News 8/24/16

Top News

Apple quietly acquired startup Gliimpse earlier this year, Fast Company discovers. The company offers tools for consumers to collect and share their electronic medical record information in both readable and codified form. Self-funded Gliimpse reported just one investment, a February 2015 seed round of $1 million. The beta release of its software was launched in October 2015.

Founder Anil Sethi studied clinical engineering at Johns Hopkins, worked for Apple as a systems engineer in the late 1980s, founded Dakota Imaging (later sold to WebMD),  then founded Sequoia Software in 1992 that was sold to Citrix in 2001.

My take on all these recently uncovered Apple healthcare moves is that new iPhone health offerings will pressure EHR vendors to open up their systems to Apple integration. The company clearly plans to use that information in consumer-facing apps and iPhone-using patients are going to demand that their providers make it available. EHR vendors won’t be able to hide behind the lack of interest their hospital and practice customers have for interoperability once patients start complaining to those providers about their non-functional app.

Reader Comments

From Gabby Hayes: “Re: Oscar health insurance. Pulling out of Dallas and New Jersey.” Oscar is a goner given its total dependence on the exchange-sold policy market that even the big insurers haven’t figured out even though it’s just a small percentage of their business and yet all of Oscar’s. My prediction is this: only individual states can stabilize the ACA-powered market since they also regulate the non-exchange policy business. You can bet that a state like Arizona — which has seen so many insurers pull out of the exchange that one county (Pinal) has none left offering policies — will exert pressure on the companies who still want to sell in-state policies and whose rate increases it approves. That might be another reason that insurers are bailing – they can’t necessarily get state approval for the rates they require to avoid losing money. I’ve heard rational, anti-government people begrudgingly state that the only answer is a single-payer system, although that single payer in question hasn’t done so great running Medicare, Medicaid, and the VA. We may end up with a UK-like system where everybody gets coverage at a reasonable price, but a thriving market of more accessible providers would serve those who can afford their services.

HIStalk Announcements and Requests

I had a “how do I do this” question about the webinar signup software we use. The vendor replied with a screen capture video that they recorded specifically for me, with one of the support reps informally walking me through the individual steps. I wonder how often healthcare software vendors do this? An analyst could create the video in a couple of minutes, obviously faster than writing out step-by-step instructions, preparing a series of captioned screen shots, or trying to schedule a screen-sharing session.

Webinars

August 24 (Wednesday) 1:00 ET. “Surviving the OCR Cybersecurity & Privacy Pre-Audit: Are You Truly Prepared?” Sponsored by HIStalk. Presenter: John Gomez, CEO, Sensato. Many healthcare organizations are not prepared for an OCR pre-audit of their privacy and security policies. This webinar will provide a roadmap, tools, and tactics that will help balance policies and budgets in adopting an OCR-friendly strategy that will allow passing with flying colors.

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

Acquisitions, Funding, Business, and Stock

In Canada, grocery store and pharmacy operator Loblaw Companies offers to buy BC-based EHR vendor QHR Technologies for $132 million in cash, although QHR is free to accept other offers until shareholders vote on the deal in October. QHR holds 20 percent of Canada’s EHR market. QHR sold its US-based clearinghouse and RCM business to MTBC in July 2015.

Healthcare Growth Partners relocates its headquarters from Chicago to Houston.

Premier reports Q4 results: revenue up 15 percent, adjusted EPS $0.36 vs. $0.36, beating revenue expectations but falling short on earnings.

Sales

Union Hospital (MD) chooses Spok for enterprise communications.

People

Patient experience vendor Docent Health, which just raised $15 million in a Series A funding round, hires Kim LaFontana (The Advisory Board Company) as chief product officer; Andrew Park (N-of-One) as CTO; Geoff McHugh (The Advisory Board Company) as VP of transformation; and Monna Nanavati (Athenahealth) as chief service delivery officer. Industry long-timer Paul Roscoe is co-founder and CEO of the company.

Michael Zaroukian, MD, PhD, CMIO of Sparrow Health System (MI) begins his one-year term as board chair of HIMSS North America. The board has 10 members, of which five work for health systems. I didn’t realize that the vendor-heavy board of the parent organization (just plain old HIMSS global) has 13 members, of which only four work for health systems.

Announcements and Implementations

A Huffington Post blog post by the EVP of Visiting Nurse Service of New York describes the results of a state-funded pilot project in which the role of home health aides was expanded to include medication review and updating client status on a tablet that automatically notifies a clinical manager of changes. The project reduced ED admissions by 24 percent. Patient status was documented using software from Practice Unite, the secure texting vendor that merged with physician engagement focused Uniphy Health in March 2016.

Santa Rosa consulting offers a one-day replacement strategy workshop for McKesson Paragon users.

In England, two London NHS trusts begin exchanging information between their Cerner-powered HIEs, allowing clinicians at each site to view patient information from the other that includes discharge summaries, diagnoses, medications, and lab results.

CommonWell Health Alliance adds patient-facing services that will allow people to enroll themselves in CommonWell, link their own records among providers, and review information about them stored on CommonWell’s network. CommonWell members MediPortal and Integrated Data Services will add the patient capabilities to their portals by the end of the year, while Aprima, Athenahealth, Cerner, Evident, Modernizing Medicine, and RelayHealth have committed to doing so without committing to a timeline.

Lexmark Healthcare announces new products: a zero-footprint Health Content Management Viewer for documents, medical imaging, and XDS content; a redesigned video capture device for PACSGear; and video and image enablement workflow for Epic.

A LifeImage survey of 100 CHIME members finds that imaging responsibility has moved from the radiology department to IT; most hospitals still can’t move imaging data between applications; and one-third of CIOs worry that their organizations could be losing revenue due to lack of interoperability that could detect orders for duplicate and clinically unnecessary exams.

Nebraska Medicine takes over operation of the student health center of University of Nebraska-Lincoln and brings Epic live there.

Privacy and Security

From DataBreaches.net:

• In Pakistan, a hospital employee steals data from its CT machine and also corrupts the machine’s software, which the hospital says it will have to repurchase for at least its original $330,000 purchase price.
• Orlando Health (FL) says it caught at least one of its employees reviewing the electronic medical records of survivors of the Pulse nightclub shootings in June.
• A HIMSS survey finds that one-third of hospitals and half of non-acute providers don’t encrypt data in transit.
• An HHS OIG report finds that the security of CMS’s wireless network has four vulnerabilities.
• In Canada, two people behind a hospital records breach in which the information of new mothers was sold to companies selling educational savings plans get off with fines and community service. Two others had already pleaded guilty and received house arrest, probation, and community service, one of them a former OB nurse who also faces professional misconduct charges.

Technology

Gartner releases its Hype Cycle for emerging technologies. Virtual and augmented reality are moving to the Slope of Enlightenment, but Gartner predicts that machine learning, software-defined anything, and natural language question answering have the shortest times to mainstream adoption at 2-5 years.

Other

In Canada, a medical marijuana consultation doctor whose poor (and possibly falsified) paper recordkeeping led to his three-month suspension is ordered by the College of Physicians and Surgeons of Ontario to implement an EHR as a condition of his continued licensure.

In Australia, Monash Health’s ED goes back to paper for two days when its Emis Health ED software goes offline, although the hospital disputes the downtime in saying that it was a planned six-hour upgrade.

A JAMA literature review of the high cost of drugs in the US blames “the granting of government-protected monopolies to drug manufacturers” and restrictions on drug price negotiation.

A JAMA research letter finds that, not surprisingly, it’s harder for medical students to get into residencies for the higher-paying medical specialties. Primary care specialties have the lowest average annual salaries at around $250,000 and only around half of those residency spots are filled with US medical school graduates. On the other end of the spectrum as a huge outlier is neurosurgery, with average compensation of $750,000 and a near-100 percent fill rate of US residents. Opportunistic graduates might want to choose pathology since it’s the highest income in the least-competitive group.

Meanwhile, those high-earning diagnostic radiologists respond to the American College of Radiology’s call to action (and its suggested use of its advocacy app) in expressing outrage at the VA’s plan to allow advanced practice RNs to order and interpret MR and CT studies without physician oversight. I’m shocked that advocacy-enamored HIMSS hasn’t developed an app of its own to give members an easy way to support profitable health IT legislation.

Here’s an interesting title for a think tank’s editorial that complains about “the federal government’s takeover of EHR.”

A vandal (or politically paid artist, I would guess given the level of sophistication) defaces Los Angles hospital signs in preparation for Hillary Clinton’s visit, apparently spreading the unproven rumors that she is not in good health. It’s surprising to me that nobody has breached and published her records as often happens with celebrities, although perhaps people have looked and found no smoking gun to be worth their trouble. No matter how the election turns out, we’ll be left with the sobering reality that a lot of Americans of all political persuasions are angry, too partisan to carry on a civil debate, quick to resort to online harassment and bullying, and not especially bright or well informed, problems that will persist no matter who’s sitting in the Oval Office for the next four or more years. I expect hospitals to be busy the week of November 8 election dealing with the human results of unfortunate post-election events.

NYC Health + Hospitals, facing a $1.8 billion annual shortfall, tries to cut costs and diversify into new businesses without running afoul of unions and city leaders who won’t support cutbacks in staffing, which represents 70 percent of its overall costs. It’s a good example of a seldom-mentioned healthcare cost problem – bloated, inefficient health systems are often the largest employer in their communities and as such earn the unwarranted support of politicians who are more concerned about local employment and hometown prestige than national healthcare costs.

Health management company Equity Healthcare refocuses its employee wellness services from cold-calling workers to encourage healthy lifestyles to instead use claims data to focus on those with chronic conditions who are most likely to respond.

Weird News Andy calls this video story “She Stoops to Conquer.” He explains, “A lady gives birth on camera while her husband parks the car. Pretty amazing video with nothing that squeamish. The good stuff starts at 1:18. She just squats and there’s the baby.”

Sponsor Updates

• Printing virtualization vendor UniPrint.net joins Imprivata’s development partner program.
• GE Healthcare employees volunteer at Milwaukee area schools to help spruce up classrooms before students return for the new school year.
• Besler Consulting will exhibit at the HFMA Region 8 MidAmerica Summer Institute August 24-26 in Minneapolis.
• Boston Software Systems releases a new podcast, “CVSHealth: Best Practices for Growth with Automation.”
• In Canada, Markham Stouffville Hospital will upgrade to Meditech 6.1.
• CoverMyMeds will exhibit at the Ohio Ambulatory Care Summit August 26 in Columbus.
• CTG profiles new President and CEO Arthur “Bud” Crumlish.
• Elsevier Clinical Solutions CMIO Jonathan Teich, MD offers his predictions for addressing the social and health demands of a growing global population.
• EClinicalWorks will exhibit at Medical Fair Asia August 31-September 2 in Singapore.
• HCTec makes the 2016 Inc. 5000 list of fastest-growing private companies in America.
• Healthfinch CEO Jonathan Baran will speak at the NCHICA Conference August 31 in Asheville, NC.

Blog Posts

• Why Claims-Based Approaches to Risk are Deficient (Arcadia Healthcare Solutions)
• Bulletin Issued for Massachusetts Requiring Use of Universal PA Form (CoverMyMeds)
• Telemedicine in Retail Stores: Evolving Role of Clinics and Pharmacy (Wolters Kluwer Clinical Drug Information)
• All Eyes on MACRA: The Latest Accelerant to Value-Based Care – Are You Ready? (The Chartis Group)
• Pursuing Success in a Value-Based World (ECG Management Consultants)
• 7 Best Practices for A/B Testing Digital Marketing in Healthcare (Evariant)
• Say Goodbye to HAIs: Reducing Hospital Acquired Infections (Galen Healthcare Solutions)
• The 21st Century Revenue Cycle Leader: 3 Key Factors for Success in the Evolving Healthcare Environment (Hayes Management Consultants)
• Meditech Training: 4 Areas That Require Special Consideration (The HCI Group)

Contacts

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

Morning Headlines 8/23/16

Apple Acquires Personal Health Data Startup Gliimpse

Apple acquires Gliimpse, a three-year-old startup marketing PHR software to help patients collect, personalize, and share their health records with providers.

Children’s Health Dallas testing ‘digitized drugs’ with sensors inside

Digital medicine vendor Proteus Digital Health pilots its sensor-embedded pharmaceuticals within a pediatric patient population at Children’s Health Dallas, allowing clinicians to monitor medication adherence among its patients after discharge.

Digital medicine: empowering both patients and clinicians

Eric Topol, MD publishes a defense of digital health in The Lancet.

Aetna, Humana blast DOJ’s merger challenge for ignoring reality

In response to a DOJ complaint, Aetna and Humana argue that its proposed merger should be allowed to move forward, noting that other private insurers would likely preserve competition by expanding into new geographies.

Curbside Consult with Dr. Jayne 8/22/16

I wrote last week about preparations for a go-live I’m supporting. My client is a hospital that has had a stalled implementation of their inpatient EHR and decided to address it by completely re-implementing the systems rather than trying to tackle adoption system by system or provider by provider. Our official go-live started at midnight, although one could argue that we’ve had a soft live that’s been going on for several years.

Monday morning can be very busy at hospitals for a variety of reasons. Often major surgeries are scheduled on Mondays so that patients can recuperate and be discharged either to home or to another facility before the end of the traditional work week. There are many more providers on the floors than the weekends, as physicians resume covering patients that may have been covered by an on-call partner over the weekend. Additionally, patients may be coming in for tests that might not be performed on the weekends or were postponed because they weren’t urgent.

Many of the hospital’s component systems were already in full use prior to this project and that definitely helped things run smoothly. Knowing that your laboratory, radiology, communications, scheduling, bed management, pharmacy, and other systems would be under control definitely reduced the stress level for providers.

In walking through the nursing stations during peak rounding hours, the most stressed group of individuals were the unit secretaries and unit clerks. Many were concerned that providers would be hostile to them as they tried to redirect the providers to enter their orders using the CPOE module rather than accepting paper orders for transcription as they had in the past. Although we had a few providers who “forgot” that it was go-live day (not sure how they could have forgotten it given the hordes of support staff in bright green shirts everywhere one looked), those few were easily redirected to the computer for 1:1 assistance. Having enough hardware available for everyone to do their work was a critical piece of our strategy, and in looking at this morning’s statistics, we only had a couple of situations where people were waiting for a computer.

Speaking of statistics, we’re aggressively monitoring the provider roster and tracking who has logged in and what they’re doing on the system. We already have a list of physicians who were strong users prior to the reimplementation and I’m not very worried about them. However, as we see new physicians access the system, round on a number of patients, and use the various modules, we move them to a “live” tracking category.

As we prepared for this, we investigated the processes that the larger medical groups use to round on their patients – whether each partner sees his or her own patients or whether they rotate by day, week, etc. We know what those schedules look like and have a hit list of providers that we will need to be targeting over the next several weeks. With that kind of data, we can adjust schedules accordingly, reaching out to providers before their next rotation on the floors to make sure we have support staff ready to meet them as they start their days. Although conventional go-live wisdom assumes that the need for support will taper over time, their first day may be several weeks out and they will still need significant support.

In addition to dedicated support team members (a mix of IT staff, clinical super users working dedicated support shifts, and contractors) we’ve also identified clinical super users who are working their normal shifts and are prepared to field questions and assist providers. I often get questions on the best way to recruit and retain super users. This hospital took my advice that they should select nurses who have been proficient users for a long time and give them extra training on the physician workflow and how to best train and support physicians. The paid training sessions that they attended counted towards their average weekly schedule requirements, so they weren’t being asked to attend training on top of their already heavy shift schedules.

Additionally, they had to demonstrate a certain level of proficiency before they received the official title. I did lobby for additional hourly payments or cash bonuses for nurses working in the super user capacity during their normal shifts at go-live, but this didn’t happen due to contractual and tax issues. Instead, we’re doing our best to reward them with gift cards and other bonuses to make sure they know we appreciate their work.

The administration also took my advice to have leadership actively participating on the floors, even if they couldn’t field questions themselves. The CMO, VP of nursing, and CIO are spending a good chunk of time this week being out with the users and assisting in whatever way they can, even if it’s just dialing the desktop support team to ask for password resets.

Speaking of password resets, we did take the hard line of resetting the password of everyone who didn’t attend training. We did this immediately prior to our midnight go-live so that if they did try to use the system, they’d have to call in first and we’d be able to dispatch a support person to their location. We can also dispatch an administrator to them, ready to help manage any unpleasantness or reluctance to accept support. We knew we only had a handful of people in this situation, but they’ve been difficult in the past so we wanted to be prepared. So far, three of them have logged in and received on-the-job training without incident.

The physician super users we had previously identified were also out with their peers, delivering pre-scheduled 1:1 support for those physicians who were most concerned about the go-live. As expected, we saw that once those physicians were able to complete documentation on several patients in a safe and supported environment, their concerns were markedly reduced. Just talking to a few of the physicians involved, it seems that simply knowing that we have physician super users that are part of the informatics team and will be looking out for physician interests going forward has been a powerful factor in bringing reluctant physicians on board.

As I suspected, even though the system has been live for a while, having a greater number of users engaged has identified some defects and some concerns with some of the order sets. Physicians who hadn’t previously participated in the creation of the defaults are now concerned with their content, so we’re documenting those concerns and will invite those physicians to participate on the committees that approve content. What we’re not going to do though is create individual order sets for the physicians who are complaining. If there is a clear and compelling reason to add a particular order, it can be added to an existing set as optional. Leadership is on board with this and having solid decision making and change control will serve them best in the long run.

As far as the defects, we’re classifying them as technical, operational/workflow, or application and are involving the appropriate groups for expedited resolution. We did engage our vendor to have a couple of application specialists available (two on site and two remote) should we need them.

One of the other things we’re doing today is starting our post-mortem review of the go-live and our entire process. Even in the excitement and activity of a go-live, it’s important to start gathering that information and determining what worked and what didn’t work so that you have a jump start on the next project. One of the things that worked well here was including the business case for many features as we trained them. For example, requiring a diagnosis on every medication, not just an indication on PRN medications. Although this should be fairly straightforward, we explained exactly what the hospital was doing with that data – formulary management, pricing negotiation, patient risk stratification, and more.

We also did a lot of education around the use of discrete data and its impact on monitoring clinical quality and potentially on research projects. The majority of physicians had no idea how the data was being used beyond “because you have to” and that helped transform what might have been perceived as extra clicks into something of value. We also opened the door for physicians to receive more data about their patients and the work they were doing, including access to ad-hoc reporting on patients they are seeing in the hospital. Due to some previous physician engagement surveys conducted by the hospital, we suspected this would be a good approach.

We also did some specific pre-work to look at how providers wanted to be trained and where they wanted to be trained. We did perform some 1:1 offsite training for providers and I think that was a good way to achieve buy-in and participation. Although we weren’t resourced to do this for every provider, we did do it for those that specifically asked. During the design phase of the rollout, we also held listening sessions with providers who were concerned about the process. Many of them were under the assumption that this would create more work for them. We were able to present the actual workflows at those sessions, demonstrating that although the work would be different, it wouldn’t necessarily be more. They were able to see in person what we were planning and we believe this reduced resistance.

Although today has gone smoothly, we know this is a process and the needs will continue for the next several weeks until all of the active physician staff members have been to the hospital at least a couple of times. I anticipate some blips but think our preparations have been solid and we’ll be able to get through them.

Don’t you love it when a plan comes together? Email me.

Email Dr. Jayne.

Uncovering the Real Value of HIMSS Exhibition

Vendors weigh in on the real ROI behind HIMSS exhibition efforts. From “meaningful conversation” metrics to the pros and cons of in-booth entertainment and décor, most have come to realize that the conference is a can’t-miss opportunity worth the all-too-real financial risk.

By @JennHIStalk

HIStalk readers have historically not shied away from airing their HIMSS-related grievances. Whether it’s booth babe backlash, sales reps who refuse to make eye contact, or the delicate balance of staying in the good graces of HIMSS organizers, there has been ample dissection of the health IT industry’s largest tradeshow since HIStalk began covering it 13 years ago.

Yet for all the back and forth, conference attendance has grown impressively. Exhibitor numbers seem to have remained steady despite show-floor grumbling about the cost of just about everything. Atlanta, New Orleans, and San Diego have been scrubbed from the conference city rotation due to constraints in their conference hall and travel logistics and Chicago was axed because of a hotel room pricing spat, leaving Orlando and Las Vegas as the only cities capable of accommodating the massive amount of infrastructure necessary to house its sprawling square footage.

Given the double-edged sword of shelling out big bucks to exhibit with a good chance of getting lost in the crowd, HIStalk reached out to several vendors with varying levels of HIMSS exhibition tenure to gauge their return on investment assessment. From first-time exhibitors to those who’ve joined the fray for the last 20-plus years, most have come to realize that the event is a necessary evil that they will endure — some more eagerly than others — for the foreseeable future.

Setting Measurable Goals Makes the Difference

Determining ROI for an event like HIMSS can be tricky given the long sales cycle for many vendors and the hard-to-quantify benefit of relationship building. And then there are the add-ons. In addition to the standard HIMSS booth pricing — which starts in the $4,000-$5,000 range depending on HIMSS corporate membership status — there are costs associated with extras like chairs, carpet, trash cans, and power, not to mention travel and lodging, advertising and marketing, signage around the show floor, and after-hours events.

Some companies, like 20-plus year exhibitor Billian’s HealthDATA (acquired earlier this summer by Definitive Healthcare), base ROI on concrete goals such as generating a certain number of prospects and closing enough sales to cover expenses for the show.

Others, like Stericycle Communications, lean toward the number of “meaningful” conversations conducted on the show floor. “Ahead of each HIMSS, we set a target for the number of deep, needle-moving conversations we want to have,” says Colin Hung, vice president of marketing at Stericycle, which has exhibited for the last four years. “These conversations could be with clients, prospects, potential business partners, suppliers, and even potential employees. We do look at other metrics like conversions and booth visitor sales generated,  but it’s the meaningful conversations metric that really determines whether or not the conference was successful.”

Some exhibitors, like LogicStream Health, see ROI more in terms of generating “new opportunities and interactions with prospects currently in our pipeline, which we expect to turn into new customers and additional revenue,” according to Scott Olson, director of marketing. The company, which exhibited for the first time in 2016, is planning to exhibit again next year. Olson adds that, “Because of the effort we put in on the front end in 2016, we easily justified the expense and expect an even better return on our 2017 investment.”

The Consequences of Taking a HIMSS Break

While none of the vendors interviewed would disclose hard financial figures, all have found their presence at HIMSS to be enough of a worthwhile venture to justify exhibiting year after year. Not one company interviewed has taken a year off from exhibiting. That steadfastness may have more to do with HIMSS incentives (and disincentives) than any hard and fast financial gain directly tied to contracts signed on the show floor.

“We do not plan to stop exhibiting at HIMSS,” says Hung, who adds that the association’s points system plays into that decision. “The points system governs how vendors select their booth space for the following year,” he explains. “Vendors earn points for various activities related to HIMSS – paying on time, booking accommodations in the hotel block, being a sponsor, booking larger booth space, etc. Points are cumulative and skipping a year cuts deeply into your accumulated points.”

Readers may remember that Cerner, which declined to comment for this story, stopped exhibiting on the main show floor for three years, citing a marketing environment that it felt was not conducive to showcasing new technologies and attracting clients. It returned in 2012 due to customer demand, occupying space on the exhibit floor that some felt was in direct correlation to the length of its hiatus.

“It is a given to exhibit at HIMSS,” reiterates one healthcare executive whose company will exhibit in 2017 for the ninth year in a row. “Clients expect to see us there. However, with our marketing budget, it’s also a trade-off. The tremendous costs equate to a significant expense, which takes away from attending other opportunities. We see HIMSS as a necessary evil. We are exhibiting at HIMSS17, but due to the exorbitant costs, we’re reducing our footprint to ramp the ROI in our favor. We may spend more relationship-building time outside of the HIMSS environment.”

The Bigger the Better?

The aforementioned executive may be the exception to the rule when it comes to downsizing exhibit space, though he does clarify that, “Regardless of size, a well-designed booth with furnishings that are comfortable yet attractive and a correct flow is equally important.” The majority of companies interviewed for this story have found value in expanding their show-floor footprint.

“Over the years, we went from a 10×10 booth to a 20×20,” says Joyce Metzer. Now retired, she managed Billian HealthDATA’s presence at the show for over two decades. “The extra space and seating allowed us to have face-to-face meetings with clients and prospects, and we were better able to accommodate attendees who wanted to see demos. Bigger booths, more seating, and more stations for doing demos is critical. Furnishings also play a big role in showing off the fact that you have money to spend on making your customers and prospects comfortable.”

LogicStream will expand its booth next year, and Olson is eager to see how much of a difference it makes. “Our booth was crowded last year because of all the traffic we drove, even being in the back corner of the main floor,” he says. “There’s a chance we missed some walk-up conversations because of the number of people we had at any given time. With a bigger presence this year, our expectation is that we’ll have more room for demonstrations of our solutions.”

Some exhibitors, however, just don’t see the value in the extra square footage. “Granted, you don’t want to be too small such that no one can find you,” says Greg Chittim, vice president of strategic marketing at Arcadia Healthcare Solutions, which has been a HIMSS exhibitor for 10 years. “But I think our customers would rather we spend our money on our products and their experience versus a second floor to our booth. That being said, we try to draw people in with eye-catching visuals that are light on the latest buzzwords and stock photos of happy doctors and friendly experts who actually execute our programs rather than people who just sell them.”

Hung, who has been to HIMSS 10 times, agrees – somewhat. “I honestly don’t think there is any difference between a 10×10 versus a 10×30,” he says. “When you are in a booth that small, you won’t be able to cut through the noise. When you get to a 20×20, that’s when you’ll get a little bit of attention, but you still have to work hard to get business. It’s not until you cross 2,500 square feet that the size of the booth suddenly makes a difference. When you have a space that size, people notice. If you aren’t able to afford 2,500 square feet, I think you’re better off going with a smaller booth and investing your dollars in other aspects of HIMSS.”

It’s What’s in Them That Matters

No matter how big the booth may be, it’s what’s in them that counts in terms of attracting passers-by and making invited guests feel comfortable. Depending on the service or technology offered, many vendors have taken to offering the aforementioned demos and in-booth presentations featuring high-profile customers.

“Presentations can be effective if you have a lot of clients or partners who attend, and if you’re willing to make the effort to market them consistently in the four weeks leading up to the show,” Hung explains. “If, however, you are counting on people just stopping in, I think you’ll be in for a very lonely HIMSS experience.”

Chittim believes that offering something compelling at the booth will help to keep the crickets from chirping. “Bringing something interesting absolutely makes a difference,” he says. “We focus on really compelling data visualizations presented like an art gallery, which does an amazing job of drawing folks from all backgrounds in for a second or third look. Entertainment that has nothing to do with healthcare or our core business is useless from my point of view.”

Hung is of the same mindset and believes that the days of having entertainers such as magicians, jugglers, and game show hosts at HIMSS are long past. “These types of entertainers attract and repel an equal number of booth visitors, in my opinion, and are thus a waste of money. I never find I have time enough at HIMSS to stand and watch a magician perform. I’m always rushing off to the next meeting. I know many fellow HIMSS attendees have similarly packed schedules.

“Having a good-looking model, male or female, in your booth is a complete turn-off,” Hung adds. “I honestly can’t understand why a company would hire a non-employee just to stand in the booth to look good. Not only is it incredibly sexist, but it insults the intelligence of attendees. This form of in-booth entertainment definitely has an impact and it’s completely negative.”

In-booth entertainment, good or bad, can often add up to one thing – noise. “Due to the nature of our business, we don’t have experience with presentations or in-booth entertainment,” the anonymous executive explains. “What we do have unfortunate experience with is the noise level at HIMSS due to the over-crowding of exhibitors in the given space. Our neighbors on multiple occasions have repetitively exceeded the decibel level specified by HIMSS, resulting in less-than-optimal business environments for us. Although HIMSS attempts to monitor and discipline offenders, this challenge is a reality on the show floor.”

Reeling the Right People In

Aside from the challenges of noisy neighbors, exhibitors have over the years defined what works for them and what doesn’t in terms of attracting qualified decision makers to their booths.

Some avoid giveaways and the “goody grubbers” that go after them altogether. The Arcadia team, for example, has found that giveaways tend to draw in only folks who aren’t decision makers, or even employees of potential customers. “The most successful thing at our booth is showing live demos by real experts – our product team, our technical leaders, and clinicians that have really used the product.”

The LogicStream team has had a similar experience. “We had a drawing for a hoverboard in 2016,” recounts Olson, “but didn’t get much traffic from people just dropping off business cards or stopping simply to get their badge scanned. We haven’t decided if we’ll do a larger giveaway in 2017. Attendees that we talked to were more interested in what we could offer their health system and how we could improve care delivery for their patients and providers.”

While tchotchkes may not work, food and beverage seem to be a no-brainer. “Giving away quality food or beverages is always a hit,” says Hung. “Whether it’s coffee, desserts, candies, mini tacos … attendees always appreciate food, especially when the alternative is a $9 cup of dark water that only looks like coffee.

“It’s really challenging to come up with a giveaway that’s unique these days,” he explains, though he adds that he did notice a lot of buzz around HIMSS16 booths featuring a custom T-shirt station and miniature obstacle course. “Everyone has access to similar tchotchke vendors, and every year those vendors follow the same trends. My suggestion is to avoid grab-and-go giveaways like pens and notepads … anything that someone can just grab from your booth without stopping. Instead, plow your money into a good food giveaway that forces the person to pause at your booth, like coffee or ice cream.”

Metzer has also found food and beverage to be the quickest way to the hearts of attendees. “Any kind of food or drawing for a gift will definitely increase traffic,” she says. “We discovered that having a cocktail hour with a drawing at the end of show hours brought in a lot of customers and prospects. The customers would tell the prospects how our product helped them do their jobs, and how easy it was to use the product.”

Due Diligence for Decision Makers

Marketing initiatives, whether they be focused on scavenger hunts, giveaways, baristas, or bartenders, are all designed to do one thing – get decision makers into booths and keep them there. As anyone who’s ever attended HIMSS knows, getting the attention of the C-suite can be challenging without the proper due diligence.

“They key to HIMSS is to invest the time and effort ahead of the conference to book meetings rather than expect walk-ins,” says Hung. Such due diligence is what helped keep the Billian’s HealthDATA booth humming year over year. Metzer says that, on average, 25 percent of booth visits were made by decision-makers, a figure driven by the sales and marketing team’s pre-HIMSS push. Olson recounts that about half of LogicStream’s drop-in visitors were of the decision-making caliber, with the rest being students, vendors, investors, lower-level health system employees, and media.

“Too often,” adds Chittim, “the real decision makers are hounded as they walk the show floor, so are understandably protective of their time and attention. Based on the fact that we’re showing something that is detailed and real versus things that appear to be vaporware, we often have a junior person come first, but they typically bring a real decision maker back with them.”

Time to Sign on the Dotted Line

The health IT sales cycle is not a quick one, and while vendors may use the HIMSS conference as a means to amplify news of a recently signed contract, it is not the type of event that lends itself to initial meetings one day and contractual agreements the next.

“HIMSS is definitely a long-term investment,” says Hung, adding that Stericycle can trace almost 80 percent of its technology partnerships back to a meeting or discussion at the show. “It’s very rare that we meet someone at HIMSS for the first time who buys in the same year. It usually takes two or three HIMSS meetings along with other touch points before a business relationship is cemented.”

Metzer puts the Billian’s HIMSS sales cycle at less than two years, while Chittim says Arcadia’s is six months or less, with 5 percent of total sales being traced directly back to the conference. The variety of times and percentages certainly seems to add to the complexity of attempting to define HIMSS ROI.

Getting Ready for Orlando

Despite the opaque accounting, vendors are already getting their ducks in a row for HIMSS17. “Between the follow-up work and evaluating the 2016 experience, and then looking at increasing our 2017 presence, it’s quite a task to manage and prepare for,” admits Olson. “Next year, we’ll bring a larger team and have a larger booth. Along with that comes bigger goals and a higher expectation of return from the conference.”

Stericycle is also planning to put more of its team members on the show floor. “It’s so valuable for our product team to see what’s happening in the industry and for them to interact with clients and prospects directly,” says Hung. “There’s no better place for that than HIMSS.”

Chittim is on the same page as his exhibitor peers, adding that, “We try to be as conservative as possible with our marketing dollars, but it’s hard to pass up an opportunity to go big in a time and place that has all of our competitors and many potential customers in one place. We’ll be right by the HIMSS17 front door with a new data gallery, new product demos, and a number of clients presenting at our booth and at HIMSS broadly. We’re already looking forward to the week even though it’s six months away.”

Morning Headlines 8/22/16

OCR Announces Initiative to More Widely Investigate Breaches Affecting Fewer than 500 Individuals

OCR Regional Offices launches an initiative aimed at increasing the number of investigations into data breaches affecting fewer than 500 individuals.

Harris’ US Healthcare group acquires digiChart, Inc.

Harris acquires OB/GYN EHR and PM vendor digiChart for an undisclosed sum.

Inside the Oddly Empty Hospital With the State’s Highest Cost Markups

A local paper profiles four-year old Texas General Hospital (TX), a 41-bed hospital that sits largely empty and bills Medicare, Medicaid, and private payers at out-of-network rates.

Cisco lays off 5,500 employees amid tech upheaval

Cisco lays off 5,500 employees, representing seven percent of its total workforce.

Monday Morning Update 8/22/16

Top News

OCR announces that it will extend its regional office investigations to breaches that involve the information of fewer than 500 people. It previously reviewed those small breaches only as resources allowed. Regional offices will pay extra attention to even small-scale incidents if they involve data theft, hacking of IT systems, or repeated breaches of a given covered entity or business associate.

Reader Comments

From Pondering CIO: “Re: Epic. We recently selected them and are pursing Epic hosting. I have been quite amazed at the terms they require! (not that I wasn’t surprised at the software terms.) This is a big issue for us. Do you have feedback from other new hosting customers? Thanks for any input you can offer!” Readers with Epic hosting experience are welcome to respond – I will forward your comments to Pondering CIO.

From Fire Jose: “Re: KLAS. Many hospital CIOs (like me) and vendors alike call it the KLAS Tax. Vendors had to pay it or risk being left off of hospital CIO vendor short lists. Then vendors called me and prompted me with incentives to rate them with high KLAS scores, which I usually did for some enhancement. Widely accepted: KLAS was the industry kingmaker of the vendors with the deepest pockets. Also, buying the Best in KLAS vendor product was the equivalent of buying IBM since as the hospital CIO, I wouldn’t get fired for selecting it even when system implementation went bad and over budget. BUT FOR THE BETTER health IT rating transparency has shifted, with clearer methodologies in the last 3-4 years. We witnessed over and over that CIO/CFO peer satisfaction commentaries are not  the best indicators of IT success, especially in complex hospital systems replacing EHRs. Organizational satisfaction among all departments must be considered carefully, not just my peer CIO input on a scale of 1-10 on how I felt that particular day about a vendor. Black Book mostly but also Peer60 and Chilmark are gaining great popularity over KLAS because they offer fresh, broader user perspectives. These competitors all have flaws, don’t get me wrong. But now we see rating firms that are stepping up to the evolving needs of healthcare buyers in 2016 and not the marketing needs of vendors.”

HIStalk Announcements and Requests

An unusually large number of poll respondents weighed in on the question of whether we should all care what vendors like Epic and Cerner spend on their campuses, with nearly two-thirds saying their reaction is negative because it’s mostly non-profit hospitals footing the bill. Some comments from respondents:

• The glitzy Epic campus really doesn’t do much for employees. After the first six weeks, all I ever saw was the inside of airplanes and conference rooms. I question whether I even needed a dedicated office since I was somewhere else more than I was there. The money spent on buildings (especially single-use auditoriums) could have been spent on development or hiring more staff to serve customers.
• We’re competing for talent. Firms like Cerner, Epic, and Athena that exclusively serve healthcare need to make the work environment attractive like other innovative tech companies.
• I have seen some very elegant hospitals with the sole intent to be visually appealing to their patients.
• Have you guys even seen Cerner’s campuses? They are nowhere near as over-the-top as Epic’s. No-nonsense cubicle farms and data centers surrounded by seas of asphalt. Several look like something that came out of “Office Space,” not a Dr. Seuss book.
• After a trip to Madison for 1.5 days of training to get "certified" (a four-hour class when it’s all boiled down without breaks and YouTube vids) paid for by my safety-net hospital, all I could think was, I wonder why healthcare costs are rising? As an employed or contracted worker in more than a dozen hospitals, I’ve worked in basements with rodents, dripping water, leaking sewers, fleas, bathrooms from the 1950s, and bad HVAC, but never in palatial quarters like Epic.

New poll to your right or here: should hospitals be required to charge cash-paying patients the lowest prices they accept from any insurer?

Peer60 polled C-level health system IT executives (mostly CIOs and CMIOs) this month to determine the reach, influence, and usefulness of the six major health IT news publications and sites. The five-question poll found that HIStalk is:

• #1 most read
• #1 most influential
• #1 in generating interest about companies
• #1 in providing information most useful for job performance
• #1 most recommended by executives to others

I’m most proud of the results from the “personal job performance” question above, of course, since it’s just me vs. those corporate-run sites that have a bunch of employees. Thanks to those who responded and to everybody who reads. You might wonder why the graph above shows only five publications instead of the six surveyed – surprisingly, one fairly visible site didn’t even register with the executive respondents.

I’ll acknowledge the poll results by starting my annual “new sponsor special” early. It’s like a once-per-year Pledge Week for healthcare IT vendors who want to support what I do and who don’t put it off until right before HIMSS when I’m super busy. Contact Lorre, who will also have HIStalkapalooza information soon.

We funded the DonorsChoose grant request of Ms. B in Maryland, whose kindergartners needed an iPad Mini for literacy work (her low-income area school has a large number of refugees and English as a Second Language students). She reports that they have only two pieces of technology in the classroom and they’re using the iPad for letter identification, rhyming, and math exercises, even pairing up during playtime so they can keep working. She concludes, “Thank you so much for helping move our classroom forward by providing this engaging learning tool. It not only teaches them academic concepts and skills, but allows them to become more comfortable with the technology that the whole world now relies on. We thank you for adding this piece to our routine and our day.”

Last Week’s Most Interesting News

• The FTC resolves its patient privacy complaint against Practice Fusion by imposing oversight and requirements for its posting of patient doctor reviews to its Patient Fusion review site.
• A security firm notes a rapid rise in infections by more sophisticated versions of the Locky ransomware, with US healthcare organizations being the hardest hit.
• An op-ed piece in JAMA says EHRs haven’t kept up with the technologies used in other industries, offering specific recommendations of how they could improve.
• Leidos closes its merger with Lockheed Martin’s Information Systems & Global Solutions business.
• Bon Secours Health System (VA) notifies 665,000 patients that a revenue cycle contractor’s mistake exposed their information to anyone performing an Internet search.
• Patient advocate and Aetna director of innovation labs Jess Jacobs dies.

Webinars

August 24 (Wednesday) 1:00 ET. “Surviving the OCR Cybersecurity & Privacy Pre-Audit: Are You Truly Prepared?” Sponsored by HIStalk. Presenter: John Gomez, CEO, Sensato. Many healthcare organizations are not prepared for an OCR pre-audit of their privacy and security policies. This webinar will provide a roadmap, tools, and tactics that will help balance policies and budgets in adopting an OCR-friendly strategy that will allow passing with flying colors.

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

Acquisitions, Funding, Business, and Stock

Cisco will lay off 5,500 employees.

The federal government awards Agfa HealthCare a 10-year, $768 million contract for diagnostic imaging, extending its DINS-PACS win streak to four. 

Harris acquires Nashville-based DigiChart, which offers EHR/PM for OB/GYN practices. It’s a bit confusing since DigiChart changed its name to Artemis in 2013 after years of news that mostly involved layoffs and refocusing, but the former Artemis website now brings up a Windows IIS welcome page that suggests that the rebranding was meekly acknowledged as another strategic misstep (although the DigiChart page is still titled “Artemis | DigiChart”). Canada-based Harris’s stable of faded US health IT stars includes Picis, QuadraMed, NextGen’s hospital EHR business, and OptumInsight’s CareTracker.

People

SAP names Thomas Laur (Sutherland Healthcare Solutions) as president of its recently created Connected Health group.

D. A. Henderson, MD, MPH, an epidemiologist who led the 10-year effort to eradicate smallpox and afterward served as dean of what is now the Johns Hopkins Bloomberg School of Public Health, died Friday. He was 87.

Announcements and Implementations

A Peer60 report on the impact of the Brexit vote finds that a strong majority of hospital leaders believe it will be negative for healthcare, especially in terms of staffing. They don’t buy the pitch that Brexit will free up government funds that will be redirected to NHS as “leave” proponents claimed. Nearly half of respondents expect IT spending to be cut, with more than half of respondents expecting to upgrade their Allscripts, Meditech, SystemC, Orion, and Graphnet CareCentrix EPR systems less frequently, while only CSC and CaMIS were the only PAS systems named by more than 50 percent of respondents as being less likely to be upgraded.

Privacy and Security

From DataBreaches.net:

• The Outer Banks Hospital (NC) announces that two unencrypted thumb drives containing the information of an unspecified number patients treated over 12 years at a recently acquired cardiopulmonary rebab practice are missing.

I’ve read several theories about the recent proliferation of ransomware and here’s mine. Bitcoin became more popular and easier to buy, giving hackers a way to collect their extortion funds anonymously and quickly (you can’t charge extortion to a credit card). I’ve heard unverified reports that hospitals are proactively opening bitcoin accounts or identifying local bitcoin-dispensing ATMs just in case they get hit with ransomware.

Other

A Dallas paper visits for-profit Texas General Hospital — which charges more than 10 times the Medicare payment rate and accepts no commercial insurance — and finds it nearly empty, with no patients and almost no staff. The four-year-old hospital accepts Medicare and Medicaid, but makes most of its profit billing out-of-network insurance companies for patient services and hoping they pay. The article describes a patient whose doctor said his foot surgery would cost $5,200 but who didn’t warn him that Texas General Hospital is out of network for his insurance, leaving him with a “please pay this amount” bill of $332,000. Pakistan-born surgeon Hasan Hashmi, MD opened the hospital with his son, spending $85 million in claiming that his goal is to provide care to the underserved.

This graph is making the social media rounds, showing just how much the US spends on health vs. the fact that we trail other developed nations in life expectancy. My thoughts:

• We are the only country in which healthcare is a free-wheeling, mostly for-profit business that costs more here than anywhere. We pay more for drugs than any other country and use more of them besides.
• Lobbyists don’t stroke politicians to earn support for public health. There’s no money in prevention.
• I would bet that a lot of our reduced lifespan comes from economic disparity, lack of access to prenatal care, violence, and an economy and generous government assistance that support life-shortening behaviors such as smoking, overeating, lack of exercise, and drug use.
• The cost figure is probably increased by heroic, expensive interventions that extend life at poor quality and require a lifetime of special care. It’s expensive to add years of life spent on a ventilator or with around-the-clock medical care provided by for-profit business.
• We’ve entrusted much of our health outcomes to hospitals, which have performed poorly yet expensively in prolonging life other than for emergency care and surgical intervention.
• We have developed a culture in which our medical expenses are someone else’s problem, our care is delivered mostly by businesses rather than family, and we pay piecework for endless tests, prescriptions, and surgeries in hopes of a quick fix that is easier than a lifestyle change.
• Like all graphs that fail to show the zero value of the Y-axis in order to exaggerate their message, the difference isn’t as dramatic as it appears. US life expectancy is 79 years vs. the top value of just over 83.
• The graph begs the question of whether we should spend less or expect more, and if it’s the latter, who should be held responsible?

Here’s Part 3 of “Rating the Ratings” from Vince and Elise, this time covering Black Book and Peer60. 

Weird News Andy is nuts about a story he titles “Entertaining Mammal Salvation.” A Connecticut EMS crew extracts a squirrel whose head had become stuck in a plastic cup, freeing up their new bro-dent pal for other endeavors.

Sponsor Updates

• GetWellNetwork sponsors the Day at the Beach for Special Surfers that benefits challenged athletes in San Diego County, CA.
• AdvancedMD opens registration for its annual conference EVO16, to be held October 11-12 in Salt Lake City, UT.
• Vital Images will exhibit at HIMSS Asia-Pac August 23-26 in Bangkok.

Blog Posts

• Amazing Client Success Stories at #TeleCon16 (TeleTracking)
• Planning Ahead: Tactics for Success in Commercial Risk Adjustment (Verisk Health)
• VitalWare Employees from Across the Country Come Together to Give Back (Verisk Health)
• 5 Strategies of Successful Retail Pharmacy Chains (West Corp.)

Contacts

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

Morning Headlines 8/19/16

Kansas Signs $215M Contract For New Medicaid Computer System

HP Enterprises signs a $215 million deal with the state of Kansas to upgrade its Medicaid computer system and integrate the new system with Cerner’s HealtheEDW software, which will allow the state to manage care with near-real time patient data.

Exchanges do work for some health plans. Ask Kaiser.

Kaiser Permanente CEO Bernard Tyson says that the health system will continue to offer insurance plans on public exchanges, despite an increase in other payers exiting the markets.

Sebastopol medtech firm spawns legal wrangles, sends robot on Sonoma West hospital rounds

The former CFO of Sonoma West Medical Center files a wrongful termination suit against his former employer, alleging that he was fired for raising concerns over the safety of the hospital’s EHR, software not in use at any other US hospitals, but one made by a startup vendor with investors on Sonoma West Medical Center’s board of directors. The hospitals former CNO filed a similar suit earlier this year.

Evolutionary Pressures on the Electronic Health Record

A JAMA article argues that EHRs have not “kept pace with technology widely used to track, synthesize, and visualize information in many other domains of modern life.”

News 8/19/16

Top News

The Federal Trade Commission resolves its patient privacy complaint against free EHR vendor Practice Fusion, which encouraged patients to fill out satisfaction surveys about doctors using its EHR and then posted those reviews on its Patient Fusion website, sometimes exposing confidential information without the reviewer’s knowledge.

The order requires Practice Fusion make its privacy and security policies clear to consumers and to stop posting patient reviews on the Internet. The company will also face ongoing monitoring with penalties for future violations.

Practice Fusion sent “How was your visit?” emails to patients under their doctor’s name, pre-checking the “keep this review anonymous” box (which still placed the review on Practice Fusion’s site, but with “anonymous” instead of their first name) and with a warning not to include personal information. Despite those notices, patients entered detailed information and questions about their medications and treatments in the free text review box, sometimes including their names and phone numbers in somehow becoming confused into thinking that they were communicating privately with the practice.

Practice Fusion now appears to not display comments at all on its Patient Fusion site, probably figuring it was too much work trying to sort through all the junk patients were entering. The company was also getting a lot of criticism from its doctor users, who were upset that Practice Fusion was contacting their patients en masse using the practice’s name.

Reader Comments

From Balance Bill: “Re: balance billing judgment. Virtually all hospitals and medical practices have a confidential charge master. They also make patients sign an agreement saying they are responsible for charges, without being able to say what the charges will be and without being able to show the amounts of any potential charges. This Virginia Judge just ruled that its not a valid contract when one party refuses to share critical information (such as the charge master). I’m not a lawyer, but I think that one of the foundations of American healthcare billing is beginning to crumble. I am hoping so.” Providers should be required to offer cash-paying patients the lowest price they accept from anyone. They should also tell patients (both insured and not insured) what those prices are so they can make responsible decisions at the point of care. It is absurd that people can be forced into bankruptcy because of a hospital’s bill at full charge master price that nobody actually pays except those with cash and no insurance. Every other industry offers cash discounts, not cash penalties. This kind of pushback might change the dynamic of insurance companies that are forced to negotiate individually with health systems as they haggle over price and volume and instead of just deciding whether they are willing to pay a given hospital’s published charges.

From Maria M: “Re: balance billing judgment. I worked for a medical center where a couple of cardiologists canceled all their insurance contracts and referred their Medicare patients to other doctors. The amounts they were charging for cath procedures, stents, and angiograms were staggering. They didn’t balance bill the patients, but instead went after the insurance companies, sometimes in court. The amounts these insurances were paying was unbelievable. They went so far as to hire a hospitalist so when cardiac patients came into the ER they were the first ones notified. This practice still continues today.” I’ve likewise heard of profit hospitals that intentionally took their entire ED out of network so they could stick the insurance companies of patients traveling outside their local areas with higher bills. I struggle with the fact that no matter how egregiously health systems and practice behave, they are operating legally within this mess of a non-system that we’ve created. It’s like tax loopholes – legal even if shameful.

From The PACS Designer: “Re: wireless heart pump. Swiss scientists develop a wireless heart pump that does not make any contact with the blood that it’s augmenting. The next phase will be capturing the wireless information from the pump so it can be viewed along with other information sources to improve treatment options.” The pump is wireless but still invasive – it controls a set of rings placed around the aorta that contract sequentially to help move blood through. The advantage is portability, lack of triggered coagulation response, and a reduced risk of infection where the wires would otherwise penetrate the skin. It seems like this could work for swallowing disorders – if you’ve ever seen a dysphagia patient whose nervous system can’t coordinate swallowing contractions, it’s pretty horrible.

From Holding On: “Re: McKesson. Did you lose them as a sponsor of HIStalk?” Yes. I had to cancel RelayHealth, McKesson, and McKesson’s Paragon business as sponsors because their ever-churning marketing departments left us without a valid contact or anyone there who even knows what HIStalk is. Of those thankfully few sponsors who don’t continue, probably 30 percent are for this reason (nobody at the company has a clue or is empowered to make a decision following turnover), 40 percent are due to acquisition by a company that already sponsors, 20 percent are because the company doesn’t have the money, and 10 percent are because they don’t see the value, usually stated by a junior marketeer who adores social media while not paying attention to what real executives read for business (i.e., not Twitter, Facebook, or Instagram).

From Gidget: “Re: DataBreaches.net. You mention them specifically in your security updates. Do you have a business arrangement with them?” No. I simply think they are doing fantastic work and it’s only fair to credit them as my source, even if they refer to a source of their own. I’m just about the only publication to give them credit, I’ve noticed. That’s pretty sleazy and self-serving for alleged journalists who are paranoid that their audience might realize how little actual reporting they do and therefore try to hide that fact by passing off someone else’s legwork as something they sleuthed out themselves. It bugs me that plenty of sites get their story ideas from HIStalk without giving credit, so I won’t do it to someone else. I use only original sources (never other health IT sites since all they do is summarize press releases and journal articles while adding no value) and I always provide a link.

From Marquis Stanley: “Re: KLAS. How they are allowed to continue on without any kind of question or reproach is remarkable. They’re as direct a beneficiary of the billions of federally infused HITECH dollars as any vendor, with no scrutiny or oversight. To Mr. H’s point, the overall lack of transparency related to survey and analysis processes and vendor relationships is curious at best – especially with KLAS being linked to the VA and DoD procurements.” There’s no second-guessing their success as long as the market for their services continues to exist.

From PM_From_Haities: “Re: KLAS. It’s better than the alternatives. Empirical evidence of good evaluations of good products aside, vendors that are not deemed Best of KLAS are of course going to grumble. I’ve never heard anyone raving about help they received by Black Book or any of the other ratings. Some of the small samples are the best you can do as some HIT software is only installed in select locations. KLAS is one data point in a good vendor evaluation. The move to MU should add commodity features that people will come to appreciate as certified vendors will have to meet some minimum bar.” I’ll be interested to see what Vince and Elise say in future installments of their “Rating the Ratings” series, which draws from responses to my own recent survey.

HIStalk Announcements and Requests

This week on HIStalk Practice: Aledade opens a new ACO in Arkansas. Modernizing Medicine announces California expansion plans. VITL partners with OhMD to offer Vermont MDs secure texting. Medicaid hassles prompt some independent practices to throw in the towel. Hello Health’s Krista Sultan offers advice on making CCM work for your practice. GE Healthcare reports on EHR use in Rio. Medina Innovation Holdings rebrands, creates new telemed subsidiary. YMCA’s Matt Longjohn, MD outlines the ways in which healthcare technology are enabling the Y’s Diabetes Prevention Program. Signature Medical Group and Heritage Medical Systems form new population health management venture.

Listening: new from long-time Nick Cave collaborator Mick Harvey, who released the third album in which he translates the work of long-dead French musician Serge Gainsbourg. You would expect something that weird from one of the always-intense Bad Seeds, which to me were like a resurrection of the dark but strangely alluring poetry of The Doors. One might logically jump from there to the little-known, baritone-led Tindersticks.

Webinars

August 24 (Wednesday) 1:00 ET. “Surviving the OCR Cybersecurity & Privacy Pre-Audit: Are You Truly Prepared?” Sponsored by HIStalk. Presenter: John Gomez, CEO, Sensato. Many healthcare organizations are not prepared for an OCR pre-audit of their privacy and security policies. This webinar will provide a roadmap, tools, and tactics that will help balance policies and budgets in adopting an OCR-friendly strategy that will allow passing with flying colors.

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

Acquisitions, Funding, Business, and Stock

Data breach and identity fraud protection firm ID Experts recapitalizes itself in bringing in two private equity firms for $27.5 million in funding and cashing out unnamed current owners. The deal values the 88-employee Tigard, OR company at $50 million.

Pregnancy wearable and tracking app vendor Bloomlife raises $4 million in a seed funding round with investors that include Salesforce founder Marc Benioff. The company’s Belli app monitors contractions during the third trimester at a price of $29 per week.

Denver-based patient engagement app vendor NextHealth Technologies closes $8.5 million in Series A funding, increasing its total to $9.5 million. CEO Eric Grossman came from TriZetto.

Nuance acquires radiology data mining analytics provider Montage Healthcare Solutions, a former Nuance partner. William Boonn, MD and Woojin Kim, MD of Montage have updated their LinkedIn profiles with titles of CMIO at Nuance.

Sales

The state of Kansas awards a $215 million Medicaid claims system contract to HP Enterprise, which will bring in Cerner’s HealtheEDW data warehouse and population health management tool to allow care managers to optimize the treatment of Medicaid patients in near real time.

People

University Hospital (OH) names Joy Grosser (UnityPoint health) as CIO, replacing interim CIO Sue Schade.

Announcements and Implementations

A new Peer60 report covers HCAHPS data collection and analysis vendors, finding that the just-acquired Press Ganey dominates, while PRC and JL Morgan also score well in satisfaction.

Extension Healthcare announces Extension Mobile 5.0 as an enhancement to Extension Engage, which is in production at Parkland Memorial Hospital (TX).

Salesforce announces a two-way video chat telehealth solution for Salesforce Health Cloud that also automatically displays the patient’s medical profile to providers. 

Sunquest announces GA of Vue 1.0, a diagnostic workstation that integrates clinical and anatomic pathology information for pathologists.

The HIMSS-SIIM Enterprise Imaging Workgroup releases another white paper, this one titled “Workflow Challenges of Enterprise Imaging.”

Government and Politics

Kaiser Permanente, unlike most of the for-profit insurers bailing out on the ACA exchange business, says it won’t do the same and is actually making a small profit on that business. CEO Bernard Tyson says,“The idea that I would turn my back on a segment of the American population who really needs the coverage and the care—I’m in for the long haul. The discussion is interesting, as big insurers claim they’re getting hit hard financially by sicker-than-expected customers who unfairly use special enrollment periods to sign up for insurance only when they’re getting sicker, while others say ACA markets are doing exactly what they should in weeding out higher-priced insurers who lose business to more aggressive competitors (the national insurers who are dropping out were nearly always are getting beaten on price). ACA business could be shored up quite a bit by stiffening the penalties for people who fail to buy insurance (just like for car insurance), clamping down on people who buy or change insurance mid-year for questionably documented reasons, and extending insurer and consumer commitments beyond today’s one-year period to settle the market down. Perhaps the biggest unexpected event that hurt the exchange insurance business is that companies didn’t stop offering health insurance to their employees as experts predicted, making the ACA marketplace smaller and riskier.

New, expensive cholesterol-lowering drugs will add up to $120 billion per year to US healthcare costs, an economic analysis finds, as the healthcare economics debate will be fueled by insurers who refuse to pay for widespread use of drugs they say are unproven. One of the drugs, Praluent, costs $15,000 per year and must be taken for life by the millions of Americans who could be clinically eligible to receive it. Cost-effective drugs are defined as costing no more than $100,000 per year of life saved, which is how Praluent is priced in Europe (a fraction of the US price) since the governments there are allowed to negotiate drug prices. That brings up an unstated philosophical argument – if a patient could live 20 more years if they take Drug A, should the rest of us happily pay $2 million to fuel the profits of drug companies whose price will always be the maximum the market supports?

Privacy and Security

Security firm FireEye notes a rapid uptick in email campaigns attempting to spread Locky ransomware, with US healthcare systems leading the number of affected sites. The latest variant uses Microsoft Word .DOCM attachments (often labeled as invoices or images) that launch macros when opened. Locky can also encrypt Microsoft OneDrive files and unmapped network shares.

From DataBreaches.net:

• A recent district court opinion in a healthcare breach case serves as a reminder that while big breaches spawn a lot of class action lawsuits from those whose information was exposed, courts are not usually sympathetic unless those filing the suit can prove that their data was used in a way that harmed them.
• The Center for Neurosurgical and Spinal Disorders (LA) notifies several hundred patients that it found a hacker-installed keylogger program its office manager’s PC that was capturing keystrokes and taking scheduled screen shots. The practice quickly and commendably responded: it notified the FBI, sent notification letters, hired a forensics firm to analyze the hard drive, notified consumer credit reporting companies, and offered free identity theft and restoration services to those affected. It also announced plans to report the breach to OCR. Congratulations to the unnamed in-house IT person who figured out what was happening and addressed it.
• A California dentist notifies patients that unencrypted hard drives containing backups from his practice’s system were stolen from his car. The dentist downplayed the exposure in his notification letter, telling affected patients that the information was unlikely to be usable. However, a security expert says the system he appears to use employees the MySQL database, which can be easily accessed given a physical copy. The dentist responded that he’s not worried after talking to the software vendor because their product is “HIPPA compliant.” There’s usually a lesson to be learned from a breach and here’s this one – if you run MySQL databases (which many or most websites and web apps do), get an expert to check its security settings. 

Technology

A Wall Street Journal article notes that patients are receiving false-positive warnings from genetic testing because older studies that found genetic correlation with disease states had non-diverse participants, making those correlations inconsistent to the population as a whole.

Other

The former CFO  of Sonoma West Medical Center (CA) joins the hospital’s former CNO in suing the hospital for wrongful termination, both claiming they were fired for complaining about the hospital’s EHR. The hospital uses EHR software developed and marketed by one of its physician executives in partnership with the hospital’s board chair. The hospital, whose average inpatient census is 13, is the only US user of the software, which has no paying customers among six non-US sites that are piloting it. Both executives say the software mixed up patient records, miscalculated medication schedules, failed to update quickly, and delayed billing.

In Denmark, the doctor’s union says rollout of a new EHR in Copenhagen’s busiest hospital should be delayed until problems with its communication with the Danish health card are fixed. Previous go-lives at other hospitals in Denmark in May and June caused medication errors and treatment delays, according to doctors there.

A JAMA editorial by three Stanford doctors says EHRs haven’t kept up with the technologies used by other industries. The authors say that billing-focused EHRs distract doctors, adding that “de-implementing the EHR could actively enhance care in many clinical scenarios” (although the authors fail to note how many of those enhanced practices would shut their doors within a year in the absence of EHR-powered billing). EHR shortcomings include:

• They haven’t integrated predictive algorithms into offering treatment suggestions based on patient parameters.
• They don’t use insurer-developed algorithms that identify high-risk patients to support the delivery of preventive care.
• They can’t identify a patients similar to the one being treated to suggest treatments based on past experience.
• They don’t  triage alerts well to prevent fatigue and workflow interruptions.
• They don’t take advantage of graphical data display that could help doctors make faster decisions and communicate to families better.
• They don’t capture social and behavioral factors from patients themselves, i.e. the “patient story,” in limiting themselves to medical data.

Weird News Andy says he likes this “alot.” A grammar-persnickety blogger that reminds WNA of me soothes her frustration created by the grammar mistakes of others in picturing a mythical creature called an “alot” when someone writes things like, “I watch alot of TV.”

Sponsor Updates

• Intelligent Medical Objects will exhibit at HIMSS Asia-Pac August 23-26 in Bangkok.
• Meditech will exhibit at the Mid-South Critical Access Hospital Conference August 19-21 in Nashville.
• The local business paper profiles Netsmart’s general manager of Netsmart Homecare, Dawn Iddings.
• Obix Perinatal Data System will exhibit at AWHONN August 21-23 in Jekyll Island, GA.
• Experian Health will exhibit at HFMA Region 8-MASI August 24-26 in Minneapolis.
• PMD makes the 2016 Inc. 5000 list of fastest-growing private companies in America for the fifth year in a row.
• The SSI Group will exhibit at CAHAM 2016 August 28-29 in La Jolla, CA.
• SyTrue will present “A Data Refinement Framework for Fueling Health Innovation” at South Georgia Radiology Associates August 27.
• The Chartis Group creates the Chartis Physician Leadership Institute.
• Direct Consulting Associates is recognized as one of the best places to work in Ohio.

Blog Posts

• Maximizing Reviews to Enhance Your Reputation Online (Influence Health)
• Organizing Clinical Optimization Teams to Support Post-Live Optimization Efforts (Impact Advisors)
• Four Ways Consumers are Demanding Changes in the Healthcare Payments Experience (InstaMed)
• What Amazing Gymnasts and Patient Payment Processes Have in Common (Navicure)
• It’s Prime Time for Neural Nets in Speech Recognition (NVoq)
• Don’t Compromise Data at the Point-of-Sale (Patientco)
• Lessons Learned from HP (PatientKeeper)
• Fast, Efficient, and Fun PMD Travel (PMD)
• Tackling the Integration Challenge: A New Breed of Analytics in Healthcare (Orion Health)

Contacts

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

EPtalk by Dr. Jayne 8/18/16

As a consulting CMIO, I often get asked to help organizations develop or refine their provider adoption strategies. Convincing people to do things that they don’t want to do can be tricky, especially if they’re not being incented to do so.

Creating incentives for employed physicians is fairly easy. Usually they are under contract and expectations regarding EHR use can be added to that framework. Creating incentives for independent members of the hospital medical staff can be challenging. Often we’re asking them to use new process that may add to efficiency for the hospital, but will lower their personal efficiency.

I’m working with a hospital that thought they could drive physician adoption strictly by saying use of the EHR was required. They had implemented various pieces of an EHR over the last decade, but use has always been optional. Physicians were allowed to continue writing paper notes that were scanned and they were allowed to continue writing paper orders that were entered by nursing staff or unit secretaries.

Because use of the systems (plural) was optional, the hospital never put the time and effort into ensuring that physicians had the training and support they needed to be successful. It was a vicious cycle of non-use costing them tens of thousands of dollars each year, so hospital administration simply decided that using it would be required.

You can imagine the revolt that immediately occurred with the medical staff. Physicians threatened to take their elective procedure business elsewhere, and did. High-dollar specialists left in droves. Now the hospital is trying to woo them back, having let some members of the administrative team go following the aftermath of their poor decisions.

I know the CMO from medical school, so he invited me in to work with them on a strategy to get things back on the rails. It was no surprise that simply “requiring” use of the systems drove providers away. Physicians weren’t presented with a compelling reason for the requirement; nor was it clear whether they were going to be retrained, supported, or left on their own to figure out how to document in the systems. Having been on the receiving end of bad policy decisions previously, they assumed the latter.

One of the first things I recommended was that we analyze their medical staff makeup, identifying what percentage of the physicians are using the systems as desired, and of non-users, how many were actually on staff when the various systems were originally deployed. Institutional memories can sometimes be short, and people were surprised to learn that the vast majority of medical staff members had joined long after implementation and training of the key systems was complete.

With that data, we were able to persuade the administration that we needed to essentially re-implement the systems. Rather than trying to target individual physicians, we’d do it over and do it right.

The VP of nursing was immediately on board since her staff had grown increasingly frustrated by having to support multiple workflows and data sources depending on the behavior of admitting physicians. The CIO was also on board, having had a sneaking suspicion that if physician adoption wasn’t achieved, leadership might decide that his systems were at fault and demand a replacement initiative. Another interesting result of the data analysis was that there was a small group of proficient users who could be leveraged to help move provider adoption in the right direction.

The CMO and I have been working together to use those power users as physician champions, helping their peers understand that fully using the electronic systems can actually make their rounding more efficient and reduce phone calls and interruptions for them. The excitement around re-implementing the system has allowed him to build a small clinical informatics team, so that the hospital has knowledgeable and trusted resources to not only help the physicians through the transition, but to carry them forward through all the changes that healthcare reform will surely throw in their direction.

Of those power users, we identified one with formal informatics training, who happened to be a community-based admitting physician. He had done a fellowship thinking he was going to go into academics, but personal circumstances put him in a small city where he didn’t think he’d get to use his expertise. He has been fun to work with, since he really gets it as far as what we’re trying to do and what else the hospital will need to accomplish over the next several years. He’s been a great help with the change management piece as we convince the physicians that this is the right thing to do for a variety of reasons, none of them being because someone said it was required. He’ll make an excellent CMIO if he’s ever willing to reduce his clinical commitments.

Rather than implementing the systems separately as has been done in the past, they’re treating it like a big-bang go-live, which I think is wise. That brings a lot more visibility to the project and allows us to have a greater number of support resources available for the providers – saturating them for the first few weeks rather than having fewer support liaisons for each of multiple system go-lives. The advantage for adoption this time around also includes the fact that the nursing staff has been live on the system for years, so they’ll be able to assist with some of the workflows that are common between nurses and providers.

Instead of only offering classroom training, we offered multiple methodologies including Web-based didactic, Web-based interactive, scenario-based training, classroom, and one-on-one. Over the last 10 years I’ve seen much more recognition of the different ways that people learn, and for those that have difficulty absorbing information, we scheduled the offerings so that providers could take advantage of multiple types of training if they found that what they selected didn’t work for them. Using this type of approach isn’t cheap, but when you look at how much they had been spending to run a fragmented, double-entry approach, it will pay for itself in short order.

I’m on site with them for the next few days, getting the command center ready for Monday and tidying up loose ends with provider preferences and favorites in the production system. We’re actually going live at midnight for in-house physicians and will be in full swing when the community physicians arrive for morning rounds. It’s been a while since I staffed a go-live like this and I had forgotten how exciting they can be. They can also be exhausting, and I’m sure by the end of next week I’ll be more than ready to head home.

Although it’s not a traditional go-live given the time the software has been in place, I’m sure having greater numbers of users doing many different workflows will still yield a number of bugs and issues that we’ll have to track down. Seeing this organization grow over the last several months gives me hope that they’ve arrived at a place where their technology and transformation efforts will be sustainable. It’s been a good recharge for me as well, since this type of work is where I got started. I’ll be on site next week and will let you know how it goes.

Email Dr. Jayne.

Morning Headlines 8/18/16

FTC Approves Final Order in Practice Fusion Privacy Case

The FTC finalizes its privacy case settlement with Practice Fusion. The company’s trouble with the FTC stems from a 2013 incident in which it solicited doctor reviews from patients without disclosing that the reviews would be publicly posted on the Internet. The settlement, which was published in a draft version in June, prevents the company from using the illegally collected reviews, and authorizes the FTC to conduct privacy audits on the company for the next 20 years.

Points for pills: Walgreens hopes gamelike program will make taking meds easier

Walgreens expands its mobile health app to include gamification strategies and Walgreens rewards points to improve medication adherence.

Aetna Warned it Would Withdraw From Exchanges if Humana Deal Was Blocked

In July, Aetna warned the Justice Department that if its antitrust officials sued to block its Humana acquisition, it would reduce its presence on ACA public health insurance exchanges.

CIO Unplugged 8/17/16

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

Re-Igniting Passion

For the past year, I have had the privilege of serving the City of New York. During the week, I live in lower Manhattan in the heart of the financial district. Each morning, my 15-minute walk to the office takes me down Wall and Broad Streets.

As I pass Federal Hall and head toward the New York Stock Exchange, crowds of tourists scramble across the brick-floored plaza to take selfies and purchase concessions. Sometimes I get aggravated as I navigate through the crowd, but soon my grimace turns to a smile.

It’s easy to determine tourist from businessperson, and it’s not always the clothes. The tourists are excited and have a sense of wonderment on their faces. Their eyes are wide as they view the Exchange and the nearby Statue of Liberty for the first time.

For me and other locals, the sights are routine. We’ve long since lost the feeling of awe and passion we initially possessed when we were new to the sights. It made me ask myself, how do we maintain that initial passion in all we do, especially in relationships and work?

We are all uniquely wired and there is no single answer. Some people are chronically unhappy and passion has long withered. Some require a consistent encouraging word or gentle reminder. Others benefit from education and understanding themselves so they can discover and actualize their fire. Some benefit from embracing vision. I fall into the gentle reminder camp.

As leaders, I believe our energy is best served encouraging passion in those who show capacity and interest. We should seek to inspire, not motivate. At the end of the day, most of us want to be able to look forward to getting up and going to work. We covet those expressions of awe and wonderment as if it were our first day discovering a new city or kindling a new relationship. A couple of ideas:

• Office in a patient care setting. Over the last few years, I ended up with a corporate office far away from patient care settings. Now, I have to be intentional about getting back out there so I can connect with patients and clinicians.
• Answer the question– why healthcare? You can practice IT in any industry. Why did you choose healthcare? If it is altruistic, write it on your heart. You will need to re-center there often.
• Figure out your mission and write it down. I have written about this more than once because it’s a message that deserves repeating. It’s not so much the written words you end up with, but the deep introspection required to better understand yourself.
• Accountability. Find a friend or partner who will remind you now and again to find that smile and confidence that comes from having a sense of purpose. They can remind you to act like those wide-eyed tourists and be joyful for your opportunity.
• Thankfulness. I really think there is a correlation between active thankfulness and personal and professional fulfillment. If you can’t find anything to be thankful for, then you will never be fulfilled. If thankfulness is hard, then simply practice it and the attitude will follow. I am even thankful for the hard stuff I have been through.
• Calling. This is similar to mission, but with a spiritual bent for those so inclined. I feel strongly that I know my identity and that my sense of purpose has been revealed to me through reading scripture, meditation, discourse, and prayer. I believe there is a calling for everyone, but it is up to each of us to seek and find.
• Humility. If you can’t admit you need help with keeping passion alive, then you probably have a pride issue—and pride will kill passion time and again. Pride is a temporary salve for pain you carry and it’s a vicious cycle from which it is hard to escape.

Having passion does not guarantee success or that you are immune from the trauma of life. My passion has served me well over the years, but it has not sheltered me from harm, lapses of judgment, or damage. However, I think it goes a long long way toward a satisfying career and a meaningful life.

How do you keep passion lit in your career?

Ed encourages your interaction by clicking the comments link below. You can also connect with Ed directly on LinkedIn and Facebook and follow him on Twitter.

Morning Headlines 8/17/16

Leidos Announces Closing Of  the Merger With Lockheed Martin’s IS&GS Business and Election Of Three New Directors

Leidos completes its merger with Lockheed Martin’s Information Systems & Global Solutions, adding three new members to its board of directors in the process.

The Bahamian Ministry of Health and Public Hospitals Authority select Allscripts Sunrise

The Bahamian Ministry of Health and the Public Hospitals Authority will implement Allscripts across three hospitals and more than one hundred clinics as the health system moves to integrate care delivery under a single software platform.

Aetna to Narrow Individual Public Exchange Participation

Aetna will scale its participation in health insurance exchanges back to just four states in 2017, citing $430 million in pretax losses since January 2014.

Xerox Research Finds Patients and Healthcare Professionals Divided on Responsibility and Cost in Healthcare

A Xerox study measuring perceptions of responsibility of consumers’ health finds that 90 percent of payers and providers say patients need encouragement and help to make living a healthier lifestyle a priority, but only 55 percent of patients say they need such encouragement.

News 8/17/16

Top News

Leidos closes its merger with Lockheed Martin’s Information Systems & Global Solutions business and adds several executives to its Board of Directors, including Gregory Dahlberg (Lockheed Martin), Surya Mohaptra (Quest Diagnostics), and Susan Stalnecker (DuPont). Originally announced in January, the merger will give Leidos an additional $5 billion in revenue thanks to legacy LM customers that include HHS, Homeland Security, and the Social Security Administration.

Webinars

August 24 (Wednesday) 1:00 ET. “Surviving the OCR Cybersecurity & Privacy Pre-Audit: Are You Truly Prepared?” Sponsored by HIStalk. Presenter: John Gomez, CEO, Sensato. Many healthcare organizations are not prepared for an OCR pre-audit of their privacy and security policies. This webinar will provide a roadmap, tools, and tactics that will help balance policies and budgets in adopting an OCR-friendly strategy that will allow passing with flying colors.

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

Acquisitions, Funding, Business, and Stock

Citing an increasingly out-of-balance risk pool, Aetna CEO Mark Bertolini announces the company will reduce its public health insurance exchange coverage from 15 states to four next year. Humana and UnitedHealth have made similar announcements in the last several months.

Less than a week after announcing its $70 million Series E, Plymouth Meeting, PA-based Accolade announces plans to hire additional staff at its new office in Prague. It expanded to the Czech Republic last month, after opening a second office in Seattle in February.

People

Sensei promotes Ashley Reynolds to COO.

Verisk Health appoints Emad Rizk, MD (Accretive Health) CEO and board director.

I2I Population Health names Jennifer Windrow (ICA) SVP of client delivery, and Jennifer Calohan, RN (Patient Engagement Advisors) VP of client success.

Nick van Terheyden, MD (Dell Services)and Jessica Federer (Bayer) join the MedicAlert Foundation Board of Directors.

Announcements and Implementations

Providers in California, Minnesota, Texas, and Virginia go live on The Sequoia Project’s Carequality Interoperability Framework. Early adopters include customers of Athenahealth, EClinicalWorks, Epic, HIETexas, NextGen, and Surescripts.

Surescripts increases its year-over-year processing of secure health data transactions by 48 percent, facilitating 9.7 billion transactions in 2015. Last year also saw a 10-percent increase in the company’s digital prescription transactions – a figure no doubt aided by state-based e-prescribing mandates.

Shamrock Solutions develops a cloud-based, automated EOB reconciliation tool for enterprise content management systems from the likes of Lexmark and Hyland.

Get Real Health adds the MyDirectives health crisis care-planning tool to its InstaPHR.

Technology

Translational Software develops a FHIR-based pharmacogenomics API to help providers, labs, and vendors create apps that can improve prescription ordering workflows, alert prescribers to potential interactions and adverse drug events, and suggest different medications.

FormFast launches FormFast Capture, a paper-to-digital records conversion service that automatically archives forms within the EHR.

Champ Software adds Direct messaging capabilities from Secure Exchange Solutions to its Nightingale Notes EHR for community and public healthcare agencies, home health agencies, and schools of nursing.

Sales

University Health Care System (GA) integrates Right Patient’s photo biometric patient identification system with its Epic EHR.

The Bahamian Ministry of Health and the Public Hospitals Authority will install Allscripts Sunrise at its three hospitals and 100-plus clinics. The health system is embarking on a complete overhaul that includes upgrading existing facilities, building several new ones, and extending clinic hours.

University of Utah Health Care implements Imprivata’s PatientSecure identification technology in hopes of reducing duplicate medical records and improving patient safety at its hospitals and clinics.

Franciscan Alliance (IN) selects unified provider management services from Phynd Technologies.

University Health Shreveport/Louisiana State University Health implement TelePreop’s telemedicine software to better coordinate pre- and post-operative care.

Research and Innovation

A JAMIA study finds that patient data obtained from an HIE is available faster and is more frequently reviewed by clinicians than data obtained via fax or telephone. The study also suggests that access to HIE data reduced ER visit length by one hour, reduced the likelihood of admission by 2.4 percent, and reduced the average cost of care for the visit by $1200.

A Xerox survey of 761 insured consumers reveals that providers and payers don’t seem to give them enough credit when it comes to managing their own care. Fifty percent of those surveyed believe they take complete responsibility for their health, but only 6 percent of providers and payers agree. Adding insult to injury, 90 percent of healthcare professionals take a rather paternalistic attitude in their belief that consumers need their help and encouragement to prioritize healthy living, while only 55 percent of consumers concur. A similar disconnect was seen between consumer and provider/payer sentiment around comparison shopping for healthcare

Sponsor Updates

• The CoverMyMeds team contributed more than 45 new automated toys and modified 30 of those so that they can be used by kids with disabilities as part of a Replay for Kids workshop.
• AdvancedMD will host its annual user’s conference October 11-13 in Salt Lake City.
• Attendees share why they love AirWatch’s Connect Atlanta conference.
• Besler Consulting and HCS will exhibit at the HFMA Region 3 Inaugural Summit August 21-23 in Wilkes-Barre, PA.
• Meditech publishes a new case study, “Avera Health Reduces Sepsis Mortality with Help from Meditech’s EHR.”
• FormFast offers the “Top 4 Reasons to Modernize Your Patient Access Department.”
• Aprima showcases MACRA/MIPS readiness at its 2016 user conference.

Blog Posts

• MIPS Scoring & Your Practice: What You Should Know (AdvancedMD)
• Risk Algorithms: The Keystone of Value-Based Contracting (Arcadia Healthcare Solutions)
• Is Leakage a Dirty Word? (Evariant)
• CMS Puts the Gas on Mandatory Bundles (HealthLoop)
• Spotlight on the Data Analyst Role in Healthcare (Evariant)
• Major takeaways of CMS Transmittal 1681 (Besler Consulting)
• What are Bundled Payments Really About? (Caradigm)
• Chronic Care Management Done Right (CareSync)
• Transforming Access Through Scheduling Redesign (Culbert Healthcare Solutions)
• Performance at the Highest Level (Spok)
• Collaboration is Critical in Care Model Transformation (ECG Management Consultants)
• Top 5 Hospital Application Portfolio Complexity Drivers (Galen Healthcare Solutions)
• The Two Sides of MACRA: Examining the Pros and Cons (Hayes Management Consulting)
• Working from Home – Do You Have What it takes? (HCTec)
• Epic Credentialed Trainers: Before, During & Post Go-Live (The HCI Group)
• Shared Decision Making “Topped Out?” Think Again (Healthwise)

Contacts

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

Morning Headlines 8/16/16

Health information exchange associated with improved emergency department care through faster accessing of patient information from outside organization

A JAMIA study finds that patient data obtained from an HIE is available faster and is more frequently reviewed by clinicians than data obtained via fax or telephone. The study also suggests that access to HIE data reduced ER visit length by one hour, reduced the likelihood of admission by 2.4 percent, and reduced the average cost of care for the visit by $1200.

Hospitals Are Partnering With Uber to Get Patients to Checkups

The Atlantic reports that health systems and payers are now turning to Uber or Lyft to help ensure that patients get to their medical appointments.

The healing power of AI

In A TechCrunch article, intellectual property attorney Erik Birkeneder discusses the growing role artificial intelligence may one day play in healthcare.

Chance Collaboration Yields an Advance in Cancer Treatment

The Wall Street Journal tells the story of an immunologist helping his stepmother fight cancer and the oncologist who treated her. The two discovered a unique immune-system cell that “robustly” predicts whether patients will respond to immunotherapy cancer treatments.

Readers Write: Why Reverse Mentoring is Beneficial for HIT Employees

Why Reverse Mentoring is Beneficial for HIT Employees
By Frank Myeroff

Reverse mentoring is when seasoned HIT professionals are paired with and mentored by the younger Millennial generation for the reasons of being extremely tech savvy, fast to adopt new technology, and not afraid of trying new things. In addition, it helps to bridge the gap between generations.

Reverse mentoring was introduced in the 1990s by Jack Welch, chairman and CEO of General Electric at that time. While it’s not exactly new, it’s gaining popularity fast. More and more organizations are recognizing the value of reverse mentoring and are developing formalized programs to ensure best practices in order to yield success. They believe that Millennials are well suited as mentors to help maximize HIT use and adoption in order to move organizations forward in this digital age.

Additionally, with the ever-changing landscape of technology and tools used in the HIT field, reverse mentorship can be extremely beneficial:

• Young, fresh talent has a chance to share their skills, knowledge, and fresh perspectives with more senior employees. Hospitals and health systems often look for their HIT professionals to use technology to improve patient care, lower costs, and increase efficiency. This means that the latest technology is routinely sought. Organizations know that tech savvy younger generations will catch on to this quickly, presenting an opportunity for them to share their knowledge with a different generation. Not only HIT systems, but also technology and platforms such as social media could be unique topics for Millennials to share information and ideas on.
• Creates a way for separate generations to build working relationships with one another. Reverse mentorship can help junior HIT employees feel more needed, confident and comfortable communicating with higher-up employees working together on projects or even in meetings. Additionally, this could create more cohesion in the workplace and begin to break down perceived barriers and stereotypes of each generation.
• Gives junior employees a higher sense of purpose in the organization. Implementing a reverse mentorship program gives young HIT professionals a sense of empowerment and the idea that they are making an impactful contribution to the company. This in turn, could help increase retention and help to shape future leaders in the organization.
• Continues to provide ways for senior employees to share their knowledge as well. Although called reverse mentorship, this type of program offers a two-way street for employees of all ages to learn from one another. Experienced professionals in the HIT field are able to share their insights and knowledge, in addition to learning new things.

While reverse mentorship can be extremely beneficial in the HIT industry and especially any industry with a tech focus, there are several conditions this type of relationship depends upon:

• Trust. Each person needs to trust the other and put effort into bettering both careers.
• Open mindedness. In a reverse mentorship, both employees will act as a mentor and a mentee and need to show a willingness to teach, but also a willingness to learn.
• Expectations and rules. It will be important for both parties in the mentorship to communicate what they are looking to get from the relationship as well as staying committed to the process.

Reverse mentorship is an innovative way to bring together generations of employees to share knowledge. In addition, today’s Millennial mentors will be tomorrow’s chief healthcare officers. We will depend on them to lead the IT department and create strategies on how to handle the growing amount of digital data for healthcare workers and new ways to support technologically advanced patient care modalities.

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

Curbside Consult with Dr. Jayne 8/15/16

There are a lot of people in the clinical informatics field who have participated in vendor focus groups and other information-gathering activities. Those can be a lot of fun as well as a great way to meet other physicians in the field. They can also be a great opportunity to see the “next big thing” as it evolves and makes its way to market.

I’ve made some good friends in the marketing space. They’ve introduced me to other organizations that might be looking for some physician input on their product campaigns. Over the last year or two, I’ve had the opportunity to work in depth with a couple of organizations.

The first engaged me to assist with questions around their functionality. Although they had a strong development team, their clinical input was limited to a handful of informatics physicians and end users of their current product. This is fairly common with startups, who might not have the to put a physician on the payroll. Sometimes they do have the funding, but are spending it in areas other than clinical expertise, and it becomes my challenge to help them see the value that regular physician input might bring to their products and their development process. It’s much easier to have someone who can vet your designs immediately rather than having them get close to release and be shot down by a focus group because you missed the mark.

In addition to working with them on product development, they also engaged me to assist in marketing efforts and in ensuring that the script for their product demonstrations was both medically accurate and clinically relevant. I can’t understate the value of having solid clinical input in this area. There is nothing that causes a physician’s brain to shut off like being presented with a clinical scenario that makes no sense or is insultingly dumbed down. It’s one thing to use a straightforward scenario, like a visit for an acute illness, so that you can highlight the product’s abilities and not distract the user’s attention. But it’s another thing entirely to work through a scenario choosing nonsense data, explaining it away “because it doesn’t matter.” Especially where features such as clinical decision support are involved, the information needs to make sense for it to be believable.

They were also one of the more fun groups I worked with. They brought me back to do some product naming work, and although none of the names we came up with in our working session were ultimately chosen, it was exciting to be part of that process and to use the creative side of my brain. I was so proud when their product launched and every time I see it in the wild, it’s fun to know I had a hand in it.

My next adventure was with a startup EHR company. One of the founding partners fully realized that they needed physician input to ensure they were spending their clinical development resources wisely. Unfortunately, the other founding partner was not completely with the program. They were more interested in bells, whistles, and flash than they were in creating a product that could meet the needs for complex documentation, and what they ultimately produced could be described as Franken-EHR. Parts of it were beautiful and glossy, but lacked the clinical functionality that physicians want these days, such as the ability to link scanned images to open orders. Other parts of it were intended to allow robust documentation with plenty of discrete data, but ended up being a complete and total click-fest. Yet another piece of it looked as if it had been clearly lifted from another vendor where a third founder had once worked. I realized a bit later that it had – when I went to remove some of their code from my laptop, I found that one of the embedded components had a license linked to another vendor. Oops!

Another group engaged me to help recruit clinical participants for a focus group. I’m also working with them to gather materials to use when the group meets. The project is primarily around selecting images for a redesigned website and some marketing slicks. I’ve been visiting quite a few competitor websites to identify potential points that might resonate with physicians so that we can present them to the group. In the course of that project, I’ve stumbled on some great marketing efforts and also on some that are truly awful. One made me question whether the vendor (who happens to be large and very successful) even had marketing professionals involved in the creation of their materials, or whether they just threw some stuff together.

In putting together stats about the clinical representations – whether they showed the physician practicing, with a patient actor, or in home/leisure pursuits – I was struck by how much stereotyping I saw in some of the ads. The majority of the physicians represented were white males, with leisure pursuits of golf and skiing represented. One did have a physician testimonial showing him having more time for his grandchildren, which was a nice change. In the majority of campaigns I’ve viewed, women are largely featured in supporting roles as are non-white males. That certainly doesn’t look like the medical world I practice in. I was surprised at how often I saw those patterns.

My absolute favorite marketing piece (in the humor category) was all around being able to see your schedule from anywhere. This was primarily funny because pretty much every single product these days has that feature, so it’s hardly a market differentiator, yet the company had latched onto that idea and featured it prominently on their home page. It was even more funny because they included an embedded animation with a clinician at the gym, lifting weights. He stops in the middle of a set, grabs his phone, makes a couple of taps, then does some kind of smile/chuckle thing.

I don’t know about the rest of the clinicians out there, but it’s rare that I look at my patient care schedule and chuckle. It looked more like he was seeing an inbound text or a witty Facebook post, and the whole “multitasking at the gym” thing just felt a bit off-putting. We’ll see what the focus group says, because we’re going to include similar content to see what the participants think. If they’re anything like the physicians I talk to regularly, they’re more likely to be checking their schedule while they’re in the carpool line trying to drop off their kids at school, or while trying to hustle to the hospital to round on patients over lunch. Either way, once a feature becomes commonplace, I’m not sure why you’d market around it, but at least we’re going to find out if we do want to market a time-saving feature, what the best scenarios might be.

With the consolidation in the EHR market and the boom in add-on solutions, there is plenty of marketing out there. I’d be interested to hear from readers what kind of marketing they feel hits the mark, and what should be sent to the hall of shame.

Got marketing stories? Email me.

Email Dr. Jayne.

Morning Headlines 8/15/16

655,000 Bon Secours patients exposed to data breach

Bon Secours (VA) reports a 655,000 patient record breach after one of its business associates, R-C Healthcare Management, inadvertently left files containing patient information accessible on the internet.

Cerner’s Neal Patterson collects payday 21 years in the making

Cerner CEO Neal Patterson cashes in on a 25-year old stock option, netting him $26.9 million.

Athens Orthopedic won’t pay for extended credit monitoring in data breach

Athens Orthopedic Clinic (GA), which has refused to pay a ransom to hacker the Dark Overlord over 200,000 compromised records, is now also refusing to provide effected patients with credit monitoring services.

Strike preparations cost Brigham $24 million

Partners HealthCare reports a $33 million operating loss due to costs associated with an anticipated nursing strike, in addition to Epic-related implementation costs, and higher than usual real estate expenses.