Florida Blue Cross and Blue Shield reports $471 million in profits from its insurance exchange business, unlike the massive losses reported by other major insurers like Highmark, Humana, and UnitedHealth Group.
Former CMS Administrator and current AHIP President and CEO Marilyn Tavenner presents the keynote speech at this year’s AHIP annual conference, calling for an increase in technology as healthcare reimbursement moves away from fee-for-service payment models.
According to a Health Affairs study analyzing end-of-life spending data for Medicare patients finds that costs run five times higher for patients with multiple chronic diseases during the last year of life.
BIDMC CIO John Halamka, MD takes issue with the “snake oil” analogy AMA CEO James Madara, MD used to describe EHRs during a speech at the AMA Annual Meeting. Halamka acknowledges that current EHRs do not share data, engage patients, or enable population health effectively, but says “There is no snake oil. We created the digital foundation that is a prerequisite for the next generation of tools.”
The former CNO at Sonoma West Medical Center (CA) files a wrongful termination suit after being fired for voicing concerns that the home-grown EHR designed and implemented by a hospital board members’ startup company was unsafe.
A Massachusetts federal court judge dismisses a patent infringement suit filed by American Well against telehealth competitor Teladoc, concluding that American Well’s patent is invalid because major elements are “too abstract” to be patentable.
A Minneapolis newspaper discusses the difficulty providers have finding advance directives within EHRs, citing a recent study that found “less than one-third of ER doctors feel very confident they could locate information in the electronic record.”
American Medical Association EVP/CEO James Madara, MD, speaking at the organization’s annual meeting, lashes out at “digital snake oil” of clinically unproven software and technology products that “impede care, confuse patients, and waste our time,” adding that “interoperability remains a dream.” He says doctors – who mistakenly failed to participate in early digital health projects – need to separate the lame digital tools from the potentially magnificent ones, explaining the present state of “digital dystopia” as:
Direct-to-consumer digital health devices—which only in the fine print say ‘for entertainment purposes only’—to our clunky electronic records, to ICUs that sound like primitive swamps abuzz with a cacophony of bells, alarms, and whistles.
However, many of the solutions that Madara offers involve products from which AMA benefits – an incubator, an innovation studio, and lobbying efforts.
Meanwhile, John Halamka takes the counterpoint to the “digital snake oil” label, saying that more study rather than politician-like hyperbole is needed to understand that “we’ve achieved exactly the results we designed” in striving to simply replace paper charts with their electronic counterparts and to meet various government mandates. He provides examples in interoperability (e-prescribing, public health reporting, and lab reporting); population health (EHR patient panel queries); and consumer engagement (patient portals), all of which laid the foundation for the next generation of tools that will support team-based workflow, lifetime encounter records, care management workflow support, and family engagement tools. Halamka repeats the same advice he offered for Meaningful Use: focus on a small number of achievable outcomes.
Reader Comments
From Pomp and Circumstance: “Re: vendor press releases. Healthcare institutions are increasingly forbidding them to distribute press releases announcing new sales or contracts. This may distort the perception of success of companies that are compliant with the wishes of their customers.” It’s tough for a vendor to tout their successes when the client asks them not to, going beyond just not naming the client specifically, but prohibiting the sale from being mentioned at all. That practice prevents some much-need visibility into who’s buying what, but I agree that there’s no value to the new customer unless the sale can be crafted into a more self-serving announcement.
From Sticky Wicket: “Re: innovation award winners. You didn’t list those from the attached announcement.” I don’t consider press releases of these types worth mentioning since the average health system CIO would have minimal interest in companies whose enterprise readiness is years away at best even if they manage to avoid being among the 95 percent that will never be successful. Thus I’ve stopped running announcements of the following types, preferring to wait for actual customer success:
Company funding under $1 million.
New accelerators forming or companies joining an accelerator.
Tiny companies winning an app contest or submitting an innovative idea.
Startups offering a new consumer-facing health app whose outcomes have not been studied.
From Duluth: “Re: Navicure. Sold to Bain.” Unverified. I’ve reached out to the company for a response but haven’t heard back. UPDATE: Navicure confirms that it will receive an undisclosed strategic investment from Bain Capital Private Equity. Founder and CEO Jim Denny and the executive team will remain with the company.
From Gray Sky: “Re: [vendor name omitted]. Has had outages for the past two weeks for all hosted applications. Inside information points to a storage information where customer data has been erased. The company continues to investigate options to restore the data to a reasonable point in time.” Unverified. A company spokesperson responded quickly after hours and is trying to reach one of its executives for a response, so I offered to withhold the company’s name until my next post, which will also include any response the company provides.
From DOSsier: “Re: US Department of State. Issued an RFI for an off-the-shelf EHR for diplomatic missions.” The RFI is here, but note that it covers EHR implementation project management services only – it’s not a RFI for an actual EHR. The original plan was for the Department of State to share the Coast Guard’s Epic system, but the Coast Guard has backed away from that project. Before that, the DoS was planning to roll out the DoD’s AHLTA, so perhaps this RFI involves the DoD’s Cerner rollout. I don’t know the source of the DoS’s existing eMED system. The RFI was posted June 3 with a two-week response date.
From Pickle Entry: “Re: ACA insurance. UnitedHealth Group is pulling out of the exchange in my state. I’ve had to change insurance companies every year since Obamacare was rolled out, paying multiples of the premium prices I paid before the ACA.” The administration touts decreasing levels of uninsured citizens. That’s good, but those newly insured people are spending a lot of insurance company money catching up on their deferred health needs while young, healthy citizens are going without insurance because they are unlikely to get a payback. You can’t blame insurance companies who are stuck with a money-losing risk pool of self-selected patients when they stem their financial bleeding by exercising the only option the government gives them – shutting down their exchange plans. You are fine if you have employer-provided insurance, have a low enough income to qualify for endless government insurance subsidies, are old enough for Medicare, have few assets and therefore little financial exposure to expensive uninsured services, or are rich enough to not care. Otherwise, you’re paying more to keep the insurance-funded profits flowing to providers, drug companies, and the endless bureaucracy of middlemen who make up most of the US healthcare non-system and who are happy that ACA gave them newly insured patients to bill without touching the real problems of unjustified prices, fraud, and the financial incentive to create overutilization.
From Dan Blocker: “Re: data blocking. John Halamka says he’s never seen it. I say he needs to look harder.” Lots of people (including ONC) claim that providers and EHR vendors intentionally block the flow of patient information, but nobody is serving up real-life examples instead of poorly sourced anecdotes. Such proof can only come from patient complaints and those are rare because: (a) patients don’t know that their interoperability expectations should be higher; (b) the moment of need is when they are unwell; and (c) they don’t have the information or incentive to figure out who to complain to. I bet that if you asked 100 people who were in the process of being seen as inpatients or outpatients to ask those providers to retrieve their history from other providers, nearly all of them would be unsuccessful, but turning that into a data blocking complaint against either of the providers or their respective EHR vendors would require a lot of investigatory legwork. Most of what’s wrong with healthcare is due to indifference or ineptitude, not carefully planned evildoing.
HIStalk Announcements and Requests
Listening: reader-recommended Fantastic Negrito, raw Delta blues from the Oakland,CA solo artist who describes his music as “uncut realness and zero concern for pop anything” and whose background is uplifting. Mark my words: all things (especially musical ones) must pass and eventually audiences will tire of shimmery musical junk food crafted by false-prophet celebrity musicians who possess no life experience and whose primary musical instrument is Auto-Tune.
Ms. Westover says students in her inaugural high school microbiology course in Georgia are making good use of the lab supplies we provided in funding her DonorsChoose grant request, examining bacteria and analyzing water samples in discovering “a whole new microscopic world.”
Webinars
June 28 (Tuesday) 2:00 ET. “Your Call Is Very Important.” Sponsored by West Healthcare Practice. Presenters: Cyndy Orrys, contact center director, Henry Ford Health System; Brian Cooper, SVP, West Interactive. The contact center is a key hub of patient engagement and a strategic lever for driving competitive advantage. Cyndy will share how her organization’s call center is using technologies and approaches that create effortless patient experiences in connecting them to the right information or resource. Brian will describe five key characteristics of a modern call center and suggest how to get started.
Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.
Acquisitions, Funding, Business, and Stock
Hearst acquires a majority stake in MedHOK, which offers health plan software including case management, utilization management, and medication management. MedHOK will be incorporated into Hearst Health, which includes First Databank, Zynx Health, MCG, and Homecare Homebase.
A federal court dismisses the patent infringement lawsuit brought by telehealth provider American Well against competitor Teladoc, with the court finding that American Well’s patent is too abstract to be enforceable. Teladoc asked the patent office to invalidate American Well’s patients in 2015, after which American Well sued Teladoc just before Teladoc’s IPO. American Well will of course appeal. TDOC shares have dropped 33 percent in the year since its IPO.
Hospital medical device spend management software vendor Procured Health raises $10 million in new funding. The Chicago-based company had raised $5.1 million, with its most recent round being completed in March 2014 with little news since.
Sunquest acquires patient flow technology from The Royal Liverpool and Broadgreen University Hospitals NHS Trust, which it will market to customers of its Integrated Clinical Environment.
Patient access and RCM services vendor MedData will acquire RCM services vendor Cardon Outreach for $400 million.
Microsoft inexplicably pays $26.2 billion to buy LinkedIn in its biggest acquisition ever. Microsoft always seems desperate to grab onto whatever is trendy at the moment, wildly overpaying to acquire companies with higher growth potential that it then runs into the ground in repeated and easily predicted examples of failed synergy. MSFT is paying a 50 percent premium to the share price of LinkedIn, whose luster has faded as its revenue stalled and the platform keeps finding new ways to annoy its users in between their rare bursts of job-seeking and self-promotional activities.
Sales
Manati Medical Center (PR) and Mayaguez Medical Center (PR) choose Meditech 6.1, raising the company’s Puerto Rico hospital count to 21.
Tampa General Hospital (FL) selects records aggregation and referrals management tools from EHealth Technologies.
Mainstreet Health will implement the HealthMedx Vision EHR for its transitional care facilities.
People
Justin Barnes (Justin Barnes Advisors) is named partner and chief growth officer of IHealth.
Extension Healthcare hires Ben Kanter, MD (Sotera Wireless) as CMIO.
Eric Kretzer (Strata Decision Technology) joins SA Ignite as SVP of products.
Announcements and Implementations
Boone Hospital Center (MO) lays off 26 transcriptionists following the decision by parent company BJC HealthCare to outsource transcription services to Madison, WI-based Amphion Medical Solutions, which was acquired by Atlanta-based IMedX in January 2016.
The American Medical Association adopts ethical standards for telehealth and telemedicine at its annual meeting, noting that technology doesn’t change the ethical requirements for physicians to place the patient’s interests first. The guidelines also urges physicians to be cautious in making treatment decisions based on the limited information available in a telemedicine session and suggests that care coordination is essential.
Government and Politics
The SEIU healthcare employee union tries again to convince California to cap total hospital CEO compensation at $450,000, the same salary earned by the President.
Technology
Microsoft’s new XBox console eliminates the dedicated port for its Kinect motion-based controller, leading to speculation that Kinect is being phased out. Kinect is used by several innovative healthcare applications for pain assessment, physical rehabilitation, and patient-provider communication. My speculation would be that Kinect turned out to be less interesting (and less profitable) for consumer use but it will continue with a non-gamer focus.
Other
The former chief nursing officer of Sonoma West Medical Center (CA) sues the hospital and one of its board members, claiming she was fired after raising concerns about problems with the hospital’s new clinical software that was developed by the board member’s company. She says the hospital allowed the board member to use its patients as his EHR guinea pigs because he has donated $9 million to keep the previously closed hospital afloat, with the resulting buggy product mixing up patient records, providing incorrect medication information, and failing to display the code status of patients. The software in question appears to be from E-Health Records International, which claims that its tablet-based HarmoniMD hospital EHR can be brought live in single day. Its only users appear to be Sonoma West and a single hospital in Africa.
A Commonwealth Fund-sponsored study finds that only 30 percent of behavioral health providers use EHRs, recommending that SNOMED and LOINC terminology be enhanced to address behavioral needs, incorporating IT costs in setting bundled payment policies, adding behavioral-specific clinical decision support and interoperability capabilities to existing EHRs, and requiring EHR vendors to beef up their security capabilities.
A Peer60 report on payers finds that BCBS and Medicare are the ambulatory provider favorites by far, with UnitedHealthcare trailing the pack. Providers like payers that get them paid more quickly with minimal staff involvement, while their least-favorite attributes are time-wasting practices, denials, and poor customer service.
CMS Acting Administrator Andy Slavitt commits at the AMA conference that CMS will simplify its processes, involve physicians in decisions that affect them, focus on patients, support small physician practices, and make “healthcare technology a tool, not an industry.” Some snippets:
Off-the-shelf tools like Certified EHRs and clinical data registries can provide complete capabilities [for quality reporting], but other options exist as well, including most types of reporting that a physician is doing today. If CMS can get data automatically or through another source, we will do so … [CMS will focus on] putting more pressure on technology vendors and less burden on physicians, so physicians can do simple things like track referrals when a patient sees another specialist or visits a hospital … It’s also time to ask a lot more of the technology and technology vendors. This is particularly true in the area of what many call interoperability … the burden needs to be on the technology, not the user. EHR vendors and hospitals that use them will now be required to open their APIs so data can move in and out of an application safely and securely. This will also serve to help eliminate the ‘desktop lock’ that occurred based on early EHR decisions by allowing technology to more easily plug and play. Today’s data silos are more a function of business practices than technology capability and we cannot tolerate it any longer.
Here’s a textbook example of how to write a bad press release. The boring headline contains glaring spelling and capitalization errors, oddly uses the past tense, and reeks of company self-importance in providing a “news item” that would interest no one except the unfortunate author who was charged with getting some company buzz out there despite a lack of buzzworthy events. It randomly capitalizes job titles and other words that are not proper nouns (“EHR Systems”) and uses awkward phrasing that suggests it was crafted by someone whose mother tongue is not English. My mom’s advice remains valid: if you don’t have anything good to say, don’t say anything.
A Virginia hospital blames a misplaced EHR click for sending a sympathy card to the family of a patient who was in fact still alive. Sentara Martha Jefferson Hospital says someone clicked “deceased” instead of “discharged to home” in Epic, triggering the obviously automated condolences. At least the errant checkbox entry didn’t create a medical error that actually killed the patient.
Athenahealth’s Jonathan Bush provides an impassioned video reaction to news that TV host John Oliver formed a fake debt collection company, bought $15 million in overdue medical accounts receivable for $60,000 cash, and then told those patients that he was forgiving their debt. I assume that buying debt at less than a penny on the dollar means it was uncollectible anyway, so it wasn’t really much of a gift.
The Minneapolis newspaper covers the problem in which patient advance directives are not easily located in EHRs. It cites a study in which less than one-third of ED doctors were confident that they could find patient preferences for resuscitation, feeding tubes, or ventilators.
Eastern Maine Healthcare System (ME) offers voluntary early retirement to 43 of the 300 employees in its IT department, which is running $3 million over budget.
The American Diabetes Association is embarrassed when it allows a drug company to present new, sensitive research data to thousands of doctors attending one of its conferences, warning them to hold the information for one hour until the public announcement and the inevitable stock market reaction. The itchy Twitter finger doctors were already blasting out photos of the presentation’s title slide even before the presentation began, after which they tweeted out the presentation’s data slides and charts despite pleas from the ADA to remove them. Novo Nordisk shares dropped 5.6 percent on the modestly positive news.
Weird News Andy loves good customer support even if it comes from sophisticated ransomware hackers who now provide live-chat operators to walk victims through the payment process in an effort to differentiate themselves professionally by improving usability. WNA suggests the hacker’s customer support agent be prepared to answer questions such as:
How do I buy bitcoins?
How do I know you will actually unlock all our data?
Do you provide training on how not to click suspicious links?
How’s the weather in Romania?
Sponsor Updates
Impact Advisors is named as one of the 500 largest technology integrators in North America.
I spent 38 of the last 72 hours seeing patients. Even the full-time physicians in my practice don’t usually work that much in a short stretch, so I’m not surprised that I found it exhausting. Normally, I find our EHR tolerable, but there were times in the last several days where it was unbearable. I experienced instability like I haven’t experienced since being a beta client for another vendor several years ago. I seemed to find more errors in the physician workflow than my co-workers found in the support staff workflows, and I could feel my attention drifting because I was becoming increasingly annoyed.
At one point, I was managing multiple high-acuity patients when I encountered a string of error messages. The one above nearly put me over the edge. End users should never see error messages like the one above. It’s insulting to the users and, although I’m sure it might mean something to a developer, it doesn’t mean anything to a customer who is trying to care for patients. It’s enough to make one want to wish for even more federal regulations – but only if they require vendors to provide mechanisms for graceful error handling.
As an EHR user, I sometimes feel like I’m a research subject in an experiment that hasn’t been approved by any kind of institutional review board. Everyone thinks that Certified EHR Technology is going to make our world a better place but the jury is still out on whether it’s going to truly be effective. And while we as physicians are having to cope with arduous workflows as a result of the regulations, there are advancements that would really benefit us that remain unaddressed.
Over the last decade, I’ve accumulated a wish list of product “enhancements” that would benefit the people in the trenches. Years later, though, they’re mostly unaddressed:
The NCPDP standard for electronic prescribing limits the “SIG” or prescription instructions field to 140 characters. I’ve been told for years that this will be addressed in a future version of the SCRIPT standard, but it remains unaddressed in any production system I’ve ever used. Physicians who have tried to prescribe triptans or other medications that require unstructured SIGs know exactly what I’m talking about. I bet 140 characters made sense at some point, but it’s time for a change. If we can regulate the picklist selections available for marital status, certainly we can regulate this.
Standardized lab ordering mechanisms are lacking. One major national reference lab supports electronic directory of services (eDOS) formatting but another doesn’t. This leads to a hodge-podge of strategies for EHR vendors who are trying to manage multiple lab compendia. Some use third parties to try to keep it straight, and others push the work onto the clients. This can result in thousands of physician offices trying to stay in sync with their reference labs, often with a lot of manual work. If we can regulate the use of CPT for lab charges, certainly we can regulate this. (I have to admit that I got a kick out of this reference on eDOS that mentioned that “MU3 proposed rules are anticipated to be published in January 2014 with final rule anticipated to be published in summer 2014.)
Requirements for lab vendors and the way they deliver results is lacking. Although physicians are required to use LOINC codes for results to meet various quality measures requirements, there is no requirement that lab vendors send LOINC codes with their results. I’m working with a handful of clients right now who are having to do manual recoding to attach LOINC codes to their results, so that they don’t get dinged on their quality reports. If we can regulate the use of SNOMED, certainly we can regulate this.
Interoperability remains elusive. Even when systems communicate, the mechanisms used to reconcile data from disparate systems can be clunky at best and downright unsafe in certain situations. Although some vendors have robust algorithms to identify potential matches and bring data seamlessly into the patient chart, others deliver a greater cognitive load than I experienced in my third semester calculus class. If we can regulative giving lip service to usability through user-centered design, certainly we can make it a reality.
Unfortunately, my list is growing longer rather than getting shorter. We’re forced to gather loads of information that could be put to good use but isn’t. For example, we collect information on race, ethnicity, religious preference, language preference, sexual orientation, and more. In many cases, it’s not used to further clinical care. It would have been great to have a prompt to ask about religious fasting the other night when I was treating a patient with profound dehydration. Although it occurred to me to ask, it didn’t occur to my patient care technician or to the resident I was supervising.
My state doesn’t have a usable database for identifying potential abuse of controlled substances. That’s not a vendor problem but a failure by our legislators to ensure that what they legislated was actually delivered as promised. It’s sad, because I could benefit from that kind of technology every single day. Other states have had it for years but here I am, calling around to try to confirm my suspicions when I’m concerned about a patient.
I know the industry is going through growing pains. There is a tremendous amount of external pressure and we’re trying to use technology to solve the broader healthcare problem rather than addressing the root causes. We can’t expect that to be easy, and I’m hoping we’ll look back on these times someday and chuckle at our relative naivety. Of course, there’s always the chance we’ll look back on these times fondly, because things will have gotten worse. Let’s hope that doesn’t come to pass.
For now, I’d settle for some friendlier error messages. I’d take “I’m sorry Doctor, I’m afraid I can’t do that” rather than hearing about unhandled exceptions or missing widgets. What’s your most annoying error message? Email me.
American Medical Association CEO James Madara, MD speaks at the AMA Annual Meeting about the state of technology in healthcare, saying, w“e’re seeing digital tools in medicine that, unlike digital tools in other industries, make the provision of care less, not more, efficient.”
The Commonwealth Fund publishes survey results measuring the impact marketplace insurance coverage has had on consumers. The survey found that over 80 percent of consumers were satisfied or very satisfied with the insurance they purchased, while just over 70 percent report that coverage options are good, very good, or excellent.
UC San Diego Medical Center suspends its plan to publish physician ratings on its website after realizing that it solicited reviews from patients without informing them that the responses would be used in a public forum.
South Australia is looking for a spokesperson to reassure the public that its over budget, behind schedule 80-hospital Allscripts EHR implementation is still a worthwhile investment.
A survey of 750 consumers enrolled in wellness programs finds that 70 percent do not compare prices before seeking medical services or pharmaceutical drugs, while only 29 percent of health plans offer online tools that would help consumers price shop.
CNET profiles the SynCardia Freedom Portable Driver, a 13 pound machine that fits in a backpack and uses compressed air to keep blood pumping through the body. A Michigan man has been using one for more than a year while waiting on the transplant list for a new heart.
June 12, 2016NewsComments Off on Monday Morning Update 6/13/16
Top News
In light of voided test results and potential CMS sanctions, Walgreens ends its relationship with Theranos, closing all 40 of its Theranos Wellness Centers in Arizona. Walgreens will redirect lab testing to third-party companies or to the certified Theranos lab in Phoenix.
Webinar
June 28 (Tuesday) 2:00 ET. “Your Call Is Very Important.” Sponsored by West Healthcare Practice. Presenters: Cyndy Orrys, contact center director, Henry Ford Health System; Brian Cooper, SVP, West Interactive. The contact center is a key hub of patient engagement and a strategic lever for driving competitive advantage. Cyndy will share how her organization’s call center is using technologies and approaches that create effortless patient experiences in connecting them to the right information or resource. Brian will describe five key characteristics of a modern call center and suggest how to get started.
Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.
Last Week’s Most Interesting News
McKesson may sell its health IT business unit to focus efforts on its core drug distribution business.
Vice President Biden announces formation of the Genomic Data Commons, an open-access cancer database that will help researchers collaborate and share information, as part of the administration’s Cancer Moonshot.
Theranos says that less than one percent of its blood test results have been voided or corrected, a clarification on earlier reports that it would need to cancel or amend tens of thousands of results.
Practice Fusion settles FTC charges that it misled consumers by soliciting reviews for their doctors without disclosing that the information would be publicly posted on the Internet, leading to patients unknowingly publishing their own sensitive patient information.
The House passes the Helping Hospitals Improve Patient Care Act, exempting ambulatory surgical centers from MU and MIPS penalties.
Privacy and Security
UC San Diego (CA) halts plans to post physician reviews and star ratings on its website after realizing the surveys it sent to patients didn’t disclose that their comments could go public, potentially revealing their identities. The two-hospital system has postponed launching the reviews to redistribute surveys with appropriate disclosure language. While one healthcare executive believes the decision is based on physician pushback in the face of potentially damaging reviews, Practice Fusion’s recent settlement with the FTC over a similar situation lends UCSD’s decision some merit.
Twitter locks accounts and issues password resets after reports surface that 32 million passwords were leaked on the dark web. The company denies that its servers were hacked, instead attributing the leak to “combining information from other recent breaches, malware on victim machines that are stealing passwords for all sites, or a combination of both.”
People
The University of Iowa Health Alliance promotes Jennifer Vermeer to CEO.
Innovation and Research
A survey of 750 insured consumers reveals that they aren’t shopping around for healthcare services as much as industry insiders seem to hope they will. Just 30 percent of health plan members comparison shop, and only 30 percent of plans offer comparison-shopping tools. While 42 percent of those surveyed ranked such tools as “very important,” it’s hard to believe that importance would translate to more savvy shopping when a similar percentage believe the "cost is covered by my health plan, so it doesn’t matter."
NewYork-Presbyterian Hospital concludes its 10-week long InnovateNYP Pediatric App Challenge, awarding $40,000 to three finalists:
FhirStarters pediatric medication administration app, developed by Riley McKenna and Anees Merzi.
Teen Screen mental health screening and resource app, developed by Vikas Mandadi.
NYP Care Companion patient engagement app, developed by Ekaterina Chernetsova, Roman Makhnenko, Andrew Gluschenko, Dan Piekarz, Alexander Demura, Margarita Olshanskaya, Egor Kobelev, and Allan Wellenstein.
Government and Politics
Illinois-based Boyd Memorial Hospital, HSHS Holy Family Hospital, and Hillsboro Area Hospital will share a $155,000 USDA Learning and Telemedicine grant to expand stroke treatment, neonatal, and pediatric telemedicine programs.
Other
Stan Larkin lives for 17 months without a heart by wearing a SynCardia Freedom Portable Driver. Powered by compressed air and worn in a backpack, the artificial heart allowed the 25 year-old – the first patient in Michigan to use the device – to live until he received a successful heart transplant in May.
South Australia Health hopes to hire a spin doctor for a six-month stint to convince the public that its highly criticized Enterprise Patient Administration System is worthwhile. The electronic records system is years behind schedule and over budget by over $200 million. Hospital physicians have formally complained that the system cut clinical activity by 50 percent, and have written a letter listing 37 major flaws and pleading for it to be shut down. SA Health named Allscripts as vendor of choice for the 80-hospital, $225 million project in November 2010 and signed the contract a year later.
The local paper looks at the hard time physicians often having locating end-of-life directives within EHRs, attributing the problem to a lack of training and/or intuitive field within the EHR. It holds up Gundersen Lutheran Medical Center (WI) as a forward-thinking organization when it comes to advance care planning documents. The hospital made digitizing such documents a priority when it implemented Epic in 2008.
Sponsor Updates
Valence Health makes the top 20 of Fastest Growing Companies in 2016 by Crain’s Chicago Business.
Practice Fusion settles FTC charges that it misled consumers by soliciting reviews for their doctors without disclosing that the information would be publicly posted on the Internet, leading to patients unknowingly publishing their own sensitive patient information.
Southcoast Health (MA) says that its $100 million Epic implementation resulted in $3 million going back to the local economy in the form of hotel room, auto rental, gas, and dining costs for the Epic staff and consultants that helped manage the implementation.
Practice Fusion settles with the FTC over charges that it misled consumers by asking for reviews of their physicians without adequately disclosing that those reviews would be posted publicly online. The reviews were published in 2012 as part of the company’s efforts to develop a public-facing healthcare provider directory. “Practice Fusion’s actions led consumers to share incredibly sensitive health information without realizing it would be made public,” says FTC Bureau of Consumer Protection Director Jessica Rich. “Companies that collect personal health information must be clear about how they will use it – especially before posting such information publicly on the Internet.” The settlement, which seems to carry no fine, prompted the FTC to publish six privacy pointers, with perhaps the most relevant being, “Disclosures should reach out and grab consumers,” and “Don’t bury key facts in a hard-to-understand privacy policy.”
Reader Comments
From EMR Expert: “Re: Financial trouble in the Middle East. Like many other vendors in various sectors, Cerner, Epic and InterSystems are having tough times collecting their money from existing clients. One of the executives of those companies stated that their Accounts Receivables of the value of more than $15 million is overdue by more than six months. Support contracts are not being renewed and payments for implementation are not honored. It is a catch 22 situation when all their clients were oil rich and now cash strapped governments/government entities.”
HIStalk Announcements and Requests
This week on HIStalk Practice: AMN Healthcare acquires Peak Health Solutions. CancerLinq announces new collaboration and practice sign-up milestones. North Carolina Medicaid reform will include the development of a statewide HIE. South Carolina lawmakers pass telemedicine-friendly legislation. SingleCare partners with American Well. Closed-door meetings in Texas could lead to more telemedicine-friendly legislation. Medfx and Falcon Physician develop software for nephrology practices. FastMed Urgent Care rolls out TouchCare telemedicine services at 57 clinics. Tandigm Health Medical Director Leslie Saltzman, DO shares the hurdles physician groups face when implementing telemedicine tech.
Webinars
June 28 (Tuesday) 2:00 ET. “Your Call Is Very Important.” Sponsored by West Healthcare Practice. Presenters: Cyndy Orrys, contact center director, Henry Ford Health System; Brian Cooper, SVP, West Interactive. The contact center is a key hub of patient engagement and a strategic lever for driving competitive advantage. Cyndy will share how her organization’s call center is using technologies and approaches that create effortless patient experiences in connecting them to the right information or resource. Brian will describe five key characteristics of a modern call center and suggest how to get started.
Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.
Acquisitions, Funding, Business, and Stock
Xerox launches Virtual Health Solutions, a new service line that will offer providers telemedicine consulting, interface design and development, and virtual clinic services.
Connecture, a technology company that builds online health insurance marketplaces, acquires ConnectedHealth, a benefits technology platform that helps employers chose health plans. Financial terms were not disclosed.
Southcoast Health (MA) reports that its $100 million Epic implementation boosted the local economy by $3 million, mainly through hotel room costs, car rentals, gas, and dining. Nearly a third of the health system’s budget for the project went to costs associated with expenses for Epic staff and consultants.
Martin Shkreli jeeringly pleads not guilty to an updated indictment – one that adds a new conspiracy charge to original December allegations that he illegally took stock from a biotechnology firm he launched in 2011 and was fired from three years later. Not surprisingly, the “habitually unavoidable-for-comment Shkreli unloaded as he spoke to customers at a Manhattan Dunkin’ Donuts outlet while live-streaming on Periscope.” In related (and absurd) news, Shkreli blocks presumably reputable reporters from his Twitter stream, and lauds an upcoming satirical musical about his purchase of a $2 million single-copy Wu-Tang Clan album. It will no doubt give Hamilton a run for its money.
Announcements and Implementations
Radiology Associates of Macon (GA) extends its RCM agreement with Zotec Partners.
Meditech develops a sepsis management toolkit for select EHR customers.
St. Vincent’s Medical Center (CT) rolls out telemedicine services from Zipnosis.
The Guam Dept. of Public Health and Social Services partners with Good Samaritan Hospital in Los Angeles to roll out a specialty care telemedicine program for island residents.
Sales
Houston Methodist (TX), Meadows Regional Medical Center (GA), and Shore Medical Center (NJ) sign on for Unified Provider Management software from Phynd Technologies.
People
North Mississippi Medical Center promotes Shannon Fryery to director of telehealth for North Mississippi Health Services.
Callie Shaver (Greenville Regional Hospital) joins Jersey Community Hospital as HIM director.
The VA fires three more administrators within the Phoenix VA Health Care System. Lance Robinson, assistant director at the Carl Hayden VA Medical Center; Brad Curry, chief of health administration service; and Darren Deering, DO the hospital’s chief of staff; were all terminated for “negligent performance of duties and failure to provide effective oversight.” The terminations come more than two years after the exposure of the cover up of a huge backlog in medical appointments that severely impacted veteran care.
The House passes the Helping Hospitals Improve Patient Care Act, excluding ambulatory surgical centers from Meaningful Use and MIPS penalties.
Innovation and Research
Cerner launches a one-year pilot study that will help determine whether patient’s genetic data can play a motivating role in promoting behavior change.
A Health Affairs study correlates the use of prescription drug monitoring programs with a 30 percent reduction in the rate of prescribing Schedule II opioids, a change that continued in the second and third years following the launch of the program.
A small Health Catalyst survey of hospital executives finds that 62 percent have between zero and 10 percent of their care tied to the value-based contracts CMS hopes to have hospitals converted to by 2018. Just 3 percent meet the CMS goal of 50 percent value-based reimbursement today, and only 23 percent expect to meet it by 2019.
Technology
Avizia adds the patient-facing MyCare app to its AviziaOne telemedicine and secure messaging solution.
Experian Health’s Coverage Discovery uncompensated-care alert tool can now integrate with Epic’s EHR.
Influence Health develops new digital presence management technologies that include directory listings, reputation, and online provider review ratings tools.
Other
Jennifer Lawrence signs on to play Theranos founder Elizabeth Holmes in an Adam McKay-directed drama about the now-infamous blood-testing startup.
A mother in Australia uses Siri to call emergency services when she discovers that her sleeping baby had stopped breathing. While the digital assistant may have contributed to saving the girl’s life, it likely had more to do with the mom’s administration of CPR, given that the ambulance took 20 minutes to arrive.
Sponsor Updates
Impact Advisors achieves top overall performance score in the KLAS Healthcare IT Advisory Report.
InterSystems and PDR will exhibit at AHIP June 15-17 in Las Vegas.
LiveProcess will exhibit at the SC Hospital Association Hospital Preparedness Summit June 8 in Columbia, SC.
MedData will exhibit at the Southern Coastal Emergency Medicine Conference June 10-11 in Kiawah Island, SC.
Medecision signs on as a founding member of the Accountable Care Learning Collaborative.
Navicure will exhibit at the Arizona NextGen UGM June 10 in Phoenix.
Nordic and Stella Technology will exhibit at the HIMSS New York State meeting June 16 in the Bronx.
Millward Brown names NTT Data to its 2016 Brandz Top 100 Most Valuable Global Brands.
Obix Perinatal Data System will exhibit at the 2016 AWHONN National Convention June 11-15 in Grapevine, TX.
Experian Health will exhibit at the Georgia Society for Managed Care meeting June 12-14 in Jekyll Island.
PatientMatters will exhibit at the Ohio Hospital Association Annual Meeting June 13-15 in Columbus.
The SSI Group will exhibit at the Gulf States ASC Conference June 15-16 in New Orleans.
Catalyze achieves a second HITRUST CSF Certification.
June 9, 2016NewsComments Off on EPtalk by Dr. Jayne 6/9/16
Thanks to everyone who sent well-wishes about my recent hand injury. I’m happy to report that I’m recovering and have traded out the giant dressing for something more sleek – today I sported a Mickey Mouse themed bandage. I’m seeing patients tomorrow and am a bit nervous about hand hygiene, but our infection control nurse is on board with a plan. I’ll also be running with a scribe, so that will help. Laughter is good medicine and I appreciated one reader’s comment that at least I wouldn’t need to buy a foam finger to cheer my team at the ballpark.
From Florida Orange: “I was reading your post and this sentence jumped out at me: “I know my practice leans heavily towards patient satisfaction scores for determining provider compensation, and the idea that giving patients what they need (rather than what they want) can impact me negatively is always a consideration.” How is satisfaction calculated? HCAHPS scores? Press Ganey? Or Yelp reviews? And what factors make up patient satisfaction?” The methods used vary depending on whether an organization is a hospital or ambulatory group. I’ve actually seen groups use all of the above to assess patient satisfaction, plus other strategies such as anonymous waiting room surveys, online surveys, and more.
In my largely ambulatory world, the factors that come into play include: satisfaction with contacting the office (which may include appointment scheduling and availability); wait time in the office; friendliness and helpfulness of staff; whether patients felt their diagnosis and treatment was explained to their satisfaction; willingness to recommend the office to other patients; and more. My practice uses a third-party survey service that emails a link to the patient and we can see responses via a practice dashboard. They’re not anonymous and we contact anyone who doesn’t give us at least four out of five stars overall or offers narrative comments that are concerning.
Everyone likes getting good reviews, and the percentage of four- and five-star reviews impacts our bonus calculation, as does our ability to care for patients in a timely manner when they arrive. As a member of the executive team, I get an email notification when a patient activates the survey link. Sometimes this happens when I know the patient has to be driving home from the visit, which is amusing. All of our patients are emailed the survey at the time of check-out, even those that we know had less than optimal experiences. The times when we didn’t’ do well are the most important for learning and we really need that feedback.
Different organizations weigh the impact of their results in different ways. I worked with an organization a few years ago that lived and died by their Press Ganey statistics, even when the results didn’t make sense as far as supporting the organization’s overall goals. As organizations evolve along with our changing healthcare system, it’s going to be increasingly important for groups to evaluate their survey strategies on a regular basis. If processes have been improved and responses are flat, maybe it’s time to measure different elements.
Patient engagement is an increasing part of patient satisfaction, and at last week’s ONC Annual Meeting they launched a Patient Engagement Playbook. It’s designed to help organizations improve patient engagement via patient portal usage. The first phase encourages clients through the critical steps of making enrollment easy; activating features that patients want; allowing proxy access for caregivers; and integrating patient-generated health data. Physicians often resist the last item, so if you work with those who might fall into that category, a quick read might be in order.
From Jimmy the Greek: “OK, Dr. Jayne, tell me why this patient portal view of lab results is useless. That’s right, campers, there’s no ‘normal range’ displayed. Just how the hell is a non-clinician supposed to interpret these values? Should I turn to Dr. Google? Should I make a follow-up appointment with my doc to talk through the results? Should I expect a phone call to discuss them? I have loads of data, but no way to turn the data points into useful information.” This goes right along with my recent post about trends in organizational patient portal release policies. The mere fact of releasing labs to patients doesn’t necessarily empower them, and without the right supporting information can lead to patient frustration or worry. I don’t immediately recognize this vendor, so I can’t tell whether there are other features that would help the patient understand their results such as hovering over them, but from other correspondence, Jimmy seems to be a pretty astute IT guy and would likely have picked up on something like that.
Aprima is hosting its annual User Conference at the Omni Dallas Hotel August 5-7th. A piece on their blog caught my eye, since it quoted a client from a practice named “Serenity Now Psychiatric and Counseling Services.” That’s probably one of the best practice names I’ve seen in a long time. The write up also caught my eye since they’re offering a service project where attendees can assist with making blankets, gift bags, and other items for patients at Children’s Medical Center in Dallas. I love seeing companies help the community.
HIStalk looks at the evolution of blockchain, barriers to adoption in healthcare, and its potential to truly put patients at the center of care. By @JennHIStalk
The blockchain concept, while not new, certainly suffers from a lack of healthcare-related glitz and glam, a dearth of bells and whistles that seems to have kept the wallets of Silicon Valley insiders tucked tightly in their pockets (or pocketbooks). Like its VC funding, healthcare headlines relating to blockchain are few and far between – a good indication that the concept has some ways to go before reaching critical mass.
Many automatically associate the word with bitcoin – that much ballyhooed digital currency that has tried time and again to take the world by storm. Those more in the know equate it to financial markets, where authentication and security are key. A small but growing number of IT insiders see it as an initially humble solution to healthcare’s many problems (cybersecurity, claims delivery, interoperability, etc.) – one that may mature into a more dazzling and potentially game-changing business process down the road.
Its true potential in healthcare and in any number of other industries will only be realized once stakeholders truly understand its nature, barriers to adoption, and potential, including moonshots and more down-to-earth applications.
Understanding What Blockchain is (and isn’t)
Definitions of blockchain abound, and, depending on the resource, can be either fairly easy to understand or almost too abstract to contemplate. Techopedia defines it as “a critical part of the bitcoin peer-to-peer payment system.” Investopedia goes a bit further, defining it as a “public ledger of all bitcoin transactions that have ever been executed. It is constantly growing as ‘completed’ blocks are added to it with a new set of recordings. The blocks are added to the blockchain in a linear, chronological order.” These summaries are, in fact, too narrow, given that a blockchain does not in fact have to be tied to bitcoin.
“To begin with, blockchain is not equal to bitcoin,” explains PokitDok Chief Scientist Bryan Smith, who is ushering the healthcare transactions technology company into early blockchain adoption. “A blockchain, at its essence, is a distributed database containing records whose contents, authenticity, and security are guaranteed. It drives efficiency, protects rights through immutable records, and establishes a system of accountability – an imperative in the often murky world of healthcare claims and reimbursement.
“With blockchain,” he adds, “engaged participants could opt in to share information that they want to share. That data could be accessible to authorized parties through a variety of front ends – from a mobile device to a sensitive compartmented information facility. There’s no other database that exists with that kind of functionality.”
Smith’s evangelism seems well founded. What provider, patient, or payer wouldn’t want access to a single database that could act as one source of truth for health data? Jerry Cuomo, vice president of blockchain technologies within IBM’s new cloud group, believes blockchain has the potential to consolidate disparate versions of the truth – a concept that would seem to play well with industry efforts around interoperability and a national patient identifier. “In the current world,” Cuomo says, “everyone is keeping their own version of the truth, their own system of record. When something comes in, everyone is working in silos. Each organization has to look at that transaction and determine if it matches their view of the truth. If not, they have to make it match by converting it to their preferred format. Those are all opportunities for things to go wrong. With a blockchain, you’re working across a replicated, encrypted, shared ledger that has an audit trail. It reduces the attack surface because now it’s just one ledger that everyone is sharing.”
Gauging its Potential
Brian Behlendorf, executive director of The Linux Foundation’s Hyperledger blockchain project, says. “Blockchain addresses concerns of security, scalability, and privacy of EHRs.”
Cuomo, whose team is working to develop blockchain pilots across a range of industries, envisions several “moonshot” applications for healthcare, including a patient-centered blockchain that would give providers limited access to a patient’s health record during time of service. “Just imagine a patient who is about to go into the hospital for an overnight stay,” he says. “The patient could set up a contract with the hospital, giving it 24-access to their healthcare records via blockchain. After the 24 hours are up, the hospital can’t add or make changes to that record, which reverts back to patient ownership. The patient sets the terms of who sees the record, for how long, and under what conditions. It becomes a truly patient-centered healthcare record that follows that patient from doctor to doctor.”
Cuomo also believes that new business models around healthcare blockchains are bound to spring up. “Imagine having the ability to advertise your healthcare information via your blockchain – to let organizations know that you’re interested in participating in clinical trials. You could proactively shop out your healthcare information to improve healthcare and better mankind. If those trials offer payment, you could theoretically offset the cost of your healthcare premium for the year. There’s no systematic way to do that today because your healthcare information is all over the place. In a blockchain and a corresponding ecosystem built up around that, patients might be able to more easily – and securely – contribute to medical research.”
From Big Ideas to Practical Applications
Moonshots often trump more practical use cases when a technology is just getting off the ground. While big ideas are essential to generating buzz around an up-and-coming innovation (Tricorder, anyone?), it is the less sexy application that ends up being a springboard for future headline-generating products and services. Where healthcare is concerned, blockchain may be poised to have the most immediate impact on the claims process.
“If you look at the healthcare ecosystem,” Smith explains, “there’s the patient, the insurance companies, and the providers. Sitting between each of them is some kind of intermediary. On average, processing a claim accounts for anywhere between 20 and 40 percent of the total bill. Overhead is significant, and it may be three months after a medical visit that you get an annoying bill that is often impossible to understand. Five years from now, we’ll see blockchain foster dramatic gains in economic productivity and authenticity much like the Internet introduced.”
Cuomo sees immediate potential in the area of dispute resolution. “A lot of these healthcare insurance environments are always dealing with disputes, often in the tens of thousands range,” he says. “It could be innocent things stemming from improper documentation. These things get held up in the system. They take time to resolve, and money isn’t flowing. When money isn’t flowing, it’s bad for everyone. You can’t pay your bill, people aren’t getting paid, etc. A blockchain could be used to enrich claims processing by tracking events. Those events could be used and consented on to be a source of truth – maybe not eliminating disputes, but reducing the time it takes to settle them. A great win-win for everyone.”
Behlendorf, who spent several years helping the White House and HHS use open-source software to drive adoption of shared medical records, also sees potential in blockchain’s ability to drive the sharing of patient records. “While we moved the needle substantially in our work on CONNECT and Direct,” he says, “there are still many who view patient data as their proprietary edge, not something that belongs to the patient. This is not just unfortunate and archaic; it is life-threatening when relevant health data isn’t shared.
“But, there are stakeholders who have a much greater interest in seeing a comprehensive record of patient care, and are in a connective position in the ecosystem. Insurers, for instance, will play a large role here, as well as the new wave of ACOs, and, by proxy, Medicare and the VA. Here, patient care and outcomes are comprehensively consulted, and the blockchain can provide not only a history of care (with permissions managed via keys), but it can also provide proof of authenticity for records shared between such organizations.”
Lessons Learned from Interoperability
Obtaining industry consensus on a common set of standards that levels the competitive playing field has historically been hard to achieve in healthcare. While Behlendorf, Cuomo, and Smith are certainly idealists in their take on the technology’s potential, they are also realists when it comes to calling out barriers to adoption.
“The barriers to adoption of information-sharing standards in the healthcare industry are many and difficult,” Behlendorf explains, “and few have to do with inadequate technology, but instead with alignment of incentives. What blockchain technology might do is introduce new players and new incentives to the market, thus potentially changing that landscape. It also introduces new risks, since we’re talking about widely shared data (even if encrypted), so we can’t be in a rush to implement. We’re very eager to work with the healthcare industry to investigate where we might see some early wins. The challenge, as always, is to find a set of stakeholders with enough of a common interest that they are willing to invest and collaborate. I’ve seen that first-hand in the healthcare industry, so I know it’s possible.”
Cuomo emphasizes the “network effect” necessary to get blockchain off the ground in healthcare. “It starts with a group of companies working together,” he says. “I think the network would be sparked by a set of influencers, like a set of major hospitals coming together, with sponsorships from one or more payers, which would motivate patients to come in and manage their health records via blockchain.
“But,” he adds, “therein lies the rub. That social pact has to be made. There has to be benefit for groups to come together. There’s a social side to it that’s probably more important. The technology facilitates businesses working together with less friction, with a heightened sense of trust and accountability, but you’ve got to agree on those things.”
Moving Ahead with Early Adoption
Smith is confident that every healthcare stakeholder – from providers to banks – will soon be evaluating how blockchain will impact their business processes. PokitDok, which itself is in the process of developing a blockchain system that Smith believes will significantly improve the security of sensitive health data while simultaneously making that data more readily accessible to authorized parties in real time. The company has also founded a Healthcare Blockchain Consortium to further evangelize the technology. While not quite ready to share specifics, Smith says that the consortium will “develop collective efforts to truly effect meaningful change in how healthcare is administered, delivered, and consumed worldwide.”
Cuomo and his team at IBM launched cloud-based blockchain services in April for healthcare, government, and financial services, and are working on internal and external proof-of-concept projects (including collaboration with the Linux Foundation’s Hyperledger Project) that he hopes will further escalate healthcare’s interest.
Behlendorf also takes an early-days approach to moving forward with blockchain in healthcare, stressing that the Hyperledger Project is not a standards effort. “We are here to build software,” he says, “and in doing so, lift the blockchain ecosystem as a whole, across all industries. We would be very excited to see new members from the healthcare industry participate so that we can understand their needs, collaborate, and build the core platform. As open-source software communities have shown, those companies that participate end up with an operational advantage in understanding how this technology can transform their business. They also see their staff develop expertise in a domain that is difficult to simply buy or outsource. This is about building an ecosystem and everyone has new roles to play if they recognize that and invest in transformation.”
Connecture, a technology company that builds online health insurance marketplaces, acquires ConnectedHealth, a benefits technology platform that helps employers chose health plans. Financial terms were not disclosed.
Cerner launches a one-year pilot study that will help determine whether patient’s genetic data can play a motivating role in promoting behavior change.
The VA has formally fired three more administrators within the Phoenix VA Health Care System. Lance Robinson, assistant director at the Carl Hayden VA Medical Center; Brad Curry, the chief of Health Administration Service; and Dr. Darren Deering the hospital’s chief of staff were all terminated for “negligent performance of duties and failure to provide effective oversight."
A Health Affairs study correlates the use of prescription drug monitoring programs with a 30 percent reduction in the rate of prescribing Schedule II opioids, a change that continued in the second and third years following the launch of the program.
Theranos says that less than one percent of its blood test results have been voided or corrected, a clarification on earlier reports that it would need to cancel or amend tens of thousands of results.
Verily, Google’s life science business unit, comes under fire as a number of its high profile projects flounder, including a cancer-detecting wristband and glucose-sensing contact lenses.
Vice President Joe Biden launches the Genomic Data Commons at the University of Chicago with $70 million from the National Cancer Institute. As part of the Cancer Moonshot and Precision Medicine initiatives, the commons will receive, store, and organize clinical and genomic data, and offer it to cancer researchers in user-friendly formats.
Webinars
June 28 (Tuesday) 2:00 ET. “Your Call Is Very Important.” Sponsored by West Healthcare Practice. Presenters: Cyndy Orrys, contact center director, Henry Ford Health System; Brian Cooper, SVP, West Interactive. The contact center is a key hub of patient engagement and a strategic lever for driving competitive advantage. Cyndy will share how her organization’s call center is using technologies and approaches that create effortless patient experiences in connecting them to the right information or resource. Brian will describe five key characteristics of a modern call center and suggest how to get started.
Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.
Acquisitions, Funding, Business, and Stock
Cerner President Zane Burke tells the Kansas City Business Journal that CEO Neal Patterson “remains very active and involved” during his treatment for soft tissue cancer, for which he was diagnosed in January. “In many respects, this will help both him and us as he focuses on his next chapter at Cerner and for Cerner. I think … being a consumer of healthcare will have significant impacts as he comes back into the day to day. I think the consumer is going to have a much stronger voice as we move forward.”
HCS moves to expanded office space in Wall Township, NJ.
Hospital purchasing analytics startup Valify raises $2 million in Series A funding led by Frist Cressey Ventures and Step 5 Capital. The Frisco, TX-based company, which has raised $2.75 million since launching in 2014, will use the funds to hire additional sales reps and developers, and for R&D.
Theranos reports that it has voided or corrected less than 1 percent of blood test results, seemingly a far cry from the tens of thousands of results it said it was planning to cancel or change last month. Perhaps the math adds up, though it’s not likely the secretive company will release exact numbers.
Madison, WI-based healthcare API vendor Redox joins the six-month Cisco Entrepreneurs in Residence (Cisco EIR) program in Silicon Valley.
Google’s Verily Life Sciences venture comes under fire as development of its much-hyped cancer-detecting “Tricorder” device, smart contact lens, and Baseline human health study continue to flounder. Several anonymous Verily employees claim that the Tricorder, originally scheduled for launch more than two years ago, has been touted internally more as a buzz generator than as a project capable of true clinical impact.
Sales
The California Emergency Medical Services Authority signs a contract with Audacious Inquiry for the ONC-funded development of a Patient Unified Lookup System for Emergencies. The standards-based system will leverage the state’s existing HIE infrastructure when activated during disasters, and ultimately build new connectivity between providers .
People
Virginia Mason Medical Center (WA) promotes former CIO and CFO Suzanne Anderson to CEO.
Jay Lechtman (Quantros) joins Riskonnect as senior director, market strategy and development.
Apple hires Rajiv Kumar away from Lucile Packard Children’s Hospital (CA), presumably to work on healthcare-related activities. Kumar developed a HealthKit-enabled diabetes monitoring system last fall in his role as medical director of clinical informatics.
Announcements and Implementations
Cardiology Associates of North Mississippi goes live on MedAptus charge capture software for services provided at North Mississippi Medical Center.
Delta Regional Hospital (MS) switches back to Meditech, confirming a late-April reader rumor that the 325-bed acute-care facility was in the process of ripping out Cerner.
Government and Politics
CMS issues a nearly 300-page final rule on MSSP ACOs outlining changes to the program’s benchmarking methodology, a new alternative participation option that encourages participants to enter performance-based risk arrangements sooner, and policies for addressing payment corrections.
Technology
Presidiohealth adds T-System’s EDIS software to its new PM technology for freestanding emergency centers.
Other
This article highlights the social media fame several plastic surgeons have attained thanks to their love of Snapchat and penchant for posting graphic procedures. Michael Salzhauer, MD (aka Dr. Miami) attempts to put an educational spin on his soap opera-like snaps: “A good percentage [of those watching] are people either in the medical field or interested in pursuing careers in medicine — maybe 30 percent, based on the messages we get. Another 30 to 40 percent are people who are thinking about having surgery, either immediately or sometime in the future.”
Sponsor Updates
AirStrip President Matt Patterson will speak at MD&M East June 14-16 in New York City.
IDC ranks AirWatch as the largest enterprise mobility management vendor in terms of market share for 2015.
Aprima will exhibit at Sleep 2016 June 13-15 in Denver.
Audacious Inquiry offers its “Health IT Framework to Support Alternative Payment Models” for download.
Besler Consulting releases a new podcast, “How to Fix Common Physician Documentation Mistakes.”
CapsuleTech will exhibit at the HIMSS New York State meeting June 16 in the Bronx.
Carevive Chief Clinical Officer and co-founder Carrie Stricker, RN will speak at the Biennial Cancer Survivorship Research Conference June 18 in Washington, DC.
CitiusTech will exhibit at AHIP June 15-17 in Las Vegas.
CoverMyMeds will exhibit at the American Diabetes Association Scientific Sessions June 11-13 in New Orleans.
Cumberland Consulting Group Managing Partner Rachel Wixson is featured in the Forbes self-made women issue.
Elsevier Clinical Solutions CEO Ron Mobed is featured in STEMconnector’s “100 CEO Leaders in STEM.”
Healthwise is honored with a 2016 When Work Works Award for its workplace strategies as part of the national When Work Works project.
Spok releases a new infographic highlighting customer success statistics and the ROI of communication technology.
Wellcentive will host its annual National Consultant and Analyst Summit June 8-9 in Atlanta.
The latest KLAS advisory report recognizes Nordic as a top performer, and The Chartis Group as one of the top five comprehensive firms.
Vice President Biden announces formation of the Genomic Data Commons, an open-access cancer database that will help researchers collaborate and share information, as part of the administration’s Cancer Moonshot.
Researchers at Geisinger Health System analyze EHR data of 2,000 patients admitted to the hospital for drug overdoses to create a risk algorithm capable of predicting which patients are most likely to die and experience other serious complications from their drug abuse.
I’m a little slow on the typing this week, owing to a little craft-related accident. Although I expect to make a full recovery, I’m glad I’m up to date on my tetanus immunizations. I’m also glad I wasn’t crafting alone, so I had someone to drive me to my office so my partners could get a good chuckle about taking care of me. I was selected to receive a patient satisfaction survey and was happy to give them five stars. My crafting buddy got a kick out of seeing what happens when a doctor phones ahead for their own urgent care visit and offered lots of moral support (and only a few snarky comments).
Fortunately, I had finished most of what I needed to do this weekend before the incident, so it was a good excuse to catch up on the Netflix mailers that have been mocking me from across the living room. I also spent some time editing a research article that a friend is working on. It’s around the release of test results (laboratory and radiology/diagnostic) through patient portals and how their use is impacting patient engagement and provider behaviors.
When I first started working on patient portals about eight years or so ago, there was a lot of anxiety about releasing results directly to patients. In particular, my physicians were concerned about being able to review results first and contact patients before they saw them on the portal. Our hospital brought in some “hired guns” to help us achieve clinician buy-in – a couple of CMIOs from hospitals that had done this previously and lived to tell. We ended up setting a pretty significant delay on the release of results to make sure we allowed for plenty of time for physicians to contact patients first.
A lot has changed since then, including physician attitudes. Meaningful Use set the expectation that visit summaries would be available to patients fairly quickly, and physicians were forced to respond. Additionally, organizations are sending full visit notes and other documentation to the patient, not just lab results or summaries. With my trip to the urgent care today, I had my visit note within an hour of arriving home. My colleague surveyed physician leaders at various institutions to obtain data on how they are releasing results. The data is interesting. Most hospitals still have delays, which coincide with the deadlines imposed by Meaningful Use. Some release inpatient labs sooner than outpatient, and some don’t release inpatient labs at all. The majority of respondents said that they don’t release sensitive lab results – sexually transmitted diseases, drug testing, genetic testing, etc.
Organizations were fairly split on the release of pathology results – some don’t release them at all, and others release but on a longer timeline, usually seven to 10 days. Several responded that they release but only based on a manual release process – no automatic triggers. A couple of respondents said they didn’t know what their institution’s release policy was and one respondent said they didn’t think there was a policy in place. One reply discussed the hospital’s plan to completely revamp their release strategy, with plans to immediately release non-sensitive blood testing and plain film radiology as soon as those tests are flagged with a final status.
In talking to my friend about her work trying to round up the results, she had some interesting stories to tell. Although many of the stories are anecdotal, they are interesting nonetheless. One hospital had decided to go to an immediate release policy and then had to go back on it, blocking release of labs from the Emergency Department. It seems that patients were getting their results from the lab before the ED staff had a chance to review and act on them, and there were several incidents of patients becoming aggressive because they knew results were available and hadn’t been addressed.
In addition to changes in how physicians address test results after the fact, the paper notes some changes to ordering behaviors. Respondents stated they were more likely to counsel patients on the potential significance of results at the time of ordering, so that the plan would be in place before the test was ever ordered. This would seem to be a big win for patient engagement, as well as for practice efficiency. I know I tended to do this when I was in traditional primary care practice, because shared decision making is a lot easier in the exam room than over the phone.
Patient portal access for adolescents continues to be a major issue, with some organizations locking out patients from ages 12 to 18. Some allow limited access for parents during the adolescent period, where others allow full parental access but require the adolescent to consent to it. Nearly all respondents grappling with the adolescent issue cited the concern that a chart with blocked information or hidden information would be a patient safety issue, although they acknowledge that there are state laws and other regulatory factors at play that make the situation difficult.
One of the other questions asked in her survey was around the ownership of the decision to release or not to release data, and when. She specifically asked whether that has changed since the institution of the patient portal. Most organizations have made changes to their release strategy and I would bet these strategies continue to evolve. In my opinion, the most significant change has been the addition of patient/family advisory groups to the discussion. We didn’t see that very often in the early days and it’s a welcome addition in my book. I haven’t edited a scholarly article in a while so it was a nice exercise, and hopefully my penmanship wasn’t too atrocious with my stiff index finger. She’ll be submitting it formally in a few weeks and I can’t wait to see it in published form.
For me, though, it’s back to Netflix. What’s your favorite streaming series? Like to binge watch? Email me.
McKesson may sell its health IT business unit to focus efforts on its core drug distribution business. The business unit is valued at an estimated $5 billion.
Fortune’s Dan Primack argues that Theranos CEO Elizabeth Holmes never should have been listed as a billionaire by Forbes because her worth was based entirely on her ownership stake in a company whose value was set by “a small group of outside investors.”
Intermountain Healthcare, Stanford Cancer Institute, and Providence Health & Services launch a data-sharing network that will transmit genomic data from cancer research to help oncologists develop more effective treatment plans.
ProMedica Bixby and Herrick hospitals (MI) informs 3,500 patients that their records were breached after an internal investigation found that seven employees were accessing patient records without justification.
HIStalk Text Ads Big audience, low price. Seven lines on the most talked about site in the industry. Easy - your ad starts in hours and is seen by thousands of visitors each day. more ...
The primary point of using the Cloud is using operating expenses vs limited capital ones and avoiding having to update…