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HIStalk Interviews Michele Perry, CEO, Relatient

December 11, 2019 Interviews No Comments

Michele Perry, MBA is CEO of Relatient of Franklin, TN.


Tell me about yourself and the company.

Relatient is based in Franklin, Tennessee, and was started in 2014. Our name is a combination of “relate” and “patient,” relating to the patient. We are 100% focused on patient outreach and engagement, and it reflects in our name. We do this only for healthcare. We get calls all the time to see if we do this for prisons, courts, schools and everything else, but we are focused on patient engagement.

I joined in 2017. I replaced the original founding CEO. I’m a Saas software solutions veteran. I focus on high-growth companies.

I’m not a Nashville native, which you’ve probably already heard based on the lack of R’s in my vocabulary. I’m originally from Massachusetts and have spent time in New York, California, and Virginia. I was in Annapolis, Maryland for the 20 years before I took this job.

Are hospitals and practices wrong in thinking that all consumers really want is a patient portal?

Patient portals served an important purpose. They were part of the Meaningful Use requirement. But they are not addressing the needs of today’s consumers and patients. Find me a patient who thinks they are.

We compliment a lot of the work that has been done with patient portals and the investments that have been made in them. Lots of times we’ll drive people to things that are stored in a patient portal. But we’re all about using that phone and making it easy for patients.

In this day of the consumerization of healthcare, we all expect to be able to access things easily from our phone. Every day I’m making reservations, planning a flight, calling an Uber, checking my bank balance, and Venmo-ing money to my kids. You can do it with just a couple of clicks. Try to make a doctor’s appointment, check for your lab results, or register for that appointment while you actually have the medicine sitting in front of you at home. Try to do any of that stuff and it’s painful.

That’s what we’ve set out to fix. We make it easy for the patient, and if you make it easy for the patient, you make it easy for the practice. We see hospitals and clinics and everybody else wanting to engage with their patients.

What are the ones that are doing a good job doing differently from those that aren’t?

I’d love to say that it’s concentrated in different areas, but it’s not. We are seeing it across all specialties. Nebraska Cancer in the oncology area is using it to reduce no-shows by 47%. I was surprised – don’t cancer patients show up? The answer was that we need to alleviate the confusion around all the different providers and appointments people have during the cancer treatments.

We are co-presenting with Oklahoma Heart at HIMSS on driving patient engagement in a mobile-first market. We have FQHCs like Access Healthcare in Chicago, who wants to be able to message not just about your appointment, but to let you know that the food trucks that take SNAP are going to be there on the day that you are there for your appointment. Pediatrics organizations like Children’s of Colorado are doing interesting things with telehealth and remote access initiatives, reaching out into rural areas. Primary and women’s care, like Seven Hills or South Bend Clinic, are focused in gaps in care and things like that.

What percentage of hospitals and clinics are using electronic appointment reminders?

The first generation of those products was pretty basic, and it’s rare for us to run into somebody who hasn’t put in a first-generation solution. But now that they have it, they’re finding that they can do so much more with that communication. Do I need to fast before my appointment? Do I need to show up extra early for testing?

Some of our large hospitals have 120 kinds of appointment types, each of which require different messaging. They need support for multiple locations, especially now with telehealth and remote health, so they can say, “Your appointment is with Dr. Smith out of the Denver office, but you are going to be in the Grand Junction office.” The second generation of products needs these kinds of communications. But it’s really rare to find someone who hasn’t done a first-generation product, except for some small two- and three-doctor offices.

Why is patient self-scheduling uncommon?

Practices didn’t have it yet. They said, “Oh, we have a scheduler.” But people want to be able to schedule after hours, during lunch, or during conference calls. I want to quickly make that appointment off my phone or off my desktop. I want to be able to do that quickly. People hadn’t set those up.

We also found providers who wanted their front desk people to have ownership of that schedule. We’ve added to our product the ability to have a two-step acceptance. Let me make my appointment at 10:30 at night. When my kid’s not feeling well and I want to make an appointment, let me make that appointment. But let it actually have to be accepted by somebody in the office in the morning. They accept this one, accept that one, and then realize that they’re accepting all of them anyway, so they are comfortable skipping that step. But the ability to have ownership was important for a couple of our providers as we were bringing them on.

On the back end, does someone have to copy-paste from the self-scheduling application into the system that keeps the real schedule?

The way we do it is important. We actually write back into these schedules. People are sometimes kind of scared about it upfront, but then when they see that it works really well, then they give up. But yes, we don’t just send an email that someone has to then set up – we do all the write-backs right into the systems for appointment reminders, scheduling, e-registration, surveys, and all of the other components.

The culture of some hospitals and practices was built around a siege mentality, where patients aren’t allowed to communicate with a provider unless they make a billable appointment and come to the office. Is that changing?

Sometimes you can bill telehealth appointments, to have those paid for. People want to have access to their doctors, so they’re trying to make it easier to do these new types of appointments, because if I don’t make my physicians accessible to you, you’re going to go down the street to the urgent care or some other clinic. They would rather not have them go away to the Walmart clinic, the CVS clinic, or someplace else. They want you to come to their providers.

Your system offers broadcast messaging for unplanned changes to normal operating hours, like weather emergencies. Do practices who don’t have it just update their Facebook page and hope patients check there?

Some of the folks still change their websites or have a message on the answering machines. We have tremendous demand for demand messaging, or the broadcast messaging capability, when you have weather problems, like New England this week or during Hurricane Dorian. But it’s also used for non-weather things, like if a doctor will be out for the next two days on bereavement, or in OB-GYN for messages like, “This doctor was just called in for a delivery. Please call the office before coming to make sure they will be here for your appointment.” Specialists make appointments months ahead, so you have to keep up to make sure that you’re not blasting the whole patient base to get a message to the 20 patients who need it.

What about health campaigns such as disease-specific follow-up or seasonal items like vaccine availability?

There’s nothing we do that you couldn’t do manually, but it takes a lot more effort. Campaigns to close the gaps of care are important, especially in primary, women’s care, and pediatrics. Getting people back in to make sure their kids are getting the right vaccines at the right time.

We’ve learned the hard way how to actually do the notifications. Maybe 3,000 patients haven’t had this particular thing that needs to get done. If we just blast everybody, your call center gets overloaded the next Monday. We do a dribble campaign and send the messages in bunches so they don’t all go out at the same time. We pull the data from the EHR and practice management system, use the campaign to contact those people and get them to make appointments, and with patient self-scheduling, we can send them to the link so they don’t even have to call the office.

Consumers vastly prefer text message communication over all other forms for convenience, but it also offers better deliverability than email or phone calls and also gives patients a way to take action without writing something down.

What we have found, and what we recommend in our best practices, is a combination of all three. We do phone, email, and text, and we do them at a certain interval over time. We don’t want to stalk you, but we want to make sure you get the message. If you do just texts, your response rate will be lower. If you’ve heard it on an answering machine and you’ve seen it in the email, you might not have reacted to it, so it’s a combination of seeing those.

We send the final reminder at certain times of the day. Some at night, some in the morning, depending on time of your appointment. You might have accepted it and intended to go, but you drive to work and forget. But if I send you a text that morning for an appointment later that day, you’ll remember. I also can’t send them too late because you don’t want to be disturbing people at night and when they go to bed.

Do you have any final thoughts?

We’re still early on with patient engagement, how we’ll engage patients over time, and how we’ll do it within the constraints of HIPAA, GDPR, and other regulations. It will be exciting to see where this will go, with things like two-way chat. But as we do this, we’re committed to innovation. Not just product innovation, but throughout our company. We’re currently rated number one by KLAS for patient outreach, with a score of 95.6. We follow this score closely throughout the company. We believe it’s the best way to ensure that we are firing on all cylinders. We need to have great products delivered by great people to work with our customers to drive the ROI on our software.If we drive that ROI, we will help our practices have happy customers.

Morning Headlines 12/11/19

December 10, 2019 Headlines No Comments

Google snaps up chief medical officer of health device maker AliveCor, weeks after buying Fitbit

Former AliveCor CMO Jacqueline Shreibati, MD joins Google Health’s clinical research team.

McKesson Appoints Nancy Flores as Executive Vice President, Chief Information and Chief Technology Officer

McKesson names Nancy Flores (Johnson Controls) EVP, CIO, and CTO.

ESO Acquires Clinical Data Management to Extend Product Portfolio in Trauma Registry Market

Emergency medical services technology company ESO acquires trauma registry software vendors Clinical Data Management, Lancet Technology, and Digital Innovation.

CommonWell Health Alliances Announces New Executive Director

Former Philips VP Paul Wilder joins CommonWell Health Alliance as executive director.

News 12/11/19

December 10, 2019 News No Comments

Top News


“Smart pill” medication management company Proteus Digital Health struggles to stay afloat after a $100 million funding round fails to materialize. Once valued at $1.5 billion, the Silicon Valley-based company furloughed employees for several weeks in November until it could acquire $5 million in emergency funding. Company officials say they are looking at restructuring options, while unnamed insiders point to a lack of traction with patients as a big reason for the company’s stymied growth.

Meanwhile, competitor EtectRx receives FDA clearance for its smart ingestible, which is being tested by researchers at Brigham and Women’s Hospital and Fenway Health in Boston for use with HIV medication.

Reader Comments

From Dr. Doyle: “Re: The Great NHS Heist. Interesting movie on the NHS.” Backers of the documentary make it available on Youtube ahead of the UK general election on December 12. The documentary, which aims to highlight increasing efforts to take the NHS private, has been in the works for a number of years. It made its theatrical debut in London last month.


None scheduled in the coming weeks. Previous webinars are on our YouTube channel. Contact Lorre to present your own.

Acquisitions, Funding, Business, and Stock


Emergency medical services technology company ESO acquires trauma registry software vendors Clinical Data Management, Lancet Technology, and Digital Innovation.


Former Outcome Health EVP Ashik Desai pleads guilty to charges of fraud, admitting that, “When I was at Outcome Health, there were practices going on there that were wrong. I participated in those practices that ended up defrauding Outcome’s customers.” Three other former employees, including former CFO Brad Purdy, have pled not guilty. Former CEO Rishi Shah and former president Shradha Agarwal will make their court appearances next week.


  • Hospital Sisters Health System Medical Group (IL) will implement Relatient’s patient engagement software.
  • Saint Peter’s University Hospital (NJ) selects Vox Telehealth’s FemmeCare for C-Section and Hysterectomy programs to help patients better prepare for and recover from surgeries.
  • Precision medicine company Astarte Medical selects commercialization services from Get-to-Market Health.



Paul Wilder (Philips) joins CommonWell Health Alliance as executive director.


Innara Health promotes Chris Mathia to CEO.

image image image image

AI-based diagnostics vendor IDx Technologies promotes John Bertrand to CEO, replacing founder Michael Abramoff, MD who has become executive chairman. The company has also hired Seth Rainford as president and COO, and promoted Danika Simonson to the new position of chief of staff.

Announcements and Implementations


Advocate Lutheran General Hospital (IL) implements AI-enabled stroke-detection software from The technology will be rolled out to the entire Advocate Aurora Health network by early next year.


Floyd Medical Center (GA) launches a telemedicine program for stroke and neurology patients leveraging providers from Erlanger Health System (TN).

IntelliGuard integrates its RFID-enabled medication tracking technology for anesthesiologists with Epic.


Wyckoff Heights Medical Center (NY) goes live on Allscripts Sunrise and FollowMyHealth software.

LogicStream Health will make its Drug Diversion App available early next year.


With help from the Medical University of South Carolina’s Center for Telehealth, Roper St. Francis Healthcare adopts tele-ICU services from Advanced ICU Care at three of its hospitals.

Privacy and Security


Hopes of returning to normal operations within a week are dashed as the Government of Nunavut in northern Canada continues to recover from an early November ransomware attack that took its computer systems offline. Health department officials still have no idea when they’ll be able to get their Meditech system and telehealth capabilities back up and running. Chief of Staff François deWet, MD says several things have made the “IT apocalypse” eye-opening:

  • Having a disaster plan already in place was key to communicating needs and updates with affiliate organizations, which in turn ensured healthcare services weren’t interrupted.
  • The fact that the department was in the midst of a Meditech upgrade before the ransomware attack happened resulted in more reliable backups, which are in the process of being restored.



A survey of 521 consumers finds that they trust their current providers and healthcare organizations with their health data far more than they do their health insurance companies, technology companies like Amazon or Google, or telemedicine vendors.

Sponsor Updates


  • Bluetree employees impact 23 organizations by volunteering 264 hours across 13 states and India during the company’s annual Give Back Week.
  • HHS expands its contract with Audacious Inquiry for the development of a national Patient Unified Lookup System for Emergencies system.
  • Avaya announces that Earvin “Magic” Johnson will keynote Avaya Engage 2020 February 4 in Phoenix.
  • Data Center Knowledge features Atlantic.Net in its “Trends in Data Center Network and IT Security” report.
  • Wolters Kluwer Health adds machine learning and AI capabilities to its Sentri7 healthcare-acquired infections surveillance software.
  • Huron will provide consulting and implementation services for Omnicell customers.
  • SymphonyRM releases a new podcast, “Edward Marx and Four Pillars of Innovative Leadership.”

Blog Posts



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Get HIStalk updates.
Send news or rumors.
Contact us.


Morning Headlines 12/10/19

December 9, 2019 Headlines No Comments

etectRx Announces U.S. FDA Clearance of Novel Ingestible Event Marker

EtectRx’s smart pill system receives FDA clearance after news breaks of competitor Proteus facing financial difficulties.

Alleged billion-dollar fraud scheme leads to guilty plea by former Outcome Health exec

Former Outcome Health EVP Ashik Desai pleads guilty to wire fraud and agrees to cooperate with prosecutors.

For Concussion, MS, Other Neurologic Disorders, Telemedicine May Be as Effective as Office Visit

A retrospective analysis of 101 telemedicine studies finds virtual visits may be just as effective as in-person visits for several neurological conditions.

Curbside Consult with Dr. Jayne 12/9/19

December 9, 2019 Dr. Jayne No Comments

As part of the Maintenance of Certification process for my clinical informatics board certification, I have to complete a quality improvement project related to practice. Although there is quite a bit of flexibility in these projects, it’s been challenging for me to come up with something because I don’t have what many would consider a “typical” informatics practice. Many of my peers are either part of academic institutions where they have clear roles and/or titles. Others are part of healthcare delivery organizations where they have the ability to use data and processes for quality improvement. As an independent CMIO for hire, I often have a seemingly random mix of employers, ranging from startup technology vendors to large healthcare systems.

In these situations, I have contractor status. It’s a strange limbo where often you are treated like an employee but you’re actually not – you have many of the same responsibilities and are subject to the same rules as employees, but at the end of the day you don’t have the ability to direct your own work or propose new initiatives that would make sense for a straightforward project for board certification. My clinical situation is unique in that I’m employed, but very much part time and with no formal informatics role these days. My informatics influence is limited to cranky emails to our IT team asking why the system is suddenly allowing us to e-prescribe controlled substances when we do not have legitimate EPCS technology in place. My employer is reluctant to allow me to do anything with our data, since I’m essentially just an hourly physician.

I have another year or two before I have to finish this project, but I still feel somewhat adrift with it. Still, I am always on the lookout for ideas. One recently came across my desk, and I wonder if the practice would be willing to let me use their data if I could find some “what’s in it for me” for them. As an urgent care, we certainly see our fair share of trauma. Recently, JAMA Otolaryngology-Head & Neck Surgery published a study investigating a surge in cellphone-related facial trauma. Reported injuries range from being injured by a dropped or thrown phone to distraction-related falls.

The authors looked at 20 years of data from the US Consumer Product Safety Commission database looking at ER visits. They found 2,500 patients with phone-related head and neck injuries between 1998 and 2017, with a surge beginning in 2007, coinciding with the advent of smartphones. Approximately 40% of the subjects were between the ages of 13 and 29, and they were generally injured while walking, driving, or texting. Although cell phone use has also been linked to repetitive motion injuries, these were excluded from the study. The most common injuries were facial and head lacerations, followed by contusions, abrasions, and injuries to internal organs. The majority of patients were treated and released. Apparently there are more than six million patients treated for lacerations every year, with an estimated cost of $3 billion.

I’d be curious to find out how cell phones compare with other sources of trauma in our urgent care practice. We see over 300,000 patients a year so there should be a reasonable amount of data. Anecdotally, I think that sports-related injuries likely make up the lion’s share of our head trauma, followed by motor vehicle accidents, and falls. I’m betting that the causes would have to be determined by a chart audit, because many of my partners aren’t as specific with their coding as they could be. My quality intervention could be to assess whether visits were documented more accurately when physicians or scribes were doing the work, and to develop a curriculum to try to increase the specificity of coding. It’s kind of a soft project, but it at least addresses something that is clinically relevant in my practice. Still, it’s unlikely that I could talk my employers into it, since there’s not a clear return on investment for the time that would need to be spent educating clinicians and staff.

Another option for the quality project is for informaticists to conduct a 360-degree evaluation project. We did a 360-degree evaluation in residency and I’ve done it with a previous employer, and also with one of the community service organizations I work with. All three times I found it to be useful, although the episodic nature of some of my work might make this challenging. Some of my projects only last a month or two, which makes it hard for someone to get to know how you work, critique it, and then re-evaluate after you’ve completed some kind of intervention or change in how you work.

These are all part of the hoops that we have to jump through to maintain our board certification status. It’s particularly challenging in clinical informatics, since there can be such breadth in the type of work that we do. Our practice environments can be very different, and we may spend anywhere between 1% and 100% of our time doing informatics work depending on how much our employer wants to fund. I am glad that the American Board of Preventive Medicine, which is my certification body, recently approved a proposed Longitudinal Assessment Pilot as an alternative to the one-day board certification exam. It is supposed to launch in early 2021 and run for 24 months. Participants will answer 24 questions a year. This differs significantly from the longitudinal assessment pilot in my primary board, where we have to answer 100 questions a year for four years in order to replace the exam. It’s hard to imagine how the scope of clinical informatics can be distilled down to 24 questions a year, but unlike my primary board, it doesn’t seem that we have the opportunity to opt-out of this pilot.

I’m curious whether non-physicians are aware of the clinical informatics quality projects and whether your board-certified colleagues have pulled you in to help them get across the finish line. How are the projects perceived? Have there been positive outcomes? Or are they just a nuisance? On the physician side, is anyone else dreading their project? Leave a comment or email me.


Email Dr. Jayne.

HIStalk Interviews Doug Cusick, CEO, TransformativeMed

December 9, 2019 Interviews No Comments

Doug Cusick, PharmD is president and CEO of TransformativeMed of Seattle, WA.


Tell me about yourself and the company.

I’m a clinician by background, although I’ve not practiced for many years. I’ve been in the electronic health industry for 35 years and I have the gray hair to prove it. I spent five of those years overseas, running a large healthcare and life sciences division for a large technology and services company.

TransformativeMed was a spinout from the University of Washington back in about 2012. It was co-founded by a practicing trauma surgeon, who continues to practice, and at that time the applications director at the University of Washington, who had overseen its Cerner implementation. The two of them together quickly saw a need to make the EHR usable, primarily for the doctors.

Does offering products that extend Cerner’s system limit the company’s opportunities?

The applications director was one of the inventors of MPages, which is used by organizations — including Cerner — to develop customizations to the Cerner Millennium software. The co-founders recognized that the EHR was just a platform, and in many cases, one that was challenging for clinicians to use. They went about inventing a series of applications that are embedded within Cerner and that have bi-directional information exchange. That allows specialty-specific workflows to be built.

By example, if you’re an endocrinologist, you need certain data at certain times in the decision-making process as part of the hospital’s overall care team. You want it in the format that is intuitive to how you practice. They developed 40 specialty-specific and subspecialty-specific clinical workflows.These are embedded in the clinical workflow, where all the action happens. Those users can manage their patient lists, the rounding and hand-off process, and care team coordination. They can also take advantage of disease-specific workflows, such as inpatient diabetes management and thrombolytics.

We continue to consume more and more of the breadth and the depth of what the clinicians need in order to make the electronic health record usable. We are moving pretty broadly across that realm.

What kind of relationship with Cerner do you need to make this work? How would that translate into working with Epic?

Our solutions are built on cooperating with the large electronic health vendors. It’s like the Salesforce model, with a great platform that is open for innovations. Cerner specifically is that type of platform. We rely on the data that is populated in the EHR. Our solutions allow that data to flow between the apps and the EHR, because it is embedded within the databases themselves.

In many cases, particularly with Cerner, the client representatives themselves come to us to help solve problems around clinician satisfaction, gaining efficiencies, and delivering on the billions of dollars that have been invested in the EHR.

It’s funny that in my 35 years in this industry, I can count on one hand how many doctors and IT people have ever said anything positive about any software solution. But in our case, what was so attractive for me coming on as CEO was that I get emails and phone calls every day from doctors and IT folks who love our embedded applications products that make their EHR usable, particularly from a specialty-specific perspective. It’s pretty amazing that for the first time in my career, we get so many kudos because doctors and IT folks love us.

How do you see the company growing? Do you hope to replicate your success in having helped other companies move up to the next level?

[Laughs] Absolutely yes, and most certainly. What was so attractive about me coming on board was that I had never seen anything like it. It isn’t disruptive to IT. Doctors and clinicians truly love us because we make their day better by delivering solutions that are intuitive to how they practice medicine. That we don’t need trainers on site speaks to the intuitiveness.

We recently went through a fairly substantial series A raise in Seattle. Before that, we were moving the company forward on customer revenue, and most of those sales had been done by word of mouth. For example, clinicians practicing at the University of Washington were moving on to other health systems and logging onto the EHR and saying, “This isn’t what I’m used to. I really need Cores,” which is the name of our product line.

When I came on board, we had a pretty nice array of clients and we’ve expanded that dramatically. I think we’re up to about 140 or so hospitals in the US. We’re selling our first international deal this week, so we’re pretty excited to expand internationally as well. Cerner has a large footprint.

We will be cautiously moving into Epic. We just closed our first contract with a health system that is moving to Epic. We couldn’t be more excited about gaining that experience, especially as interoperability and FHIR begin to take hold of the industry.

What business arrangement do you have with those EHR vendors?

We do not have a formal business relationship with them. We contract directly to the health systems. But with so many articles being published around physician burnout and lack of efficiencies and crises galore, the EHR vendors are seeing opportunity to deliver more innovation through their platform. The EHR is just data storage and the ability to move data around.

Health systems are recognizing that the EHR vendors aren’t going to deliver everything they possibly need. With the amount of true innovation that is going on across the industry, how can they add applications that make it more usable in a standardized fashion, but personalized for the clinicians who have to use it?

Particularly in this era of EHR optimization, we need to move way beyond the re-implementation of the EHR as the industry currently conceives it. EHRs need a massive overhaul to make them usable by the clinical community, and we have lots of studies to support that. CIOs are beginning to recognize, along with the clinical community, that they have a responsibility to help solve some of the problems.

It’s surprising that you can work with Epic without the company’s participation, and also that you can create add-on products without having problems when Cerner or Epic upgrade their underlying EHR.

MPages allows us to be directly embedded within the Cerner databases and all clients use it. Once we are given access to the system, it becomes our heavy lift and not an IT department burden, so CIOs love us. Plus, we are delivering huge benefits to the clinical community, namely the doctors who are finding that it is much more usable.

Epic is a different model and a more closed architecture. But we’re finding, particularly today in our first engagement, that Epic has been collaborative in terms of bringing our solutions within this health system. We’ll go live with them later in 2020. We couldn’t be more excited about the opportunity to move further into the EHR world. And not just here — the problems we face are being seen worldwide as more countries and systems purchase American EHRs.

EHRs weren’t necessarily designed for physician shift work and the resulting handoffs, such as hospitalists covering large numbers of patients for a fixed period, residents whose work hours are limited, and the use of multidisciplinary care teams. What does the market need beyond basic EHR functionality to support that model?

IT needs to become more interoperable. The 21st Century Cures Act is helping drive that interoperability forward, but health IT vendors as a whole are slow to comply.

I can use my phone to take a picture, edit it before texting it to my kids, share it on Facebook or Instagram, and my sister can download it and post it to her Nixplay electronic picture frame. This is real interoperability, and it should translate to healthcare because consumers expect it.

Doctors and other clinicians are spending so much time today away from the bedside and tied to a device – desktop or mobile – trying to get the data they need to make decisions. They need solutions that make it seamless and allow them to function as part of a care team. In the old days, you had just one doctor, like Marcus Welby, MD, but today that’s not the case. How do we continue to coordinate care across the health system to get the individual clinicians what they need immediately to make clinical decisions that positively affect the patient?

Our philosophy is about making that seamless communication and hand-off process as beautiful as possible so that clinicians can get back to the patient. They can deliver care as they’ve always wanted to. They are not tied to a computer to get the data they need in hunt-and-peck fashion. They go about doing their business and, in the process, become happier, and happy clinicians deliver better patient care.

Health systems, because they’ve invested so many billions, are now trying to figure out how to derive further value after these purchases. Companies like ours that are delivering innovation directly into the clinical workflow, where all the action happens, will be important. Because we’ve had such a substantial jump on it for the last seven years or so, we’re excited about the opportunity moving forward.

Beyond usability, EHR-related burnout seems related to the timing of system interruptions or guidance and the lack of workflow cohesiveness. Does that differ across specialties?

Absolutely. Consider the difference between what an endocrinologist may require when making a decision versus the oncologist. Although there are standards of practice, each specialty requires certain elements of data in a certain format that’s intuitive to how they practice medicine so that they can acquire that data with just one click, get everything they need, review the most appropriate and non-nuisance decision support, and then pass that on to the rest of the team.

That approach has garnered improvements in clinician satisfaction and efficiency. Instead of spending an hour and a half preparing for rounding, as some residents do, they don’t have to prepare. It’s right there for them, everything they need to do for rounding and hand-off. Those kinds of gains are making a huge difference, recognizing that some personalization needs to be done, but in a standard fashion.

Less than 1% of our solutions are ever customized because they are already intuitive to how the specialists practice medicine. That makes a huge difference, particularly with IT and the implementation process itself. Instead of taking 12, 15, or 18 months to implement a big EHR, we’re providing our applications from start to finish in less than 90 days. That’s a huge opportunity for doctors and executives to get those quick wins that deliver value immediately.

What prevents EHR vendors from using your ideas to develop competing functionality?

In the Salesforce model, these big vendors can only do so much, and they have a heavy lift across the entire system. As companies like ours begin to specialize and create niche markets, particularly for us around clinical workflows and disease-specific workflows, it’s easy for a health system just to drop it in and use it without the big lifts that they are traditionally used to with the big EHR vendors.

How will your business change as EHR vendors start using technologies from Amazon, Google, and Microsoft?

The difference is being truly embedded within the clinical workflows. The struggle in the industry is that a lot of great companies are doing a lot of great things, but they’re doing it from the outside, trying to get in. You have to toggle over to another system, or do something that disrupts the clinical workflow. We are clinicians and we are deeply embedded within the clinical workflow, where everything’s actionable. If you are using our secure messaging system, you get an alert that a particular patient’s creatinine level is high. It’s important to be able to take action from that message within the clinical workflow.

There’s much disruption and opportunity across the industry, everything from machine learning to artificial intelligence and certainly population health and analytics. Sometimes just getting the basics right around making it more usable in the clinical workflow for the clinicians is the huge opportunity. These players, Amazon included, are making huge strides in making the practice of healthcare delivery better. We welcome all of the opportunity, because it will change all of our lives, help us deliver better patient care, reduce cost, and produce better outcomes. We welcome the opportunity for companies like Amazon and Microsoft, which has now stepped back in in a dramatic fashion, because it means that healthcare will be better.

Do you have any final thoughts?

As we continue to see the industry mature, EHRs will become the platform where data is entered and stored. Companies like ours will make it innovative and useful to those who interact with it every day. This is the most change I’ve seen in 30 years, particularly as EHRs have become standard and problems had begun to arise that were never anticipated, problems that we have begun to fix across many health systems. I couldn’t be more excited to be in the industry. I still have the passion and the drive to deliver the change that we’re expecting, and it feels really good.

Morning Headlines 12/9/19

December 8, 2019 Headlines No Comments

Hackensack Meridian’s ‘core clinical systems’ back online after week-long disruptions

Hackensack Meridian Health (NJ) brings its clinical systems back online after a downtime of several days, rumored to be the result of a ransomware attack.

Partners reports stellar financial results as it preps for rebrand

Partners HealthCare, soon to be renamed to Mass General Brigham, cites Epic’s more accurate coding as part of the reason it took in $484 million of operating income in its most recent fiscal year.

Digital health start-up once worth $1.5 billion is racing to keep lights on as investors flee

Once valued at $1.5 billion, “smart pill” medication management company Proteus struggles to stay afloat after a $100 million funding round falls through.

NHS gives Amazon free use of health data under Alexa advice deal

In England, NHS gives Amazon the option to use its clinical content in the development of future products and services as part of its contract for an Alexa skill that offers medical advice culled from the NHS website.

Monday Morning Update 12/9/19

December 7, 2019 News No Comments

Top News


Hackensack Meridian Health (NJ) brings its clinical systems back online after a downtime of several days, rumored to be the result of a ransomware attack.

The 17-hospital system, New Jersey’s largest, rescheduled 100 elective surgeries.

The health system did not post updates on its social media accounts and declined to comment other than describe the problem as “externally-driven technical issues that are affecting the performance of our IT network.”

Reader Comments

From OptumOrange: “Re: Optum / UHG layoffs. Looks like it was 1,400 people who received two weeks’ notice. March 2020 is the next round.” Unverified, but several folks said they were affected. Company executives just told investors that Optum generates more than half of UnitedHealth Group’s profit in bringing in an expected $112 billion of the parent company’s $260 billion in revenue for next year. Optum offers pharmacy benefits management, direct care via urgent care centers and physician offices, post-acute care, analytics, and population health management.

Smartfood99 left a comment about EHR vendors offering low-margin RCM services that I thought was wise enough to deserve its own spot here. It explains the hazards in adding services that are profitable, but less so than the company’s core business:

Software may be high margin, but the cost to maintain customer relationships through service and updates is low margin. While there there is a built-in revenue stream, it weakens the balance sheet for new vendor-searching hospital executives concerned about the fiscal health of the EHR company. In short, hospital executives look very closely at the bottom lines of companies they are about to make a 10-year investment with. Profitability = survival, especially when rumors of EHR vendor demise are the norm over the past few years and planted by competitor sales people like a software bug.

If you are already paying for lots of support people and development people that cut in to the bottom line, you have to be careful how you add to that mix and what it does to the balance sheet. Losing even just two or three net-new business deals a year because hospital executives base their final decision on perceived vendor long-term viability can snowball for any EHR vendor not named Epic. Such decisions that seem to make short-term sense often put the EHR vendor on the path to the dustbin of history after a slow, drawn-out death that leaves the hospital partner in a lurch.

Sure, even marginal profits and larger revenues matter, but in this business, perception of sustainability means much, much more. This doesn’t even cover the fact that having the capital to enable your business to pivot as needs change and your systems age is served in no way by being a glorified consulting company, but with all the risks that come with employing and managing larger staffs as business ebbs and flows.

HIStalk Announcements and Requests


I’m super impressed with my $480 (Black Friday special) HP laptop. It’s sleek and made of metal rather than plastic, it’s fast because of its solid state disk drive and 16 GB of memory, it makes no sound at all, the touchscreen display is surprisingly large and vibrant, and setup took just a few minutes with no bloatware to de-install. It’s been years since I set up a new laptop, so I was surprised at how easy Windows makes it – you just log on with your Windows ID and a few minutes later it’s all done. Bitdefender reminded me that I don’t have a VPN installed and I pledged to be better about using one when on public Wi-Fi, so I chose Surfshark since it was Cyber Monday priced at $48 for 27 months and it works just fine.

Thanks to the following companies that recently supported HIStalk. Click a logo for more information.



December 10 (Tuesday) 1:00 ET. “Move on from the age of the inefficient EHR.” Sponsor: Intelligent Medical Objects. Presenters: Jim Thompson, MD, physician informaticist, IMO; Obaid Baig, product manager, IMO. The EHR seems more like transactional workflow system rather than an intuitive clinical documentation tool, creating the possibility of loss of data consistency and the need for manual workarounds. The presenters will describe how to turn an EHR into a powerful tool that can help improve workflows and documentation so that clinicians can focus on care, not coding and reimbursement.

Previous webinars are on our YouTube channel. Contact Lorre to present your own

Acquisitions, Funding, Business, and Stock

The best and most concise health IT investment and market report I’ve seen comes from Healthcare Growth Partners, which just posted its November highlights of M&A, buyouts, investments, news headlines, and public company performance. It notes that valuations are driven significantly by sentiment versus metrics, and both sentiment and the markets are at all-time highs. 



Zach Mortensen, MBA (ZM Advisors) joins pharma services provider Parexel as chief strategy officer.


Population health management technology vendor Geniq hires Jay Colfer (SSI Group) as co-CEO.

Government and Politics

The Bureau of Labor Statistics says healthcare added 45,000 jobs in November and 414,000 jobs in the past 12 months. We don’t know what those people are doing, but we know who is paying them (all of us).



This is insightful. AI companies will focus on the US market because, unlike in the rest of the world, providers here can make money finding and treating undiagnosed patient conditions. That gives AI a business case.

Welcome to our American healthcare non-system. A tiny online survey finds that diabetics — most of them covered by health insurance — are buying, selling, and trading insulin and glucose strips on the black market because of lack of affordability or timely availability.


A study finds that unintentional ED ordering of duplicate laboratory and radiology orders was reduced more than 40% by swapping out interruptive alerts for a simple on-screen highlighting of the existing order in red, although no improvement was seen with medication order duplicates. The alert displays when the duplicate item is being selected instead of as a final step or after-the-fact order queue alert. The study raises an interesting point – how many duplicate orders are created because of poor visual layout or navigation of the active medication list? We assume that just because information is displayed somewhere, somehow in the EHR that duplicates are inexcusable, especially with the added layer of warnings. I speculate that clinicians are just too busy attempting to multi-task with poor keyboarding technique in disruptive environments since even smart and careful ones make mistakes.


In England former Oxford University Hospitals CIO and Chief Digital Officer Peter Knight pleads guilty to fraud for falsifying his educational credentials to get the job, which he held for two years before resigning.

Partners HealthCare, soon to be renamed to Mass General Brigham, reports earning $484 million of operating income on $14 billion in revenue in its most recent fiscal year. The CFO says the increased profit came from having sicker patients and raising its prices, along with Epic’s more accurate coding.

HIMSS announces Global Health Equity Network, which allows interested parties to support its work by (a) paying to attend HIMSS20; and (b) sponsoring HIMSS. You can also “dialogue” with leaders, probably via A and B.

Informatics troubadour Ross Martin, MD, MHA lays down “Put the Patient First*,” a healthcare protest song that Ross says he’s been contemplating writing for 15 years. The asterisk-referenced refrain is brilliant – “Put the patient first, right behind me.” I also note that Ross’s utterly amazing and complex “HITECH: An Interoperetta in Three Acts” celebrated its 10th anniversary this year.

Sponsor Updates


  • StayWell contributes to the Las Americas Immigrant Advocacy Center.
  • Black Book Research recognizes Netsmart as the number one post-acute technology platform for the fifth year in a row.
  • CereCore collects and delivers supplies to the Tennessee Baptist Children’s Home.
  • Pivot Point Consulting employees in Chicago work with Project C.U.R.E. to assemble medical supplies for delivery to hospitals in developing countries.
  • Redox releases its first podcast, “An Interview with Jonathan Bush.”
  • SymphonyRM releases a new podcast, “Edward Marx and Four Pillars of Innovative Leadership.”
  • TriNetX expands into South Korea in partnership with EvidNet.
  • Visage introduces semantic annotations for the Visage 7 Enterprise Imaging Platform.
  • UASE Ministry of Health collaborates with Vocera to improve care team communication and optimize patient safety.

Blog Posts



Mr. H, Lorre, Jenn, Dr. Jayne.
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Weekender 12/6/19

December 6, 2019 Weekender No Comments


Weekly News Recap

  • Premier is reported to be working with bankers in seeking a sale of the company.
  • Waystar acquires Recondo.
  • John Halamka, MD announces that he will become president of Mayo Clinic Platform in January.
  • Agfa is negotiating the sale of its Europe-focused healthcare and imaging IT business to Italy-based clinical software vendor Dedalus for more than $1 billion.
  • Cerner names Amazon Web Services as its preferred cloud, AI, and machine learning provider.
  • A server problem causes Dexcom’s continuous glucose monitor to stop sending messages and alerts for several days.
  • T-System experiences downtime from an apparent ransomware attack.
  • Amazon Web Services unveils a healthcare transcription service for software developers.

Best Reader Comments

You don’t want the company distracted by a shiny new thing while the core competency is getting less attention. So it’s often not a question of “Oh, hey, let’s just do this other thing too.” If you were in a perfect world with an arbitrarily large number of qualified people to take on the job, then moving into these peripheral areas would be a no-brainer. In reality the value gained from the distraction needs to be more than the cost of the distraction. The technical economic term for this is opportunity cost. (TH)

We doctors should stop thinking about EHR as a “special thing.” It is just a tool to get the job done. I can ask the same questions that you asked about paper and pen documentation system and probably add a few more about accessibility across locations, storage challenges, etc. Why is no one complaining about that system of records and why was it not part of so-called “physician burnout?” The reason I believe, is that we all learnt how to use it during our training and accepted it as part of life. Rules of the game changed in the last decade and we need to get on with the program. (EHR is just a tool)

This should drive home the reality that the investor class isn’t comprised of smart people, just people who knew each other or went to the same universities and have consistently promoted and hired each other into positions of authority without any demonstrated qualifications. (HIT Girl)

If the digital companies would have seriously and thoroughly tested their products with MANY physicians and not only one SME, then maybe the EHRs of today wouldn’t have been the monstrosities that they are. (Been there)

I still can’t believe institutions like Goldman make these horrible investments. Between Outcome Health and Theranos, you’d think the investors involved would at some point ask some healthcare industry experts whether these companies were viable enough to pass the sniff tests. Readers on this site have called out the charade for both before. (Elizabeth H. H. Holmes)

The billing methodology in this country has gone totally out of control. Unfortunately, I’m in the middle of a medical situation and the last EOBs made me laugh. For a CT scan with and without contrast, the billed amount was $18K, allowable $18K, amount paid $400, patient due amount $0. How stupid is a system that allows this? If I didn’t have insurance and the provider wasn’t in the network, I’m sure they would have tried to collect the $18K. (David Pomerance)

The moral of the Outcomes Health story is that if you f*ck over @GoldmanSachs & friends for $500m you go to jail. But if you ARE @GoldmanSachs & friends and you f*ck over the US taxpayer to the tune of $62bn, we will hand over the money and allow you to keep doing it. (Matthew Holt)

While I’m (mostly) never delighted when a person loses his/her job, all David Duvall MBA, MPH needs to do is open up about 50 hospital leadership websites and then another 50 HIT vendor leadership pages and tell me where the discrimination lies. I promise you it isn’t against middle-aged white guys. (ellemennopee)

Watercooler Talk Tidbits


The publicly traded owner of North Tampa Behavioral Health (FL) confirms that it has reassigned the facility’s 31-year-old CEO after a newspaper’s investigative report found that he had no healthcare experience and was formerly a quarterback for a pro football team’s practice squad. A company spokesperson said it’s not unusual to recruit hospital CEOs from other industries and the attributes of B. J. Coleman  include “team leadership, situational analysis, and sound decision-making.” Inspectors found that under his leadership, just four of the 96 employees who performed lab work had proper training. The kitchen’s lead cook was covering as director of dietary services even though he wasn’t qualified, so the kitchen ignored special diet requirements and sent trays containing silverware to suicidal patients.


A Tennessee neurologist files a $25,000 defamation lawsuit against a woman who wrote a scathing Yelp review saying that he threw a tantrum when she took out her phone to record her father’s visit. She says she deleted the recording at the doctor’s request even though state law does not prohibit such recording, after which a clinic employee called her to say that phones aren’t allowed in the office. Also named in the suit is the son of the woman’s friend, who overheard her talking about it and posted a negative review on Google. Meanwhile, the negative Yelp reviews are piling up as idiots from several states who admit that they just read the online story, calling the doctor a “filthy animal” and a “nasty immigrant who is suing a real American.”

Kaiser Permanente uses text messaging to encourage 11,000 of its members to sign up for California’s CalFresh supplemental nutrition program. Kaiser didn’t have access to income data to help  choose which of its 9 million patients might benefit, so it used a census-derived “neighborhood deprivation index.”

A CMS analysis finds that the US spent more $1.2 trillion on hospitals in 2018, representing one-third of all healthcare spending. 


NICU nurses at Brookwood Baptist Medical Center (AL) dress up newborns to celebrate their first Thanksgiving.

In Case You Missed It

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Morning Headlines 12/6/19

December 5, 2019 Headlines No Comments

Premier considers sale with banks

Premier is reportedly arranging talks with several potential acquirers in seeking a sale of the company.

Stephanie Reel to retire as chief information officer of university, health system

Stephanie Reel, CIO/vice provost for IT at Johns Hopkins University and SVP/CIO of Johns Hopkins Medicine, will retire on July 1, 2020 after a 30-year Hopkins career.

Former Outcome Health employees plead not guilty to felony charges in alleged $1 billion scheme to defraud pharma clients

Two former Outcome Health analysts plead not guilty to charges of felony conspiracy to commit wire fraud.

VA launches National Artificial Intelligence

The VA establishes the National Artificial Intelligence Institute to research and develop AI solutions that will improve healthcare for veterans.

News 12/6/19

December 5, 2019 News 3 Comments

Top News


RCM vendor Waystar acquires Recondo Technology, which specializes in automated revenue cycle software and services.

Reader Comments

From Foundational Confused: “Re: non-profit hospital donations. You’ve said that sending money to them is a terrible use of it. How do you personally differentiate between a foundation doing good versus one just burning money?” I like supporting organizations that truly need the money and will put it to good use for a directly connected social mission. Health systems stretch the definition of non-profit (and certainly that of a charity) with million-dollar executives, vast real estate holdings, and a can’t-miss business model that allows them to charge high prices and stifle competition on the backs of people in need, not to mention that they are so adept at raking in cash that they, themselves donate to other non-profits. My paltry donation would pale to the amount of money they can print via cranking out via high patient charges and collections. I would rather help a smaller, struggling non-profit that doesn’t have the luxury of sticking it to Medicare and insurers, whose mission is in danger of disappearing without outside help and that doesn’t employ mahogany wings full of power-broking suits who spend their day plotting deeper dives into the healthcare cookie jar (I say that while acknowledging the irony that I’ve been part of that particular problem for a long time). My personal donation choices are animal rescue and sanctuary organizations, food banks, Donors Choose, and Salvation Army, where a few hundred dollars can really make a direct difference instead of covering maybe one hour of the HR VP’s time.


From Party On: “Re: HIStalk reception at HIMSS20. Wondering how to obtain an invite and which evening it will occur.” The tenth and final HIStalkapalooza was at HIMSS17, I’m sorry to say. Maybe we can all schedule a time during HIMSS20 week to simultaneously reminisce by watching the video of that final evening with Party on the Moon and several hundred industry kindred spirits. 


December 10 (Tuesday) 1:00 ET. “Move on from the age of the inefficient EHR.” Sponsor: Intelligent Medical Objects. Presenters: Jim Thompson, MD, physician informaticist, IMO; Obaid Baig, product manager, IMO. The EHR seems more like transactional workflow system rather than an intuitive clinical documentation tool, creating the possibility of loss of data consistency and the need for manual workarounds. The presenters will describe how to turn an EHR into a powerful tool that can help improve workflows and documentation so that clinicians can focus on care, not coding and reimbursement.

Previous webinars are on our YouTube channel. Contact Lorre to present your own

Acquisitions, Funding, Business, and Stock


Premier is reportedly arranging talks with several potential acquirers in seeking a sale of the company, with reports of its interest sending share price and trading volume up this week.


Clinical surveillance and data visualization company Decisio Health closes a $13 million Series B funding round.


  • Seminole Hospital District in Texas will implement CPSI subsidiary American HealthTech’s post-acute EHR at Memorial Health Care Center.
  • In England, Birmingham and Solihull Mental Health NHS Foundation Trust chooses Hyland Healthcare’s OnBase content services software.
  • Integris Health (OK) and Woman’s Hospital (LA) select Health Catalyst’s Corus Suite of patient, departmental, and equipment utilization and cost analytics.
  • Cleveland Clinic London will use Vocera’s care team communication and workflow technology when it opens in 2021.
  • In California, Natividad and the Monterey County Health Department will implement NextGate’s Enterprise Master Patient Index across its 19 clinics and other agencies.
  • American Oncology Network selects PatientPoint’s patient and provider engagement solutions for its community oncology practice network.



Stephanie Reel, CIO/vice provost for IT at Johns Hopkins University and SVP/CIO of Johns Hopkins Medicine, will retire on July 1, 2020 after a 30-year Hopkins career. She says that she’s channeling Elton John in announcing her “Love Mondays World Tour” and sent me her Thanksgiving letter that outlines her future plans to enjoy family, travel, life in general, and a move from Baltimore after 25 years to Falls Church, VA. Few CIOs have had her tenure and breadth of IT responsibility over one of the country’s highest-ranked health systems as well as its correspondingly highly-ranked university through the impressive growth of both as an unfailingly steady hand on the IT tiller. I’m not saying I “know” her personally, but a couple of interviews and some private conversations about personal issues in which she was generous with her time and offers to assist make her #1 in my book.


Change Healthcare EVP/CIO Alex Choy will retire early next year.


Cletis Earle (Kaleida Health) joins Penn State Health and Penn State College of Medicine as SVP/CIO.


John Halamka, MD will join Mayo Clinic (MN) as president of its Mayo Clinic Platform, an initiative he describes as a “portfolio of new digital platform businesses focused on transforming health by leveraging artificial intelligence, the internet of things, and an ecosystem of partners for Mayo Clinic.” Halamka has spent the past 25 years in various positions, including CIO at Beth Israel Deaconess Medical Center in Boston, now part of Beth Israel Lahey Health.


Patient transfer solution vendor Central Logic promotes Barry Dennis, RN, MBA to the newly created position of SVP of clinical operations.


Google co-founders Larry Page and Sergey Brin will step down from their respective roles within parent company Alphabet as part of management streamlining that will see Google CEO Sundar Pichai take on the additional role of Alphabet CEO.

Announcements and Implementations


PatientPing enhances its collaboration network with Callouts (sharing member information with point-of-care providers using multiple EHRs) and Spotlights (a performance dashboard for readmissions, hospital utilization, and post-acute network management).


PMD makes patient-to-provider messaging and multi-provider group messaging with patients available through its app’s secure messaging capabilities.

Kindred Healthcare (KY) implements Netsmart’s Referral Manager software across its 70 LTAC hospitals.


A Surescripts report finds that the use of EHR-integrated prescription price tools more than doubled in 2019, also noting that prescriptions represent 17% of spending on goods and services that are provided directly to patients and are projected to increase 6.3% per year.


A KLAS report on ERP implementation consulting finds that among software vendors, every Infor consulting services client that was contacted is dissatisfied because the company’s consultants don’t understand the software or how to apply change management. PwC earns high marks from clients; KPMG performs well and Deloitte poorly on Workday and Oracle implementations; and for Infor implementation work, ROI Healthcare Solutions delivers high value while Avaap delivers strong outcomes.

Government and Politics


The American Hospital Association and other hospital groups file a lawsuit challenging HHS’s proposed requirement for hospitals to publicly post confidential pricing information. The plaintiffs say that disclosure of negotiated insurer charges would confuse patients about their out-of-pocket costs, adding that the rule is unlawful anyway because it exceeds CMS’s authority. 



Physician services firm TeamHealth, which was acquired by investment firm Blackstone for $6.1 billion in early 2017, tells the Senate that it didn’t send surprise, out-of-network ED bills to thousands of patients in 2017 to generate revenue – their real purpose was to pressure insurers into signing more lucrative contracts. It also says that most of the public griping about balance billing comes from patients who don’t understand their coverage and mistake their co-pay, co-insurance, or deductible as a balance billing. The company suggests that Congress require insurers to immediately pay out-of-network providers at 125% the average allowed amount; require them to send the provider a check for the full amount that includes patient responsibility and then let the insurer rather than the provider collect the patient’s portion; cap ED patient cost-sharing at $1,000; and offer arbitration for dispute resolution.


UC Davis will offer an online course titled “The Health and Wellbeing of Medical Providers,” which will be taught by UC Davis Health Chief Wellness Officer Peter Yellowlees, MD, MBBS (yes, he did earn both degrees years apart even though they are basically equivalent). The 20-CME, $800 course begins on February 24. The course text, “Physician Suicide Cases and Commentaries,” was written by the instructor.


Cerner loses a $600,000 lawsuit that was brought by an air ambulance company after Cerner’s health plan refused to pay for a toddler’s air ambulance transportation after initially authorizing it.


In Australia, a women is sentenced to 25 months in prison for falsifying her application for a high-paying government CIO role. She lied about her education and work experience, gave herself a glowing recommendation in posing by telephone as a former employer, and used a supermodel’s photo as her LinkedIn headshot. Her attorney blames her actions on being “off with the pixies” due to stopping her weight loss drug.

Sponsor Updates

  • Ensocare will exhibit at the National Veterans Small Business Engagement December 9-11 in Nashville.
  • First Databank’s Meducation medication adherence solution wins Cerner’s first Open Developer Experience Program Member Adoption Award.
  • Glytec will exhibit at the IHI National Forum December 8-11 in Orlando.
  • EClinicalWorks publishes a new customer success story, “Compass Medical: Growing a Practice, Saving Lives.”
  • Gartner has recognized InterSystems as a leader in its “2019 Gartner Magic Quadrant for Operational Database Management Systems.”
  • Kyruus Executive Assistant and Office Manager Lisa Marie Rosson Guidi wins the Spirit Award from The Admin Awards.
  • PCare leverages cybersecurity services from By Light Professional IT Services as it pursues HITRUST certification.
  • PatientPing adds enhanced member information sharing capabilities and real-time network utilization dashboards to its enterprise care collaboration technology.

Blog Posts



Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.


EPtalk by Dr. Jayne 12/5/19

December 5, 2019 Dr. Jayne 1 Comment

A recent NEJM Catalyst piece looks at the role of physician gender when looking at EHR usability and clinician burnout. Researchers at the University of California San Francisco found that female physicians created longer notes, addressed a higher percentage of patient contacts within 24 hours, and spent more after-hours time using the EHR than their male counterparts. Female users were also more likely to use copy/paste and other tools to make documentation more efficient, but spent more time in the EHR. These factors may explain a higher rate of female physician burnout when looking specifically at EHR use. The study was fairly broad, looking at over 1,300 physicians across nearly 90 specialties. It looked at various six-week time periods over the course of a year.

The authors suggested that healthcare organizations could do a better job reducing EHR burden overall, including creating clear expectations for EHR use and timeliness of patient contacts. I’d go further to suggest that they look at the FTE support staff in various practices and whether the physician to staff ratios are equal.

I’ve seen several practices in my recent travels that relatively understaffed some physicians (both male and female) despite equal productivity. Staffing ratios there depended more on physician personality and the fact that some providers demanded more support staff, where others were more likely to pitch in and do staff-level work or didn’t want to rock the boat asking for more help. Although the study controlled for staffing, my experience in non-research environments is that staffing can be highly variable.

Other teams have also looked at this issue. A recent JAMIA article looked at usability and gender, along with age, professional role, and years of experience. Among intensive care physicians, they identified “significant gender-based differences in perceived EHR workload stress, satisfaction, and usability – corresponding to objective patterns in EHR efficiency.” Drawing conclusions based on gender can often create friction among clinicians, but I’m glad they’re looking at the problem.


I’ve been on several vendor webinars this week and have experienced sessions spanning the range of good, bad, and downright ugly. For those of you who have to deliver webinars, I have some tips.

First, make sure you have your content fleshed out ahead of time. You don’t have to write a full word-by-word script, but you need to know what you are planning to say. On the other hand, if you struggle with impromptu speaking or have a tendency to go off track, write a script. Whatever you do, please do not simply read the slides to the audience. You’ll lose them in a flash. If you use a script, practice reading it in a conversational way, not like a robot.

Second, check your slides for visual appeal. Text should not be too bulky in content or too small in font. Use visuals to convey your ideas along with your word track and it will be more memorable to the audience. If you’re including polls for the audience, please show the results as you go – don’t just grab the data for your own marketing purposes. Attendees often want to understand how they compare to others on the call – whether they’re ahead of the game or trending the same as other organizations.

Last, make sure any photos used during introductions are professional or appropriate to the audience. Your hair should be combed, at a minimum, and it would be nice if the background was uncluttered and the lighting was good. Under no circumstances should you crop yourself out of a group wedding photo (yes, I saw this).

Mr. H already mentioned this article about physicians and tech staff clashing at digital health companies. Having been a physician working in digital health including with vendors, I wanted to add my two cents.

The article makes the point that clinical and product teams are “at odds,” which I have definitely seen. I’ve also seen teams where everyone works well together and drives the solution forward because they have a mutual understanding of each other’s experience, goals, and priorities. One of the biggest barriers to successful collaboration is the presence of preconceived notions about the members of the team. If tech team members have had previous negative experiences with physicians, they’re likely to make assumptions based on those experiences. Similarly, physicians may not understand the roles and processes of various tech team members or how an agile process works. Getting everyone in the same room to learn about each other and how they need to work together is a start.

Another barrier I’ve seen is lack of structure – inconsistent sign-off processes that may not fully explain how requirements or other work product should be flowing through the organization and lack of defined processes for clinical and other subject matter experts to provide their feedback. That can result in unpleasant shocks at the end of the process when clinical folks are presented with workflows that aren’t going to work, but could have been better engineered if the clinician input was at a better place in the process.

Physicians also need to have a common framework for how they’re going to make decisions around clinical content. Is the company striving to be evidence-based, or is customer satisfaction or sales the lead driving factor? These elements aren’t mutually exclusive, but there has to be a common goal or physicians may be in conflict with each other. This goes back to governance, including team charters and product charters that make sure everyone is working towards common goals and there is clarity about how decisions need to be made, or how to handle when physicians or other clinical SMEs are not in agreement.

This isn’t just a clinical issue. I’ve seen the same problems in other areas of the healthcare IT industry, whether it’s revenue cycle, billing, patient engagement, etc. Everyone needs to understand the role that team members play and needs to respect the roles and knowledge of others on the team or there is going to be conflict. This goes back to leadership. If the individuals in charge don’t buy into this concept of mutual respect, and either team feels like it’s being marginalized or attacked, the effort is not going to be successful.

Do you have clinicians who are part of your development organization? What advice can you offer? Leave a comment or email me.


Email Dr. Jayne.

HIStalk Interviews Amanda Hansen, President, AdvancedMD

December 5, 2019 Interviews 3 Comments

Amanda Hansen is president of AdvancedMD of South Jordan, UT.


Tell me about yourself and the company.

I started in the position of president of AdvancedMD in June. It represents my 15th role within the organization over the past 13 years. AdvancedMD provides integrated workflow solutions and services to more than 35,000 physicians and providers in the ambulatory market.

How is that market changing?

We are in a replacement market. We sign a couple of hundred clients per month. The new clients we’re signing are on their second or their third EHR, so they are much more selective. Where historically with EHR it was about meeting regulation and Meaningful Use and driving towards that compliance, now it’s more about usability and workflow. Doctors don’t want a solution that is going to interrupt their workflow and add significant labor and administrative work on the back end.

The need for systems to be integrated and fully connected, that all-in-one, has definitely evolved over the past several years. Specialty-specific clinical records are more prevalent within certain subsets. You get a lot of benefit from having everything connected and working well together.

Is it fair for clinicians to say that the EHR causes burnout?

I do think it’s fair. It is necessary to have EHRs and the data structure and the storage of the information. Hopefully over time we’ll be driving more towards a patient-controlled health record in addition to the clinical records from the physician, and having those work in tandem.

But when you look at the demographic in healthcare, somewhere around 50 to 55% of physicians are over 50 years old. In that segment, it has driven some degree of burnout. The millennial generation, the generation that is rising now, grew up with all this technology at  their fingertips, so those types of physicians and providers are excited about the technology. I think it’s more of a generational issue than additional work that has driven burnout.

How are consumer expectations changing with regard to how technology can allow them to interact with their providers in ways that are convenient for them?

We spend a lot of time thinking about this and building strategies. The consumerism of healthcare is here to stay. I’m the perfect demographic to talk about it. I don’t have a primary care physician. My husband and I have three kids and we have an established pediatrician that we go to. But if I get sick, I go to urgent care. I want the same thing. I want an app that I can use. I want to do telehealth or do a telemedicine visit. I want that immediate gratification, that instantaneous response and result. In the healthcare IT space specifically, vendors have to put more resources on having those mobile applications.

Even at AdvancedMD, historically we’ve focused on patient engagement. But the patient engagement we focused on was more driven about how to help physicians engage with their patients, not to help patients engage with their physicians. We need to flip the switch. It has to be patient centralized, where everything drives from that patient and how they interact with their doctors.

With my pediatrician for my kids, we got a patient portal login. We never used it because it was really complicated. We couldn’t remember it. It was dual authentication, just very complicated. Whereas if I get a simple text message that says, go ahead and fill out this consent form and confirm your visit, I’m much more likely to do that than I am to remember some login. It puts pressure on the vendors to make sure that they’re delivering technology in a way that patients want to consume it.

How should interoperability work optimally when a patient’s records are scattered over multiple providers and there’s no PCP to collect and manage all their information in one place?

This is a huge opportunity. This is the secret sauce to making healthcare IT great, being able to have that interoperability and the connectivity. To make it successful, it has to shift from a clinical record from the physician to a clinical record from the physician that the patient can take with them always. This is something that I’m passionate about.

My dad was a type1 diabetic. He got diabetes when he was 20 months old. He passed away about two and a half years ago after two kidney transplants, two pancreas transplants, thousands of dialysis appointments, and a complete loss of vision. He was a modern day health miracle in many ways. He passed away when he was 60. It’s important to me because my mom would take him to doctor’s appointments and she would literally have to bring a binder of his health information with her everywhere they went. It had the prescription history, his conditions, his ailments, the procedures that had been done. It limited the ability of his physicians – specialists, primary care, mental health, behavioral health — to focus on his care at that moment because they were so focused on what had happened historically.

With FHIR and all the standards that are coming out in interoperability and accessibility of information, it really needs to be a record that is controlled by the patient. It doesn’t mean the patient is the only person inputting information we want. There’s a reason doctors go to medical school. We want it to have that flavor and we want it to be certified in the right way, but the patient should be able to take that information with them. What’s missing in healthcare IT is that patient. Companies are trying to address it, like Apple with the Apple Health Records app, and if you’re on an Epic system, you can get your medical record history. It’s something to assemble all of those records into one place that the patient can take with them

Why hasn’t the Health Record Bank concept taken hold?

There could potentially be a role for it. No one cares about a patient’s health as much as that patient. It is like your job, where nobody cares about your career or your progression at an organization more than you do. You have to own that.

Ideally, that the patient would have access to all of their own information and they could carry it with them and be the quarterback for themselves. Some people are in a situation where they can’t do that, and then their caretaker, spouse, family, or loved ones can help drive that. I really believe that it should be patient centralized, because we care about our own health more than any physician or provider is going to.

What is the mechanism of that patient carrying their data around?

That’s the mystery that that we all need to solve. It goes back to your earlier question, which is, can you have some sort of health data bank? We believe in big data. The challenge that we have had with big data so far is it has helped us to understand risk profiles of patients and to segment different patient bases, but it doesn’t create the action plan. If the information can be assimilated, whether it’s through a data bank or something else, that’s great. But the missing link has been what’s done with the information.

We know that 20% of our patient population has a high risk for adult onset diabetes, but outside of that, there’s not anything to link to what those next steps are. It’s tying that data into proactive tools, like our HealthWatcher solution that automates some of that process.

There are hundreds of EHR vendors and healthcare IT solutions. Unless we have some sort of universal health plan where there is only one vendor, then that can’t be the keeper of everything. We have to rely on something else, whether it’s the patient to control their own fate or if there’s some sort of health data bank. But we need to make sure that whatever information is assimilated, that there are action items and automated processes that happen as a result of the information. That’s the missing piece.

Are EHR vendors backing away from offering revenue cycle management services?

There is high demand for revenue cycle management, especially with the increasing complexity of getting reimbursed. Regulation is consistently changing and it makes it more and more challenging for doctors to get paid for the work that they do.

At AdvancedMD, we’ve seen a big influx in our revenue cycle management demand. Kareo recently divested their revenue cycle management business. I don’t believe that was for lack of demand. It seemed that it was more about the financial profile of the organization, where revenue cycle management is a more expensive business. It’s lower margin. With the exception of Kareo, the main vendors that we see day in and day out all have a revenue cycle management offering.

It has helped that providers and physicians want choice. If they want to do their billing themselves, they can use the software. If they want to have someone else do it, we have billing partners, and then we also have our own revenue cycle management division.

What was the strategy behind payments technology vendor Global Payments acquiring AdvancedMD in 2018?

Global Payments is focused on integrated payment solutions. The philosophy is that if they own software companies that have payments integrated within them, customers will be less likely to switch out their payment vendor for an alternative solution. They have, I think, 10 software companies in multiple verticals. Healthcare is a strong vertical, making up almost 20% of the opportunity in the US. We were their first effort in healthcare to have the integrated payment experience.

How do companies build a development schedule around technologies such as AI and voice-powered user interfaces that may be at various points on the hype cycle?

It’s always a balance. Technologists always want to work on the latest, greatest, really cool things. Sometimes those really cool things end up not being practical, or they aren’t something that’s even needed. A customer would rather you move a button or decrease the number of clicks to do a step in their workflow process. You see that more with startup organizations, where they are developing things that they think are really cool and revolutionary and then the adoption becomes much more of a challenge.

We experienced that historically with a couple of solutions that we put out. One of those was a benchmarking solution that we felt really excited about, paired with our analytics solution. What we quickly learned is that 70% of our client base is practices of fewer than five providers, independent practices, and they didn’t really care — even in a really cool way — to benchmark themselves against their competitors.

The most important thing that companies can do is to make sure that they keep the voice of the customer at the forefront. Not only do market research, but solicit those clients, internal and external, to help drive their roadmaps and make decisions on what to invest in and what to build.

What lessons have you learned in being promoted many times within one company instead of following the conventional wisdom that you have to move out to move up?

I’ve had a lot of friends come and go at this organization since I’ve been here. I can’t point to any of them and say that they are in a better position, or better off than I am, for having worked through the inner workings of an organization to drive my way to the position that I’m in today.

The biggest thing that I’ve learned is that moving ahead requires taking the jobs that no one wants to do. I’m sure that physicians, providers, and others in the healthcare space understand that sentiment as well. Sometimes it’s not the glamorous things. Sometimes it’s the ones that seem extremely challenging and difficult, but that propel you forward.

We have a great team assembled at AdvancedMD. I am extremely grateful and humbled for all of the people that I’ve been able to work with in my 13 1/2 years at this company. Nowadays, especially, you don’t see a lot of people who are fiercely loyal in sticking with an organization. It requires your own drive and will to do it. It also requires having mentors and advocates who look for opportunities for you. Lastly, it requires raising your hand to do the jobs that that may seem impossible at the time, but they’re not. Anything is possible.

Do you have any final thoughts?

We are excited and enthused about the opportunity to help propel the consumerization of healthcare forward, focusing on flipping the switch and with the patient being central to patient engagement rather than the physician. That’s through mobile applications and various programs to engage patients to play a more active role in their healthcare experience.

Morning Headlines 12/5/19

December 4, 2019 Headlines 1 Comment

Waystar Acquires Recondo Technology, Gains Best in KLAS Patient Access and Business Office Technology

RCM vendor Waystar acquires Recondo Technology, which specializes in automated revenue cycle software and services.

Kalispell hospital sued over data breach

A former patient sues Kalispell Regional Healthcare (MT) for failing to adequately protect his PHI from a ransomware attack that occurred in May.

Houston virtual health care company receives investment from GE for its $13M series B

Virtual care monitoring company Decisio wraps up a $13 million Series B funding round with an investment from GE Healthcare.

ENT and Allergy Associates® Announces the Formation of QMMS USA, LLC

ENT and Allergy Associates (NY) launches QMMS USA to provide its 46 clinics and other practices with billing, practice management, and health IT, among other back-office services.

Morning Headlines 12/4/19

December 3, 2019 Headlines No Comments

Dr. John Halamka named president of Mayo Clinic Platform

John Halamka, MD will join Mayo Clinic as president of a new initiative that will use technology and data to improve care and extend the clinic’s global reach.

Health System Sues Software Co. For ‘NotPetya’ Cyberattack

Heritage Valley Health System (PA) sues Nuance for negligence that resulted in the system becoming the victim of a ransomware attack in the summer of 2017.

A letter from Larry and Sergey

Google co-founders Larry Page and Sergey Brin will step down from their respective roles within parent company Alphabet as part of management streamlining that will see Google CEO Sundar Pichai take on the additional role of Alphabet CEO.

News 12/4/19

December 3, 2019 News 10 Comments

Top News


Amazon Web Services announces the rollout of Amazon Transcribe Medical, a real-time transcription tool that software developers can use to transcribe speech and then send the resulting text to EHRs and other AWS tools such as the Amazon Comprehend Medical language service.

The company is positioning service as a replacement for transcriptionists, scribes, and transcription software.

It’s a “service” only in the technical sense – despite some sites misinterpreting it as a standalone product, it isn’t. Developers will need to build it into their own products and AWS will charge for usage. 

Reader Comments

From Curious: “Re: Meditech. I’ll l be interested to see if MaaS + Expanse can make Meditech competitive with CPSI, which owns the community and price-sensitive hospital market because they do the billing for their clients. Meditech should get into outsourced billing. The margin isn’t great, but they need it to gain new customers. However, no one who works for Meditech in Boston is going to say it since the people who would be hired to do billing aren’t going to work in Boston.”

HIStalk Announcements and Requests

I’m finding that reading Samuel Shem’s “Man’s 4th-Best Hospital” is more of a chore than I anticipated, which is surprising given how much I liked “House of God” (this one is long and heavy-handed with simplistic cynicism), but I’ll probably finish it despite its tiring anti-EHR diatribes. Meanwhile, I’ve purchased Elizabeth Rosenthal’s “An American Sickness,” which I’ve somehow managed not to read since it came out in 2017.


December 10 (Tuesday) 1:00 ET. “Move on from the age of the inefficient EHR.” Sponsor: Intelligent Medical Objects. Presenters: Jim Thompson, MD, physician informaticist, IMO; Obaid Baig, product manager, IMO. The EHR seems more like transactional workflow system rather than an intuitive clinical documentation tool, creating the possibility of loss of data consistency and the need for manual workarounds. The presenters will describe how to turn an EHR into a powerful tool that can help improve workflows and documentation so that clinicians can focus on care, not coding and reimbursement.

Previous webinars are on our YouTube channel. Contact Lorre to present your own

Acquisitions, Funding, Business, and Stock


Agfa is negotiating the sale of its Europe-focused healthcare and imaging IT business to Italy-based clinical software vendor Dedalus for more than $1 billion, excluding expected frontrunner CompuGroup Medical. The business includes enterprise imaging, hospital information systems, an enterprise content management solution, and patient engagement tools. It looks like a done deal since the companies have already said they expect it to close in Q2 2020. The business generates around $200 million in annual revenue, so that’s a pretty rich multiple for a company to pay to acquire a slightly larger competitor.


Cerner names Amazon Web Services as its preferred cloud, AI, and machine learning provider. You aren’t having déjà vu – Cerner named AWS as its preferred cloud provider in July 2019, so this announcement adds the obvious AI and ML components that will be incorporated into the Cerner Machine Learning Ecosystem for creating and deploying machine learning models. AWS called Cerner a “healthcare and life sciences organization” in the announcement rather than a software vendor, which I guess is slightly accurate since a microscopic part of its business involves running a few workplace clinics. As far as I know, its life sciences work is limited to selling patient EHR data to drug companies. 

Allscripts launches a $200 million private offering of convertible senior notes in a transaction that is far too complex for me to understand. 

An investigative report finds that Amazon’s on-site medical unit contractor Amcare is failing to send injured warehouse employees to outside care providers when needed and is also, per OHSA inspections, using unsupervised EMTs and athletic trainers outside of their allowed scope of their practice. Amcare is authorized to render first aid using EMTs, but OSHA’s investigation of employee complaints found evidence that employees are being refused treatment and their injuries are not always reported per federal law.

Heritage Valley Health System (PA) files suit against Nuance for failing to prevent the 2017 malware attack that the lawsuit claims spread from Nuance to the health system, taking down its computer and biomedical systems.


  • Two health systems in Puerto Rico select Health Gorilla’s interoperability solution.

Announcements and Implementations


Change Healthcare offers providers free access to National Decision Support Company’s CareSelect clinical decision support system that meets Medicare’s PAMA advanced imaging requirements, which take effect on January 1, 2020.


KLAS looks at PACS outside the US, noting that in Europe, Sectra and lesser-known regional vendors are tops at meeting customer expectations; Philips and Agfa are seen as best positioned to address future needs; and Change Healthcare, Fujifilm, GE Healthcare, Philips, and Cerner are frustrating customers with their lack of development. Philips has taken the lead in Canada with the decline of Intelerad and Change Healthcare, while Intelerad and Philips lead performance in Asia and Oceania although satisfaction scores in that region are lower and customers complain about poor vendor support. KLAS concludes that some market leaders are lagging as the market is demanding cloud technology and lighter infrastructure over client-server PACS. 

Government and Politics


FDA will hold a public workshop on the use of AI in radiological imaging February 25-26 on the NIH campus in Bethesda, MD that will also cover potential FDA regulation. A post-event webcast will be available.



Dexcom confirms that its G6 continuous glucose monitor hasn’t sent results and alerts – most of them intended for the parents of children with diabetes who are managing their conditions – since Friday due to a server overload problem. The company, which didn’t notify users until a Saturday morning Facebook post, experienced a similar one-day outage a year ago. Dexcom’s most recent Facebook update, from Monday, says they are back to “near normal performance.” Users complained that the company didn’t issue alerts by other channels such as text message or even its webpage for customers who don’t use social media and didn’t update its support line with a notice that they were experiencing issues, forcing callers to remain on hold for long periods. Shares of the publicly traded company, which has $1 billion in annual revenue, dropped a few percentage points at Monday’s market open but have since rebounded.


Researchers find that the few mental health smartphone apps that have actually undergone clinical trials – 19 trials versus the hundreds of available apps whose efficacy hasn’t been measured — are not effective when used alone. Apps for depression, anxiety, substance use, self-injurious thoughts, sleep problems, depression, alcohol, and smoking aren’t as effective as web-based interventions, possibly because the apps aren’t used as often, interventions might be less effective due to the casual and impromptu nature of smartphone use, and the form factor does not allow simply translating proven, on-site psychotherapy processes to the screen as has been done with web-based apps. The authors warn that ineffective apps may discourage users from seeking interventions that actually work. They recommend that phone apps be designed to take advantage of that platform’s unique capabilities for context sensing, always-on access, prompting, and the ability to perform physiological assessments.


A researcher’s review of anonymized electronic patient records of cardiac arrest patients who were transported by ambulance to Lifespan Health System (RI) finds that at least 11 patients over 2 1/2 years had misplaced breathing tubes, all of whom died. Rhode Island is one of few states that does not limit ET tube placement to paramedics, but a firefighter’s union killed a proposal to bring the state in line with others, declaring to audience applause in a public meeting, “We’re the experts, not doctors who are doing it when they’re in nice ORs or nice ERs with bright lights and a lot of people helping them.” A misplaced ET tube is considered to be a “never event” in emergency medicine since placement can and should be confirmed. Ambulance services, like hospitals, are required to report such mistakes to the state’s health department, but they would be aware of issues only of the hospital notifies them after the fact.


Kaiser Health News looks at rarely useful interruptive medical monitoring alarms, whose most frequent outcome is disturbing patient rest and burning out clinicians who are forced to listen to their insistent clanging all day long. Joint Commission says 85% to 99% of the alarms don’t require clinical intervention. Bed alarm sales jumped in 2008 when CMS decided to stop paying for hospital fall injuries even as CMS later discouraged their use in nursing homes in considering them a “restraint” as residents remained bedridden to keep the alarms quiet. The article observes that alarm proliferation has created a market for clinical alarm management consultants and software vendors who review alarm-capable device settings and install software that reviews the alerts before notifying employees.


HIMSS will “curate” (there’s a trendy millennial word for you) 12-15 digital health startups to pitch investors at the J. P. Morgan Healthcare Conference via its Health 2.0 acquisition, which seemed more appropriate when Health 2.0 was a for-profit company instead of having the non-profit HIMSS choose which companies get in front of potential investors. FYI to HIMSS – it will be 2020 soon, so please fix that date. Also note that the socialism-despising sharks at J.P. Morgan Chase who oversee this investor orgy happily received $25 billion of your tax dollars stay afloat back in 2008, although they had to pay $13 billion for ignoring their own due diligence process in screwing around with mortgage-backed securities. Both numbers are chicken feed to a company whose annual profits are tracking at around $50 billion. Greed is good, at least for the company’s bottom line and for CEO Jamie Dimon, whose net worth is around $2 billion.


The systems of urgent care software vendor T-System are apparently offline, as reported by malware hunters who found evidence of a ransomware attack on its servers. The company’s PR contact didn’t respond to my inquiry and any problems have not been publicly acknowledged, but the company’s website has been down since at least Friday when we last checked. UPDATE: a T-System spokesperson provided this response:

Through proactive monitoring of our systems, last week T-System identified a cybersecurity incident that has temporarily affected the availability of our Advanced Coding System (ACS) services. After learning of the incident, we promptly took relevant systems offline and commenced an investigation with the assistance of external experts who have expertise in the specific type of malware involved in the incident. Over the past few days, we have been working with our internal team and the external experts to restore backups and move back into production the systems that we initially took offline. We are working closely to restore these systems as quickly and safely as possible. Because of our early detection of the incident and our architecture, we do not – at this time – expect the incident to impact unsecured PHI or other personal information. We have been in direct contact with our clients with updates about the incident. The investigation is ongoing.

In Australia, a cancer center’s six-month, small-scale trial of IBM Watson for matching patients to available clinical trials worked well, but the cancer center won’t move ahead pending product improvements and its own EHR implementation.


Weird News Andy channels “Young Frankenstein” in titling this story Abby Normal. A Duke Health surgeon successfully completes the first transplant of a dead donor’s heart into a live patient, a procedure that has been performed for 10 years in the UK and in 619 procedures in last year alone in expanding the potential donor pool. WNA notes that equivalent US numbers would be nearly all of the 3,400 US heart transplants that were performed last year.

Sponsor Updates

  • Avaya names Jon Brinton (Mitel Networks)  as VP, North America channel sales.
  • Bluetree Network names Florid Sau (City of Hope Medical Center) an executive partner.
  • Clinical Architecture will exhibit at the IHI National Forum December 8-11 in Orlando.
  • AGS Health is recognized in the top 75 of “India’s Best Workplaces in IT and IT-BPM 2019” based on a rigorous assessment of the company’s fairness, credibility, respect, pride, and camaraderie.
  • EPSI announces a new advanced analytics product.
  • Hyland Healthcare announces new products and updates at RSNA.
  • CoverMyMeds will exhibit at the NG Healthcare Summit December 9-11 in Amelia Island, FL.
  • Cumberland Consulting Group will exhibit at the AHIP Consumer Experience & Digital Health Forum December 10-11 in Chicago.

Blog Posts



Mr. H, Lorre, Jenn, Dr. Jayne.Get HIStalk updates. Send news or rumors.
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Morning Headlines 12/3/19

December 2, 2019 Headlines No Comments

Amazon Transcribe Medical – Real-Time Automatic Speech Recognition for Healthcare Customers

AWS unveils a healthcare-focused version of its transcription service for cloud customers that converts dictated medical notes or multi-party conversations to text in real time.

Agfa-Gevaert Group enters into exclusive negotiations for the sale of a part of its HealthCare IT activities to Dedalus Holding S.p.A. – Regulated information

Italy-based Dedalus Holding will acquire Belgium-based Agfa’s health IT business, including its HIS and Integrated Care solutions, in Q2 2020.

Cerner Achieves 500th Patent With Voice-Assisted Technology

Cerner’s 500th patent pertains to voice-assisted technology that captures verbal interactions, then extracts relevant information and presents it on a physician’s mobile device.

Dexcom glitch kept parents of children with diabetes in the dark over their conditions this weekend

Blood glucose monitor maker Dexcom recovers from a server overload that has prevented updates and alerts from reaching users.

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Reader Comments

  • clinical nlp: I also think that most health systems will feel threaten with this Amazon Care. It will be (i think) the biggest player ...
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  • Ross Koppel: Thank you for this. Currently, "influencers" focus on snake oil, worse nonsense, and of course reflect the wishes of Rus...
  • Frank Poggio: Funny, I must be 'over the hill' since I always considered clients 'customers'., some even called them 'partners'. Yep,...
  • Bill O'Toole: Interesting that Epic distances from Google due to lack of customers' interest and Meditech signs up with Google. Two of...
  • Bill O'Toole: Government and Politics are forever part of health technology, however, I am constantly irritated with the government ma...
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  • Fellow Ex-Epic: Echoing this sentiment. Epic threw away the goodwill they accrued from the years I helped them improve healthcare, and f...

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