.
The Madison paper runs some highlights from Epic UGM:
The company is working to provide Syrian refugees with their health information on flash drives.
Epic will offer free licenses and maintenance to federally qualified health centers.
MyChart will be enhanced to allow patients to get an estimate of their care costs and to apply online for charity care.
Epic will integrating with state doctor-shopper databases and using predictive modeling to help manage opioid use in individual patients.
Video visit capability will be built into Epic.
The company says its Cosmos Research Network of big health systems will support better understanding and treatment of diseases.
Naveen Rao observes the hostile user response caused by United HealthCare’s recent app update, noting that the company even recycled an apparently rare positive user comment from an old press release touting a previous upgrade in the absence of any other positive user reaction. He questions how a company of UHG’s size with a technology and innovation budget of $3 billion could release an app that apparently won’t work for many people, why users should be expected to re-enter information from elsewhere, and why UHG seems indifferent to the feedback of its customers. My conclusion is that it’s not only tough to create a consumer app that’s easy to use, is thoroughly tested under an infinite number of scenarios, and gives immediate gratification, but it’s also true that app developers aren’t used to scaling their support services to meet the understandably high expectations of patient-customers who just want a human to respond to both their technical and medical needs.
Perhaps UHG should have read this fascinating article (thanks to Eric Topol, MD for tweeting it out) called “The Scientists Who Make Apps Addictive” that describes how the digital interface can be used to shape user decisions and how companies use complex psychology in their apps to get people to do their bidding. Expert B.J. Fogg gives Uber as an example of why companies should design for habits, where the experience is so positive that users won’t even consider alternatives. He also advocates that apps “make people feel successful,” as in Instagram’s photo options that make people feel like artists. The article notes Facebook’s use of psychology in playing to each user’s yearning for social approval via likes and invitations to connect, concluding that “whoever controls the menu controls the choices” in a digital world designed by a few 20-something men working for a handful of mega-app companies in San Francisco. The article compares apps to casinos, where slot machines are “Skinner boxes for people” and algorithms predict when a given player’s losses might encourage them to walk away, at which time the casino dispatches a “luck ambassador” to give them a free show ticket or a steak dinner to keep them losing money. The article brilliantly summarizes with insight that should interest app developers:
The casinos aim to maximize what they call “time-on-device.” The environment in which the machines sit is designed to keep people playing. Gamblers can order drinks and food from the screen. Lighting, decor, noise levels, even the way the machines smell – everything is meticulously calibrated … But it is the variation in rewards that is the key to time-on-device. The machines are programmed to create near misses: winning symbols appear just above or below the “payline” far more often than chance alone would dictate. The player’s losses are thus reframed as potential wins, motivating her to try again. Mathematicians design payout schedules to ensure that people keep playing while they steadily lose money. Las Vegas is a microcosm. “The world is turning into this giant Skinner box for the self,” Schüll told me. “The experience that is being designed for in banking or healthcare is the same as in Candy Crush. It’s about looping people into these flows of incentive and reward. Your coffee at Starbucks, your education software, your credit card, the meds you need for your diabetes. Every consumer interface is becoming like a slot machine.” These days, of course, we all carry slot machines in our pockets.
Sponsor Updates
Volunteers from Impact Advisors worked with an Illinois environmental education group to recycle crayons for children’s hospitals last week.
Iatric Systems, Meditech, and Santa Rosa Consulting will exhibit at InSight 2016 September 27-30 in San Antonio.
MedData will exhibit at the HFMA Fall Revenue Cycle September 28 in Bellaire, MI.
Black Book names Navicure #1 in end-to-end RCM technology solutions for hospitals under 100 beds.
Definitive Healthcare releases a new version of its app that provides access to its provider data from Salesforce.com.
NTT Data will sponsor Blue Cross Blue Shield’s Information Management Symposium September 25-28 in Detroit.
Obix Perinatal Data System will exhibit at the Nursing Perspectives Conference September 28-30 in Buford, GA.
NCQA awards PCMH 2014 pre-validation status to the analytics platform of Arcadia Health Solutions.
September 22, 2016Dr. JayneComments Off on EPtalk by Dr. Jayne 9/22/16
The Epic UGM was held this week and I was pleased to receive an invitation to LogicStream Health’s “Taste & Toast” event. Hosted at the Frank Lloyd Wright-designed Monona Terrace and lead by a certified sommelier, it sounded like a great event. I wasn’t able to make it to UGM this year due to conflicting priorities, but wanted to give them a particular mention for offering free Uber services upon request. The risk of driving under the influence is definitely reduced when you don’t drive yourself.
A recent study published in Annals of Internal Medicine looks at whether hospital employment of physicians improves the quality of hospital care. The study looked at readmission rates, mortality, length of stay, and patient satisfaction at hospitals between 2003 and 2012. There were 800 hospitals that had moved to a more employed physician model vs. 2,000 that had not. The authors noted no association between the presence of employed physicians and most of the scores, although there was a slight change in pneumonia readmissions. The study looked only at Medicare beneficiaries aged 65 and older, so it’s not clear how the data would apply to other populations. It also didn’t look at government-run facilities.
Another study that caught my eye this week looked at “The Effect of Wearable Technology Combined With Lifestyle Intervention on Long-term Weight Loss.” The authors compared a “technology-enhanced weight loss intervention” to standard behavioral modification techniques, looking at nearly 500 participants between 2010 and 2012. Everyone was treated with initial diet and counseling. At the six-month point, participants were split into a group who self-monitored and a group that used a wearable device. Weight was tracked every six months for a total of two years. Researchers also looked at fitness, physical activity, dietary intake, and body composition.
Nearly 75 percent of participants completed the study. Although both groups improved in fitness, activity, diet, and body composition, young adults with a body mass index (BMI) between 25 and 40 lost less weight if they were in the wearable group. Based on technology-related fitness behaviors I observe in the workplace, there’s a chance participants focused more on the technology than on their actions or personal responsibility. There’s also the chance that as they saw the activities racking up, they felt it was OK to eat a bit more since they were being active. The bottom line is that we still have a lot to learn about the effectiveness of technology interventions in solving complex health problems such as obesity.
If anyone questions the challenges facing healthcare, they only have to look as far as the recent FDA decision approving the drug eteplirsen. The FDA’s own advisory panel voted against recommending approval for the drug, based on a clinical trial that only involved 12 patients and didn’t have adequate placebo control. Critics accuse the FDA of setting a dangerous precedent for approving drugs based on patient and pharmaceutical company lobbying rather than on science. The FDA will require the manufacturer to conduct trials to confirm the clinical benefit, and depending on the outcomes may opt to withdraw approval of the drug.
In preparation for the October 1 update for ICD-10 codes, CMS is alerting providers to resources such as the 2017 ICD-10-CM and ICD-10-PCS code sets. I know a lot of providers that fail to understand that these need to be updated each year or are content to let their office staff or EHR vendor figure it out. Not having the correct codes installed after the cutoff can result in denied claims and a ton of extra work, so it’s worth a minute to make sure your practice has a plan.
AMIA is seeking submissions for the iHealth 2017 meeting. The event is focused a bit more towards the application of clinical informatics as opposed to research, and participants are encouraged to submit programs, pilots, and innovations in health informatics. Submissions are open through October 18 and this year’s conference topics are grouped under:
Analytics and the Learning Health System
Clinical Informatics
Interoperability and Informatics Infrastructure
Health Policy and Payment Reform
AMIA also announced that they’ll be offering licensed childcare during the AMIA 2016 Annual Symposium to be held November 12-16 in Chicago. The Women in AMIA task force led the efforts to make this a reality. Cerner and Epic were listed as sponsors on the email announcement.
I see several physicians at the local academic medical center. All of them are of the “once a year” variety, so I don’t expect a lot of communication from them. I had no recent appointments and nothing scheduled, so I was surprised to start receiving communications about my upcoming surgical appointment along with patient questionnaires and more. I called the help desk to figure out what was going on and they said they could see no appointments for me in the system, yet the messages kept on coming. Apparently I’m having a consultation for spinal surgery for my ongoing pain management problems, or at least that’s what the system thinks is going on.
I fully understand glitchy computer systems that do seemingly unexplainable things, but I’ve run into some attitude from help desk staffers that act like they don’t believe I’m actually seeing what I’m seeing. I’ve offered to forward the emails back to them along with screenshots of the portal, but they don’t seem keen on using that to troubleshoot. In this era of medical identify theft and big data, patients have the absolute right to have their documentation be correct and telling them to “just ignore the information if it doesn’t apply” is not the right answer.
Have you had success in correcting erroneous online records? Email me.
During an HHS Advisory Panel on Outreach and Education, CMS agreed to developing an online tool that will help providers estimate the impact choosing either the MIPS or APM track of MACRA will have on revenue.
Facebook CEO Mark Zuckerberg and his wife Priscilla Chan announce that they will invest $3 billion over the next decade on projects that align with an overall goal of preventing, curing, or managing all diseases by the end of the century.
A legal filing by the Justice Department reveals that both Anthem and Cigna are accusing one another of violating the terms of their merger agreement. The Justice Department is suing to block the merger on anti-trust grounds.
The views and opinions expressed are mine personally and are not necessarily representative of current or former employers.
Gotta Serve Somebody!
Contrary to some readers’ comments last blog, I remain committed to the concept that “you’re gonna have to serve somebody, yes indeed.” Bob Dylan made this slang popular with his song of the same name. (Gotta Serve Somebody).
The negative reaction to the concepts of servant or act of service in the workplace is not surprising. Disheartening, but not surprising. If you break it down simply, there are two kinds of people. Those who choose to serve and those who desire to be served. I choose the former. I choose to serve with the former as well.
I view life as service and the workplace no different. I serve my family. I serve my church. I serve my community. I serve my God. I serve my patients. I serve my boss. I serve my employer. I serve those who report to me. I serve my employees. Everything is service. Life is service. I often miss the mark and selfishness creeps in, but service is my default orientation and what I aim for.
I am not sure how a life of service mindset begins. Are we born with it? Is it developed? Is it discovered? I often reflect on it because I believe it is foundational for who we are as people and who we are as leaders. I practice a few things to keep my service orientation keen and my heart soft, and to encourage those who serve with me to do the same.
Simple things:
Service vocabulary. We spend most of our lives “working,” so I purposefully substitute service for work in my daily speech. It reframes the way I view things. I don’t loathe to go to work. No! I look forward to serving!
Voice of the customer. I programmatically create opportunities for my teams to serve. Clinician shadowing and listening sessions are just a couple of techniques.
Healthcare volunteering. I encourage everyone to give back through volunteering. It does not have to be a hospital setting, though healthcare volunteering does directly reinforce the concept of workplace serving. For five years, my oldest son and I volunteered weekly at a children’s hospital. For many years you would find my family spending Christmas dressed as elves accompanying Santa on his rounds.
Direct reports. Ask each of them how you can serve them. How you can help them reach their goals? How you may wash their feet? The greatest leaders wash feet, clean toilets and are present in all life transitions.
Testimonials. I try to have customers or patients give talks at every team meeting. A 10-minute talk from a patient or clinician is more effective than 500 minutes of speeches from you or me. Recently our CMO spoke to our team. Quiet in demeanor and voice, you could have heard a pin drop as she eloquently wove her personal and professional story together, culminating in reinforcing the critical nature of our team’s service. Wow!
Patient encounters. Engage patients whenever possible. Learn their stories. Ask them for feedback. Round with your peers!
Life is difficult and all have been hurt, bruised, offended, or abused. I will never claim to relate to it all, but I can relate to some. I believe we are born with soft hearts, but life happens. Over time, our hearts can become callous and hardened. It is tragic. It is invisible.
External appearances often mask the real world inside. Left unchecked, our attitudes and world view become jaded. I do not pretend to understand the depth of another person’s pain. I am also not going to hide my head in the sand and pretend personal pain does not impact the workplace or how we view things such as service.
While I have been fortunate to witness the softening of hearts in the workplace, I offer no magic formulas or cure-all. Transformations come from counseling, medications, prayer, and other tools I am less familiar with. I am not pushing one transformation method over another, but if you are a leader, I implore you reconsider your viewpoint if you do not believe your role should include servant leader. As a leader, one key to success is to model service, both to those you report to as well as to those who report to you. By embracing this mindset, I guarantee you and your team will transform.
I share this idea in order to break hearts. To reach a broken heart, you must first break the heart. When I see dying kids become excited from winning Bingo, my heart breaks. When I see an elderly couple hold hands one last time in the ICU, my heart breaks. When I see clinicians wrestle with the loss of life, my heart breaks. When I witness a marriage of a couple in our hospital because one of partner is too sick to go home, my heart breaks. When I hear loved ones grieve in our waiting rooms, my heart breaks.
My heart has a propensity to harden, so I constantly try to experience first-hand the impact of my team’s service. Having served this way for many years, I can attest to the fact that when entire teams are mobilized, culture changes and transformation occurs. The best thing? Not only does the organization change and become exceptional at serving patients and clinicians, the individual team members transform as well. Performance and outcomes improve.
You have to serve someone. You might as well choose what and whom.
Footnote. The best resource I have found on servant leadership is Greenleaf.
Ed encourages your interaction by clicking the comments link below. You can also connect with Ed directly on LinkedIn and Facebook and follow him on Twitter.
Eric Widen is co-founder and CEO of HBI Solutions of Palo Alto, CA.
Tell me about yourself and the company.
I’ve worked in healthcare my entire career. I’ve had an eclectic mix of experience working for consultancies, electronic health record vendors, for myself for a period of time, and for providers. All with a focus on implementing technology to drive improvement, from a health system standpoint and now more so from a population standpoint.
The theme has always been around using data that’s inherent in these systems to help drive performance improvement. We founded the company on that concept of helping health systems and organizations take advantage of data to improve their performance, Specifically to improve population health approaches by leveraging data that’s mostly residing in electronic health records, which have become more ubiquitous over the last 10 or 15 years.
How do you position the company among the many that offer analytics and population health management technology?
Population health, analytics, and even predictive modeling are broad-based terms and topics. Many vendors are saying similar things.
Where we differentiate is that we’re not a platform company. We’re very much a focused solution that we term a precision health solution or precision medicine solution that’s leveraging real-time predictive models that are proprietary intellectual property that we’ve developed. These are our own real-time predictive models that we provide that drive our precision health solution. That’s a niche focus.
We’re technology platform agnostic. We see this as an important piece to identify people at risk for untoward events before those events happen. In real time, meaning leveraging electronic health record data to do that in order to keep people healthy and from creeping up the disease and cost curve over time. That engine that we built can be installed in many different types of platforms. We think it’s an important piece of the puzzle.
Population health includes analytics, care management to take care of the patients, and the interventions that are going to be applied to patients. Our focus is in real time identifying people at risk for poor outcomes before they happen and then identifying the interventions to apply to those patients in order to mitigate the risk from ever happening.
That engine is what we provide. It can be deployed on many different types of platforms, including interoperability system platforms or EMR platforms. Those two examples of interoperability solution vendors and electronic health record vendors also pitch that they do population health. They provide the platform to do that. Very few organizations are providing the specific engine that we provide.
Are providers becoming willing and able to intervene when their patients are flagged as high risk?
What happens on the provider side today is that they’re balancing multiple incentive structures. They’ve dipped their toe in the water. What we’re seeing is 10, maybe 20 percent of the health system’s population is under a new payment mechanism, meaning at risk and/or upside gain for populations. But they’re still balancing the fee-for-service methodology at the same time. These are schizophrenic conversations. Everyone agrees that future is coming and that taking care of patients and keeping them healthy is going to be the new care model going forward, but they’re not there yet.
Organizations are confused about the speed of when that’s going to happen and it freezes decision making a little bit. Organizations are being successful with the experiments in taking care of patients proactively to keep them healthy in order to make financial gain under these new payment mechanisms. Where they can carve out those patient populations and apply these methods, they’ll restructure their care management processes to do that.
They’re really struggling with that decision when and how to do that. We see them doing it well where the incentives are aligned and there is a service component to that to help them rewire their care management processes to think differently about taking care of patients pre-disease or taking them from an at-risk standpoint as opposed to post-disease, which has been the old care model.
Is it an ethical struggle for providers who are beginning to see the value of providing population health management but realize that it could cannibalize their incomes if they do it or everyone, including those for whom they’re being paid fee-for-service?
I don’t think it’s an ethical struggle. It’s a clear problem to solve. It gets back to the acceleration of when are these going to come in full force.
We have clients that have done exactly that. They’ve done such a good job at using our solution to target patients at risk, keep them out of the emergency room, keep them out of the inpatient setting, keep them on the right care programs to mitigate disease progression, whereby they have reduced admissions and volume to their hospital. They’ve had a struggle with that.
What they’ve said is that this is the right thing to do for the patients at the end of the day, to keep them healthy and out of the acute care settings. What they’re looking to do is figure out how to accelerate taking on more incentive-based contracts and risk-based contracts in order to keep this going.
I don’t think it’s unethical. They had upfront conversations about it and they’re trying to figure out strategically how to continue to navigate this process. All of the organizations we’ve talked realize it’s coming and they’re willing to prepare for it. It’s just a matter of speed.
Providers can’t just unilaterally reach out to a high-risk patient and tell them what to do. Is it a marketing challenge as well as a clinical challenge to get patients engaged in this process that’s new to them?
Disengagement from a patient standpoint is a continuous problem for care managers. The ability to engage the non-engageable is a never-ending problem for the care management folks.
What we’re seeing and what we think is important is that the applying the same interventions to the whole population is inefficient. Applying risk stratification information to your patient population allows you to target both resources and the right interventions to the right patients in order to focus. It’s a much more efficient deployment of resources in order to be successful in this game so you’re not wasting time on patients who are otherwise low risk.
The non-engaged patient population, there’s always a sub-cohort of those patients that are always there. It just requires different skills to engage them from a care management standpoint. It’s very much an approach and a methodology that these organizations need to think about to solve that problem.
We will probably look back years from now and see the readmission focus as tactical, with an uncertain impact on outcomes and maybe even on overall cost. Will this push to identify high-risk patients extend further than just keeping them out of the ED and inpatient beds?
I think that’s right. CMS has been thoughtful about their approach for aligning incentives. They’ve gotten better over time for doing this. You see the commercial insurers following CMS’s lead.
The one metric of focusing on readmissions post-discharge, you do have to apply advanced proactive and thoughtful discharge planning to mitigate a patient from coming back, which includes understanding the local and outpatient ambulatory resources that are available in order to mitigate the acute readmission from happening. Even though it was focused on an inpatient metric, the ability to affect that measure required them to think pretty broadly about systems that are potentially external to their four walls to put these programs into place.
I thought it was a good exercise to being able to mitigate that measure or outcome on patient population against a broader portfolio of measures that they’re going to put into place, which is going to inevitably head to capitation 2.0, payment to keep patients otherwise healthy and not using unnecessary resources to stay healthy.
Couldn’t hospitals dig through their EHR data themselves without additional technology? Also, is it enough to use that inpatient data snapshot alone vs. what might have happened to that patient in the 30-day readmission window?
The philosophy is to use any and all available data on the patient in order to understand what’s going to happen in the future. EHR has provided a great, rich resource for that data set. They are real time and they’re clinically based. But you can augment that with claims data, billing data, and things like natural language processing, which is extracting information from the notes and also connecting that to publicly available data from things like the CDC or census information to understand average income levels or average education levels per ZIP code. All the information that is becoming more and more available on patients is very helpful in predicting the future that’s going to happen.
You want as much information as you can possibly get on a patient to predict the future. That includes not just the inpatient data, but the full gamut of inpatient, outpatient. You’ve got public HIEs, which can provide a rich resource if they’re structured correctly in capturing data centrally to have a longitudinal health record across the geographic area. But what you’re seeing health systems do more and more now is deploying more private HIE infrastructure to tap into that ambulatory information that’s extending beyond their four walls and at least setting up agreements with ambulatory providers to capture as much information to provide a comprehensive view on the patient.
Where solutions like what we provide come into play is allowing the machine to do as much as work as possible to help augment clinical cognitive thinking on the patient population. Computers and computer machine learning and so forth can automate a lot of information that a physician and or care manager wouldn’t otherwise be able to do. It can help them augment their clinical education and background in order to take care of patients by providing more information that they otherwise wouldn’t have.
Another component is the ability to integrate into the workflow. Risk information is helpful in providing the content to understand which interventions to apply to mitigate the risk. Automating that into the clinical workflow so that it becomes part and parcel of what a clinician and or care manager is doing on a day-to-day basis is a necessary component in order to not have bifurcated systems and make the workflow as efficient as possible.
What this gets down to is identifying proactively patients at risk with the interventions that apply to that and automating suggested care plans and orders on the patient that a physician or care manager can quickly think through in order to provide the right intervention to the patient.
Where do you see the concept of predictively identifying patients at risk playing out over the next five years?
When we first started this, there weren’t too many players in the game. What we saw mostly in the market were legacy, claims-based risk vendors who were focused on the insurance market or health plan market. What we’re seeing now are more companies like us using clinical information to provide real-time risk stratification information.
Over time, these will become more of a commodity and part and parcel of doing work because it’s necessary for organizations to think this way proactively about their patients and patient population and keep them healthy at home. All the right incentives are aligning to make this a necessary core component of taking care of patients while they’re healthy, while they’re in a pre-disease state, forever escalating up the risk curve.
McAfee says that ransomware hackers target hospitals because they oversee a perfect intersection of “legacy systems and medical devices with weak security, plus the life and death need for immediate access to information.”
The FDA launches a developer challenge to encourage the development of an app that would help fight the growing opioid epidemic by connecting “ those experiencing an overdose with the potentially life-saving antidote.”
In England, private doctors are offering third-party video visits, such as those marketed by Babylon Health, as an alternative to long appointment wait times, with NHS footing the bill. The British Medical Association warns that it’s risky for patients to receive video advice from doctors who don’t have access to their NHS medical records.
Doctors in England can get paid as video visit providers as long as the patient is outside their geographic area, which critics have called a “slippery slope towards privatization.”
Reader Comments
From Spiffed Up: “Re: telemedicine visits. Have you ever had one?” I have not, counting myself among the 88 percent of respondents to my April 2016 poll who have not experienced a virtual visit of any kind. It would be fun to hear from doctors who have been involved in virtual visits, either as a provider or patient. I’m especially interested that despite the value we place on electronic medical records and continuity of care, we are OK with for-profit vendors of such services performing a kind of medical speed-dating (as mentioned in the news item above from England). On the other hand, Americans tend to undervalue those ongoing relationships in reducing the art of medicine to their 30-second description of their problem, preferably with the prescription-issuing process overlapping since that’s what they really want as an outcome. Patients will score doctors highly if they offer easy parking, don’t keep patients waiting, have good bedside manner, and crank out the meds. Only in medicine do we expect vendors (doctors) to exhibit ethical behavior in not selling people profitable things that are bad for them.
HIStalk Announcements and Requests
Eight companies have taken advantage of my New Sponsor Pledge Drive specials so far in September, earning bonus months added on to their new, year-long sponsorships. Contact Lorre to join them. Usually one of the first questions companies ask Lorre is, “Can we attend HIStalkapalooza?” (answer: yes, Platinum-level sponsors get two free tickets). Another is, “Can Mr. H interview our VP of sales about a new product we’re announcing?” (answer: no, I don’t do interviews that focus on company and product pitches and I only interview CEOs).
Speaking of HIStalkapalooza, I begrudgingly agreed to do it again despite the big personal check I’ll be writing if event sponsorships don’t cover the significant cost (the House of Blues bar tab analytics from previous years suggest that a good time was had by at least some). Contact Lorre for a sponsorship information packet. We’re even offering one and only one sponsorship for big spenders who want a bunch of invitations for clients and employees, CEO stage time, backstage access, and many other customized perks.
My latest industry observation: salespeople (and thus CEOs of companies that mostly promote salespeople) rarely have advanced degrees. it’s usually a state college or no-name bachelor’s at best.
Webinars
September 27 (Tuesday) 1:00 ET. “Put MACRA in your Workflow – CDS and Evolving Payment Models.” Sponsored by Stanson Health. Presenters: Anne Wellington, chief product officer, Stanson Health; Scott Weingarten, MD, MPH, SVP and chief clinical transformation officer, Cedars-Sinai. Reimbursement models are rapidly changing, and as a result, health systems need to influence physicians to align with health system strategy. In this webinar, we will discuss how Stanson’s Clinical Decision Support can run in the background of every patient visit to help physicians execute with MACRA, CJR, et al.
October 13 (Thursday) 2:00 ET. “Glycemic Control During Therapeutic Hypothermia.” Sponsored by Monarch Medical Technologies. Presenter: Tracey Melhuish, RN, MSN, clinical practice specialist, Holy Cross Hospital (FL). Using therapeutic hypothermia (TH) as a method of care can present risks of hyperglycemia, hypoglycemia, and blood glucose variability. Maintaining safe glucose levels during the cooling and rewarming phases of TH reduces the risks of adverse events. Tracey Melhuish, author of “Linking Hypothermia and Hyperglycemia,” will share best practices for optimal glucose control during TH and the success Holy Cross Hospital sees while using a computerized glucose management software.
Huntzinger Management Group acquires Next Wave Health Advisors.
WebMD parts ways with CEO David Schlanger by mutual agreement, replacing him with President Steven Zatz.
Morgan Stanley is reportedly facilitating discussions among Infor and buyout firms that are interested in investing in the business software company, whose value may exceed $9 billion.
Sales
McLeod Health (SC) chooses Cerner Millennium and HealtheIntent to replace its Invision and Soarian systems in seven hospitals.
Prime Healthcare chooses Santa Rosa Consulting for Epic go-live support at its 43 hospitals, with the first wave of activations scheduled for October 1.
People
Imprivata, fresh off the close of its acquisition by Thoma Bravo, names Gus Malezis (Tripwire) as president and CEO. He replaces Omar Hussain, whose plans were not announced.
Verscend Technologies (the former Verisk Health) hires Joe Morrissey (McKesson) as SVP of client services.
Video visit vendor HealthTap names Dan Edmonds-Waters (Edmonds Ventures) as VP of strategy and global sales operations.
Announcements and Implementations
McKesson announces Intelligence Hub, which connects its reimbursement solutions to third party solutions and to each other in providing API management, identity and access management, and application service orchestration.
ACOs using population health management solutions from Lightbeam Health Solutions delivered $84 million in savings to Medicare Shared Savings Program in 2015, the company announces.
Oneview Healthcare will hire 100 employees in 2016, half of them assigned to its headquarters in Dublin, Ireland and the rest to its offices in the US, Dubai, and Australia.
Craneware announces data transparency functionality to its chargemaster tools that allow organizations using integrated systems such as Epic and Cerner to view data in one place.
St. Louis-based Ascension will organize itself into two divisions, with the Healthcare Division covering its hospitals and clinics and its Solutions Division running its IT services, group purchasing, and investment activities that are in some cases marketed to other healthcare organizations. The company will also name its 141 hospitals consistently with “Ascension” first to emphasize its national footprint.
Surescripts will offer EHR vendors free access to its National Record Locator Service until 2019.
Coordinated Care Oklahoma will integrate DrFirst’s Backline communication and collaboration tool into its HIE.
Government and Politics
FDA announces the 2016 Naloxone App Competition, offering a $40,000 prize for an app that overdosing opioid users can use to connect with anyone nearby who is carrying the reversal drug naloxone. That’s both a creative technical solution and a sad commentary on America’s massive dependence on prescription and non-prescription narcotics.
A team from CMS’s Center for Clinical Standards and Quality wins the Federal Employee of the Year category in the annual Service to America (Sammies) awards.
The FDA, under pressure from well-organized and impassioned patient advocacy groups, approves a muscular dystrophy drug against the recommendation of experts who say there’s no evidence it works. Shares of Serapta Therapeutics — which offered as evidence only one poorly designed trial involving 12 patients — soared on the news, not surprisingly given that the new drug will cost $300,000 per year.
A New Zealand medical resident is fired for obtaining information from the local health boards on two members of his family, which he then used as evidence in a court case against them.
Four former New York nursing home aides are charged with felonies for taking iPhone pictures of residents in undignified positions and filming themselves verbally and physically tormenting a resident, with some of the images being posted to Facebook.
A cybersecurity firm’s brute force scan of Internet-connected FTP servers finds at least 800,000 that can be accessed without logging in.
The quarterly threats report from McAfee Labs notes that hackers are targeting hospitals with ransomware because their legacy systems have weak security, employees don’t have much awareness about security, workforces are fragmented, and hospitals value immediate access to information above everything else. Interestingly, it reports that many hackers consider hospital hacking as violating the unwritten hacker code of conduct, with others worry that the resulting publicity will result in a backlash against Bitcoin. A ransomware author and distributor provides Bitcoin account screenshots that apparently prove that he raked in $121 million in just six months.
A man protests that a Montana law requiring renters to get permission from their landlords before growing medical marijuana for their own use is a HIPAA violation since it forces him to reveal medical information to a third party. Like many under-informed people (some of them in healthcare), he is mistaken in thinking HIPAA broadly guarantees medical privacy rather than requiring only that covered entities practice it (providing a roof over his head doesn’t qualify his landlord as a “covered” entity).
Technology
MIT researchers develop the experimental EQ-Radio, which uses wireless,room-based heartbeat and breathing sensors to analyze an individual’s mood with 87 percent accuracy.
McKesson CIO/CTO Kathy McElligott says that analytics and blockchain are the rising trends that most interest the company.
Other
Microsoft says it is working to “solve” cancer by using technology to individualize cancer treatments and analyze tumor images.
Apple hires Mike Evans, MD, a Toronto family practitioner best known for his five-year series of YouTube health cartoons. He declines to provide specifics about his new job, but says it involves his ability to convey a message. He describes the future of healthcare as:
I think the way we engage people will totally change. What happens now is I see you. Let’s say you have high blood pressure. I prescribe you a pill for that. I see you two or three times a year. In the future, I’ll prescribe you an app. One of our whiteboards will drop in and explain what high blood pressure is. The phone will be bluetoothed to the cap of your pills. I’ll nudge you towards a low salt diet. All of these things will all happen in your phone. I see you two or three days a year. The phone sees you every day.
A federal labor judge awards $216,000 to two laid-off CSC employees turned whistleblowers who had complained in 2012 that the company’s occupational medicine EHR could not accurately track patient health risks. CSC went live with the system despite acknowledging the problem, after which the employees were suspended for colluding with one of CSC’s subcontractors. The judge called CSC’s arguments “an astonishing display of chutzpah” given that the company couldn’t say what information the employees were supposed to have shared, could not identify who suspended them, and withheld the special pay it promised the employees for the extra hours required to bring the EHR live.
In South Australia, the Allscripts Sunrise EPAS system is blamed for losing computer entries and thus not allowing a hospitalized dementia patient’s death to be reported to the coroner as the law requires. The health minister says the system is being urgently upgraded to highlight deaths that occur while undergoing treatment.
In England, Leeds Teaching Hospitals NHS Trust diverts patients after a computer problem leaves it unable to report pathology lab test results.
Drug companies that sell opioid painkillers have unleashed an army of lobbyists and donated millions of dollars to political campaigns in trying to protect their profits by defeating proposals that would restrict the prescribing of narcotics. The companies are funding non-profits, including the American Cancer Society’s Cancer Action Network, that advocate narcotics-friendly policies. Drug companies even strong-armed the passage of a Maine law that they themselves wrote that requires insurance companies to pay for their particular painkillers.
A rural hospital in Iowa complains that it can’t always reach its doctors by telephone and patients who call the hospital for appointments don’t always get through. The problem is caused by the patchwork system of telephone carriers required to deliver calls to rural America, with big telephone companies sometimes electing to simply drop a call rather than pay a rural carrier an amount that would leave it with no profit.
In Australia, NSW Health pledges to implement chemotherapy dosing guidelines in its systems following the under-dosing of at least 130 patients by a “fly-in, fly-out” oncologist who responded to a pharmacist’s questioning of doses with, “Tell them to mind their own business.” The doctor argues that oncology dosing guidelines are often outdated and says he used lower doses to reduce toxicity.
A Validic survey of drug companies finds that 60 percent have used digital health technologies in their clinical trials and 97 percent expect their use of such tools to increase.
Epic UGM is underway in Verona, WI this week, with attendees and others tweeting some photos.
Sponsor Updates
Forward Health Group is sponsoring the Best Practices for Value-Based Care conference September 21-22 in Dallas, TX.
Aprima will exhibit at the American Academy of Pain Management annual meeting September 22-24 in San Antonio. The company also completes its move to new headquarters in Richardson, TX.
Aventura will exhibit at Health 2.0 September 25-28 in Santa Clara, CA.
GE Healthcare will invest €150 million to establish a biopharmaceutical manufacturing campus and advanced manufacturing training center in Ireland.
TeleTracking President Michael Gallup testifies before the House Ways and Means Subcommittee on Health.
Clinical Computer Systems will integrate its Obix Perinatal Data System with Medhost.
Impact Advisors is named to Modern Healthcare’s Largest Revenue Cycle Management Firms.
Besler Consulting releases a new podcast, “What the end of the ICD10 grace period means for your hospital.”
CapsuleTech and FormFast will exhibit at the InSight McKesson User Group Conference September 27-28 in San Antonio.
CoverMyMeds sponsors the Columbus Women in Technology Conference.
Cumberland Consulting Group will exhibit at HFMA’s Revenue Cycle Conference September 25-27 in Phoenix.
ECG Management Consultants will exhibit at the West Coast ASC Seminar September 27 in Los Angeles.
Regarding the 99% drop in AmWell stock -- True fact--I mad a profit buying AmWell on a dip once, and…