News 1/28/15

Top News

HHS Secretary Sylvia Burwell announces an ambitious plan to tie 30 percent of Medicare provider payments to alternative payment models by 2016 and 50 percent by 2018, and also to link 85 percent of Medicare fee-for-service payments to quality and value by 2016. The announcement was received positively, although with guarded enthusiasm due to the lack of details and the mixed results of early adopters.

Reader Comments

From Nihilist: “Re: BJC. Rumor is that the Epic install will be run out of a yet-unnamed holding company as a partnership with Washington University School of Medicine, which employees the academic hospital faculty. That’s why no job postings have appeared.” Unverified.

Acquisitions, Funding, Business, and Stock

Huron Consulting will acquire Pensacola, FL-based, healthcare leadership consulting firm Studer Group for $325 million. The 235-employee company was founded by former hospital CEO and author Quint Studer in 1999 and was reported to have had 2013 revenue of $67 million.

China-based Alibaba Group, one of the world’s most valuable technology companies, partners with a medical software company to develop cloud-based services for physician practice, payment systems, e-prescribing, and drug tracking.

Roper Industries reports Q4 results: revenue up 7 percent, adjusted EPS $1.85 vs. $1.65, falling short on revenue expectations but beating on earnings. Chairman, President, and CEO Brian Jellison says the company will be making at least one more Q1 acquisition that relates to its Sunquest business. He adds that Roper paid $140 million for Strata Decision Technologies, which has $30 million in annual revenue, but Roper gets an immediate $40 million in tax benefit because the company was operating as a limited liability corporation.

Sales

Eastern Idaho IPA chooses Valence Health’s vElect contract administration system to allow physicians to compare fee schedules to Medicare benchmarks in selecting and declining payer contracts.

Two hospitals in Dubai will use Oneview Healthcare’s interactive patient engagement and clinical workflow system.  

University Medical Center Health System (TX) extends its agreement with Cerner.

MedConnect chooses clinical interface terminology from Intelligent Medical Objects for its EHR.

People

Biotechnology company Biogen Idec hires Naomi Fried, PhD (Boston Children’s Hospital) as VP of medical information, innovation, and external partnerships. She was Kaiser Permanente’s VP of innovation and advanced technology from 2006 to 2009.

Announcements and Implementations

Georgia’s GRAChie HIE – founded by Cerner, GRHealth, and Navicent Health — reports increased numbers of data sources and system usage.

The DEA approves EHNAC as the sole certifier of applications for electronic prescribing of controlled substances.

The Anesthesia Quality Institute recognizes Shareable Ink’s newly released ShareQuality mobile quality capture product as Quality Clinical Data Registry ready, allowing practices to use CMS’s preferred reporting mechanism.

CoverMyMeds announces that its electronic prior authorization system has been integrated with Epic.

Decisio Health earns FDA marketing approval for its EHR-powered bedside clinical decision support and triage dashboard that was beta-tested by Memorial Hermann Hospital (TX).  

The Apple Watch will begin shipping in April.

Government and Politics

An HHS OIG report says CMS should coordinate its multiple quality improvement programs to reduce duplication of effort and to make it easier to attribute results, adding that CMS awarded Quality Improvement Organizations a new $4 billion contract just after spending $500 million to roll out two other programs.  

Privacy and Security

St. Peter’s Health Partners (NY) warns that a manager’s stolen, unencrypted cell phone contained emails with patient scheduling information for its physician practices. I think I read that iOS 8 encrypts everything on the iPhone by defauult.

Innovation and Research

Samsung engineers create a smartphone-powered early warning stroke detection headset that analyze brain waves, expressing hope that the sensors may also be useful for other brain-related conditions. The engineers add that while the prototype model is a headset, the rubber-like sensors could be attached to less-obtrusive eyeglass temples.

Technology

Logitech announces a $500 portable videoconferencing solution for medium-sized rooms, which might be interesting for remote teams and IT meetings. ConferenceCam Connect works on any device that has a USB port and includes both battery and AC power.

Other

Weird News Andy says it’s like deja vu all over again. A doctor describes his patients’ constant deja vu as being trapped in a time loop. “As he walked in, he got a feeling of deja vu. Then he had deja vu of the deja vu. He couldn’t think of anything else.”

Western Missouri Medical Center’s COO gives its Meditech-to-Cerner conversion a B+ grade, saying that continuity, integration, and data collection improved markedly, but getting data from Meditech was hard. They say they “never new when upgrades are coming” with Meditech.

Weird News Andy says it’s like deja vu all over again. A doctor describes his patients’ constant deja vu as being trapped in a time loop. “As he walked in, he got a feeling of deja vu. Then he had deja vu of the deja vu. He couldn’t think of anything else.”

Sponsor Updates

• Nordic suggests five areas that should be part of a 2015 health IT plan.
• Beacon Partners explains Business Intelligence Competency Centers and how to implement them.
• PatientSafe Solutions CNIO Cheryl Parker, PhD, RN publishes “Smartphone-Based Mobility for Nurses.”
• Besler Consulting participates today in the HFMA Florida Chapter Mid-Winter Conference and the Tri-State Winter Institute in Mississippi from January 28-30.
• Caresync CEO Travis Bond asks, “What’s it Really Going to Take to Have Personalized Medicine?” in the latest company blog.
• Brian Mitchell of CommVault, asks if “2015 is the Year of Data Dystopia?”
• Clockwise.MD is nominated as a finalist in the inaugural Georgia’s Top Startup Awards.
• AirStrip’s Alan Portela writes about “The Healthcare Dinner Party” at the company’s Mobile Health Matters blog.
• Craneware lists the “Top Five Reasons for Denials” in a new blog post.
• Awarepoint posts a new article, “The ROI in RTLS for Hospital Asset Management.”
• Divurgent writes about “The ABCs of Ambulatory EMR Training and Acceptance.”
• Clinical Architecture’s Charlie Harp writes about “The Road to Precision Medicine” in a new company blog.
• Jaffer Traish of Culbert Healthcare Solutions writes about data sharing.

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan.

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

Morning Headlines 1/27/15

Progress Towards Achieving Better Care, Smarter Spending, Healthier People

HHS Secretary Sylvia Burwell unveils a new plan, and timeline, for moving the nations healthcare providers from fee-for-service model to a value-based reimbursement model. Burwell says that by 2018, 50 percent of all Medicare payments will be made through alternative payment models.

AMA’s letter to ONC

Former ONC Deputy National Coordinator for Health IT Jacob Reider, MD pens an open response to a letter drafted by AMA last week lobbying for renewed emphasis on EHR usability and interoperability. Former National Coordinator for health IT Farzad Mostashari, MD adds his two cents in the comments section.

Revised SOFTWARE Act ‘a huge step forward’

Marsha Blackburn (R- TN) has introduced a revised draft of the SOFTWARE Act, that has received broad support thus far. The bill would limit the FDA’s authority to regulate health IT products by establishing a narrow definition for both medical software and medical device accessories.

New simplified map for Veterans Affairs

The VA unveils plans to consolidate its reporting structure so that all divisions, including the Veterans Health Administration, will report through the same channels. The new five-region structure will be in place by June and is being called “the biggest organizational change in VA history.”

Curbside Consult with Dr. Jayne 1/26/15

I know many readers are on the edge of their chairs waiting to find out the answer to the career question I pondered in last week’s Curbside Consult. I spent several days out of the office last week putting my thoughts around whether I want to join our health system’s migration to a single vendor platform or pursue other career options.

Although I enjoyed the day I spent thinking about nothing work-related, things became complicated mid-week when I received an unexpected phone call. One of my CMIO colleagues knew I was off the grid and not checking email while I weighed the situation. He wanted me to know that a draft organizational chart was circulating and it had some interesting features.

First, the physician leadership is remarkably absent. We knew that there would be consolidation in the leadership, but not to the degree represented. My colleague wanted to know if I thought there was some kind of supplemental organizational chart that would have us on it. I don’t think there is one, but seeing it confirmed the fears of some of our medical leaders who have already jumped ship.

Second, although the number of mid-level administrators was as bad as we expected, they didn’t seem to be arrayed in a way that will be effective given our history and culture. With all the work that needs to be done, we almost need two teams for each hospital or entity, one for managing the transition and conversion and one preparing the new system. Of course they would have to work closely together, but given how we’ve worked historically, I can’t imagine a team being able to focus on two things at once and not end up cutting corners in favor of one side or the other.

Third, we were surprised to see a senior leadership level that was much smaller than anticipated. I’m not sure how they think a handful of top executives will have enough bandwidth to deal with the magnitude of change we’re expecting. The “Chief Culture Officer” I hoped would materialize was nowhere to be found. It looks like, at least to some degree, that we’re going to continue to try to do things the same ways we have always done them, yet are expecting they will have different outcomes.

Depending on where the organization is thinking about plugging some of the other CMIOs, there may not even be a place for me. Those of us that came up through the ambulatory ranks have a little less status than those who are purely hospital CMIOs.

The good thing about my time off is that I was able to come up with a self-employment business plan that makes sense, at least in the short term, if I end up being downsized. I bounced it off of some smart people I know and they agreed it was viable. My clinical group is willing to let me flex my hours as much as I need. It doesn’t hurt that they just opened a sixth location and are a little short covering some of the weekend and evening shifts, which I’m happy to do.

Since we don’t even have a signed vendor contract yet, I still have some time. I have to admit I’m leaning towards staying if there ends up being a position that is a good fit. Knowing I have a fallback plan (as well as a respectable nest egg) makes it a little easier to handle the uncertainty. Regardless of how it turns out, it will be entertaining and educational to watch all the players jockey for position.

In the mean time, I can find my entertainment with the reader responses to my question from last week: If you could do anything you wanted, what would it be? So far, early retirement, gardening, and travel continue to be themes. I haven’t had a lot of people saying they’d stay in healthcare, information technology, or the wild and wacky universe we call healthcare IT. Of the clinicians who have responded, no one wants to go back to direct patient care and that’s a sad commentary about healthcare in the US.

I saw patients two days this week and was reminded how miserably our system has treated some of our patients. I was also reminded of the sacred trust our patients place in us and how things that are not a big deal to us can make us look like superheroes to others. If you’ve ever seen the look on a parent’s face when you reduce their child’s Nursemaid’s Elbow, you know what I’m talking about.

What makes you feel like a superhero? Email me.

Email Dr. Jayne.

Startup CEOs and Investors: Speculating Scribbler

Finding Those First Few Paying Clients
By Speculating Scribbler

Having been an investor in and advisor to a number of various stage healthcare startups, I have observed a common constraint that applies to nearly every startup before they enjoy early success: finding those first few paying clients. They might have created the best product in the world, a revolutionary way of doing things better or faster, or a way to fill a void that has never been filled. They might have a brilliant team of tomorrow’s Mark Zuckerbergs and Steve Jobs. Without some early clients taking a chance, however, the potential could sadly go untapped.

Startups can have some inherent advantages over the big guys. They are nimble, and if they have the right team, can adapt and adjust their product faster than a large company. They generally have no sacred cow product lines, so the “Innovator’s Dilemma” that can curse large companies that protect cash cow product lines often doesn’t apply to them.

Still, it can take a leap of faith for a hospital, health system, or physician group to engage a startup. Even as an enthusiast of startups, there are some that I would do business with in a heartbeat if I were a hospital, yet others that I would never take a chance on. The old adage that, “You don’t get fired for buying IBM” applies in healthcare, too, even today in the age of the cloud computing and mobile everything.

For those who want to give that smaller, hungry company a chance at earning your business or who need to prove to your bosses or board that you’ve done your diligence before suggesting engaging a startup, here are a few key questions to ask to cover your bases and get comfortable with the startup.

What Will This Contract Do To Your Business?

You don’t need to know how profitable they will be or what kind of revenue increase your order would do for them. It is fair, though, to understand what sequence of events scaling up to serve you might trigger. Maybe they will need to change their server structure. Maybe they will need to set up the support department they have never needed before. Perhaps they will need to double their development staff with to-be-determined resources.

Whatever the case, the key is to have the open discussion and get comfortable with their plans. A thoughtful company has thought a lot about how they would scale to accommodate your business. At a minimum, they should have growth plans and timelines that are clear and that you can get comfortable with. The red flag is if they either don’t have a plan or give you the impression they aren’t rigorous enough about the scaling question.

Am I A Sustainable Client?

You might be tempted to get an insanely good deal from the startup founder who is hungry for your business. Given the lean nature of most small companies, there should in fact be a very good value proposition for you.

Don’t overdo it, though. The best long-term answer is for you to get a deal you can feel good about and for the startup to have enough revenue flowing in to continue to improve their product and an incentive to spend the time needed to serve you with topnotch attention. Startups often forge new ground in a space that does not yet have tried-and-true pricing mechanisms, but be sure that your business deal gives the company the cash flow it needs to do a great job for you.

Are You All Doing This Full Time?

This is one of the questions I ask as an investor and that I would ask it as a potential customer as well. If you are entrusting a startup to fill a key need that you have, you should expect that the people you are talking to are “all in.” It might be a relatively small team, but it is important they are fully committed to their business.

I have observed startups run by people who are moonlighting or trying to get the company going on evenings and weekends. I admire bootstrapping and the founders just might be brilliant and could be the next big thing. If I were a hospital system or physician group, though, I would insist that I only contract with someone who is fully committed to their business. It is a lot easier to walk away from a venture and your contract if you still have a nicely-paid job to go to on Monday morning.

How Will Our Organizations Communicate?

Frankly, this kind of expectation-setting question should be done with companies of any size. You probably have experience with big guys who have 40 percent market share dropping the ball on this.

A startup sometimes does not have their customer service or account management infrastructure fully built out, so it is a good question to explore. You just want to be sure you have a clear path for communications to and from the company, whether that be escalating an issue or having regular status updates. A red flag is if the CEO dismissively says “Oh, just call me on my mobile if you need anything.” While it might be flattering to have the founder on your speed dial, it is a sign that they have not thought about how to scale up for multiple customers like you.

How Are You Protecting My Data?

I would never suggest that just by virtue of being a startup, a small company is not as good as protecting data. In fact, some of the startup firms I have worked with are doing things with data protection that could set a standard for the rest of the industry. But in the spirit of being able to tell your leadership and board that you responsibly vetted the startup, explore the topic. A well-run startup will welcome the question because it gives them a chance to show that they are a step ahead of their competitors.

Conclusion

All of your go-to large vendors were startups one day. I see first hand many startups filling niches that have gone ignored too long. You might find that engaging the right startups could be the start of a great, long-term partnership for your organization. Just ask the right questions first. The mediocre startups will demonstrate that they aren’t ready for your business, but the good ones will show you that they can do things for you that nobody else can.

The author is a healthcare angel investor, board member, and mentor to numerous startups.

Book Review: “America’s Bitter Pill”

“America’s Bitter Pill” is not a feel-good book (pun intended). It’s not a fun read except for those folks who enjoy a maddening, blow-by-blow description of how legislative sausage is made. It tries to add drama and personal vignettes to events whose outcome is already known. Steven Brill tells us the obvious – the US healthcare system is a mess, the Affordable Care Act is a Band-Aid rather than major surgery, (and in fact made things worse in some ways), and there’s no resolution in sight.

The main message is that the Obama administration realized it had no chance of pushing through comprehensive healthcare reform given the presence of a strong healthcare lobby and rabid Republican opposition, so the ACA ended up being a Frankenstein law that was watered down with so many compromises that it did little except to expand the sales of medical insurance.

Political reality forced the administration to limit ACA to addressing coverage, not cost. Hospitals, drug companies, and device manufacturers stand to make even more money under ACA, which is why their powerful lobbyists – who practically sat at the table while the ACA was being negotiated – gave their required blessing.

Creating drama from politics requires characterizing people and organizations. President Obama is portrayed as well intentioned, but a bit detached and lazy in leaving the ACA details to others. White House staffers are seen as power-hungry and anxious to get Obama’s ear. CMS is a plodding, incompetent bureaucracy that vastly overestimated its ability to launch Healthcare.gov. Former US CTO Todd Park and HHS CTO Bryan Spivak are nice, geeky guys who weren’t invited to the Healthcare.gov table until it melted down. Insurance companies are low-margin businesses that are held hostage by greedy and ever-expanding hospitals that use their consumer brand identity to force high prices; insurance companies are also an easy but undeserving political target because that’s where the healthcare rubber meets the road for most consumers.

It’s interesting to read about how much influence data geeks have. An army of government number-crunchers has to to turn vaguely worded legalese into budget impact numbers that can make or break campaign promises, i.e. are new government ACA costs taxes or is the program budget neutral? Insurance companies have their own quant people whose insurance pool models determine their financial risk over many years. The stars of the book might just be the analysts whose numbers drove big political and business decisions.

The basis of Obamacare is the Romneycare three-legged stool: (a) a competitive insurance marketplace disentangled from employers; (b) a mandate that everyone buy medical insurance to avoid the self-selection in which healthy and young people opt out of subsidizing sicker and older ones by buying insurance; and (c) massive government welfare programs to help pay the medical insurance premiums for those who can’t afford them.

You can imagine the ugly details involved in rolling out this three-legged stool as a huge, complex law that even those legislators who passed it didn’t read in its entirety.

The book makes medical device makers as bad guys who escaped significant impact other than being charged a small medical device tax that they simply passed along to their customers. Their profit margins are extraordinary, their customers are hospitals who not only buy their products at high prices but then mark them up in selling them to patients, and they have positioned their products as a beacon of American medicine.

Drug manufacturers are bad guys, too, using their political influence to prevent importation of drugs from Canada (which like every other country, has much lower prices than here), to gain extended patent protection for biosimilar products, and to kill a provision that would have allowed Medicare to negotiate drug prices rather than paying made-up market prices.

Lobbyists had their fingers in the pie at every step, including those representing odd industries such as soft drink manufacturers, tanning bed groups, and ambulance services. Every member of Congress made sure to protect any back-home businesses that would have been negatively affected, including those that should have been targeted.

The author is sympathetic to physicians. He says Congress targeted them inappropriately in 1997 in its panic over rapidly increasing Medicare spending, implementing the Sustainable Growth Rate (SGR) payment cuts that have been overridden by Congress every year since. A fix was supposed to be in the ACA, but that, too didn’t make the final bill, and neither did tort reform.

CMS is characterized as just about as inept and bureaucratic as you would expect.They were afraid that Congress would de-fund some of their “offices” in their hatred of Obamacare, so they renamed them “centers” to make them an internal expense rather than a separately budgeted “office.” That bit of political sleight of hand came back to bite them, as the newly demoted “office” that was supposed to be overseeing Healthcare.gov was outranked by CMS’s procurement groups.

The result was a plodding bid process in which the same old government contractors made promises they couldn’t keep, with CMS deciding it would run the project internally. Literally nobody knew who was in charge – the author asked a bunch of people where the buck stopped and rarely got the same answer twice. Brill says the Beltway contractors “never met a botched product, cost overrun, or missed deadline they can’t pin on someone else.”

Still, the blow-by-blow on Healthcare.gov seems to be a distracting attempt at injecting drama and maybe selling a few more copies of the book. Government software failures, cozy contractor deals, and cost overruns are the rule more than the exception. The site was quickly implemented and horrendously complex, a massive integration effort involving other government systems run by the IRS, Homeland Security, and others. It failed, but it was fixed fairly quickly. Healthcare.gov is only a tiny part of the ACA. There were no particular lessons learned except perhaps that rushed, complex legislation that requires a rushed, complex technology solution is probably a bad idea all around.

Non-profit health systems are portrayed as somewhat well-intentioned monopolists unwilling to give up huge profits and executive salaries, using their hometown pride as big employers and their vague public threats of reduced quality from reduced payments to protect their huge incomes. The author mentions the complaints of the CEO of Montefiore Medical Center, who wailed about potential ACA-caused patient harm through lower margins just as the hospital turned a $197 million profit and that same CEO took home $4 million for the year. Brill talks about the cutthroat Pittsburgh market in which UPMC and Highmark hardballed each other and got into each other’s businesses trying to dominate the market.

Brill concludes that President Obama should be admired for pushing through broad healthcare reform even though he hadn’t expressed much interest as a candidate, but says that his failure to get involved with the details of ACA’s implementation will be be his unfortunate legacy. The backroom deals with profit-making entities ensured that the ACA fell far short of true reform and in fact will probably increase corporate profits as newly insured people consume their products and services as patients.

Brill says Obamacare won’t stand as a popular Democratic program such as Medicare and Social Security since it only helped the 20 percent of Americans without an insurance and another 10 percent or so who had been fooled into buying low-quality insurance whose benefits would run out after even a short hospitalization.

The end result is that most middle-class Americans continue to struggle to pay insurance premiums and inflated medical bills, the country still can’t afford the out-of-control medical spending that makes the US globally noncompetitive, and employers and hospitals got an easy out in blaming their ensuing self-serving actions on Obamacare.

Brill makes it clear that he would have preferred a single-payer health system, but he doesn’t notice the irony that in calling out CMS as inept bureaucrats, they run the closest thing we have to a single-payer system in the form of Medicare. He should have spent more time writing about that (and the VA’s government healthcare delivery system) than in trying to create TV moments in the form of Healthcare.gov war room arguments.

For all the problems recited, the book is short on solutions. Brill proposes:

• Let the big health systems get bigger and cut out the middleman by starting their own insurance companies, as long as each major metro area has as least two big players, but cap their profits.
• Limit hospital executive salaries to 60 times the salary paid to a first-year medical resident, or about $3 million in UPMC’s case (the CEO is making $5 million now). That’s not only a generous CEO salary cap, it also ensures an unintended consequence of raising resident salaries. Why not cap CEO salaries as a percentage of operating revenue instead?
• Pay doctors for quality. Sounds good, but the devil is (as was the case with ACA) in the details, which are missing.
• Encourage health systems to run urgent care centers and other less-expensive care venues. I think ACA is already doing that.
• Create an ombudsman appeals process for patients or doctors who think care is being compromised.
• Require health system CEOs to be licensed physicians with practice experience. He doesn’t provide reasoning for this argument, but he does express disdain for corporate types that move into running health systems. He also doesn’t say much of anything about for-profit chains, including publicly traded ones.
• Require health systems to insure a given percentage of Medicaid patients at a specific discount.
• Eliminate the chargemaster and require hospitals to charge uninsured patients no more than they charge insurance companies.

Steven Brill knew little about healthcare when he wrote his Time article and this book. In that regard, he comes across as a curious layperson outraged by what he learns, but perhaps too easily swayed by people and policies that he has filed away as “good” or “bad” in his populist outrage. 

The Affordable Care Act is a political lightning road and isn’t likely to be fine tuned by intelligent Congressional deliberation, so good or bad, it’s here to stay. Most of the people involved in creating it have already left government work and the Obama administration is counting down its remaining months. Meanwhile, the healthcare cash register keeps ringing for the same companies, organizations, politicians, and people who know how to make the system work for them. That’s what makes “America’s Bitter Pill’ unsatisfying as a reader – it’s unlikely that anything will really change as a result as healthcare costs continue to bankrupt individuals, companies, and the country itself.

Morning Headlines 1/26/15

VSS exits Strata Decision Technology

Roper Industries has acquired Strata Decision Technology, a cloud-based analytics platform used by 1,000 hospitals for financial planning and reporting. Financial terms of the deal were not disclosed.

New Technology May Save Patients an Additional Visit to a Specialist

The University of Virginia Health System will pilot a remote consultation system that connects primary care providers with specialists for quick questions or second opinions on cases that otherwise would have resulted in an unnecessary referral.

How Are We Today? Study Lets Patients Help Write Medical Notes, Google Doc Style

Beth Israel Deaconess Medical Center will pilot a new program called OurNotes that will expand on the OpenNotes concept by allowing patients to access and contribute to physician notes in their EHR.

ONC Annual Meeting, February 2 – 3, 2015

ONC will host its annual meeting on February 2-3 in Washington DC. Karen DeSalvo, MD, now both the National Coordinator for health IT and the acting assistant secretary of health, will deliver the opening remarks and lead a session on ONC’s nationwide interoperability roadmap.

Monday Morning Update 1/26/15

Top News

Private equity firm Veronis Suhler Stevenson completes the sale of Strata Decision Technology to Roper Industries. Strata’s StrataJazz financial planning and analytics software is used by 1,000 hospitals. Roper’s other healthcare IT-related acquisitions include Sunquest Information Systems, SHP, and CBORD.

Reader Comments

From Kim Jong-un: “Re: HIStalk. The CMIO of a large Midwest health system told me that the IT department has blocked web access to HIStalk. Now I am wondering if HIStalk was responsible for the Sony hacking.” I like when an organization blocks access to HIStalk since that means I’m providing accurate and potentially disruptive information. It’s always been vendors doing the blocking, though. Email me your employer’s name if they’ve blocked HIStalk so I can give them a mention.

From Harold Reems: “Re: Bayhealth. Looks like they’re going Epic.” Apparently so – they’re running Epic job listings.

HIStalk Announcements and Requests

Two-thirds of respondents say that technology hasn’t significantly empowered patients. AlmostAdjusted commented that we’re getting there, but “technology has brought complexity to the patients and our patients are spastically grasping at a number of hyped solutions that for now are causing more disillusionment than empowerment,” while Mak says providers need to trust patients and put all of their information on their portal. New poll to your right or here:  will you in the next 6-12 months buy an Apple Watch, a different smart watch, or neither?

Speaking of empowering patients, I’m paying for five, $1,000 travel scholarships for real patients to attend the HIMSS conference, following through on an idea that patient advocate Regina Holliday and I had when I interviewed her last March. We’re accepting applications through February 9 and will choose the five based on their patient stories and their writing ability (since I want them to document their experience afterward). Those chosen  will wear a special tee shirt with a picture Regina painted just for that purpose (above is an example, but she’ll paint a new one specific for this project) as they attend sessions and visit the exhibit hall to represent the patient’s point of view. See Regina’s description and send entries to Lorre.

More on the patient travel scholarships: HIMSS declined to participate (like by comping their registration fees), so I could use some help. Exhibitor badges will work fine for the scholarship winners since they provide full conference access, but I only get five for my tiny HIStalk booth and I’ll use at least 2-3 of those. If anybody has extras, that would save me a bunch of money. UPDATE: Thanks to the several companies that offered to help out … CTG Health Solutions was quick to respond with an offer to provide badges to our patient representatives. Thanks to Amanda at CTG for supporting our project.

I learned a new, made-up word: “listicle,” a combination of the words “list” and “article” that refers to those lazy, click-baiting online pieces that start with a number, such as “10 EHR Vendors to Know” or “6 Cool Health Startups.” I like that it sounds like “Popsicle,’ a nutritionally devoid diversion that delivers little beyond the initial impulse to give it a quick lick (or “click” in this case).

Last Week’s Most Interesting News

• A group of medical associations urges ONC to refocus EHR certification on usability, interoperability, and safety.
• Industry groups ask that Meaningful Use and EHR certification require EHRs to accept the scanned barcodes of implanted medical devices.
• ONC hires Michael McCoy, MD to the newly created position of chief health information officer, where he will oversee interoperability efforts.
• Mayo Clinic selects Epic.
• CMS Administrator Marilyn Tavenner resigns.
• Harvard Medical School launches the Department of Biomedical Informatics, to be led by Isaac Kohane, MD, PhD.

Acquisitions, Funding, Business, and Stock

Emdeon is considering an IPO, sources say. The earnings multiples of recent sector deals suggest a valuation of $5.4 to $6.6 billion, which would create huge profits for the two private equity firms that took Emdeon private in 2011 for $3 billion.

California Healthcare Foundation invests in Seamless Medical Systems to develop and pilot patient engagement software for safety net providers and patients.

People

Nursing informatics pioneer Carol A. Romano, PhD, RN, who was chief nurse officer of the Public Health Service, is named dean of nursing school of Uniformed Services University of the Health Sciences.

Announcements and Implementations

Wolters Kluwer Health releases an eBook describing how health systems can create an antimicrobial stewardship program.

Government and Politics

ONC’s annual meeting will be held February 2-3 at the Washington Hilton. Karen DeSalvo will deliver opening remarks, describe the nationwide interoperability roadmap, lead a fireside chat with Tom Daschle and Bill Frist, and join a panel discussion with all four former National Coordinators (Brailer, Kolodner, Blumenthal, and Mostashari). The meeting will be streamed via webcast as well. It will be interesting now that HITECH is winding down if attendance at this meeting and Health Datapalooza will suffer.

Other

OpenNotes co-founder Jan Walker, RN says the next project phase, OurNotes, will allow patients to add their own notes to their electronic chart. It will be piloted at Beth Israel Deaconess, Geisinger, Harborview and Group Health in Seattle, and Heartland Health. Above is a screen shot from Joe Boyce, MD, CIO/CMIO of Heartland Health, which is using Cerner to collect information from patients (visit goals, meds, problems, care preferences) ahead of their scheduled appointments. This is brilliant – there’s no reason to waste precious appointment time collecting routine information, plus patients get flustered and forget important facts when forced to recite them on demand.

A study of New York nursing homes finds that EHR adoption increased 7.7 percent from 2012 to 2013, but HIE participation remains minimal. Those using EHRs had no specific characteristics different from those that didn’t, but HIE participation was related to being associated with a hospital and not being run as a for-profit business.

University of Virginia Health system announces that it is one of five academic medical centers that will use a $7 million CMS grant to pilot an eConsults/eReferrals model. PCPs can use Epic to send a quick question to a specialist who can then review the patient’s electronic chart to provide an answer. The goal is to free up specialists to see patients who really need a face-to-face appointment vs. PCPs looking for a curbside consult.

Weird News Andy says this story is untitleable: an Australian woman chooses a “maternal-assisted C-section” for her 10th and 11th children, meaning she removed the babies herself during the otherwise normal procedure.

Sponsor Updates

• Surgical Information Systems team members make over 50 blankets for Project Linus at its SIS Cares event.
• ZirMed announces results of the end-to-end ICD-10 testing of its customers.
• Huron Consulting releases its Healthcare CEO Forum report.
• Trey Lauderdale writes about the interconnected nature of physician messaging and alarm management in a new Voalte blog.
• Versus Technology updates the agenda for its 2015 User Group Meeting, taking place May 11-13 in Chicago.
• Verisk Health SVP of Population Health and Risk Adjustment Matt Siegel pens an article titled “Risk-Adjusted Base Payments can Support the Move to Value.”
• HHS CTO Bryan Spivak visits Validic’s Durham, NC headquarters and poses for a photo.
• Valence Health will participate in HFMA’s first Illinois Managed Care Meeting in Chicago on January 29.
• Qpid Health releases the latest podcast in its “Intrepid Healthcare” series.
• Thomas White at Phynd Technologies blogs about “Why a Single Provider Profile Matters.”
• Patientco CEO Bird Blitch blogs about “Why 2015 is the Year Providers Will Embrace Cloud Technology.”
• PatientSafe Solutions CNIO Cheryl Parker writes on the topic of supporting the cognitive workload of clinicians with mobile technology.
• Nordic releases the fourth installment of its video series on Epic’s Cupid application.
• Navicure’s Amanda Brown posts a new blog on “The New Normal for Revenue Cycle Management in 2015.”
• NVoq’s Debbi Gillotti writes a new blog post on how to “Drive Even More Value from Your EMR with SayIt 9.3.N
• TT Data’s Phil Thames provides his executive viewpoint on industry predictions for 2015.
• In a new white paper, Perceptive Software Principal Solution Architect Larry Sitka writes about vendor neutral archiving as more than just a place to store images.
• MBA HealthGroup publishes a new blog on “Security Risk Assessment – Balancing Data Protection & Efficient Workflows.”
• Medicity offers a new blog on “The 10-Year Interoperability Roadmap: How do We Get There from Here?”
• Sean Biehle writes about “Extending Patient Engagement Beyond the Point of Care” in a new MedData blog.
• MedAptus takes an Austin Powers tone in its latest blog, entitled “$375 Billion Dollars … mwwahahahahahaha.”

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan.

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

Morning Headlines 1/23/15

 EHR Certification Improvements

A large cohort of medical associations lobby to ONC to focus MU3 certification on usability, interoperability, and safety.

NHS disregards patient requests to opt out of sharing medical records

The NHS confirms that it has disregarded tens of thousands of requests by patients to opt out of a new national medical record sharing program, citing concerns that patients did not understand what they were opting out of.

Pew Submits Letter to Health and Human Services Regarding Unique Device Identifier Capture in Electronic Health Records

Geisinger Health Systems, Intermountain Healthcare, and a number of industry groups send a letter to ONC asking that implant medical device tracking be included as a required feature for EHR certification.

ONC adds chief health information officer position

ONC hires Michael McCoy, MD, to its newly created position of chief health information officer. 

EPtalk by Dr. Jayne 1/23/15

While everyone is waiting for the Meaningful Use Stage 3 shoe to drop, let’s not forget we are only eight months away from ICD-10. CMS announced that those organizations that participated in their January end-to-end testing event have already been registered for the upcoming testing week in April. If you missed out on the fun, you can volunteer through your Medicare Administrative Contractor. The chosen few will be announced by February 13. Don’t miss out on this exciting pre-Valentine’s Day gift — volunteer today!

CMS has also released an enhanced version of its Open Payments data search tool, allowing users to view summary information about physicians such as total dollar value of all payments and total transactions. I looked up a couple of friends and am wondering exactly what kind of “Informational Meal” one of them enjoyed for $2.68. I’m guessing that the colleague who enjoyed the $168.72 “food and beverage” line item might have had a better time.

I’m behind on email, but wanted to comment on the recent article in JAMA titled “Wearable Devices as Facilitators, Not Drivers, of Health Behavior Change.” I agree with its conclusion that having a device in and of itself isn’t going to change behavior, but putting strategies around use of the device could help reinforce behavior. They mention improving the design of feedback loops as a way to get wearers to continue, specifically lottery-based designs and the concept of “anticipated regret.”

As part of the annual conference this year, HIMSS is promoting the “HIMSS 15 Wellness Challenge.” Registrants can either purchase a Misfit Shine device or use their own. I was initially enthused and registered, but when presented with the fine print, had a case of actual regret. Winners will be announced at the Connected Patient Learning Gallery throughout the conference but must be actually present to win. I’m pretty sure by the end of each day I’m going to just want to put my feet up.

Usually I don’t read JAMA, but this week’s table of contents was a winner. They must be taking their headlines straight from the tabloids. For a moment I thought I was reading The Onion:

• The Implications of Marijuana Legalization in Colorado
• Improving Long-term Psychiatric Care: Bring Back the Asylum
• Navigating the Rise of High-Deductible Health Insurance: Childbirth in the Bronze Age
• Flamed on the Net

Because nothing says professional like addressing a c-level as “Hey %%FirstName%%”: I’m begging HIMSS to please engage some proofreaders. As many teachers have said over the years, “Hey [sic] is for horses.”

I’ve had a tremendous amount of feedback on Monday’s Curbside Consult. Based on some of the responses, it looks like the industry might be having a collective mid-life crisis. I haven’t had a chance to respond to everyone but appreciate your support. We always love hearing from readers, so keep the comments coming. I’ll share some of them in my next Curbside. Until then, I’ve got a hot date with a cup of cocoa, a handmade afghan, and some Netflix before I head back to the office.

Email Dr. Jayne.

News 1/23/15

Top News

A group of medical associations that curiously includes CHIME but not HIMSS urges ONC to refocus EHR certification on usability, interoperability, and safety and to disconnect EHR certification from the Meaningful Use program. They add concerns that ONC isn’t paying enough attention to how ATCBs certify EHRs for privacy and security, such as not requiring complex passwords or insufficiently logging user privilege changes. Apparently the groups don’t think the free market is working since the implication is that the EHR vendors they keep buying from are ignoring their customers and won’t change without government intervention. Vendor priorities were so much more straightforward before Meaningful Use. 

Reader Comments

From JustAsking: “Re: Allina-Health Catalyst deal. Lots of headlines about a $100 million ‘valuation’ but no mention of additional equity, yet Allina now owns a piece of the company that investors sunk $40 million into last year. Was the customer unhappy? The Allina CEO took pains to say that it’s not an exclusive arrangement.” Unverified. I agree that the highly touted $100 million figure is meaningless since no details were provided about what that number represents, so I think the company overemphasized that just to add some sizzle (although the press seems to have accepted it without question). I don’t get the sense that Allina is unhappy with Health Catalyst at all – they seem to be thrilled with the information they’re getting. Most of Health Catalyst’s board members are from investment firms who would make sure to protect shareholder value, so I’m assuming the deal makes good business sense. The only downside for the company is that whatever impressive results Allina announces won’t be entirely credible given that they’re now a part owner.

From Hawaiian Charlie: “Re: Scripps. I heard Cerner dropped out before demos start next week.” Unverified. The semi-insider I know wasn’t aware of anything new.

From Just a CEO: “Re: our national user conference. I’m looking for a speaker and one name came to mind – Mr. HIStalk! We can give you a mask or burka.” I’ll pass, but I will instead ask readers: have you heard a really good keynote-type speaker lately, especially one with credibility in the ambulatory world? Let me know and I’ll pass it along.

From Pure Power: “Re: fitness trackers. Their allure is fading fast.” As it should. It’s fun for a couple of days to count steps, but the novelty fades fast as most people don’t really want to be reminded to do something they don’t enjoy (and whether fitness trackers change long-term exercise patterns is questionable). Wearables that can make a different in healthcare will need to: (a) measure something medically actionable; (b) contain enough smarts to figure out when data patterns – rather than a single reading – are meaningful, customized down to the individual patient; and (c) communicate those results quickly and perhaps silently to clinicians who are committed to act on them (probably without much hope of getting paid). Infrastructure will also need to be in place for clinicians to monitor what’s coming in, like those people who sit in burglar alarm monitoring centers who decide whether to dispatch police. Wearables won’t do much for healthy people, but with adequate sensors could help with chronic disease management, provided that those sensors aren’t unpleasant to wear. From a business perspective, steer clear of wearables that diagnose new conditions since nobody wants to pay for new medical problems – focus instead on reducing the costs of managing existing, expensive conditions. We diagnose people pretty well – it’s their care management that’s killing us (and them).

HIStalk Announcements and Requests

Teach for America teacher Mrs. DiPaula sent over photos of her low-income Idaho first graders using the math games we HIStalk readers bought them a few months back via DonorsChoose.org. She adds, “Thank you from the bottom of our hearts!” I funded a bunch of grant requests using the proceeds from the top-of-page ads that I ran right before the HIMSS conference last year and I’ll do the same this year if companies buy those spots.

This week on HIStalk Practice: Auburn University Medical Clinic rolls out new electronic immunization record-keeping system. Wake Emergency Physicians launches RelyMD telemedicine business. Security divas scrutinize the current state of cyber threats. ARcare selects new pop health tech. Ringly raises a new round. Kaiser makes it official with the NBA.

This week on HIStalk Connect: the FDA issues clarifying guidance on general wellness apps. Stride Health raises $2.4 million to scale up its Healthcare.gov-like insurance shopping app. A team of Harvard and MIT scientists launch InnerAge, a mail-away blood test used to predict lifespan and provide personalized nutritional recommendations to extend life. 

Welcome to new HIStalk Platinum Sponsor Anthelio. The Dallas-based company has been a single-source provider of healthcare-only technology solutions for 15 years, offering a long list of services (outsourcing, application hosting and management, data protection, data warehouse and analytics, service desk, EHR implementation and optimization, HIM outsourcing, revenue cycle optimization, clinical documentation improvement, population health management, legacy system archiving, and ICD-10, among many others). Products include a population health management platform, patient portal, patient-facing mobile app, and a physician coding improvement collaboration tool. You probably know industry long-timers CEO Asif Ahmad (formerly of Duke and McKesson) and SVP Gary Trickett. Thanks to Anthelio for supporting HIStalk.

I always head over to YouTube to look for videos about new sponsors, so here’s an intro to Anthelio I found there.

Acquisitions, Funding, Business, and Stock

Quality Systems (NextGen) reports Q3 results: revenue up 13 percent, adjusted EPS $0.16 vs. $0.11, beating estimates for both.

Private investment firm Veronis Suhler Stevenson gets FTC approval to sell Strata Decision Technology to Roper Industries, which owns Sunquest. Stratus founders Catherine Kleinmuntz, PhD and Don Kleinmuntz, PhD moved on not long after selling the company to VSS in 2011. Roper also acquired post-acute care analytics vendor Strategic Healthcare Programs in August 2014 and already owned hospital dietary software vendor CBORD, so it’s liking the healthcare software business.

Device and wearables Integration technology vendor Human API raises $6.6 million in venture funding.

The Advisory Board Company announces a $200 million add-on public offering. Above is the one-year share price of ABCO (blue, down 29 percent) vs. the Nasdaq (red, up 15 percent). The company’s market cap is $1.6 billion.

Sales

Sixteen-bed Jerold Phelps Community Hospital (CA) chooses Healthland Centriq for clinical and financial systems.

University of Texas MD Anderson Cancer Center selects Capsule Tech’s SmartLinx to integrate information from 2,000 medical devices with Epic.

Government and Politics

Several industry groups request that Meaningful Use and EHR certification require that EHRs be capable of electronically tracking implanted medical devices. They want EHR users to be able to scan the device’s bar code (which contains an FDA-assigned unique identifier) to update the patient’s record for outcomes tracking, adverse event reporting, and recall management. They add that the information could also be used by the EHR to trigger patient-specific device warnings.

ONC hires Michael McCoy, MD for the newly created position of chief health information officer. He’ll report to Karen DeSalvo and will lead ONC’s interoperability efforts. He ran a two-person consulting firm (Physician Technology Services) and has spent time as a CMIO and working for vendors such as DigiChart and Allscripts.

Privacy and Security

In England, NHS admits that it has ignored all of the thousands of requests it received from patients who don’t want their records shared, saying that those who opted out may not have understood that they wouldn’t have been notified of preventive services such as cancer screening.

SplashData studies 3.3 million leaked passwords from 2014, with the top 10 most used (and thus the worst ones to choose) being:

1. 123456
2. password
3. 12345
4. 12345678
5. qwerty
6. 124567890
7. 1234
8. baseball
9. dragon
10. football

Innovation and Research

The Center for Integrated Diagnostics at Massachusetts General Hospital (MA) is performing genomics research using InterSystems HealthShare, using the population information it collects for personalizing treatments.

Technology

Microsoft announces the HoloLens, an eye-worn appliance that blends holograms with vision. If nothing else, it should nudge Facebook to bear down harder on its Oculis Rift virtual reality headset. The company also announced that Windows 10 will be released later this year as a free upgrade for users of Windows 7 or 8 if they upgrade in the first year. I like Windows 8 just fine, but a free upgrade offer means plenty of users don’t.

Other

It’s interesting to read Mayo Clinic’s history as it prepares to implement Epic and its “one patient, one record” philosophy. Henry Plummer, MD created the concept of a centralized medical record at Mayo in 1907, replacing ledger books kept by each of its clinics. Mayo built a pneumatic tube system to move records from location to another. It looks a lot like the ones still used by bank drive-through tellers. Most of the hospitals I’ve worked in considered the tube system or dumbwaiter to be their central nervous system – computers work fine for information, but not for objects. I once convinced one of my tiny co-workers to climb into the dumbwaiter so I could send her up to third floor, where she popped out and terrified a nurse who was waiting for something to be sent other than a mischievous, perky blonde.

New York gun rights activists file an injunction to strike down the state’s two-year-old SAFE Act, saying that it gives authorities access to protected health information that is used to confiscate the firearms of people who seek mental health treatment. The tough gun control law was passed a month after the Sandy Hook shootings of December 2012.

Early bird pricing for HIMSS15 ends January 26, so members will save $100 by registering now instead of later (or even more for the real procrastinators who’ll pay $1,145 if they wait until March 17). Attendees also get free online access to the session recordings, which is a nice benefit  — I used to always buy the CDs to review later.

I was reading an interesting legal case that involved an EHR. A patient being treated by a physician practice for insomnia found that his wife was having an affair and then killed her and then himself. The man’s estate sued the practice, claiming that the doctor failed to diagnose his depression and should have referred him to psychiatric help. The doctor testified that he asked the patient about suicide even though the pre-populated EHR checkbox didn’t say so. The plaintiff’s attorney used that discrepancy as an argument that the physician was practicing “point and click medicine” and wasn’t listening to the patient, arguing that the EHR interfered with the physician’s thought process. The jury found the practice liable for $8 million. The interesting aspect is that the jury’s deciding factor was conflicting, auto-generated EHR entries.

Hospitals in Vietnam report that thieves are posing as the family members of patients in order to steal jewelry or money (inpatients usually have cash because hospitals there require upfront payment for each service). In one case, a guy posing as a doctor convinced a woman in the OR waiting room to pay him for her husband’s perioperative blood transfusion, after which he he printed her a receipt from his iPad then took off with her money.

Weird News Andy says he could understand if it were pediatrics, but OB/GYN? Police responding to a hospital’s call about a “young black male who appeared to be a child was dressed as a doctor” find find a fully garbed 17-year-old in an exam room with a doctor and a patient. The teen, who had been hanging around the hospital for weeks, wasn’t charged since his mom says he’s under unspecified medical treatment and refuses to take his meds.

Sponsor Updates

• The Sandlot Connect clinical interoperability platform from Sandlot Solutions earns ONC-ACB certification.
• T-System announces the five winners of its client excellence awards and will make a charitable donation on behalf of each.
• Pat Adamiak of Liaison Technologies writes a new blog on “Making Your Big Data Project Successful.”
• Influence Health opens registration and speaker abstract applications for its Influence 2015 Client Congress, taking place in St. Louis May 3-6.
• Impact Advisors post two new blogs: “When an IT Project Isn’t an IT Project” and “Meaningful Use 2014: Lessons Learned and Looking Ahead.”
• Hayes Management Consulting Director of Informatics Pete Rivera offers insight into “What You Need to Know About Hiring Veterans.”
• Healthwise wins gold and silver Web Health Awards for its health education videos.
• HealthMEDX participates in the Georgia Health Care Association 2015 Winter Convention taking place today in Atlanta.
• Amanda Randall blogs about the “5 Benefits of Working at Healthgrades.”
• Healthfinch posts a new blog entitled, “A Nod to Nature: Building a Balanced Healthcare Ecosystem.”
• E-MDs CEO David Winn pens a new article entitled, “Time to Let the Air Out of the Tires on ICD-10.”
• Healthcare Data Solutions offers a new blog on content-marketing strategy.

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan.

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

Morning Headlines 1/22/15

Precision Medicine: Improving Health and Treating Disease

The White House releases details on the new precision medicine program President Obama announced during his State of the Union Address. The program will work to individualize treatment plans through advances in genetic research, medical imaging, and health information technology.

Survey finds physicians being forced to switch EHRs

The American Academy of Family Physicians releases survey results from physicians who have recently switched EHRs. The majority reported that the switch was an organizational choice and not their own. 61 percent of those that had a say in which EHR was selected reported being happy with the new system, versus a paltry 19 percent approval rating from new EHR users that were not involved in the selection process.

Doctors Choose the Best Health Apps of 2014

HealthTap, an online Q&A site where doctors respond to anonymous medical questions, publishes a list of the top 100 mHealth apps based on voting by its contributing doctors. The top three were all calorie counter apps, and there were no medication reminder or chronic disease management apps within the top 10.

Cerner Collaborates With VFW to Help Improve Lives of Service Members During and After Their Service

Cerner announces a virtual veterans job fair that it will co-host with the VFW on February 18, and a new conversion tool on its recruitment page that will convert a military job code to an ideal job at Cerner.

Health IT from the CIO’s Chair 1/21/15

Fine print: the views and opinions expressed in this article are mine personally and are not necessarily representative of current or former employers.

Predictions

January brings the new year and the new year reliably brings two things: resolutions and predictions. I’ve already broken my New Year’s resolutions, so I’m going to try my hand at predictions.

For them to be any fun, I think they need to be as specific as possible and sufficiently bold so they don’t state the obvious. “I predict there will be a lot of change in the healthcare system in the year ahead” is not a prediction – it’s a campaign promise.

Here goes, in no particular order.

1. Provider healthcare organizations will move into the cloud by adopting Office 365 and moving email off premise at record rates. Hospitals historically wanted grand atriums (often with pianos) and big, shiny data centers. No prediction on the pianos, but not only will the tipping point occur on cloud-based email in 2015, but this will be the start of the shift away from “everything needs to be managed by hospital tech staff” and will pave the way for ERP and EMR to be next (in that order).
2. While I’m on the topic of Microsoft, I predict that when it comes to Windows, you will hear two things in 2015: (a) “What happened to Windows 9?” and (b) “I hate to say this aloud, but Windows 10 is kind of cool.” Microsoft has a lot of ground to make up to win the hearts and minds of their base, the enterprise user. But Windows 10 will bend the curve back in Microsoft’s favor.
3. Security will be in the news and will shape everything, period, everything. The focus on cybersecurity — with the help of Apple, who is making fingerprints mainstream — means we will see biometric everywhere. Two-factor authentication will become the norm. Your finger will be your password by the end of 2015.
4. Wearables. We are all growing tired of the huge number, but this spring will bring the iWatch. It will spur the market and create the needed tipping point that has been missing – software and apps to make wearables worth the effort. The iWatch will be huge, no, I mean really big! Apple will not be able to make them fast enough and waits will be measured in weeks. Innovation will abound and the Internet of Things will all start to make sense.
5. Virtual reality will capture our imagination. Magic Leap will forever change things this year. The “cinematic reality” startup raised over $500 million from names we know. We will all soon understand why. Our imagination will be captured as we think about new ways we never imagined we could interact with a computer.
6. Big data will stay flat. By the end of 2015, we will have nothing new to report. We will be using the same buzzwords and holding the same optimistic promises. 2015 just won’t be the year we figure it out. I do predict we will stop using the term “data lakes,” but I can’t tell you why.
7. HIE obsessions will give way to FHIR talk. The HIE interoperability goal was moving the record from Point A to Point B. The yardstick has shifted and will be defined by how we can integrate workflows from site to site. FHIR will gain even more steam and be the talk everywhere.
8. The VA decision will change everything. It won’t go to Allscripts, Cerner, or Epic (which will be unfortunate), and while the project will be huge and take many years to deliver, in 2015 it will act as an engine to drive standards and data structure conversations as a new open source style system will be born.
9. 2015 will continue to set records in terms of health IT startup funding. Many major health systems will become more active by investing directly in companies in an attempt to capture the value they believe they help create. At least one health IT software company will IPO in 2015, setting a record. Cerner, McKesson, The Advisory Board, Allscripts, and Athenahealth will all continue to exercise one of the few advantages they have over Epic in the EMR space — they will continue to buy strategic assets to innovate at the fast pace required.
10. Cerner will seek to divest the Device Works division so that it may become a company that can compete in the whole market, not just in Cerner accounts. The new entity will become a powerhouse and take market share from both Philips and GE.

Think my predictions are wrong or ridiculous? Don’t tell me why. Instead, leave me a comment and give me yours. Remember: be specific and be bold.

Darren Dworkin is chief information officer at Cedars-Sinai Health System in Los Angeles, CA. You can reach Darren on LinkedIn or follow him on Twitter.

Readers Write: Oh, To Be a Dog in Boulder

Oh, To Be a Dog in Boulder
By Bonny Roberts (and Juneau and Lily)

I adopted my standard American bulldog, Lily, from the Humane Society of Boulder Valley (HSBV) about two years ago. Due to her excessive and exuberant tail-wagging that resulted in a chronically open wound at the tip of her tail, we decided that, while the burgundy, Jackson Pollock-esque wainscoting that now decorated our home was provocative, we needed to dock Lily’s tail.

HSBV’s veterinary clinic agreed to do the procedure “at cost” since she had so recently been adopted. The bill was $300. Since that experience, I have taken both our dogs to their veterinary clinic for annual checkups and emergent needs. The staff is friendly and responsive and the veterinarian has a strong bedside manner and always calls post-procedure. 

My other dog, a Siberian Husky named Juneau, required two surgeries in 2014 to remove mast cell tumors, the first near her shoulder, the second on her hip. The latter healed poorly based upon its location and required both an after-hours urgent care visit and one additional “observation day” at the clinic. I paid for everything out of pocket – prep, anesthesia, supplies, vet time, OR time, meds, the “Cone of Shame,” recovery time in post-op, urgent care, observation day, suture removal. The total was $875, not to mention the complementary pedicure they had given her while under anesthesia. 

A couple of weeks ago, the HSBV veterinary clinic sent me a link to a Pet Portal. After an easy enrollment process –consisting mainly of creating a login id and password, I instantly had access to both my dogs’ vaccination, visit, and medication history. I also had the option to:

• Set alerts and reminders for vaccinations and appointments (medical management).
• Join community groups (social).
• Read care guidelines on everything from behavior and aging to safety and disease (education).
• Review diet details, if applicable (education).
• Create a customize care instruction document, which after investigating in detail, could only be compared to discharge instructions inclusive of a pre-populated med list and exercise routine (care transition).
• Complete a customer survey (satisfaction and quality improvement).
• Schedule our next visit based on visit categories, such as vaccinations, sick exam, follow-up, blood work, etc. 

I couldn’t help but compare my own lack of portal access with my primary care provider or the fact that my children’s pediatrician used to charge to fax over immunization records. If only I were a dog in Boulder County, my information would be far more accessible. 

Interesting facts about the Humane Society of Boulder Valley, a non-profit facility based in Boulder, Colorado:

• HSBV is a no-kill, or live release, shelter that also offers behavioral training and medical services to stray and relinquished dogs and cats.
• On average, dogs are adopted in seven days, cats in 12. In 2013 alone, they facilitated 5,698 adoptions. The relevance to this volume is that according to their annual report, “Medical rehabilitation mends the bodies and spirits of more than 40 percent of the animals in the shelter annually. In concert with our medical care, we are dedicated to the mental health of our animals as well. Techniques and protocols developed at our facility are now being used by shelters to save more lives all across the country.”
• The HSBV has ~700 volunteers and each dog gets three walks a day, while each cat is played with or stroked four times a day.
• Fifty percent of the organization’s income comes from investment and trust income and contributions, with 55 percent of that going to healthcare for the sheltered animals

While this study and comparison is apples to oranges on many levels, I do think there is relevance and value to the comparison. What can we learn from organizations serving other verticals with similar missions, much like we do with foreign healthcare systems? In addition, I am convinced that the innovation and technology we have developed and are promoting here in the US has incited progress and more encompassing services to meet the holistic needs of more than just humankind.  Here is to small victories. 

Bonny Roberts is director of sales operations for Aventura of Denver, CO.

Startup CEOs and Investors: Michael Barbouche

Why I’m Happy That I Did Not Go to the JPMorgan Conference (Or, You Can Go Back to College)
By Michael Barbouche

Now in the sixth year of my entrepreneurial journey with Forward Health Group, one thing is abundantly clear—I don’t watch TV. No, really. I know nothing. “Breaking Bad?” That’s my email inbox. Many things in my world come down to the wire, but not “The Wire” [1]. About the only thing I do try and sneak into the mix is college football. [2] Fall Saturdays are my day. Social media? The only social texting in my life involves my beloved Badgers and occasional jabs at impostors. [3]

Now that the college season has ended, I will miss many things:

• Tailgating.
• The University of Wisconsin Marching Band, the best college band, ever, in Intergalactic [4] History.
• SEC-on-SEC cannibalization.
• The games that immediately follow Notre Dame’s annual 7-0 start.
• Dish Network’s kangaroo-imbued commercial (you know, the one with Heath Shuler, the pretty boy from USC, and The Boz!)

I was reminded of Dish’s fluffy kangaroo as I read Marty Felsenthal’s very entertaining (and accurate) post last week. Having attended JPM last year, let me be the first to share the secret with my struggling peers. Yes, you can go back to college! JPM is nothing more than a return to your freshman year—cluelessness, social awkwardness, and the occasional spilled beverage.

Let’s begin.

Cluelessness

The first thing you need to know is that the JPMorgan folks must be pretty powerful because even the Google can’t point you to the conference registration page. Try a search right now. Here’s what no one tells you—JPMorgan is like that blowout fraternity party you didn’t attend during your first week on campus. If you don’t have an invite, well, sorry, you’re not going to the actual party.

And, as a matter of record, freshmen just don’t get invited. Those are the Rules. I spent three days hoofing up and down the hills of San Francisco and never once saw your typical conference nametag. No lanyards were spotted. I would ask people, “Hey, where is the conference — you know, the actual JPMorgan event?” None of the folks I met could give me the answer.

Cunningly, JPM is setup just like your college class schedule. But for the first couple of days, you are the only person that doesn’t know how it works. Soon, however, you begin to understand the cryptic system. Meetings are scheduled on the hour, every hour. The meetings really can’t last more than 40 minutes because you need to sprint to your next meeting. Invariably, you are late to every meeting, and as you the entrepreneur stare at the clock, the fear of outright missing the next appointment overcomes your consciousness. Like the phantom fear of missing a final exam, you begin to sweat for no good reason.

Social Awkwardness

Imagine a square drawn around Union Square—four blocks by four blocks. Think of this as a human dog park. There are people running all over the place with no particular destination in mind (how else to describe the same people running the opposite direction four minutes later?) [5] The entire reason you are in San Francisco is to engage in brief, repeated sniffing sessions. After your fifth pitch session (of the day), you begin to figure out a few of the signals. [6] By Day Two, you have the routine down:

Savvy Investor (in his 43rd pitch meeting of the week): “What were your revenues last year?”

Struggling Entrepreneur: “We had a pretty good year. We did [$x]! We are really excited about this year—we think we can do [$4x], which is really great.”

Savvy Investor: “That is great. Wow. I must say, however, that our minimum investment for this fund is [$15x]. We have invested in companies as low as [$10x], but that’s atypical.”

[two minutes of awkward stumbling and rambling comments by Struggling Entrepreneur …]

Savvy Investor: “We definitely want to stay in contact with you to monitor your progress. Is it OK if we follow up with you later in the spring to see how you’re doing?”

Struggling Entrepreneur: “Sure. And thanks for the bottle of water.”

Occasional Spilled Beverage

On that Tuesday morning of JPM week, you are filled with excitement. The reason you are in San Francisco in the first place is because all of the analysts [7] at VC firms use the exact same Salesforce install with the exact same auto-email template. Beginning in late November, the auto-email template updates to include this sentence:

“Also, wanted to set a time to meet with you at JPM.” [8]

As you scan your full roster for the day, you see that the first discussion lists “2317 HYATT” as the meeting location. You are six blocks away from Union Square and you realize that there is a plurality of hotels named “HYATT” in San Francisco-proper. [9] When you get to the correct Hyatt, your native instinct is to look for the conference rooms. Oddly, when you get off the escalator, the conference rooms are named after landmarks — no numbers. A few minutes of elevated heart rate leads to a discovery—23rd floor! You get off on the 23rd floor, and, again, look for conference rooms. No such luck. You walk down the corridor of hotel rooms. Whoa, room 2317. Could it be? Seriously? You knock. The door opens. There are numerous men dressed [10] in those flat-front, skinny lapel suits that only the “I’m training for an Iron Man right now but I’m doing a half in April” triathlete crowd wears. This is your meeting location.

Think of the scene in the hotel room like the pre-party before the house party hosted by the older brother of your new college roommate’s friend’s cousin. You “know” only one person in the room—the analyst guy who emailed you to setup the meeting. There are not enough chairs. The bed has been moved into the corner to serve as a sectional sofa. The coffee table is in the corner serving as a buffet table /business card holder [11] / collection point for half-emptied water bottles. There are more butts than there are flat surfaces. Someone will be standing the entire meeting.

The hotel room door opens often as new people in skinny suits enter the room and current participants exit gracefully. That is, until one of the bed-sitters has to be excused for another meeting. This is what triggers the coffee or juice or soda spill. Thankfully, the beverage vessel is usually half-empty [12] and your analyst friend quickly jumps in with a bathroom towel to avoid a dry cleaning situation.

Though I did not attend JPM this year, I have few regrets [13]. If you are an entrepreneur and you are contemplating JPM in 2016, make your hotel reservations [14] soon. Your email invitation from that analyst is already in the queue.

Michael Barbouche [15] is founder and CEO of Madison-based Forward Health Group. At the 2014 JPM, Michael had dinner with Marty Felsenthal in the Wednesday evening 7:00 PM-8:00 PM slot.

[1] Note for Millenials–this is a reference to an HBO program that has not aired in years. You should be able to stream from your parent’s HBOGO account.

[2] True confession—I TiVo “College Gameday” to watch Lee Corso put on the headgear.

[3] Yeah, I’m talking to you, Goldy Goopher fans.

[4] Unclear if Epic has exclusive use of this term in the health IT space, so thought it was prudent to footnote. Further research needed on specific citation required.

[5] See below for explanation.

[6] If someone refers to you as “Jugdish, Sidney, or Clayton,” and that is not your name, the investors are likely to be working their iPhones before you have even finished your intros.

[7] The people who email incessantly to set up a call to pump information out of you.

[8] If you want to spend $145, you can verify with your lawyer—this simple inquiry is not the legal equivalent to a court-issued summons.

[9] During JPM, it is not uncommon to hear numerous exclamations that contain the phrase, “F*#@%ing Google Maps!”

[10] Ties are strictly prohibited. Obviously.

[11] At one of my meetings in 2014, there were business cards (face up) from two of my direct competitors.

[12] For the record, I view the vessels as half-full.

[13] I’m overdue in connecting with Ben Rooks and Michelle. Guys, we should chat soon!

[14] www.hotwire.com

[15] When I was in college, adding footnotes to your paper was complete pain in the ass. Now, it is so simple.

Morning Headlines 1/21/15

Mayo Clinic Selects Epic as Strategic Partner for Electronic Health Record and Revenue Cycle Management System

Mayo Clinic announces that it has chosen Epic to replace its incumbent Cerner and GE Centricity EHR and revenue cycle systems.

Federal Marketplace: Inadequacies in Contract Planning and Procurement

A report from the HHS Office of the Inspector General finds that CMS failed to oversee Healthcare.gov development work adequately, failed to review past performances of vendors selected for key Healthcare.gov contracts, and structured vendor contracts so that the risk of unanticipated cost increases were absorbed solely by the government, rather than shared among the selected contractors.

Geographic Clusters in Underimmunization and Vaccine Refusal

Kaiser Permanente uses its EHR data to pinpoint areas in California with low rates of childhood vaccination,  finding in one school that 50 percent of the children were unvaccinated due to “personal belief exemption.”

MMRGlobal Proceeds With $30 Million Patent Licensing Case and Files Three New Federal Appeals

MMRGlobal announces that it will appeal decisions made by the California district court to throw out its patent infringement lawsuit against Allscripts and WebMD.

News 1/21/15

Top News

Mayo Clinic chooses Epic, as I mentioned a few days ago from a reader’s rumor report. Cerner gets a double whammy – not only do they lose the Mayo bid, some of their systems will be displaced as they (along with GE Healthcare) are the Mayo incumbent. Actually, there’s one more Cerner insult: former Mayo CEO Denis Cortese, MD sits on Cerner’s board.

Reader Comments

 

From Banned in Boston: “Re: McKesson Horizon. The attached letter verifies its sunsetting on March 31, 2018. The event has passed with little fanfare since Horizon has become increasingly obsolete.” The letter, signed by McKesson EVP Pat Blake and President Jim Pesce, says the company will issue a Meaningful Use Stage 3 update and thanks Horizon users for their “partnership,” a trite, vendor-created synonym for “sending checks as a customer.”

From Jose Francisco: “Re: Scripps Health. Will be moving to Epic. Impact Advisors led the system selection – Cerner never had a real shot. Decision will become public in 30-60 days.” Unverified. Scripps chose GE Healthcare’s Centricity Enterprise in 2007 and Allscripts Enterprise for its outpatient clinics in 2009. Assuming the rumor is true, EMR critic and Scripps cardiologist and author Eric Topol, MD will become an Epic user – it will be interesting to see what he says about it among all of his smartphone infatuation. Update: I reached a non-anonymous source who says that Scripps hasn’t yet made a decision as far as he or she knows.

From Lips Pursed: “Re: HISsies voting. It’s just a popularity contest and the ballot choices are stupid.” Of course it’s a popularity contest, just like the Presidential election – what did you think it was? Readers (few of whom are stupid) make the nominations and vote for their choices as they’ve done since 2008, with the most-nominated entries appearing on the ballot. Having people who didn’t nominate anyone complain now is like moaning about the Presidential candidate chosen by your more responsible peers in that primary election voting you skipped.

HIStalk Announcements and Requests

The results of my reader survey are always interesting and useful. Thanks to those who responded.

Some nice point-counterpoint commentary was generated by CommonWell’s answers to HIStalk reader questions and a reaction article by Brian Weiss of Carebox. The comments are getting interesting as Brian suggests that (a) HIStalk readers vote as consumers on the approaches of the respective organizations, and (b) that the organizations consider developing a prototype for exchanging information securely and under the control of patients, driven only by their email address. They are also discussing patient-controlled health record banks.

Welcome to new HIStalk Platinum Sponsor Oneview Healthcare. The Dublin, Ireland-based company (with US offices in San Francisco and Pittsburgh) offers a Microsoft-powered customizable interactive patient care system that’s accessible by smartphone, tablet, or in-room TV. Patients get education, entertainment, communications services, messaging, scheduling, way-finding, meal ordering, nurse rounding, and remote consultation, while clinicians use it to access electronic medical records and other point-of-care applications. Two big reference clients are the newly built Chris O’Brien Lifehouse in Sydney, Australia (they have a patient experience focus and every patient interacts with the Oneview system) and UCSF Mission Bay (a three-hospital campus opening in a couple of weeks). Maimonides Medical Center (NY) SVP/CIO Walter Fahey says, “The capability that the Oneview solution can deliver is second to none and it will transform the healthcare experience, not only for our patients, but for our healthcare teams and hospital managers.” Thanks to Oneview Healthcare for supporting HIStalk.

I found this overview video of Oneview Healthcare on Vimeo.

Listening: Gary Lewis and the Playboys. Like most of America, I can’t understand how the unattractive, minimally talented son of the annoying Jerry Lewis could have become a 1960s pop star, at least until his career was waylaid when he was drafted and shipped off to Vietnam in 1967. I’ve seen him live a couple of times –he’s good natured (he’s 68 now) and he had some massive songwriting and production firepower behind his records. I have a strong need to hear “This Diamond Ring,” “Palisades Park,” “Everybody Loves a Clown,” “Save Your Heart for Me,” and “Little Miss Go Go “ every few years. Trivia: there were no actual Playboys on the records – it was all Gary and some studio musicians, heavily overdubbed and recorded using the opportunity created by his mom’s money and his dad’s name.

Acquisitions, Funding, Business, and Stock

Xconomy profiles nonprofit Wisconsin investor BrightStar, which funnels charitable donations of around $200,000 to complete funding rounds for early-stage companies that are creating state jobs. It quotes Forward Health Group CEO Michael Barbouche, who says working with BrightStar is painless and easy.

Patent troll MMRGlobal challenges recent court rulings in which its infringement lawsuits against Allscripts, WebMD, and others were rejected. Above is an illustration from one of its 13 patent applications from its 300 open lawsuits. MMRGlobal’s penny stock shares (literally: its shares are listed at $0.01 on the pink sheets) have dropped 59 percent of their value in the past year. Founder Bob Lorsch and his spokesperson/president wife were featured in a 2012 TV show called “Interior Therapy with Jeff Lewis” in which they are portrayed as emotional hoarders of a crammed houseful of stuff. I interviewed him a couple of year ago and found him charming and his product interesting, although the endless lawsuits overshadow all of that. He made one of his fortunes selling 976 telephone services in the 1980s, including a Santa Claus hotline (he sued a phone sex company for using a number similar to his) and running a children’s 976 phone service as a fundraiser for museums in which he kept $1.75 from each $2 call.

The Washington Post profiles hCentive, a software development company started by a guy who in 2009 downloaded a copy of the Obamacare bill the Senate was then debating and saw opportunity. The Affordable Care Act was signed into law nine months later and the three-person company now has 700 employees and $50 million in annual revenue after building four state exchanges and being signed by the federal government to build a small business site after it fired CGI for the failed Healthcare.gov rollout.

Sales

Wheaton Franciscan Healthcare (WI) chooses Epic in a $54 million, five-year project.  

Southeastern Health (NC) chooses eClinicalWorks Care Coordination Medical Record.

Aetna selects HealthEdge’s rules-powered health management system for payors.

People

Randy Carpenter (Omnicare) joins Stoltenberg Consulting as SVP of strategic services.

Xerox Government Healthcare names Scott Bennett (Siemens Healthcare) as SVP of sales.

Announcements and Implementations

PeriGen announces a doubling of its customer base in 2014, with 140,000 births to date supported by its PerCALM Tracings electronic fetal monitoring system.

St. Maarten Medical Center says it will be the first hospital in the Caribbean to use a fully electronic system when it completes its implementation of CPSI, which replaces a Siemens MedSeries4 system that was “no longer reliable and nearing a system failure.”

GE Healthcare and NextGen earn EHNAC’s first practice management system accreditation.

Government and Politics

Computer scientist Kathy Pham, a new employee of the United States Digital Service, attended Tuesday night’s State of the Union address as one of 22 guests invited by the White House. She has been a healthcare informatics researcher, a software engineer for Harris Healthcare Solutions, and a healthcare consultant with IBM. She also serves as a patient advocate for her mother, who has acute lymphoblastic leukemia.

A report by HHS’s Office of Inspector General finds that CMS’s work on Healthcare.gov was sloppy, hurried, and poorly overseen, awarding no-bid contracts worth hundreds of millions of dollars without reviewing past company performance or having firm requirements defined. As has been widely reported, CMS hired 33 companies to work on the site, but didn’t name any one of them to be in charge, although they just assumed that CGI Federal was running the project. The agreements also didn’t cap payments and allowed overbilling with minimal documentation, so some companies were paid up to three times their bid amount. CMS originally estimated the value of six key contracts at $464 million, but has paid $824 million so far.

Privacy and Security 

A security company finds that Healthcare.gov connects in the background to dozens of private websites, including Facebook, Google, and Twitter, raising concerns about cybersecurity exposure and whether user information is really private.

Innovation and Research

A new research article describes how Kaiser Permanente analyzed its EHR information to identify neighborhoods with a low rate of childhood vaccinations, allowing it to mount outreach efforts to five areas. One private school had a 50 percent rate of “personal belief exemption.”

Technology

in England, the medical director of NHS says wearables will play a vital part in future health in allowing people to be monitored at home for irregularities in heart rhythm, breathing, and edema. He adds that NHS will push a “huge rollout” of those technologies.

Bizarre: Airbnb-inspired Airpnp lets app users in need of a bio break rent bathrooms in private homes. The founders were inspired by a New Orleans decision to ban street-located Porta-Potties during Mardi Gras. It’s hard to fathom that sellers would allow a stranger into their homes (and bathrooms) for a dollar or two. It sounds like a spoof to me, but then again it’s sometimes hard to tell if a startup is serious. Perhaps the same skepticism applied early on to Uber, however, which just announced that its San Francisco revenue alone is $500 million per year – nearly four times the entire taxi market there — and is growing 200 percent per year.  

Microsoft patents user-configurable technology that can automatically dim and silence a smartphone when the phone’s GPS detects that the user has entered a theater, when it senses darkness and quiet, or when so instructed by the Wi-Fi system being used.

Other

An epidemiologist with New York City Department of Health and Mental Hygiene tells the Health IT Policy Committee that fast outbreak identification and control requires better integration between EHRs and its disease surveillance system. She envisions EHRs sending real-time data for surveillance and then receiving back prompts for additional information, such as patient demographics.

A North Carolina OB-GYN says doctors should use computers and not vice-versa, urging his peers to look at the patient instead of the screen. “The folks who sold us these systems talked about all the wonderful things EMR can do … One might assume the EMR would excise the tumor, lower the blood glucose and stop the hallucinations. The problem is that the EMR really should not ‘do’ anything. Patients tell us their concerns. Practitioners do their best to listen and perform the appropriate evaluation, with or without technology … everything we need to know about our patients is in their face, in their voice, and in their eyes.”

Forbes India profiles India-based Narayana Health, whose first non-India hospital opened in the Cayman Islands a year ago in a partnership with Ascension Health. Founder and cardiac surgeon Devi Shetty got the idea for his medical tourism hospital from a friend who mused, “The most profitable hospital in the world is the one which is built on a ship and parked outside US waters because it gets to serve American patients and yet stays away from its jurisdiction.” The hospital has implanted an artificial heart for what Shetty says is less than half of the $1.2 million US hospital price. He’s working with two US-based health systems on new hospital software (I’d be curious to learn more about that) and is talking about starting a Caymans medical school.

Weird News Andy likes the glucose-monitoring temporary tattoo on the left better than the diabetes-hating one on the right, although I’ll add that both might illustrate diabetic monitoring assuming there’s a Diastix right above the word “diabetes.”  

Sponsor Updates

• Zynx Health VP Guillermo Ramas writes about attaining the impossible in the company’s latest blog.
• Frank Myeroff of Direct Consulting Associates interviews Denver Health CIO Jeff Pelot.
• Huron Consulting Group will exhibit at the AHLA 2015 Legal Issues Affecting Academic Medical Centers and Other Teaching Institutions conference in Washington, DC from January 22-23.
• Voalte Product Manager Anthony Mitchell blogs about the smart use of smartphones in the latest company post.
• ExitEvent highlights Validic and its relationship with digital health startup Qardio.
• T-System Clinical Systems Engineer Deon Melton, RN shares “Life Lessons Learned in the ER” in a new blog.
• Caradigm Director of Product Marketing Scott McLeod pens a new blog, “All Signs Point to Population Health Management.”
• AtHoc President and CEO Guy Miasnik writes about the role AtHoc technology played in protecting Gritman Medical Center from an active shooter.
• The local business paper highlights the venture capital funding raised by CareSync in Q4 2014.
• CareTech will attend the January 28 MCACHE event on “Building a Leadership Team for the Healthcare Organization of the Future.”
• AirWatch’s Noah Wasmer offers five end-user computing technology predictions for 2015 in a new blog.
• ADP AdvancedMD offers tips on leveraging practice data to view key performance indicators in a new blog.
• Besler Consulting offers advice on how to increase Medicare EHR incentive payments.
• Aventura will exhibit at the IMN Health Impact Conference of the Southeast in Tampa on January 23.
• CitiusTech achieves the ISO 13485 quality management system standard for medical devices.
• CoverMyMeds shares a moment with Account Coordinator Josh Campanella in the latest installment of its “Hey, You!” blog series.
• ABCNews.com lists Clockwise.md amongst other companies making a name for themselves developing online booking software.
• CommVault launches new endpoint data protection to secure, support, and back up mobile enterprises.
• Craneware lists its goals for 2015 in a new blog post.

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan.

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

Startup CEOs and Investors: Michael Burke

Accelerators and Incubators: Have They Jumped the Shark?
By Michael Burke

It seems lately that startup incubators and accelerators have become like belly buttons — everybody has one. The number of healthcare-specific platforms has increased dramatically over the past few years. A skeptic might ask if we are in an accelerator / incubator bubble. A more important question might be, “Why should I care?”

If you’re an aspiring startup founder, you may care. The well-known accelerator/incubator platforms like Techstars and Y Combinator can serve the same purpose for a startup founder as a Harvard MBA does for a young executive who wishes to climb the corporate ladder. They open doors and provide a measure of validation.

The jury’s still out on whether the newbie platforms will offer similar cachet. One of my fellow “villagers” at the Atlanta Tech Village, Kyle Porter (Founder/CEO of SalesLoft) mentioned that his experience at Techstars Boulder with Brad Feld immediately prequalified him and his company in the eyes of investors, partners and potential employees. He states:

“Accelerators taught us how to navigate the investor landscape, put together a presentation, and connect with relevant mentors.  And the networking benefits are insane.”

If you are an investor, you definitely care. A friend of mine, Greg Gottesman, is uniquely qualified to comment. Greg is an informal advisor to Clockwise.MD (my startup), and he has a vested interest in the topic. In addition to founding Rover.com and serving as Managing Director of Madrona Venture Group, he also leads Madrona’s recent leap into the incubator world: Madrona Venture Labs. Here’s what he has to say:

“To the extent that accelerators and incubators enable more ideas to be tested quickly, I think they are a good thing. But most of these early concepts won’t and shouldn’t get funded with significant dollars. The best teams and ideas — the ones with customer traction and viable business models — will stand out relatively quickly. I wouldn’t look at the percentage of successes these accelerators and incubators create over time, but rather whether they can produce a small number of meaningful winners.”

Accelerators and incubators can clearly help investors sort the wheat from the chaff early in the life of a startup. David Cummings is a serial entrepreneur, partner in Atlanta Ventures (which has its own accelerator), and creator of the Atlanta Tech Village( a “community of innovation powered by a 103,000-square-foot building”). The Tech Village is a big laboratory of over 100 startups ranging from companies consisting of a single person to upwards of 50. In addition to the ping pong tables, gaming consoles, and free Cokes, there’s also a ton of exciting stuff happening — lots of big successes and big failures, all of which are observable to the community there. It’s not strictly an accelerator, an incubator, or even a co-working space. It sort of combines the best of all those platforms. David states the advantages simply:

“[These platforms] help bring structure to a messy process and increase the likelihood of success.”

That’s fine for an aspiring founder or an investor, but how does that help the purchasers of the innovation these platforms are supposed to generate? What’s in it for health IT customers?

My company has had a number of big customers choose us over larger competitors. These customers know that a startup (i.e., a company whose size makes them more flexible and responsive) can give them a greater measure of control over the process of solving a problem with technology. They assume (correctly) that they’ll have more influence over the final deliverable than they might if they worked with a bigger company. A startup from an accelerator, incubator, or “community of innovation” can – as David Cummings pointed out – increase the likelihood of success and mitigate the risks for the customer.

Donna Hyland is the CEO of Children’s Healthcare of Atlanta (CHOA). CHOA is one of the largest and most recognized health systems in the US dedicated to the care of children. She and her staff have been regular visitors to the Atlanta Tech Village and work with several companies from the village, including Clockwise.MD. Here’s what she has to say:

“Atlanta is very fortunate to have a burgeoning community of technology innovators and entrepreneurs. Children’s Healthcare of Atlanta is continuously looking for ways to better care for and serve our patients and families. We are working with companies from Atlanta Tech Village on great tools to improve care and the patient experience. We are grateful to have so much technology talent in our community.”

Back to the original questions. Are there too many incubators and  accelerators? Do they add value?

I don’t know if there are too many of these platforms, but I suspect that many if not most add value. If we revisit the business school analogy, we see that not everyone can get into Harvard, but most will probably still get a great education at a lesser B-school. I assume the same is true for these innovation platforms. I further assume that accelerators and incubators themselves are subject to the same Darwinian forces that send the majority of startups out of business, and that we’ll see a changing of the guard, if not a thinning of the herd, over the next several years.

Michael Burke is an Atlanta-based healthcare technology entrepreneur. He previously founded Dialog Medical and formed Lightshed Health (which offers Clockwise.MD) in September 2012.