Recent Articles:

Morning Headlines 1/18/16

January 17, 2016 Headlines Comments Off on Morning Headlines 1/18/16

New Guidelines Nudge Doctors to Give Patients Access to Medical Records

The New York Times covers the recent OCR clarification reminding providers of their obligation to provide electronic copies of medical records to patients.

NHS out-of-hours GP service 12-hour wait ‘clinically unsafe’

In England, NHS callback times have reached 12 hours for patients calling out of hours with non-emergency conditions, a situation some describe as a “significant risk to patient safety.” The delay is blamed on a shortage of doctors and inefficient call handling.

Privacy-breach discipline against 24 of 48 health-care workers withdrawn

In Canada, 24 healthcare workers accused of inappropriately accessing medical records have had disciplinary actions against them dropped after a nurses union successfully argued that the hospitals policy was unclear.

Comments Off on Morning Headlines 1/18/16

Monday Morning Update 1/18/16

January 17, 2016 News 1 Comment

Top News

image

The New York Times takes public the recent OCR clarification for providers whose patients request copies of their medical records. An American Hospital Association SVP says the guidelines are “a helpful reminder,” the need for which she didn’t mention – that most of AHA’s members do everything they can, including citing non-existing policies or legal requirements, to avoid giving patients copies of their own information.

The statement was welcome, but areas of concern might be:

  • The law was already in effect and was being widely ignored by doctors and hospitals, with no announcements of any resulting fines or enforcement actions.
  • Patients will need to understand their rights and how to complain to OCR, which 99.99 percent do not.
  • The effort required to file a complaint – and the potential for disrupting the provider relationship for doing so — will discourage most people from notifying OCR even if they know how.
  • Providers still have a ridiculous amount of time to provide records that are most likely stored electronically.
  • Many hospitals use release-of-information companies to handle patient records requests, allowing those companies to bill high per-page charges. It’s not clear to me whether that practice will be abolished since OCR’s requirements affect providers, not third parties.
  • It would be nice if insurance companies, which have a lot more clout with providers than patients, would accept and manage records requests of their insured patients.
  • OCR will have to respond to an increasing volume of complaints, which given their lack of response to a complaint I filed in July 2015 for exactly this situation from either the hospital or OCR, seems unlikely.
  • OCR hasn’t done much to stop HIPAA violations, rarely using its power to levy fines.
  • The only positive outcome for a patient who files an OCR complaint is finally getting the records, probably after a long delay in which their clinical value has been greatly reduced.

Reader Comments

From MU Later: “Re: your comment that CMS might be disappointed by how ONC has run Meaningful Use. ONC does not manage the program – that is solely done by CMS. ONC provides certification parameters and feedback to CMS, which is free to do whatever it wants.” I admit that I incorrectly think of ONC as being in charge of Meaningful Use since I’m not all that knowledgeable about the inner workings of ONC, CMS, and HHS or how much of ONC’s effort involves MU. Reading about the initial implosion of Healthcare.gov and the political differences between federal “agencies” and “offices” with their sometimes dueling fiefdoms and competing CIOs made me glaze over.

image

From Pustular Exudate: “Re: CareCloud. Of the 10 leadership positions listed on their website, nine are held by men. The one female is the head of HR.” CareCloud’s executive team is therefore 90 percent male, compared to Cerner (80 percent), McKesson (78 percent), Allscripts (92 percent), Athenahealth (90 percent), Meditech (62 percent), and Nordic (54 percent), just to list a few companies that I chose randomly.

image

From Gettin’ Jiggy: “Re: Becker’s Hospital Review. I wondered who is doing those clicky, empty stories. New grads, that’s who. Checked their LinkedIn employee list.” Reviews on Glassdoor say things like, “This is not journalism … editors suggested that writers rerun quotes and portions of old features and cobble them together to create new content” and “recapping real reporters’ healthcare news to spit out on our sites … working on a feature story with some sort of catchy, click-friendly title like ‘7 Ways to Make More Money.’” They are the industry’s Buzzfeed, cranking out click-baiting headlines and mindless lists from content reported better elsewhere, read by folks who can’t resist the temptation of journalistic junk food. I can’t fault it – it apparently has quite a few readers and its employees say it makes a fortune for the owner.


HIStalk Announcements and Requests

image

Two-thirds of poll respondents aren’t interested in company funding announcements. New poll to your right or here: what impact will providers see from CMS’s planned changes to the EHR incentive program?

image

Mrs. Perez is a new teacher in the gifted program of her Florida school and reports that her students are using the portfolios we provided via her DonorsChoose grant request to organize and present their materials when they attend their gifted class. She isn’t allowed to send photos that include student faces, but was nonetheless creative in having them pose with their “thank you” signs attached to their brand new portfolios.

image image

Ms. B checked in from her Illinois kindergarten class, for which our grant provided STEM exploration kits. She provides some background: “Thank you for providing my little scholars with the opportunity to experience the STEM activities from this proposal. You may say, ‘why linking monkeys?’ Well, just look at the joy on my students faces when they’re using the linking monkeys to learn the standard of number representation… What about the classifying chart? My scholars love to size up the various pictures and debate on who has it correct. Is a bus larger or smaller than a ball?”

image

Recruitment and consulting firm Healthcare IT Leaders donated $1,000 to DonorsChoose to secure a presenter spot at my CIO lunch at HIMSS (contact Lorre if you would like to do the same or to volunteer as a CIO attendee). I’ve exhausted the matching funds from my anonymous vendor executive, but I was still able to use dollar-for-dollar matching funds from third-party foundations to fund these teacher grant requests from their donation:

  • Five tablets and three headsets for Ms. Johnston’s elementary school class in Aurora, CO
  • Math manipulatives for Ms. Krieg’s fourth grade class in Round Lake, IL
  • Math center games for Ms. Yoder’s first grade class in Jacksonville, TX
  • A library of 13  literacy and numeracy DVDs for Ms. White’s kindergarten class in Phoenix, AZ
  • Two Osmo gaming systems for Mrs. Jochum’s elementary school class in Norfolk, NE
  • Math games for Ms. Medel’s fifth and sixth grade classes in Indianapolis, IN

My new dentist offers a $400 per year plan for patients without dental insurance that includes two cleanings, a whitening treatment, annual exam with x-rays, and a 30 percent discount on other services. I was running the numbers to decide whether I’d be better off dropping dental insurance and paying him directly when I realized that the most valuable contribution of insurance companies is to negotiate pricing in their contracts. His list price for a filling is something like $240 vs. the insurance-negotiated price of just over $100, so his 30 percent member discount would leave me paying $168 ($240 x 0.7) vs. $40 with insurance ($100 x 0.4 since insurance covers 60 percent of the negotiated price). I’m back to my never-ending question – why do providers charge so much more for cash-paying patients as a “cash surcharge” rather than a “cash discount?” Maybe it’s naive to think that they should offer the same rate to everyone, but that’s how it seems to me. It’s easy to understand why ever-expanding big health systems are increasing prices through pricing power rather than decreasing them through efficiency – because they can.


HIStalkapalooza

image

About 900 folks have signed up to attend HIStalkapalooza, so the window will soon close on your opportunity if you aren’t one of them. Barry and Jennifer will host again, the red carpet is set, and at least three HISsies winners will appear on stage. The good news is that unless I get swamped with additional requests, I’ll be able to invite everyone who signs up, same as last year. 

If you haven’t attended previous HIStalkapaloozas and are wondering why so many people rave about the band, here’s a video of Party on the Moon, who fills the dance floor literally from their first note to their last. As a music snob, I’ve never seen anything like them, which is why I keep bringing them back. They love the HIStalkapalooza crowd and are rewarded with reciprocation.


Last Week’s Most Interesting News

  • A House committee review finds that the VA’s self-developed claims processing system is being used only as a document repository despite a budget that is running double the original estimate of $580 million.
  • CMS Administrator Andy Slavitt announces the end of the Meaningful Use program in its current form in favor of “something better” in remarks delivered at the JP Morgan Health Care Conference, where he also warns that “data blocking will not be tolerated.”
  • The National Center for Policy Analysis criticizes the Texas Medical Board’s “protectionist” restrictions on telehealth, noting that the state is worst in the country in providing access to care.
  • The American Medical Association gets into the for-profit incubator business by spending $15 million to launch Health2047.
  • OCR clarifies provider responsibilities in giving patients copies of their medical records, noting that they can’t require patients to physically visit their premises, can’t refer them to an online portal, and must provide electronic copies if patients want their records in that form.

Webinars

None scheduled soon. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.


Sales

image

Duke University Health System chooses Phynd’s Unified Provider Management platform.


Announcements and Implementations

TierPoint appoints four former executives of its acquired Windstream Hosted Solutions to key leadership roles. The company offers cloud, co-location, and managed services.


Privacy and Security

image

In Canada, Alberta Health Services drops disciplinary action against 24 of the 48 employees it had accused of inappropriately accessing patient records in a high-profile case, including rehiring the one employee it had fired and paying any missed wages that resulted for all of them. The nurse and public employee unions successfully argued that hospital’s policies weren’t clear.

Montana health plan New West Health services says a stolen, unencrypted laptop full of PHI covering 25,000 people has inspired it to install “additional security on all company laptops.”


Other

I just noticed that Epic has been running job ads for Epic Hosting as “we enter the realm of multi-tenant hosting and create a data center with a cloud-based approach.” The way it describes the employer as “Epic Hosting” suggests that it’s a separate company.

image

In England, a doctor shortage is blamed for delays in returning patient calls to the non-emergency 111 service that’s run by a private company, with patients waiting up to 12 hours to hear back. Employees say they were told to falsify records to make the service appear more efficient.


Sponsor Updates

  • The Salt Lake City television station features Health Catalyst in a report on the cost of healthcare.
  •  T-System, VitalWare, and ZirMed will exhibit at the HFMA Region 11 Healthcare Symposium January 24-26 in San Diego.
  • Valence Health will exhibit at the South Dakota HFMA Winter Meeting January 21-22 in Chamberlain.
  • Verisk Health’s Sam Stearns and Jon Edwards pen a guest column on on-site clinics for Employee Benefit News.
  • Versus real-time location solutions receive Novation’s Innovative Technology designation.
  • Huron Consulting Group President and CEO James Roth shares his 2016 predictions with Consulting Magazine.
  • The local business paper profiles WeiserMazars Digital Marketing Manager Gabrielle Chwazik-Gee.
  • YourCareUniverse releases the latest edition of The Navigator newsletter.

Blog Posts


Contacts

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

125x125_2nd_Circle

Morning Headlines 1/15/16

January 14, 2016 Headlines Comments Off on Morning Headlines 1/15/16

Walgreens, UnitedHealth Are In Talks To Buy WebMD

Rumors of a buyout send WebMD share prices up nearly 10 percent today, but prices tumbled after the company issued a press release stating that no acquisition was being planned. Share prices ultimately overcorrected, closing down 7.7 percent.

Medical Taylorism

An opinion piece published in NEJM argues that EHRs, while “introduced with the laudable goals,” have undermined patient care by monopolizing the provider’s limited time during patient encounters. The author explains, “Open-ended interviews, vital for obtaining accurate clinical information and understanding patients’ mindsets, have become almost impossible.”

Athenahealth CEO uses CPR to resuscitate a stranger

Athenahealth CEO Jon Bush, a former EMT and combat medic, provides CPR to a man who had collapsed, commenting about the encounter afterwards, “It was like the US health care system. Everybody was standing there, nobody was helping.”

Chief Information and Technology Officer

In England, the NHS publishes a job description for a national chief information and technology officer to lead “the strategic procurement and successful implementation of the information and technology priorities that will support a modern, sustainable health and care system.”

Comments Off on Morning Headlines 1/15/16

News 1/15/16

January 14, 2016 News 5 Comments

Top News

image

WebMD shares rise on the rumor that the company is up for sale, with Walgreens and UnitedHealth Group named as possible acquirers. The share price dropped back to previous levels when the company denied the rumors.


Reader Comments

image

From Lax It Is: “Re: CareCloud. Missed 2015 revenue numbers wildly and its strategic partnerships have fallen apart. Sales execs are being axed and a high-level executive is being let go although the company is trying to keep it under the radar.” Unverified. I reached out to the company but haven’t heard back.

image

From Darned Kids: “Re: Cerner. I’m CIO at a health system implementing Cerner. We’re having trouble with resources, mostly leadership. A Department of Defense halo effect that I am battling with.”

From Beautiful Loser: “Re: Quality Systems/NextGen. Following its purchase of Health Fusion, the company is ceasing development of its next-generation ambulatory product and is laying off the entire Austin office. Everyone is seeking jobs at Mirth and other QSI divisions. What a waste of time and money to scrap the new system after three years of work.” Unverified. The company has so far not responded to my offer to comment.

image

From Pushing Daisies: “Re: Leidos Health. They are definitely recruiting for Epic people.”

From CMIOHio: “Re: CMIO lunch at HIMSS. Are you having another one this year?” I’m not opposed to the idea, but it won’t be as easy since the Bistro HIMSS lunch service program right on the exhibit floor isn’t offered in Las Vegas. I’m open to suggestions.

From NantWatch: “Re: NantHealth. The head of sales and business development has abruptly quit.” Unverified. His LinkedIn profile remains unchanged and there’s no executive page to check on NantHealth’s site since the only person listed has always been founder Patrick Soon-Shiong, not that he has a outsized ego or anything.

image

From Justa CIO: “Re: Denver Health. How many CIOs will have their careers either tarnished or blown up due to Epic? The body count continues and adds credence to the not-so-funny joke of how many CIOs does it take to do Epic? Three: (a) the one who was there when it was picked; (b) the one who implements it; and (c) the one who comes in after the financially driven bloodshed after the install. What is the cause of this effect? I would love to see thoughts other than my own.” I’ll hopefully be able to provide a bit more insight shortly as I’ve been working on a report with the Peer60 folks about Epic sites, in which we surveyed a bunch of CIOs, CEOs, CFOs, chief medical officers, and chief nursing officers to get their candid assessment of their Epic projects. I asked some blunt questions and got some great answers that I’ll make available for free once we’ve written everything up.

image

Here’s what one health system CEO said in my Epic customer survey: “Epic has increased our operating cost at a time when we had no ability to absorb that cost. The Epic EHR, at least until now, has not added an strategic advantage or underlying improved operations.” In contrast, a CIO said, “Epic has been a great vendor and partner of ours for over 10 years. I continue to get more impressed with them in most things through time and have yet to find another vendor (for any application) that is even close to matching up with them in quality, support, and future viability.” By the way, thanks to the many folks – including around 100 Epic-using CIOs — who responded to the survey.


Reader Gripes

  • New CIOs who come into a hospital IT department that has had relative success for many years and the first new package they want to install is employee productivity software. Or worse yet, manual logging of time spent on every activity. How much good ever comes from this morale-busting practice?
  • The VA system. The latest news of the Phoenix employees surfacing elsewhere in the system is just BEYOND outrage but wait, it’s the government—screwing the people that laid down their lives to keep us free.

You can sound off about your gripe or you can even say something positive if you’d rather.


HIStalk Announcements and Requests

Thanks to Nordic, Xenergy Healthcare, BlueTree Network, XL Health Partners, and Dak Systems Consulting, all of which offered to run the check-in table at HIStalkapalooza. It’s gratifying to mention a need and have so many people volunteer. Santa Rosa Consulting offered quickly and is taking charge admirably, even reviewing the possibility of using electronic invitations and barcode-powered check-in to shorten the line, something I’ve always wanted to do.

image

I’m declining to comment on the President’s so-called “cancer moon shot” because I think that concept is well-intentioned but naive, this perception that cancer is a single, curable disease that can be defeated by throwing money at research, having technology geeks lovingly stroke their Watson or NantHealth computers, or encouraging people to run around while wearing pink in October. Americans in general and non-scientist politicians in particular love the idea that bold innovation and taxpayer money can fix specific problems, but what we really need in US healthcare isn’t diagnostic supercomputers, gene editing, and yet another data-spewing wearable that benefit a small percentage of the population at best. We need to embrace the public health approach to improve the health of the most people, which involves far less sexy work such as:

  • Focusing on the 80 percent of health that has nothing to do with impressive buildings containing people wearing scrubs. “Healthcare services delivery” is a small subset and a not necessarily major determinant of “health” despite its budget-busting cost.
  • Making healthcare services affordable and accessible to everyone since we’re going to pay collectively for the consequences.
  • Reducing the prescription and non-prescription drug epidemic that has a big chunk of the population stumbling around in a mind-altered haze, pocketing cash for fueling it, or being expensively supported by taxpayers while incarcerated because of their role in it.
  • Turning healthcare into something other than profit center for drug and device companies, supposedly non-profit hospitals, insurance companies, and procedure-cranking specialists.
  • Addressing obesity and physical inactivity as the only exercise more and more Americans get is lifting their forks and their phones to their faces.
  • Dealing with mental health problems that cause expensive overreliance on EDs and community organizations.
  • Increasing patient engagement responsibly, allowing patients an equal say in how their health is managed  while committing to education to stop their irresponsible requests for narcotics, antibiotics, and over-advertised prescription drugs.

image

We funded the DonorsChoose grant request of Ms. Carbo in Georgia in purchasing an iPad Mini and programmable robot to teach programming to her first graders and to allow them to participate in the Hour of Code. She sent some photos, including the one above.

This week on HIStalk Practice: Dr. Gregg thinks HIT might benefit from a little rock-n-rollness. GE Healthcare relocates to the US. Teladoc reports record revenue and visits, while American Well touts its top-app ranking. CMS releases its latest round of MU EP payment figures. Fitbits become one university’s link to student fitness and academic performance. Lyft gets into healthcare.

This week on HIStalk Connect: Flatiron Health raises a massive $175 million Series C to further develop its oncology EHR and clinical decision support platform. Researchers from multiple labs are working to change the way cancer screenings are conducted. Higi raises $40 million to expand its health and wellness platform. AiCure, backed by $7 million in NIH grants and a fresh $12 million Series A, works to solve medication non-adherence with an artificial intelligence platform.

image

It’s odd that Andy Slavitt from CMS moved so quickly from MU Stage 3 cheerleading to distancing himself from it in proudly announcing that it will be going away via Twitter this week. Maybe HHS is unhappy about how ONC has managed the program, or it could be that the endless whining of provider organizations about it was wearing thin, or perhaps it relates to the upcoming elections. Surely John Halamka’s call for its demise must have rattled the federal folks given his long and constructive involvement with the federal programs. I asked John what he thinks and he expanded on his Thursday blog post:

image

This is a general consensus among healthcare systems in the US that prescriptive regulations will not work. My feeling from speaking with many stakeholders in industry and government is that MACRA will offer incentives (not penalties) for achieving an outcome without mandating a workflow or requiring certified technology. Instead of “reconcile medication lists 80 percent of the time for transactions sent 50 percent of the time and incorporated 40 percent of the time,” the outcome might be, “Improve patient compliance with medications.” If you do that with Apple Watches and a patient-facing medication administration app, great. If you send high school students with a clipboard to inventory a patient medicine cabinets (with their consent), that’s OK too.


HIStalkapalooza

image

Signups are still open for HIStalkapalooza, which promises to spice up the otherwise mundane Monday (the equivalent of Sunday in non-Las Vegas HIMSS days). The HIMSS conference opening reception won’t have the fabulous Party on the Moon band, stage show, and the HISsies.

Sponsors of HIStalkapalooza 2016 are:

image
image
image
image
image
image
image
image
image
image
image

HIStalkapalooza Sponsor Spotlight

image

Validic provides the industry’s leading digital health platform connecting providers, pharmaceutical companies, payers, wellness companies, and healthcare IT vendors to health data gathered from hundreds of in-home clinical devices, wearables, and consumer healthcare applications. Validic was named to Gartner’s “Cool Vendors” list, received Frost & Sullivan’s “Best Practices and Best Value in Healthcare Information Interoperability” and was recently featured as a “Top 10 Healthcare Innovating Disruptor” in Forbes. Its scalable, cloud-based solution offers one connection to a continuously-expanding ecosystem of consumer and clinical health data, and reaches more than 223 million lives in 47 countries. Check them out at validic.com, on Twitter @Validic, or at their HIStalkapalooza Cabana on the House of Blues dance floor.

image

The CIO lunch to raise money for DonorsChoose will be Wednesday, March 2 from 11:00 a.m. until 1:00 p.m. at Maggiano’s Little Italy, just down the street from the convention center. A $1,000, tax-deductible vendor donation will provide admission to one person who will provide a company overview and then socialize with volunteer CIOs such as Dana Moore (Centura), Ed Marx (NYC Health + Hospitals), Drex DeFord (freelance consultant), Ari Entin (Natividad Medical Center), Chuck Podesta (UC Irvine Health), Steve Hess (UCHealth), and others helping out for a good cause. I’m paying for lunch, so all the money goes to DonorsChoose. Contact Lorre to sign up, either as a CIO or donating company. I’ll announce everyone who is involved.


Webinars

None scheduled soon. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.


Acquisitions, Funding, Business, and Stock

image

GE will move its global headquarters from Connecticut to Boston to avoid high Connecticut taxes and to gain access to technology organizations and talent. Boston and Massachusetts are providing up to $150 million in incentives.

Practice Fusion says its 2015 revenue grew 70 percent.

CVS Health announces affiliations with John Muir Health, University of Chicago Medical Center, Novant Health, and University of Michigan Health System in which it will exchange EHR information and offer services from its MinuteClinic locations. All of the organizations, including CVS, use Epic.


Sales

image

Parkland Health & Hospital System (TX) expands its use of Kaufman Hall’s products to include cost accounting and capital planning software.

In Australia, St. George Hospital chooses Spok for radiology result notification to smartphones.


People

image

WEDI President and CEO Devin Jopp, EdD resigns to start a consulting firm.

image

Tim Kuebelbeck (NantHealth) joins LogicStream Health as EVP of sales.

image

Stuard Hammond (SCI Solutions) joins Forward Health Group as VP of sales.


Announcements and Implementations

HIMSS Analytics launches Logic, a more personalized, dashboard-driven version of its HIMSS Analytics Database. It will offer demos, not surprisingly, at the HIMSS conference.

Health plan MDwise will extend its use of ZeOmega’s Jiva population health management solution to monitor medication adherence and safety.


Government and Politics

image

The House Committee on Veterans Affairs reviews the VA’s “over budget and underachieving” self-developed claims processing system system, the cost of which is running double the original $580 million estimate at $1.3 billion and counting. Committee Chairman Congressman Jeff Miller (R-FL) says the Veterans Benefits Management System (VBMS) was supposed to fully support disability claims and pension applications but is only being used as a document repository for appeals. Testimony from the GAO says the system was designed only to serve as that document repository and delayed timelines are due to scope creep in extending its capabilities. GAO also concludes that the VA’s agile development methodology has prevented it from setting firm completion estimates, timelines, and deliverables.

image

In England, the NHS posts a job opening for the newly created position of CIO/CTO.

image

Florida eliminates decades-old quality standards for pediatric heart surgery following big political donations from for-profit hospital operator Tenet, which owns a hospital that had earned widespread media coverage for its poor outcomes. Death rates for pediatric heart surgery at Tenet’s St. Mary’s Medical Center were triple the national average while performing only 27 cases per year, information CNN had to obtain through Freedom of Information Act requests since the hospital refused to publish the data publicly and tried to block CNN’s investigation. CNN’s report aired in June 2015 and the state dropped the standards in July, claiming that the Department of Health didn’t the Legislature’s approval to implement them in  1977. The hospital closed the program and the CEO resigned in August.


Technology

image

Oral Roberts University will track the physical activity of all of its incoming students, who will be required to purchase Fitbits. The university had previously required all students to log their exercise in a fitness journal as part of its Whole Person Education program.

image

TechCrunch profiles Medal, which claims its software can be installed on a doctor’s computer in 60 seconds and can then move EHR information around to other providers. “We’re hoping to create true interoperability for the first time in this country,” says the founder. 


Other

image

Athenahealth CEO and former emergency medical technician Jonathan Bush elbows observers aside outside the JP Morgan Healthcare Conference to perform CPR on a man who had collapsed on the sidewalk. Bush did mouth-to-mouth as another good Samaritan handled compressions. Bush describes, “It was like the US healthcare system. Everybody was standing there, nobody was helping.” It’s a public relations bonanza for Athenahealth, which just happened to have a camera on hand to snap an action photo.

An opinion piece in NEJM decries the forced, efficiency-driven “one best way” standardization of the physician-patient encounter that is causing dissatisfaction and burnout as patients find themselves answering EHR-driven checklist questions instead of being allowed to speak freely. It adds,

Encounters have been restructured around the demands of the EHR: specific questions must be asked, and answer boxes filled in, to demonstrate to payers the “value” of care. Open-ended interviews, vital for obtaining accurate clinical information and understanding patients’ mindsets, have become almost impossible, given the limited time allotted for visits — often only 15 to 20 minutes. Instead, patients are frequently given checklists in an effort to streamline the interaction and save precious minutes. The EHR was supposed to save time, but surveys of nurses and doctors show that it has increased the clinical workload and, more important, taken time and attention away from patients.

image

In South Australia, technology vendor Global Health wins the EHR business of Adelaide Primary Health Network despite the company’s ongoing legal battle with the South Australia government, which refuses to stop using a 1980s Global Health application that the company insists has been sunsetted.

image

An Oregon health news site reports that PeaceHealth’s former president was fired in 2014 because of declining profit margins and problems with its implementation of Epic.

Bizarre: drug companies are chasing underage hemophilia patients like colleges pursue star high school athletes — hiring their relatives, taking them to dinner, infiltrating disease support groups, and paying recruiters (often patients themselves) a percentage of drug sales in hoping to convince the patients and their families to use drugs that cost up to $1 million per year (paid by insurance companies and taxpayers, of course, not the patient or families being courted).

image

Weird News Andy says that a good cleaning was apparently “out of scope” as a Senate investigation determines Olympus knew that the design of its duodenoscopes made them hard to clean, which caused at least 141 patients to become infected while undergoing procedures. WNA concludes that, “Clarence Darrow would not monkey around, he’d just win this trial.”


Sponsor Updates

  • Leidos Health will exhibit at the Meditech Executive Institute January 17-19 in San Diego.
  • Medecision CMO Ellen Donahue-Dalton discusses the consumer healthcare experience at the Atlanta CMO Breakfast series.
  • Nordic representatives will attend the HIMSS Dallas/Fort Worth Chapter event January 22 in Arlington, TX.
  • Recondo recaps 2015 and offers 2016 RCM predictions.
  • PeriGen CNO Becky Cypher, RN contributes to a study on the effect of elective induction on C-section delivery rates published in Obstetrics & Gynecology.
  • Summit Healthcare will exhibit at Meditech’s MUSE Executive Institute January 17-19 in San Diego.

Blog Posts


Contacts

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

125x125_2nd_Circle

EPtalk by Dr. Jayne 1/14/16

January 14, 2016 Dr. Jayne Comments Off on EPtalk by Dr. Jayne 1/14/16

clip_image002 

In the early days of Pay for Performance, many physicians and patient advocates worried about the practice of cherry-picking patients. They feared physicians would refuse to take more complicated patients who might negatively impact their quality metrics. We didn’t see a significant spike in situations where patients were terminated from the practice, but in those days, the stakes were significantly less high than they are today.

Today we not only fail to realize an incentive if our quality doesn’t measure up, but we are at risk of actually being penalized. This grates on those of us who strive to do right by our patients but simply can’t control their behavior no matter how much motivational interviewing we conduct, what support systems we provide, or how well we try to partner with our patients.

I’m wondering if we’re about to start seeing the feared spike in patients who are asked to leave physician panels. My suspicions started when I saw a recent article in one of the throw-away practice journals that talked about the “right” way to terminate a physician-patient relationship. Some of the overtones involved patient non-compliance.

I’m not against the idea of terminating a patient for failure to follow the care plan, but have only done it when the patient’s failure to follow the plan was directly putting their life at risk and I felt that we had reached an impasse where they no longer trusted my judgment and I could no longer be effective as their physician.

Since that first article, however, I’ve seen at least three more. The most recent one specifically addressed the idea of terminating patients when their failure to comply impacts quality measures. Some of the concepts discussed were well past the “slippery slope” stage, so I hope this isn’t where we’re headed.

I had a recent experience where a patient who was branded as a controlled substance drug seeker turned out to have a much more complicated situation. Although she indeed had become dependent on narcotic pain medications while appearing to have no physical findings to support the need, she was eventually found to have an extremely rare condition that was only identified after visits to multiple specialists across several disciplines. Her pain was legitimate, but vague enough to make her potentially appear as if she was a liability concern.

I personally had only seen her once before and she expressed concern about making sure that her records reflected her recent surgery. The only problem was the fact that she was again at the urgent care with pain, stating her regular physician was unreachable and that the medications she had at home were not working.

Thinking about it from the other direction, though, putting on my value-based-care hat, it would certainly be cheaper to keep her in an ambulatory practice and just keep her supplied with pain pills than to get her into a pain management treatment program or have her turn up in the emergency department (at least in the short term). That’s where the equations measuring quality, cost, and access become less reliable than they might otherwise be.

clip_image004

A reader asked about my recent purchase of a Surface Pro 4 just prior to the holidays and what I thought about it after several weeks of use. Other than some self-inflicted casualties (like deleting my Outlook data file on accident and purging my trash before I realized it) it’s been a generally good experience. I love the fact that it’s more powerful than my previous laptop yet much lighter, although the keyboard is such that I can’t use it on my lap without a lap desk. I haven’t used it much in non-keyboard mode but the ability to use the touch screen while typing (just reach up, swipe, tap, whatever) feels like it’s more efficient than mousing or using the keyboard’s touch pad, especially when working with PowerPoint.

I had some initial bad experiences with the charging cable. Although it’s cool and magnetic, it’s at an odd place on the tablet and the cord seems pretty short. Because of the length and position position, it’s always bent at a 90-degree angle, which I’m guessing will wear it out. It would be “plugged in, not charging” for no good reason. That seems to have settled down quite a bit, but I haven’t figured out the battery life.

On my trusty Dell laptop, when it hibernates, it uses no power at all. The Surface seems to consume power even when it’s in sleep mode, sometimes akin to the way that college students consume tequila on spring break. It’s intermittent, though, and I can’t find a pattern.

The only other negative is because I’m a creature of habit, and that’s the problem that I can’t run Microsoft Money on Windows 10 without hacking the registry. (Yes, I’m using software that was sunset in 2009, because it’s free, works well, and provides continuity for my data.) I’m looking for new financial software, though, and would appreciate any recommendations. I use QuickBooks for my consulting business, but it’s more trouble than I need for home finances.

Bottom line though, I’d still buy it again. Two of the vendors I work with have gone to Surfaces for all their executives, which is what finally convinced me to take the leap.

clip_image006

I finally had some quality time to sit down today with the HIMSS agenda. I was hoping to plot out a strategy for trying to obtain the American Board of Preventive Medicine LLSA credits required for those of us who are board certified in clinical informatics. Those of us who certified in the first year have to finish 30 hours by the end of 2016 and unfortunately my recent trip to the AMIA Symposium didn’t net me as many as I had hoped.

Although the conference says it’s approved for up to 19 hours of LLSA credit, I couldn’t figure out how to determine which of the 300 sessions were approved. ABPM is fairly picky about how they give credit and attendees generally have to complete questions for each activity, so I want to make sure I do it right. I found a couple of links but unfortunately became trapped in a circle of “page not found” errors.

Have you cracked the code for LLSA credit? Email me.

Email Dr. Jayne.

Comments Off on EPtalk by Dr. Jayne 1/14/16

Morning Headlines 1/14/16

January 13, 2016 News 2 Comments

Lawmakers Blast $1.3 Billion Price Tag For VA’s ‘Agile’ Paperless Claims System

Lawmakers are questioning the cost projections of the VA’s new paperless claims system as its total cost approaches $1.3 billion, more than double its $579 million budget. The VA is using agile development methodologies on the project and requests funding for new functionality annually. The system is credited with shrinking the disability claims backlog to 80,000, the lowest in the VA’s history.

Digital health firms, say goodbye to easy venture capital

Analysts at the JP Morgan Healthcare Conference forecasted a contraction in digital health investments in 2016 due to poor healthcare IT stock performance. GE Ventures director Ruchita Sinha says, “There will be a correction. There’s a strong sense of realism coming back into the market.”

Devin Jopp Resigns as President and CEO of WEDI

WEDI president and CEO Devin Jopp resigns and is now the CEO at Future Focus Health, a health IT consulting agency. The WEDI Board of Directors has formed a search committee to identify a replacement.

Morning Headlines 1/13/16

January 13, 2016 Headlines 1 Comment

Comments of CMS Acting Administrator Andy Slavitt at the J.P. Morgan Annual Health Care Conference

CMS Administrator Andy Slavitt announces that Meaningful Use will soon be shut down, explaining “Now that we effectively have technology into virtually every place care is provided, we are now in the process of ending Meaningful Use and moving to a new regime culminating with the MACRA implementation.”

Why Shares in McKesson Slumped 10% Today

McKesson shares fell 10 percent after dropping the upper limit of its 2016 EPS forecast from $13.00 to $12.90.

Electronic Health Record-Related Events in Medical Malpractice Claims

A study analyzing malpractice claims from 2012-2013 uncovers 248 cases in which health IT was cited as having caused patient harm. 80 percent of the health IT related claims resulted in moderate or severe harm to the patient.

The Doctor Will See You Now?

The National Center for Policy Analysis publishes a report critical of the Texas Medical Board for its efforts to limit telehealth visits in the state, noting that Texas ranks last in the country for access to medical care.

News 1/13/16

January 13, 2016 News 3 Comments

Top News

image

The Meaningful Use program will be shut down soon, according to a series of tweets from CMS Administrator Andy Slavitt from the JP Morgan Healthcare Conference. He says it will be replaced by outcomes-based measures, with details to follow in late March. The full transcript of Slavitt’s comments is here, in which he says:

The Meaningful Use program as it has existed, will now be effectively over and replaced with something better … the focus will move away from rewarding providers for the use of technology and towards the outcome they achieve with their patients. Second, providers will be able to customize their goals so tech companies can build around the individual practice needs, not the needs of the government. Technology must be user-centered and support physicians, not distract them. Third, one way to aid this is by leveling the technology playing field for start-ups and new entrants. We are requiring open APIs in order to the physician desktop can be opened up and move away from the lock that early EHR decisions placed on physician organizations so that allow apps, analytic tools, and connected technologies to get data in and out of an EHR securely. And finally, we are deadly serious about interoperability. We will begin initiatives in collaboration with physicians and consumers toward pointing technology to fill critical use cases like closing referral loops and engaging a patient in their care. And technology companies that look for ways to practice “data blocking” in opposition to new regulations will find that it won’t be tolerated.

From Iroquis: “Re: Andy Slavitt CMS tweets. Isn’t CMS prohibited from unilaterally commenting on MU or other policy changes? And ‘deadly’ serious – gimme a break.” I don’t know what he’s allowed to tweet about, but it does seem unusually frank. “Deadly” doesn’t seem like the best choice of words given the subject and I don’t know that showy Mom-like threats will change anything in the absence of specific definition, legislation, and investigation.


Reader Comments

image

From FlyOnTheWall: “Re: medical transcription and coding provider Amphion. The grapevine says it has been acquired by competitor IMedX, which if true would be one of the larger recent deals in the space as the HIM follows the EHR market in consolidating.” IMedX responded to our inquiry and confirmed the acquisition. We also reached an anonymous IMedX insider, who offered some unverified opinions:

  • The IMedX CEO came from poorly regarded C-Bay and shifted the company’s emphasis from sales to mergers and acquisitions, resulting in a “rat’s nest” of 17 supported systems that are difficult to manage.
  • The IMedX business model is to grow dangerously fast and hope to sell quickly to the highest bidder.
  • The transcription market has been decimated by EHRs, so IMedX is trying to boost its coding revenue.
  • Two recent company acquisitions saw their KLAS scores drop 10-20 points afterward.
  • Amphion employees are being let go without notice. One found out that he had been fired when he couldn’t log in to his work computer.

image

From Ample Sample: “Re: Peds2040 conference last week. It was great and covered AI, big data, 3D printing, genomics, and health IT. I was blown away by how much cool stuff is going on at peds centers and by the energy, intelligence, and positive feelings there. This was a Patients Included conference, with patients and their parents involved both as attendees and speakers, helping attendees remember the humanity of what we do.” I hadn’t heard of Patients Included, which requires conferences that use its logo to attest that they will:

  • Involve patients in the program’s design.
  • Invite them as attendees to all sessions.
  • Pay the travel costs for patients who are presenting.
  • Accommodate any disabilities.
  • Offer free streaming video when possible to support virtual participants.

From In the Wind: “Re: McKesson. Paragon employees jumping ship are being replaced by offshore employees. At least two clients that were moving from Horizon to Paragon have abandoned their efforts.” Unverified. Jenn is reaching out to current and former Paragon and Horizon customers to get a feel for what’s going on. Let me know if you’re one and willing to speak on or off the record.

image

From SeahawkDoc: “Re: new UCLA Health CEO Johnese Spisso. Word is that she left University of Washington Medicine because of an impending $500 million Epic price tag that she was previously championing. The CFO also retired at the end of 2015. Seems like no one wants to be left holding the hot potato.” Unverified.

From Little Caboose: “Re: HIMSS16. My employer has rejected my travel request. Should I spend $4,000 and use vacation time to meet friends and former colleagues and hopefully accelerate my job search?” I would spend the money in hopes of making the right contacts, especially since your employer has declined to pay and thus is questioning (a) your importance to them; (b) the value of the conference; or (c) their ability to fund the travel. Registration will set you back $865 if you sign up by February 2, although maybe you know a vendor who will slip you one of the exhibitor’s badges that they usually have in abundance. Bid an off-Strip hotel on Priceline for maybe three nights and don’t plan to spend much on food and entertainment because it will be everywhere at no cost. The biggest expense will be the flight, but you could even compare the cost of flying to Los Angeles, Phoenix, or other not-too-far cities and driving a rental car to Las Vegas. It will be worth whatever the cost if it lands you a better job, which could happen if you reach out to your contacts (through LinkedIn, for example) and let them know you’re interested in talking to companies that week.

image

From Supplemental Fluids: “Re: JP Morgan conference. Sign of a bubble!”

From Graying CIO: “Re: Meaningful Use. CMS Administrator Andy Slavitt said at the JP Morgan Healthcare Conference that data blocking will not be tolerated. Interoperability and data blocking are two separate topics. Our lack of focus on making interoperability work (blame that we all share equally — vendors and health systems alike as well as a MU schema that undervalued actual data sharing) does not equal data blocking. There are many of us who do not have well-developed systems to share patient data easily. That does not mean that we are actively data blocking or seeking to retain information for our own gain.” The data blocking issue is receiving unwarranted government attention due to some poorly researched news stories that provided no evidence that the practice exists. The term suggests a level of intent that would be impossible to prove.

image

From Pee Gee: “Re: drive-up window of my local pharmacy. I thought you would get a kick out of the ‘HIPPA’ sighting!” It’s a slippery slope when people try to make unpronounceable acronyms into words because, as here, reverse engineering them back into the original acronym is fraught with potential error. We should have stuck with sounding out each letter or reducing the number of letters. How would you spell “JCAHO” (or now Joint Commission) if all you heard is people pronouncing it “Jayco?”

From Fly on the Wall: “Re: Mike Tarwacki, Zynx Health SVP of sales and marketing. Is out of the company for reasons unknown.” Unverified, but his executive bio page has been expunged.

image

From Rational Exuberance: “Re: DonorsChoose. The reader’s comment that it sounded like your write-ups are bragging is nuts. Your style in describing the wonderful results attained by small amounts of money is perfect and they are more likely to give when they can see the direct result. I’ve thought once or twice that you might overtly ask readers to contribute. The only thing you might to differently is add more photos of the faces of the recipients – the smiles and excitement about learning on their faces shows how much it’s worth it.” I’m uncomfortable asking readers to donate since everybody’s charitable works are their own business, so I’ve only provided instructions when someone asked. Readers can also donate directly to DonorsChoose and do what I do in finding worthy projects and matching funds. With regard to photos, I think some schools must have a policy of not running student photos since it’s sometimes apparent that they intentionally omitted or obscured the faces, which is understandable.

From Woodstock Generation: “Re: TPD’s comments about VNAs from last month. They make no sense. He said it’s easier to connect to an HIE with an electronic data warehouse instead of a vendor-neutral archive, not surprising since historically EDWs manage only discrete, ASCII, structured data. The ability to federate internal storage and external data sources is something mature VNAs have done for a while. Taking the ‘A’ (archive) out of PACS accounts for perhaps 10 percent of provider value, while robust VNAs also provide bi-directional, dynamic tag mapping as well as matching disparate (image) studies, something an HIE would require. In thinking about this, perhaps a better name for VNA would be EDW or perhaps Enterprise Service Bus, operating with all sources and types of data, storage, and applications.”


HIStalk Announcements and Requests

image

Ms. Oelrich says her Wisconsin sixth grade class of at-risk students have become energized as they use the materials we provided (math manipulatives, calculators, and blank journals) in funding her DonorsChoose grant request. She reports, “In our math intervention group, students learned about fractions by playing our new Pizza Fraction Fun game. During this time, one student shouted, ‘Wait, this piece of pizza is a fraction of the whole! Math is so fun!’”


HIStalkapalooza

Signups are still open, so act now if you want to come. Several folks said “I signed up last year but wasn’t invited,” which must mean their company’s spam filter was hyperactive in rejecting my invitation since everybody who signed up was sent one. I’m amused that a couple of vendors had an admin sign up dozens of executives, a list I’ll enjoy trimming since people who can’t be bothered to sign up on their own usually don’t actually show up. Some vendors seem to think I’m throwing them a company party.

I’m a bit anxious that Sagacious Consultants has cancelled plans to handle the HIStalkapalooza check-in table again this year following the company’s acquisition by Accenture, which doesn’t want to participate. I could use a company’s help in providing a few folks to get everybody checked in, even better if they have experience with barcode-scanned invitations that would get everybody in the door more quickly. Let me know if your company can help.

Meanwhile, I’m enjoying the fun comments that folks added to their sign-up:

  • I love the nightlife. I love to boogie.
  • I’ve been a devout HIStalk follower since 2006, but have never been at HIMSS long enough to chase the Palooza dream. Hopefully this is the year I get to rub shoulders with the celebrities and snarkists, or I can assist with velvet rope bouncing since I’m bigger than their security. Thanks for all you do, keep breakin’ necks and writin’ checks.
  • Thanks HIStalk for so many good reads over the years! You guys are routine part of my workday. Actually, since I moved from the east coast to the west coast, I read it every evening before I go to sleep. So thanks for all the evenings hanging out in my bedroom. I go to sleep now with a smile.
  • Pretty sure it’s the best cardio I get every year. Who wouldn’t dance with that band?
  • FYI, I am an informatics celebrity. As a long-time clinician and informaticist, have the dubious honor of being the first person in the United States to have been sued while documenting with an electronic record. The plaintiff’s attorney contended the record of care was not mine, as I had not written it, a machine had.
  • I only seem to get to dance once a year. Hope to do so again!
  • I’m 25, this is my first job out of college, and older women seem to love me. The older women thing is certainly a contributing factor as to why I’ve made the ever-shrinking list of people my company sends to HIMSS. Whatever, I’ve never been to Vegas so I guess I’ll take it. Here’s a haiku about HIMSS: “This place is a zoo, Wish I wasn’t hung over, Give demos all day.”
  • I’ve been known to tip bartenders heavily and uncomfortably dance to the music, which in its own right is impressive given my lack of wealth and rhythm.
  • Me! Me! Pick me! In exchange I will dance, smile, laugh and generally entertain all attendees within a fair radius of my being.

Only 17 sponsors have responded to our invitation to submit information for our HIMSS guide, so this is the final heads-up for those that haven’t. Contact Lorre or the guide is going out without your company’s information in it, which would be a shame. 


Webinars

January 13 (Wednesday) 1:00 ET. “Top 5 Benefits of Data as a Service: How Peace Health Is Breathing New Life Into Their Analytics Strategy.” Sponsored by Premier. Presenter: Erez Gordin, director of information management systems, Peace Health. Finding, acquiring, and linking data consumes 50 to 80 percent of an analyst’s time. Peace Health reduced the time analysts were spending on data wrangling, freeing them up to create new actionable insights.

Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.


Acquisitions, Funding, Business, and Stock

McKesson shares drop 10 percent Monday after the company lowers the upper range of its 2016 earnings per share guidance.

image

Health media company Healthline Networks spins off Talix, its risk management analytics software business.

image

The American Medical Association invests $15 million to launch for-profit incubator Health2047, naming venture capitalist Doug Given, MD, PhD as CEO.

image

DrFirst acquires the assets of mobile e-prescribing app vendor iPrescribe.net.

image

Higi, which offers retail health kiosks for measuring and rewarding consumer health metrics, raises $40 million in funding.

image

The management of Hayes Management Consulting buys out the ownership interest of founder Paul Hayes.


Sales

image

Partners HealthCare (MA) will use QPID Health’s quality reporting system to ensure that surgical procedure decisions are evidence based.

image

UPMC will implement Health Catalyst’s data warehouse and has licensed its cost management technologies and content to the company for commercialization.

image

Meridian Health (NJ) chooses Patientco for patient-friendly billing and payments.

Reconstructive Orthopedics (NJ) selects the eClinicalWorks EHR.

Marin General Hospital (CA) signs a $90 million, 15-year agreement with Philips, which will provide the hospital with imaging systems, patient monitoring, telehealth, and informatics technologies as well as consulting services.


People

image

Ron Wozny (ZeOmega) joins Healthx as VP of marketing.

image

University of Michigan Hospitals and Health Centers CIO Sue Schade resigns and will hang out her shingle to offer consulting, coaching, and interim management.

image

Capital BlueCross hires Scott Frank (Aetna) as CIO.

image image image

Sunquest hires Rob Atlas (Atlas Medical) as SVP of strategic solutions, Tom Arena (General Genetics) as SVP of North American sales, and Andrew Branski (GE Healthcare) as VP of finance.

image image

Healthgrades names Scott Booker (Stella & Dot) as CEO. Former CEO Roger Holstein, who had been CEO since early 2012, will remain on the board but return to his venture capital firm.

Jonathan Cook (NCQA) joins Arcadia Healthcare Solutions as CTO.


Announcements and Implementations

MindLeaf Technologies will offer Security Audit Manager from Iatric Systems along with its medical compliance and support services.

HCS extends access to its HCS Interactant Incident Management to the SaaS environment.


Government and Politics

image

Public research non-profit National Center for Policy Analysis criticizes the state of Texas for restricting the use of telemedicine, noting that the Texas Medical Board has resisted efforts to expand telemedicine “with the possible exception of patients few doctors want to treat – prisoners.” It also points out that Texas is one of two states (with Arkansas) that require a face-to-face visit first and one of three (with Alabama and Georgia) in requiring an in-office visit afterward, both of which it says are “striking considering Texas ranks 51 out of 51 (including Washington, DC) for access to medical care in the United States.”

Kentucky will shut down its $290 million Kynect state health insurance marketplace, moving signups to Healthcare.gov.


Privacy and Security

A South Carolina newspaper covers several instances in which a physician practice closed without warning, failing to tell patients how to get copies of their medical records. The state is considering new regulations that would set requirements for medical records protection when a doctor “is incapacitated, disappears, or dies.”


Other

image

A review of a national malpractice claims database finds 248 cases in which health IT caused patient harm, one-third of which involving medications. The authors conclude that technology-caused harm is more significant than previous studies suggested even when looking only at those incidents that triggered malpractice lawsuits. They recommend that organizations focus on higher-risk settings (ambulatory specifically) and common problems (medications and diagnostic errors) rather than attacking a list of specific technology problems.

image

The Denver paper observes that several executives of Denver Health Medical Center have quit since a new CEO took over, also noting that the health system will spend $170 million to implement Epic after eliminating 122 full-time nurse positions in 2013. The article adds that CIO Gregory Veltri parted ways with the organization after warning his bosses that the cost of the Epic project could balloon to $300 million.

The Boston business paper covers the switch from Meditech to Epic at South Shore Hospital (MA), which was a primary reason it had hoped to be acquired by Partners HealthCare until the state nixed the deal over antitrust concerns. Now they’re implementing Epic on their own at unstated cost.

Weird News Andy seems unduly fascinated by fecal transplant news, so he urges that we “don’t poo-poo this idea” in which scientists gut microbes from thin people in capsules that obese people will take to see if it makes them lose weight.


Sponsor Updates

  • Burwood Group achieves Cisco Master Collaboration Specialization in the US.
  • Atlanta Tech Village includes Clockwise.MD’s graduation in its list of 2015 achievements.
  • CoverMyMeds recaps hosting Startup Weekend.
  • Clinical Computer Systems, which offers the Obix perinatal data system, adds new videos to its Obix University.
  • Valence Health signs a collaboration agreement with risk and benefits solutions vendor Aon.
  • First Databank VP of clinical applications Dewey Howell, MD, PhD publishes “Improving care transitions in 2016.”
  • Wellcentive CEO Tom Zajac offers “5 Population Health Management Predictions for Providers in 2016.”
  • First Databank releases a new issue brief on medication adherence.
  • Healthcare technology analysts and organizations honor Extension Healthcare throughout 2015.Blog Posts

Blog Posts


Contacts

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

125x125_2nd_Circle

Morning Headlines 1/12/16

January 11, 2016 Headlines Comments Off on Morning Headlines 1/12/16

Medical device maker Medtronic to buy back up to $5 billion shares

Medtronic raises its full-year EPS forecast from $4.33 to $4.36 and announces a $5 billion share buyback program that it will execute over the next several years.

New hospitals and health care providers join successful, cutting-edge federal initiative that cuts costs and puts patients at the center of their care

HHS announces 121 new Medicare ACOs, including 21 organizations that are the first to enroll in the Next Generation ACO Model, bringing to total number of ACOs to 477.

Texas board asks appeals court to block suit challenging telemedicine rules

The Texas Medical Board files an appeal with the 5th US Circuit Court of Appeals after telehealth vendor Teladoc won the right to proceed with its antitrust case against the board over its restrictive telehealth policies.

Barton Health First to Implement Proteus Digital Health’s Innovative Solution for Patients with Chronic Conditions

Smartpill vendor Proteus Digital Health announces that Barton Health (CA) will be the first health system to implement its medication adherence technology. The project will focus on improving uncontrolled hypertension.

Comments Off on Morning Headlines 1/12/16

Curbside Consult with Dr. Jayne 1/11/16

January 11, 2016 Dr. Jayne Comments Off on Curbside Consult with Dr. Jayne 1/11/16

Even though I haven’t been their CMIO in some time, my former employer continues to include me on many of the communications as they move forward with their migration to a single EHR platform. They just sent out a “year in review” listing some project highlights.

Although we were always strapped for staff, they’ve mysteriously found the budget to bring on more than 300 positions, the majority of which are incremental additions. I shudder to think of what we could have done with the “old” platform if we had even five more staffers. It always felt like we were holding things together with bubblegum, baling wire, and duct tape. The software was often blamed for problems that were, more often than not, due to our implementation or processes.

They also listed how many hundred hours of training, design, and decision sessions have occurred. Again, I know that had we been able to pull people away from their daily work, we could have made a tremendous difference in their user experience as well as in patient care.

Leadership appears to be on board, but I wonder if it’s because they really believe in the project or whether it’s because they know it’s a substantial financial commitment and they have to be on board. Maybe it’s also the “me too” effect since we’re the last health system in the region to move to a single product platform.

I was amused by their back-slapping about being on a single “seamless” record because they seem to be overlooking the fact that they carved out the lab systems and the revenue cycle systems. Of course they’ll be interfaced, but that’s not always what it’s cracked up to be.

I was surprised though to read that they’re going to allow the platform to be hosted outside of their corporate data centers. The mere idea of hosting anything externally was enough to make them cringe when we brought up our HIE the better part of a decade ago. I still remember making the rounds trying to twist people’s arms since I knew that independent hosting was the only way to get the community-based physicians on board.

Although they’re consolidating clinical applications, they’re bringing several new vendors into the fold. I’m not surprised since they tend to come along with some of the big-name systems these days. They provided a detailed list of what they’re keeping and will integrate with the new system and it was significantly larger than I expected.

There are whole hospital departments that will keep their same software, although it will interface to the central EHR. In some areas, the physicians will keep documentation in an external system but the nursing staff will document in the new system, which although likely intended to keep the physicians happy, feels a bit like a recipe for disaster.

Not two emails later, I received notice of the monthly fixes to the inpatient application that was written in a new format (probably in honor of the new year) that was extremely difficult to read. If you have to use multicolored highlighter on every single item, you’re probably not writing clearly enough for your audience. The amount of color on the document was enough to make my head spin. For a few moments I contemplated sending them back a user interface document on effective and appropriate use of color, but figured that I’d much rather them not know I’m reading so I can continue to play along with the home game and not risk being removed from the distribution list.

Although the EHR consolidation project is at the top of the scale for visibility, promotion, and funding, I’ve heard there are rough waters ahead. There may be an impending shakeup in the clinical leadership and possibly in the IT leadership as well.

It wouldn’t be the first CIO that we’ve seen sign up for a major initiative like this and then step out the door, although usually there are cost overruns or delays first. Maybe the CIO in question was planning to use this endeavor as his swan song all along – it’s hard to tell sometimes. I’m putting money on the fact that he won’t until go-live, though.

Reading all the updates reminded me of how much I miss the CMIO role. Being a consultant definitely isn’t easy and the travel isn’t glamorous, fun, or sometimes even tolerable. However, it’s been a great way to see under the covers of dozens of hospitals and health systems and to learn in a way that I would not have been able to had I stayed in my previous role.

Unlike Mr. H (who just got his Global Entry), I may be ready to put my rolling luggage in the closet permanently. I’ve decided to hold on accepting new clients while I consider going back on the market as a CMIO. Spring is just around the corner and I’m ready for some new growth.

Who else is planning to job hunt at HIMSS? Email me.

Email Dr. Jayne.

Comments Off on Curbside Consult with Dr. Jayne 1/11/16

HIStalk Interviews William Winkenwerder, MD, Chairman, Winkenwerder Strategies

January 11, 2016 Interviews 2 Comments

image 

William Winkenwerder, MD, MBA is chairman and founder of Winkenwerder Strategies. He was formerly president and CEO of Highmark, Inc.; assistant secretary of defense for health affairs for the United States Department of Defense; and has held leadership positions with Blue Cross Blue Shield of Massachusetts, Emory University, Prudential Healthcare, Kaiser Permanente, and the Department of Health and Human Services. He serves on the boards of health IT vendors CitiusTech, Cureatr, and Accreon.

Tell me about yourself and what you do.

I am the chairman and founder of Winkenwerder Strategies. We’re a healthcare advisory and consulting firm. I focus my efforts currently — and our firm does — on innovative healthcare companies. In that vein, I work with a number of leading private equity firms who are investing in healthcare companies, serve on the boards of these portfolio companies, and invest in these companies. In addition to that, I have a group of advisory clients in the healthcare industry.

Prior to this, I served as the CEO of Highmark Health, one of the largest health insurers in the United States. I also served as assistant secretary of defense for health affairs with responsibility for all the healthcare for the US military and the Tricare program. My background prior to that was about 20 years in the healthcare industry working in the managed care sector, both on the health plan side and the provider side.

I’m an internist by background and training, board certified. I also have a business degree from the Wharton School.

What are the biggest challenges and opportunities in healthcare IT?

There are tremendous opportunities today in the area of health information technology. Healthcare continues to pose tremendous challenges for corporate budgets, personal budgets, and our federal budget, not to mention state budgets.

We continue to spend more money each year. We thought for three of four years that the healthcare cost growth might have been tamed, but it appears that it’s taking off again this year. We are spending now over $3 trillion a year on healthcare in the United States, representing about 17-18 percent of our entire economy. What is a really amazing fact is that over the next 10 years, we will spend many trillions of dollars on healthcare, and within 10 years, we’ll be spending over $5 trillion in a single year.

There are tremendous challenges with all of that cost growth to provide healthcare and pay for healthcare in more efficient ways. I firmly believe that health information technology as an enabler of better business solutions and better care processes is critical to that task.

Where do you think we’re spending too much and getting too little return in terms of overall population health?

We’re spending too much inside of institutions, principally in hospitals. The hospital sector is the most single expensive sector of the entire healthcare economy. More recently, we’ve been concerned about pharmaceuticals, especially because of price increases these last two or three years, but pharmaceuticals just represent 10 or 11 percent of the entire healthcare dollar. We’re spending a lot of money in the area of long-term care in caring for people with chronic conditions.

It’s difficult to put your finger on a single sector or single area within the entire healthcare economy that is responsible for most of the problem. It really cuts across all the sectors.

We can do things so much more efficiently. But in order to accomplish that task, there have to be the right financial incentives in place and the right information, not just for clinicians and administrators in the healthcare system, but also the right information for consumers to choose and make decisions about their healthcare in order to create more of an economy for healthcare services.

Until just the past few years, there has not been, in many areas, sufficient information for people to make decisions. There has not been sufficient engagement by consumers. That’s beginning to change. People are beginning to take healthcare decisions more into their own hands, principally because they are now experiencing some of the costs directly themselves through the changes in the benefit designs, which have more high deductibles and more co-insurance and cost sharing.

The individual and the family have a vested interest in getting value for their dollars. Even though that creates some pain right now, it’s a good thing in the sense that it’s going to force more economical provision of care.

You just called out the elephant in the room. Are people realizing that their despite non-profit status and source of community pride, hospitals are looking out for their own interests as they integrate to command more market power?

There are lots of shared and conflicting interests when it comes to the local community hospital or even the regional hospital system of today. The problem is that in many markets — in fact, probably most at this point — there is just one hospital system,  two, or potentially as many as three. This leaves in place a situation where there’s not sufficient competition. This is especially the case when the hospitals and doctors have come together in a community and really are just one force.

It reduces the number of choices that people have. Frankly, I think it creates a situation where there’s not sufficient room for innovation and change in the way that care can be provided. Being a physician, I think some of the most innovative models of care are through physicians driving change. I hope that, in the future, we’ve got physician-driven systems that are able to compete on equal footing with big hospital-based systems.

You worked in the Pittsburgh market, which was a bellwether for what was about to happen everywhere as providers became insurers, insurers became providers, and competition got ugly. You had UPMC as a national and even international brand. Will that also become common, where we’ll see the emergence of regional or national provider brands?

I do see the emergence of regional and national provider brands. To be clear, I don’t believe that this is all bad by any stretch. There are many great organizations that provide great care and that have developed a great brand because of their quality, their service, and their capability.

The problem comes when that entity acquires many of the resources, the assets for care within a given geographic region. Because healthcare is local, that creates a situation where there’s not choice, because people typically can’t drive hundreds of miles to receive services. It’s not like you can get your healthcare on Amazon or get the service delivered through UPS. You have to go to a local institution, a local doctor and so forth.

It’s important that regardless of who owns the assets, the rule book allows healthy competition to take place. In the absence of that, the only vehicle for control, if you will, of pricing is the government. The government typically has not been reluctant to step in to set prices or influence pricing where they can. I would expect that there will be a push to do that in other ways in other ways, pharmaceuticals, for example.

What has been the impact of the Affordable Care Act and what will it be going forward?

The Affordable Care Act has got, at best, a mixed set of results associated with it. On the positive side, we have more Americans who are insured, principally through the expansion of Medicaid, and to some extent, through the creation and operation of exchanges in most states.

The total number of additionally insured people, I think now is in the range of 16 to 18 million. Much of that is through Medicaid. I think the breakdown on that is like 10 to 12 million through Medicaid and six or seven million through exchanges. The target for the Affordable Care Act was in the range of 32 to 35 million. It’s fallen far short of the target. 

At the same time, it’s introduced a lot of requirements and burdens on employers that have not made a lot of employers happy. It’s also created a bureaucratic regulatory infrastructure that I worry introduces unnecessary costs as well as a potential for limiting innovation.

On the positive side, in addition to the newly covered lives, you do have some benefits from the introduction of products on these exchanges that take advantage of things like narrow networks or higher-deductible benefit plans that do, in fact, save costs. These, ironically, are the same things that many people complain about, but they are — from an insurance perspective — the best way to limit the cost to the individual. There’s really a Catch-22 going on with some of these developments.

Certainly this is a highly political issue. It’s been that for six years now, since 2010, and it’s going to be a factor in the 2016 elections. We’ll see where all of that goes. My expectation is that there will be a continuance of certain elements of the Affordable Care Act regardless of who becomes president, but there could be a lot of change to the Affordable Care Act depending upon who gets elected.

The middle class is being hit hardest financially with higher premiums, deductibles, and co-insurance because lower-income families receive federal insurance subsidies and high-income families can afford the higher costs. One ED visit could bankrupt the average family even with insurance. What do you think the average voter wants to happen?

You have to read lots of different polls and you get different answers. People seem to want, in my reading of all of this, coverage to be available that’s affordable, on the one hand. On the other hand, they like to have choice and they would like protection against some of these high costs of healthcare.

It’s really a double bind. There’s no way to provide a really highly affordable coverage plan, for example, in a market where there’s consolidation of providers and not much insurance competition. The cost of care is just going to be expensive.

My hope is that we set the conditions and the incentives into place such that cost of care can be driven down, not just held at bay or made to grow at a slower rate of increase. There’s evidence that care can be delivered at a lower cost than it is today, many times using good technology solutions and putting information into the hands of individuals and providers.

People talk a lot about patient engagement and consumer involvement.  Do consumers have more influence as customers and are providers recognizing that they must operate differently as a result?

I do believe that consumes are more engaged, have more influence on their care, and want more influence on their care. They are able to get their hands, if they’re reasonably educated and interested, on information about their particular condition. That’s available on the Internet. That’s available through information sources that people can easily access. People are driving decisions at a consumer level today in ways that just weren’t happening a decade ago.

People think insurance companies are the bad guys, but what are their challenges in trying to create and manage a risk pool?

This is where CitiusTech comes into the conversation. CitiusTech is a highly innovative health information technology company solely focused on healthcare and working across all sectors, providers, health plans, life sciences, pharmaceutical, and also working even with other technology companies.

What’s needed, as you try to develop new kinds of risk- and performance-based arrangements between the payers, between the health plans and the providers, and even the pharmaceutical companies, you need really good information. You need large databases. You need to be able to integrate the data. Ideally, you’re using the capabilities of the cloud. You’re delivering great information.

That’s what I found so attractive about CitiusTech that caused me to want to work with them. We started out our relationship about a year ago in an advisory capacity and then I was asked to join their board about six months ago. They’re a great example of a new kind of company that’s totally focused on healthcare and as deep knowledge of not just the bits and the bytes of the technology, but of clinical issues, clinical information, and clinical operations. When you take that and marry it to the financial side, the health plan world, you begin to create some tremendous capabilities and the kind of capabilities that people need today.

What kind of health IT companies would get you excited about either advising them or investing in them?

CitiusTech would be one for sure. I love what they do. I’m excited with what they’re doing. I think their focus is great. It’s not just the technology, it’s the services and solutions and great talented people. That’s one example.

Another great company that I’ve had a relationship with in the past, serving as a board director, is Athenahealth. Again, a cloud-based company that is on the leading edge of change in how they do things.

There are some newer companies that are focused in specific areas. Say, for example, companies like Vitalz and ZocDoc that are focused on things like the consumer and consumer choice. They’re companies that are focused on even things like personalized genetic information. That’s going to come into the lexicon and come into people’s consciousness in terms of things they want to know about themselves that may be predictive of their future healthcare issues and needs.

There are just a lot of great companies out there. Cerner is a great company, in my opinion. They just recently won the contract to create the next-generation electronic healthcare record system for the military, partnering, by the way, with Accenture and Leidos. I served as an advisor to them in their effort to win that contract, which they did.

There’s a long list. There’s just a lot of very interesting and exciting companies out there today. Obviously, if you go to HIMSS, you’ll get to see all of them and more. It’s an interesting time.

You led the Department of Defense in building their EHR that’s now being replaced. What was your reaction to its decision and the never-ending pressure on the DoD and VA to integrate their systems?

It needed to. The system that was implemented in 2003-2004 — that’s 12-13 years ago — was an earlier-generation system. It worked, but it was really clunky. It was not sufficiently meeting the needs of the Military Health System on a global basis.

It was a big step forward at the time. It was, at the time, the largest global electronic health record system in the world. People there can be proud of what was accomplished then, but rightly in my opinion, there was a focus on creating a next-generation system utilizing the resources of a world class consulting firm like Accenture along with Cerner and along with Leidos, which was formerly SAIC and had a lot of legacy relationships and had done legacy work for the Military Health System, and so knew and understood a lot of the ground-level issues. When you put those three entities together, I think you’ve got the best-of-breed total solution.

If you were king of healthcare for a day, what would you do to fix it?

Boy. It would take more than a day [laughs]. That’s my first response.

I think of the healthcare challenge in the United States on multiple levels. One is at a political level. The politics of healthcare have to be addressed and navigated. One is at a government level. We have existing government programs in place. They need reform, including Medicare and Medicaid. Then we have a private sector system that is connected to, partly governed by, and heavily influenced by government. They are moving parts and they’re connected. Any solution or set of solutions needs to take all of that into consideration.

At the end of the day, I think that what most needs to happen is policy change at the federal government level to set the Medicare and Medicaid programs on a course of financial sustainability. They’re not sustainable right now. There are policy changes that need to be undertaken, things like extending the age of eligibility to get into Medicare, other changes with Medicare and Medicaid, etc. I won’t go into all of them, but there are important policy changes that need to happen within those federal programs.

On the private side, we have to work to create a competitive system, as I’ve alluded to earlier, where there is competition between and among providers and providers and insurers. A system in which individuals can be engaged financially themselves, but at the same time, it’s a system that people of low income and little means have support and protection. When healthcare is costing $10,000 a year per person, or for a family, $18,000 or $20,000, somebody who makes $30,000 a year literally is not going to be able to afford healthcare. We need a support system for those individuals. We just must be very careful that we don’t create something that is not sustainable. Right now, we’re on a non-sustainable track.

The politics need to take ideas from both parties and it needs to be clear-eyed in its movement forward. One of the biggest faults of the Affordable Care Act is that it did not have a single vote from one member of a party that represents half of the people. It actually had votes against it from within the Democratic party. That’s not a good thing. When you want to make big changes, you really need some level of bipartisanship. I hope, as we look at 2016 and beyond, that there will be more of that mindset applied to try to solve those problems.

I’m ever the optimist. I like to believe that America is an innovative place and we want to do right by everybody, but we need to continue to develop solutions that can provide high-quality care to most or all of the people and do that at a reasonably affordable price. That’s the goal. I believe that health information technology is central to that objective.

Morning Headlines 1/11/16

January 10, 2016 Headlines 1 Comment

Understanding Individuals’ Right under HIPAA to Access their Health Information

OCR mandates that patients will be provided electronic copies of their medical records on request, with no unreasonable delays or processing fees, noting that redirecting requests to a patient portal is unacceptable.

Suspended VA bosses to return to agency jobs next week

Two key VA administrators suspended and then given termination notices during the Phoenix VA waitlist scandal have been reinstated and reassigned to new VA positions after internal investigations on the men were hampered by “conflicts, delays, and contradictory findings.”

Leader, Global Healthcare – Amazon Business in Seattle, United States

Amazon is searching for a healthcare leader to run its B2B healthcare marketplace.

Tax filing issues could jeopardize health law aid for many

HHS reports that 1.4 million Healthcare.gov customers may lose their federal subsidies or insurance coverage after failing to properly disclose the entitlements in tax filings last year.

Monday Morning Update 1/11/16

January 10, 2016 News 4 Comments

Top News

image

The Office for Civil Rights declares that it won’t tolerate providers who refuse to give patients copies of their medical records, publishing clarifications of what providers must do, with these examples:

  • Covered entities must provide designated record sets to patients or their designee.
  • They can verify the requester’s identity however they like as long as the verification process doesn’t delay the delivery of the information.
  • They cannot require patients to physically visit their premises or mail a paper form to submit their request.
  • They must offer records delivery by email if requested.
  • They cannot withhold records copies just because the patient hasn’t paid for their services.
  • They must provide requested electronic copies of paper documentation if they have a scanner.
  • They cannot tell patients that, “We have a patient portal, so log in and print your own information.”
  • The patient has a right to obtain all information about them, not just EHR data. That includes images, billing and payment records, claims data, and any information the provider used to make decisions about their care.
  • They must provide electronic copies of information they store electronically if the patient requests electronic instead of paper. They cannot insist that the patient accept paper copies instead.
  • Fees charged must be “cost-based,” which includes the labor required to make paper or electronic copies, supplies, and postage. The fee cannot include the cost of retrieving and verifying the information. This is a big deal since providers impose absurd per-page charges – often through their third party release of information vendor – even when providing information in electronic form. OCR is clear that federal law overrides state law in this case, so extra fees are not allowed even if state law says they are.

The question is what OCR does now that it has clarified the rules. Patients most likely don’t know how to file complaints despite widespread lack of provider compliance with these guidelines.

From my own experience in having filed an OCR complaint six months ago about a hospital that refused to give me an electronic copy of my electronic records resulting in no response, I doubt they are geared up to take fast action even when patients are knowledgeable enough to contact them.


Reader Comments

image

From Little Buddy: “Re: President Obama. This quote sounds like someone very much out of the loop who happens to have the solution to healthcare woes with Obamacare.” The President said, “I don’t have a Fitbit yet, but I work out hard. Word is these Apple Watches might be a good companion for my workouts. So I’m gonna see, I’m gonna test it out.” I actually think it’s kind of cool that he’s not afraid to drop some pop culture references and that he takes care of himself with technology help. Speaking of the Watch, I got stuck behind an older lady in the airport security line the other day who was confused about which items to place on the scanner belt, oversharing with the TSA agent, “I have an iWatch.” People apparently don’t even know the name of their expensive, short shelf life gadget, which is not called the iWatch because smart companies had already trademarked the name before Apple.

From Apollo Creed: “Re: health IT companies. Which ones do you like?” I don’t think my opinion is relevant, or if it is, it’s not available. It’s best that prospective investors and employees perform their own due diligence, especially since I’m not an investor or employee of any of them.

image

From DC VA Insider: “Re: VA CTO Marina Martin. Will be leaving soon.” Unverified.

image

From Rowdy Roddy: “Re: Leidos. I heard a Leidos ad on a Madison classic rock station. They are looking for Epic and Cerner help. Is the world that short of Cerner expertise that they have to find Epic folks, which themselves are in short supply?” I can’t imagine that many Epic youth spend their commute gramps-moshing to “Sweet Emotion” and “Sultans of Swing” in between Leidos commercials. There’s a business opportunity for you: launch an Internet radio station just for Epic or Cerner employees – including company gossip, the cafeteria menu, and customer news interspersed with Justin Bieber and Adele songs — and sell ads to consulting firms that want to poach them.

image

From The PACS Designer: “Re: iPhone 7. With Apple reducing the price of iPhone 6 Plus S by 30 percent, soon there had to be a reason. Now,we know why. The iPhone 7 leaks have started and sales will drop as everyone waits for the new model.” The cell phone and services market are changing quickly as competition heats up (thanks, Google, for creating Android). The major carriers are getting better and cheaper as they worry about upstarts and companies selling unlocked phones that use their networks at a discounted rate. A new Consumer Reports survey found that the worst-rated carriers for value are Verizon, AT&T, and Sprint, as smaller providers like Consumer Cellular and Ting top the customer satisfaction scale.


Reader Gripes

  • “Epic’s #6 list of principles says they don’t do deals, yet it’s hard to imagine Mayo wasn’t swayed by Epic’s $46 million offer to buy its data center.”
  • “When I am alone with a patient, one on one, in an exam room and try to show caring and compassion, as I have always done over these many years as a clinician, it gets harder knowing that everyone and everything around this patient is treating them like the latest gold rush or oil boom. Their insurance company, hospitals and their administrators, pharmacies, medication manufacturers, many of my colleagues with their over-testing, etc. I do the best I can. I still think medicine is a noble profession and am proud that both my children wish to become doctors.”
  • “It bothers me that you’ve created yet another forum to complain, like the comments section wasn’t enough. No one comes to HIStalk to hear people crap on companies or news, much less co-workers. I would rather see a Great Box, stories of awesome stuff people are doing in this industry. We don’t hear enough about the outcomes of our work.”
  • “CommonWell members Cerner and McKesson, who claim to be in favor of interoperability, won’t allow us to interface to their systems even if we match the spec of one of their existing interfaces. Even though they interface to our competitors. Even though their own clients request it. Hypocrisy is alive and well.”
  • “People that are more interested in building their fiefdoms than great companies.”

You can sound off about your gripe or you can even say something positive if you’d rather.


HIStalk Announcements and Requests

Thanks to the CIOs who volunteered to raise DonorsChoose funds by making themselves available to donating vendors at a lunch on Wednesday, March 2 at the HIMSS conference. CIOs interested in raising money for education by spending a couple of hours socializing with vendors can contact me.

image

About half of poll respondents will attend the HIMSS conference next month. A few more folks who attended in 2015 won’t attend vs. those who will attend, but I don’t think that necessarily portends lower overall attendance. New poll to your right or here: do company funding announcements make you curious to check them out?

Listening: Blackstar, the new album from David Bowie. The Thin White Duke is 69, but he eschews the profitable victory tour of mindlessly mumbling moldy hits in favor of creating complex, fresh music that throws down the gauntlet in setting the pace rather than wheezing to keep up with it. The album came about because Bowie saw a jazz band he liked and decided to perform some musical experimentation them. He just keeps doing his own thing, emerging from obscurity only when he has something new to say musically. The music is among his most experimental, the lyrics are hard to comprehend yet poetic and chilling (especially the title track), and it sounds like a real band with occasional boluses of electronica just to challenge the listener. It won’t change your mind if you don’t like Bowie, but it’s a gift if you do. UPDATE: a few hours after I posted this review, I was shocked to hear that David Bowie has died.

image

Mrs. K’s middle school science class in Brooklyn is using the iPad Mini we provided in funding her DonorsChoose grant request for researching STEM projects. She reports, “On behalf of my students, I want to thank you for your generous donation of an iPad mini. This gift will provide our students with real world connections to current research that will support all our ongoing investigations in our classroom. Curiosity and access to technology is the key to our success as productive Americans. Thank you for your support!”

image

My Christmas present to myself even though I don’t travel all that much is Global Entry, a known traveler program powered by fingerprint scan that lets you skip the line when entering the US by plane or car. It also includes TSA’s Pre-Check (shorter line, shoes and belt left on, laptop left in bag, metal detector instead of scanner), which is newly important since the days of free “upgrades” to Pre-Check often are about to end. Global Entry costs $100 for five years, only $15 more than Pre-Check alone. Every road warrior should (and probably does) have it. One might quibble that Department of Homeland Security is charging a premium to bypass its intentionally created inefficiency, but arguing that point with everybody else stuck in long lines doesn’t make sense unless you can’t spare $20 per year to save a lot of time and frustration.


HIStalkapalooza

image

Sign up to request an invitation for HIStalkapalooza. I have only about 400 requests so far, but I just announced it Friday.


Last Week’s Most Interesting News

  • Henry Schein Practice Solutions pays $250,000 to settle FTC charges that it overstated the database encryption technology used in its Dentrix G5 dental practice management system.
  • Oncology software vendor Flatiron Health raises another $175 million, increasing its total to $313 million.
  • The Rochester, MN paper reports that Mayo Clinic will run Epic hosted from Epic’s Wisconsin data center, while the data center Mayo sold Epic for $46 million will be used only for failover. The organizations will also work together to create new products.
  • Health kiosk vendor HealthSpot shuts down.
  • NantHealth acquires NaviNet to create a payer-provider collaboration network. 
  • Navigant acquires 70-employee consulting firm McKinnis Consulting Services for $52 million.
  • “Brain training” app vendor Lumosity pays $2 million to settle FTC charges that it made unproven claims that its software can reduce age-related cognitive decline.
  • A local paper reports that Epic’s headcount has grown to 9,400, increased by 1,400 in the past year.

Webinars

January 13 (Wednesday) 1:00 ET. “Top 5 Benefits of Data as a Service: How Peace Health Is Breathing New Life Into Their Analytics Strategy.” Sponsored by Premier. Presenter: Erez Gordin, director of information management systems, Peace Health. Finding, acquiring, and linking data consumes 50 to 80 percent of an analyst’s time. Peace Health reduced the time analysts were spending on data wrangling, freeing them up to create new actionable insights.

Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.


Acquisitions, Funding, Business, and Stock

image

UltraLinq Healthcare acquires Cardiostream as the companies combine their medical image management expertise.

image

Several  Fitbit users sue the company, saying that its fitness trackers cannot accurately record heart rates during intense exercise even though the company markets them for that purpose. One of those users said her Fitbit showed a heart rate of 82 beats per minute when it was actually measured at 160, making the trackers “worthless.” In an interesting response, Fitbit stands by its technology but adds that its trackers “are not intended to be scientific or medical devices.”


Sales

image

Mount Nittany Medical Center (PA) chooses paperless electronic forms on demand from Access.


Announcements and Implementations

image

MedStar Health adds a “Ride with Uber” button to its home page that will hopes will make it easier for patients to keep their scheduled appointments on time. They should do something similar with discharged patients since, as bizarrely as it sounds, a top reason for extended length of stay is patients who can’t get a ride home and calling 911 for a free ambulance ride only works for those headed to – not from – the hospital.


Government and Politics

image

Two Phoenix VA executives who were suspended over scheduling wait times surface in new VA jobs 19 months after they were suspended with full pay and given a notice of termination that never happened.

The IRS says that 1.4 million households may lose their Healthcare.gov insurance subsidies because they they took government tax credits in advance last year but didn’t account for them in their federal tax returns. That means that 30 percent of households that received insurance subsidies handled the tax implications incorrectly. The announcement was made late Friday, when the federal government often releases unflattering information about the administration’s pet projects.


Other

image

@Cascadia caught this: Amazon is recruiting for a Leader, Global Healthcare for Amazon Business, the business-to-business supply marketplace it is building.

Nemours is considering IT as one of this areas in which it may reduce headcount.

Donna Walters, CIO of Sharon Regional Health System (PA), is hit by a car as she crosses the street in a crosswalk in front of the hospital. She is apparently OK, suffering a broken wrist. The driver, who was driving with a suspended license, was charged with a felony.

image image

In bizarre healthcare news:

  • Workers partially demolish a hospital in China that is still being used with patients inside, with locals suspecting that a company working on nearby roads ordered it removed (photo above left).
  • In Russia, hospital security cameras capture a doctor killing a patient in the ED admitting area with a blow to the head after accusing the patient of touching a nurse, the most recent of several incidents in which the doctor used physical force on patients (photo above right).
  • In New York, a patient commits suicide by jumping off a building and lands on Mount Sinai St. Luke’s Hospital’s oxygen tank, forcing its ED to be evacuated.
  • In South Sudan, 10 patients – including premature babies – have died because its main hospital has run out of money to fuel its electrical generators.
  • In Cincinnati, the parents of a recovering seven-month-old baby overdose on heroin in the hospital. The mother died in the baby’s hospital room, while the father was arrested after being found in a hospital bathroom with a heroin needle in his arm and a loaded pistol in his pocket.
  • A San Francisco group sues to halt construction of a new professional basketball arena near UCSF Benioff Children’s Hospital, saying, “Some people will die trying to get to the hospital if this stadium is built next to the emergency room.”

Sponsor Updates

  • Extension Healthcare lists its 2015 awards and achievements.
  • Caradigm publishes an infographic on electronic prescriptions for controlled substances.
  • Valence Health CEO Andy Eckert will present at the JP Morgan Healthcare Conference, taking place January 11-15 in San Francisco.
  • ZeOmega ranks number 54 on the 2015 SMU Cox Dallas 100.
  • Strata Decision Technology publishes “Margin + Mission: A Prescription for Curing Healthcare’s Cost Crisis.”
  • YourCareUniverse receives national recognition for innovative patient engagement tools.

Blog Posts


Contacts

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

125x125_2nd_Circle

HIStalk 2016 Reader Survey Responses

January 9, 2016 News Comments Off on HIStalk 2016 Reader Survey Responses

image

I run an HIStalk reader survey once each year, inviting anyone to provide feedback and ideas. This year’s survey generated 396 responses, with the highlights summarized below.

Years in the industry
More than 20: 46 percent
11-20: 26 percent
1-10: 28 percent


Employer type
Vendor: 43 percent
Hospital: 28 percent
Consulting firm: 17 percent:
Other: 12 percent


Primary job
IT staff/management: 26 percent
Vendor management: 17 percent
Vendor staff: 17 percent
Clinician in an IT role: 7 percent
CIO: 6 percent
CEO: 5 percent
CMIO: 2 percent
Other clinician: 2 percent
CFO: 1 percent
Other: 17 percent


Elements appreciated in order of most to least popular
News
Rumors
Headlines
Humor
Dr. Jayne
Interviews
Readers Write
CIO Unplugged


I have a higher interest in companies when I read about them in HIStalk
True: 84 percent
False: 16 percent


Reading HIStalk helped me perform my job better in the past year
True: 88 percent
False: 12 percent


Respondents provided these suggestions that I thought were most important, which I’ll list with my comments. The one I won’t mention is “don’t change anything,” which was thankfully by far the most common response.

Respondents also suggested a lot of new areas I should cover in the same way I write HIStalk, but I don’t have the time or interest to stray far from healthcare IT and thus will most likely not be able to pursue those areas (but it’s pretty cool that someone thinks I’m the guy to cover them anyway).

Thanks to everyone who took the time to provide their advice. It renews my energy every year right about this time. I also promised to randomly draw a respondent to receive a $50 Amazon gift card, but then I decided to make it two respondents instead – those folks have received their prize.


Include more rumors because they nearly always pan out.
I run all the rumors I hear or receive and always welcome submitting more. Some respondents scolded me for running unverified rumors.

Do more reviews of books that are supposed to make me better and to educate me about what’s right for patients, families, and providers.
I’m happy to do that given the limits of time and my willingness to purchase books just to review them. Most of those books I’ve reviewed came from reader suggestions.

Limit Readers Write to less vendor and consultant PR.
I’ve tightened up the requirements and rejected quite a few submitted articles, but the real issue is that only vendors and their public relations firms take the time to write something. Everybody likes to read, but nobody likes to write, as evidenced by the folks who want to read more reader submissions but don’t write anything themselves. However, some articles are good and I’m reluctant to shut down reader submissions just because some aren’t.

Do more interviews.
I only interview CEOs for the most part on the vendor side, but I’ll interview different kinds of provider folks – CIOs, CMIOs, nurses, informatics experts, etc. It’s a bit tricky because quite a few people can’t be interviewed without the approval of their employer.

Get more contributors, such as CNIOs and CIOs. Dr. Jayne is no longer a CMIO and most of what Ed Marx posts is off topic.
Most people don’t have the interest or time to contribute, but I’m willing if they are. Just about everybody who has ever vowed to overwhelm me with frequent posts drops out after the first 2-3 when they realize that it’s more work than fun for them. Dr. Jayne and Ed have many fans.

Provide less commentary.
More folks chose “provide more commentary” in explaining the background of stories, which I do if I feel like I have something relevant to add.

Do more investigative and original reporting, following up on rumors.
Good idea if I can figure out how to make it happen. I’ll take that as a to-do.

Cover more about AMIA, CHIME, ACHE, AMDIS, RSNA, and review articles from academic publications.
I don’t really have any connections with those groups and it would be tough (and expensive) to get away to attend all of their meetings. I’ve tried a few times to get a clinical informatics expert to scan the literature and summarize the important articles, but have had no luck so far. I need to find a way to get electronic journal library access from home and then I could review some of the articles myself if I don’t find someone.

Define the acronyms you use in stories.
I keep thinking about publishing an always-updated acronym list. Maybe I should do that. Of course it’s also easy to Google a term as long as it’s not used in multiple ways.

Run a column of anonymous gripes people want to say to their bosses, students, colleagues, etc.
Great idea, although my experience is that it would dry up quickly due to lack of submissions. Another respondent said I should set up an electronic complaint box and run the results – I like that idea and have put it in place.

Do videos or podcasts.
I’m not a fan of watching or listening to something I could read myself a lot more quickly. I’ll think about it, but that’s one of those things lame sites do (along with writing over-sizzly headlines and tweeting pointlessly) that I like to think most of my readers wouldn’t enjoy in proportion to the effort involved.

The DonorsChoose project is important work, but it looks like you are bragging about your donations. Are the donations tax deductible to the donor?
All of the DonorsChoose projects I write up are paid for by reader donations, to which I apply any and all matching funds I can find. I don’t publicize the DonorsChoose projects that I fund personally. The DonorsChoose donations are indeed tax deductible – the folks there came up with a “gift card” method in which they donate directly to DonorsChoose and I just pick the projects to fund with their money. I try to make it clear that the projects are funded through the generosity of HIStalk readers and I hope that we can all celebrate the results.

How about creating a discussion board?
I could do that, but I’ve tried a couple of times and participation was minimal. Quite a few attempts to create a health IT social network failed miserably because the folks involved took a “build it and they will come” position and, fact is, the industry is 99.9 percent readers and 0.1 percent writers.

Offer a job board.
I already have one. It doesn’t get much use.

Provide an annual summary by company of the news you ran about them.
I’ve thought about that, although I’m not sure who would need that information. It wouldn’t be hard since anything that appeared in HIStalk already passed the “is this really newsworthy?” filter.

Reveal your true identity when you retire or die.
I would hope that nobody really cares at this point since I’ve been doing it for 13 years and I’m not looking for recognition, but I keep thinking (somewhat morbidly) that I should write a “posthumous use only” post to say goodbye and perhaps squeeze in one more music recommendation instead of just leaving up whatever news post I wrote last. I fear being like an actor who dies with their IMDB list of appearances being capped by an awful movie role they shouldn’t have taken.

Comments Off on HIStalk 2016 Reader Survey Responses

Morning Headlines 1/8/16

January 7, 2016 News Comments Off on Morning Headlines 1/8/16

Dental Practice Software Provider Settles FTC Charges It Misled Customers About Encryption of Patient Data

Henry Schein Practice Solutions pays $25,000 to settle FTC charges alleging that the encryption used in its Dentrix G5 dental practice management system was not true encryption. Schein also makes the dental solution included in Leidos’ winning DHMSM bid.

Flatiron Health Raises $175 Million Series C Round to Further Bolster its OncologyCloud Software Platform for Providers and Accelerate Personalized Medicine

Oncology software vendor Flatiron Health closes a $175 million Series C funding round led by Roche, bringing its total funding to $313 million since its 2012 launch.

Top 9 issues that will affect physicians in 2016

The American Medical Association lists Meaningful Use, health data security, and the large-scale adoption of telemedicine as some of the top issues that will affect physicians in 2016.

Mayo plans more collaboration with Epic Systems

Mayo Clinic reports that it will only lease a small portion of the data center it recently sold to Epic, but confirmed that Epic will host its EHR platform at a larger data center in Verona.

Comments Off on Morning Headlines 1/8/16

News 1/8/16

January 7, 2016 News 2 Comments

Top News

image

image

Henry Schein Practice Solutions will pay $250,000 to settle Federal Trade Commission charges that it overstated the data encryption level used in its Dentrix G5 dental practice management software. Schein also agreed to let its customers know that its product does not use Advanced Encryption Standard as NIST suggests in complying with HIPAA requirements. You may recall that the Leidos consortium that won the Department of Defense EHR bid includes Henry Schein’s Dentrix Enterprise,which I assume is a different product.

Schein has updated its website to indicate that it no longer calls its database security “encryption,” explaining, “Available only in Dentrix G5, we previously referred to this feature as encryption. Based on further review, we believe that referring to it as a data masking technique using cryptographic technology would be more appropriate.”


Reader Comments

image

From Punditry: “Re: things you could add to HIStalk. How about a gripe box where people can anonymously vent about a company, news item, or person that annoys them?” That could be fun. I created an anonymous Gripe Box form. Let’s see if anyone has something entertaining to complain about. I like just about anything that personalizes a sometimes impersonal industry.

image

From Topanga: “Re: another HIPPA sighting. In a click-baity headline besides.” They fixed the HIPAA misspelling in the questionably health IT-related story afterward.


HIStalk Announcements and Requests

image

Attention CIOs: Centura SVP/CIO Dana Moore raised a lot of money for DonorsChoose at the last HIMSS conference by offering to meet with any vendor in return for their donation. We’re thinking about expanding it in Las Vegas by having other CIOs participate, where vendors who have made a DonorsChoose donation will be given a couple of minutes to pitch to the assembled CIOs and then mix and mingle during the lunch that we’ll provide. If you are a CIO who can spare two hours during lunchtime on Wednesday, March 2 during the conference for a great charitable cause, let me know.

Thanks to everyone who completed my reader survey and provided good advice. I’ll recap the results in Monday’s post.

image

Mrs. Torres sent photos of her Texas pre-kindergarten students using the two Kindle Fire Kids Edition tablets we provided by funding her DonorsChoose grant request.

This week on HIStalk Practice: Doctors Administrative Solutions rebrands after acquiring ConXit Technology Group. The Orthopedic Institute of Wisconsin selects RCM tech from McKesson BPS. CES gives the notorious HIMSS taxi queue a run for its money. Vecna Technologies puts a designer spin on patient vitals, while President Obama touts Healthcare.gov in Jerry Seinfeld’s car. Momentum Physical Therapy upgrades clinical and financial software. DuPage Medical Group secures a $250 million investment. Covenant Surgical Partners selects PM and RCM tools from gMed.

This week on HIStalk Connect: CES kicks off in Las Vegas, bringing a number of notable digital health announcements. Under Armour introduces its UA HealthBox, which includes a fitness tracker, wireless scale, and heart rate monitor. Fitbit, Fossil, and Healbe unveil new wearable devices of their own. Hometeam raises a $27 million Series B to expand its caregiver platform.


HIStalkapalooza

image

The “I want to come” form for HIStalkapalooza is open. Submit your information if you want to attend – even if you’re a sponsor, long-time supporter, or VIP, I still can’t invite you if I don’t know you want to come. I’ll follow up with actual invitations in a couple of weeks.

We had a couple of companies interested in our top-tier “HIStalkapalooza Rock Star” event sponsorship that couldn’t make it happen. The event goes on regardless, but without a few niceties and additional attendees that having a primary sponsor would have provided. We have about a week remaining before we have to move forward, so contact Lorre if your company is interested and can commit quickly. It’s really expensive to put on an event at this scale.


Webinars

January 13 (Wednesday) 1:00 ET. “Top 5 Benefits of Data as a Service: How Peace Health Is Breathing New Life Into Their Analytics Strategy.” Sponsored by Premier. Presenter: Erez Gordin, director of information management systems, Peace Health. Finding, acquiring, and linking data consumes 50 to 80 percent of an analyst’s time. Peace Health reduced the time analysts were spending on data wrangling, freeing them up to create new actionable insights.

Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.


Acquisitions, Funding, Business, and Stock

image

Northwell Health (the former North Shore-LIJ) and consulting firm Newport Health form Health Connect Technologies, which will commercialize population health management products. The joint venture was announced in August 2015, at which time I expressed some puzzlement as to who Newport Health is given its apparently intentional obscurity: “I couldn’t find much of anything on Newport Health other than it’s apparently connected to Newport Private Group with a real office in Newport Beach, CA and mail drawer addresses in New York and Texas.” Bean Enumerator’s pithy comment at that time was, “Newport says it has experienced and innovative health IT talent, but the only person listed as working for the company has no relevant experience whatsoever. It’s a bad sign when an investment banker starts a health IT company. How did Allscripts lose this one given their supposedly tight partnership with NS-LIJ and their population health management aspirations?”

image

Pamplona Capital Management invests an unspecified amount in Patientco and will embed the company’s patient payment products into those of its other holdings, MedAssets and Precyse.

image

An India-based newspaper profiles CitiusTech, which has doubled its revenue to $100 million since 2014 and expects to grow at 35 percent annually as it expands beyond its primarily US customer base. Co-founder Rizwan Koita says entrepreneurs focus too much on raising venture capital, having bootstrapped the company until it reached $50 million in revenue and 1,000 employees in 2014. The company is investing its 2014 $100 million investment from General Atlantic in expanding its capabilities in analytics, big data, and mobility.

image

Health kiosk vendor HealthSpot shuts down, turning off its kiosks in Ohio Rite Aid drug stores and Cleveland Clinic. The company had raised $23 million. 

image

Oncology software vendor Flatiron Health raises $175 million in a Series C funding round, increasing its total to $313 million. The lead investor in the round is drug company Roche, which takes a board seat with the investment. GV (the former Google Ventures) led the Series B round in mid-2014.

image

Here’s a great tip from @RasuShrestha: registration is free for accessing live and recorded webcasts from the J.P. Morgan Healthcare Conference next week. Perhaps that will soothe our egos at not being invited to attend in person.

Allscripts and Medfusion announce that they have settled their legal differences over Allscripts reselling Medfusion’s patient portal, but then favoring the product it acquired from Jardogs in 2013.


Sales

image
Sutter Health (CA) chooses QPID Health’s query and clinical reasoning software to mine its Epic EHR for actionable information.

image

Franciscan Alliance (IN) chooses Vocera for secure clinical communications.


People

image

PeraHealth hires Sloan Clardy (Parallon) as SVP/chief growth officer.

image

Rick Adam (Recondo Technology) joins Stanson Health as president/COO. Long-timers will remember him as founder of New Era of Networks and president of Ibax.


Announcements and Implementations

image

In Canada, Grace Hospital is testing patient flow software from Kitchener-based Oculys Health Informatics.

image

Validic launches VitalSnap, a mobile app that allows consumers who use in-home medical devices that have limited digital connectivity to capture the information via their smartphone’s camera, have it translated using optical character recognition, and send it to their provider.

image

Sensato will launch its Cybersecurity Tactical Operations Center next month, which will offer services to small and large provider organizations via a membership model that can include real-time monitoring, planning, threat intelligence, emergency support, and testing (phishing, social engineering, and penetration). It will also offer biomedical device monitoring.

Prestige Emergency Room (TX) goes live with Wellsoft EHR, designed specifically for freestanding emergency centers.


Government and Politics

Massachusetts Governor Charlie Baker announces plans to create a digital health hub that will offer accelerator space and networking opportunities.


Privacy and Security

image

Application security auditing vendor FairWarning announces that all NHS Scotland hospitals are using its privacy monitoring software.


Technology

image

image

Surgeons at Nicklaus Children’s Hospital (FL) use the $20 Google Cardboard virtual reality smartphone accessory to plan a child’s heart surgery. You can actually get a better deal on Cardboard from eBay – just $2.99 with free shipping. Or you could spend $599 for the just-released, Facebook-owned Oculus Rift, which is finally almost ready to ship.


Other

image

The American Medical Association lists the top issues that will affect physicians this year, among them the “burdensome” Meaningful Use program, insurance company mergers, narrowing provider networks with increased out-of-pocket costs, soaring prescription drug costs, health data security, and elimination of telemedicine barriers.

image

The Rochester, MN paper says Mayo Clinic will lease back only part of the data center it sold to Epic for $46 million. The article suggests that Mayo will have Epic host its implementation from Verona, while Epic will use the Rochester data center to store backups and as a failover location for Mayo and other of its customers. That sounds like pretty big news that Epic is apparently doing full hosting for Mayo, a model Epic is just beginning to embrace. Mayo says it will also help Epic develop software and services that Epic will roll out to its customer base.

image

I’ve seen quite a few recent examples where headline writers misstate the relationship between public health and geographic location, as in , “Where you live has an enormous impact on health, well-being.” If that were true, moving would fix the problem. It’s only true that where someone live reflects certain aggregate health determinants – a ZIP code doesn’t impose its will to make someone unhealthy.

ECRI Institute lists its top technology advances to watch for in 2016, with the health IT-related ones being medical device cybersecurity and wearables.

A New York Times survey of insured Americans under 65 finds that 20 percent of them had problems paying their medical bills last year as insurance companies raised deductibles and co-insurance. Of those who had problems with medical costs, 63 percent spent all of their savings, 42 percent took on a second job or worked more hours, 14 percent moved or took in roommates, and 11 percent resorted to charity.


Sponsor Updates

  • PatientPay reports that Women’s Health Care Group of PA has shortened payment time to less than nine days and reduced billing expenses by 30 percent after implementing the company’s paperless billing solution.
  • Healthgrades SVP Mayur Gupta explains how marketing technology could transform healthcare.
  • MedData will exhibit at the ACEP Reimbursement & Coding Conference January 11-13 in New Orleans.
  • The Jacksonville, FL TV station runs a video story about HCI’s global expansion featuring CEO Ricky Caplin.
  • Crossings Healthcare Solutions publishes its Q4 newsletter.
  • Huron Consulting Group announces several promotions to managing director in the healthcare practice.
  • Experian Health publishes a new white paper, “Collect Now or Pay Later.”
  • PerfectServe CEO Terry Edwards is featured in a Global Big Data Conference article on health IT trends in 2016.
  • A Recondo Technology survey finds that manual insurance claims follow-up costs providers around $4 per claim vs. the previously accepted $3 as those providers don’t use exception-based technology.
  • GNYHA adds Phynd’s Unified Provider Management software to its contract portfolio.
  • PMD enhances its secure text messaging software to allow users to invite others to join at no additional cost.

Blog Posts


Contacts

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

125x125_2nd_Circle

EPtalk by Dr. Jayne 1/7/16

January 7, 2016 Dr. Jayne 2 Comments

Lots of buzz this week about practices getting ready for Meaningful Use attestation. One of my independent colleagues reached out to me about an offer to provide batch attestation for all physicians in the practice for less than $1,000. Looking at the amount of time that practices can spend doing an attestation, it certainly sounds tempting. Given the risks of a badly-done attestation, I’d make sure that I read the fine print and included some kind of language on performance or lack thereof. If anyone has used one of these services, I’d be interested to hear about it.

clip_image002

AMIA as requesting submissions for the iHealth Clinical Informatics Conference to be held in May. The submission deadline is January 22. I’ve been to Minneapolis and enjoyed it. I’ll likely attend if I don’t have a conflict with a client engagement. I’m still working to get all my Maintenance of Certification hours for Clinical Informatics. I know there are some available at HIMSS, but I’m not sure if the courses are going to work with my social schedule. I did finally complete the required “patient safety module” for the certification and am grateful for ABPM for giving a six-month grace period to those of us who were in the first certification class.

I’ve received quite a few LinkedIn announcements lately that are congratulating people on new positions that they’ve actually held for some time. This usually makes me think that they’re buffing up their profile in preparation for job hunting, especially if they couple it with a “please endorse me” message. The one I received today was particularly amusing as it was from a former colleague who has habit of overstating his qualifications. I’m not likely to put my reputation on the line for that. In other cases, people might just have been delinquent in updating their profiles, but it’s more likely to be the former.

Speaking of job hunts, a reader responded to my recent comments on Glassdoor suggesting several more companies whose reviews are downright entertaining. I almost spit wine all over my new computer, so he’s lucky he’s not buying me new hardware. Feel free to send me your funniest examples and I’ll put together a top 10 list.

clip_image004

Now that we’re in the new year, I’m starting to get excited about HIMSS and have secured my date for HIStalkapalooza. This year it’s someone clinical, so it will be interesting to hear feedback from that perspective. I’m starting to work on wardrobe and of course accessories. Last year I had a wardrobe malfunction involving my handbag becoming tangled up with my dress on the dance floor, so I’m not eager to repeat that episode. If you have any great wardrobe finds, let me know.

The new year is also a time of stress for many patients. I was at my own doctor appointment the other day and watched multiple patients being turned away because of issues related to a change with their insurance coverage. Some didn’t have referrals and others didn’t realize the physicians they were trying to see were out of network on their plans.

One of the patients had an interesting situation where she has a PCP on her HMO insurance but actually sees a “direct primary care” physician for her primary care needs. Although she had a consultation request from her actual PCP, she didn’t have one from the PCP on her card who she had never seen, so the practice wouldn’t see her unless she agreed to pay in full. Most of the patients were extremely frustrated, which is not surprising. The way we deliver care in the US is just crazy.

My visit was frustrating for other reasons. I was having stitches taken out from a skin biopsy and had received the results by phone the other day. The medical assistant offered me a copy of my results and I said yes, since I hadn’t received them through the practice’s patient portal and wasn’t sure they did pathology that way. She then said, “Oh, I need to go talk to the doctor and see if you need a re-excision” and walked out of the room leaving me with a giant “!?!” hanging in the air. Certainly people shouldn’t be calling with results if they don’t know the whole care plan or if it’s not documented anywhere.

She returned a few minutes later saying, “You’re good to go,” but didn’t have the result in hand. I was pushing being late for a client call and will just request my own copy of the results so I didn’t argue the point, but it was not the care I expected from a major university health system.

Once I made it home and finished my client call, I was glad to see this blurb from another reader with a fondness for unusual news. Possibly some competition for Weird News Andy? A suburban Chicago funeral home recently received approval for a liquor license. They’re hoping to partner with a nearby Italian restaurant to offer the refreshments and build the idea of funerals as a “life celebration.” I think EHR vendors could offer similar refreshments at their training centers – it certainly would make the experience more pleasant.

What do you think could be done to enhance EHR training? Email me.

Email Dr. Jayne.

Text Ads


RECENT COMMENTS

  1. "HHS OIG rates HHS’s information security program as “not effective” in its annual review, the same rating it gave HHS…

  2. Do these Nordic Healthcare systems concentrate the risk of a new system more that would certainly happen in the more…

Founding Sponsors


 

Platinum Sponsors


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Gold Sponsors


 

 

 

 

 

 

 

 

RSS Webinars

  • An error has occurred, which probably means the feed is down. Try again later.