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Do Hospital Leadership Pay Attention to Healthcare Startups?

Today I got the press release announcing the 2014 class of startup companies that will be participating in the New York Digital Health Accelerator (NYDHA) program. I’ll put the list of companies in the 2014 class at the bottom of this post for those that are interested.

While I find all of the various healthcare IT incubator/accelerator programs quite interesting, I wonder how many hospital executives are really paying attention to what’s happening with these companies. My gut feeling tells me that very few of them are watching it at all. The reality is that most of them are so busy with the operational aspects of their business that they don’t have time to look at the latest batch of healthcare IT startup companies. Although, I think this is a mistake since they could learn a lot about trends in the industry by looking at these companies.

However, I think there’s a deeper issue here than them just making the time to look at these companies. The larger issue is that most of these health systems write off the idea of working with these “startup” companies without even taking a look at what they’re doing. I think that this is part of the industrialized thinking that we need to change in healthcare to really improve.

Let’s also not confuse what I’m describing with being wreckless. We have a special duty in healthcare to take care of patients in the best way possible. I think working with healthcare IT startup companies helps us fulfill that duty. Sadly, I think many executives don’t see it that way.

What I think could help these executives is to have a forum where they could easily sort through the latest and greatest of what’s happening. Unfortunately, I don’t think anyone’s created that forum yet.

2014 NYDHA Healthcare Startup Companies
AllazoHealth addresses the problem of medication non-adherence by leveraging existing member data to anticipate which patients will not take their medications to predict how best to effectively influence each patient to take their medication.  (www.allazohealth.com)

Clinigence’s solution—built around clinical data analytics, sematic data aggregation, and predictive modeling—provides real-time clinically-based reports about care gaps which help healthcare providers improve outcomes to proactively address the shift to value-based models and the growing demand for quality patient care. (www.clinigence.com)

Covertix helps healthcare organizations protect and control confidential data shared between patients, healthcare professionals, hospital networks and third party vendors to improve their coordination of care.  (www.covertix.com)

iQuartic’s technology merges, structures and mines EHR, PBM, claims and mHealth data for analytics that inform and benchmark care based on outcomes/best practices and adjusted population.  (www.iquartic.com)

Noom makes software to help people live healthier.  For consumers, the Noom Weight Loss Coach, with over 11 million downloads, coaches users on nutrition and exercise. Noom’s different patient engagement apps are based on its consumer-facing app. (www.noom.com).

Quality Reviews empowers patients through their flagship product, RateMyHospital.com, a real-time, mobile patient feedback tool.  (www.q-reviews.com) 

Sense Health uses mobile technology to build personal connections between providers and high-risk Medicaid patients to improve outcomes and the quality of care.  (www.sensehealth.com)

July 22, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Patient Flow in Hospitals

I’ll admit that I still feel relatively new to many of the technologies that are being used in the hospital. I’ve learned a lot over the years, but I came from an ambulatory background and so I still have plenty to learn about the hospital IT environment. Luckily in the world of EHR, there’s a lot of cross over between hospital and ambulatory.

An example of a place I have a lot to learn is around Patient Flow in hospitals. This was highlighted for me really well when someone from CentralLogic pointed me to a great new hospital patient flow resource they created. Basically, it’s a simple way to access their inventory of videos from the Patient Flow Summit they held in Las Vegas.

They also have a YouTube channel with various Patient Flow videos. For example, here’s one video from Dr. Eugene Litvak, PhD, Institute for Healthcare Optimization, JCAHO Patient Flow Editor, Harvard Adjunct Professor sharing ideas on where to get started with improving patient flow at your hospital.

I love this amazing world we live in where you can go online and learn about pretty much any topic. Plus, it’s just going to get better and better.

July 18, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Surpassing Expectations

Ever since last season I’ve been addicted to the TV show America Ninja Warrior. The TV show was brought over from Japan and features insane obstacle courses that show off the amazing talent and strength of so many people. While pretty much everyone involved on the show is amazing, I can’t help but be impressed with 5 foot 100 lbs Kacy Catanzaro who was the first woman to finish the city finals course. In case you missed it, here was her run.

There’s a reason that the clip already has 3.6 million views on YouTube. Americans love an underdog that surpasses people’s expectations. I watched the show live and I couldn’t believe that someone who was 5 foot nothing could complete the course where height really made a big difference. However, Kacy used the talents she had, improvised a solution, and completed the course. She absolutely exceeded the expectations of those watching the show. Amazing!

What type of person are you in your organization? Are you someone who surpasses expectations like Kacy or are you someone just treading along with no desire to be better than expected? We all know the people in our organizations who are just treading along trying to get through the day. That stands in stark contrast to someone who’s working to be a high achiever.

The same could be said for your hospital. Is your hospital one that surpasses expectations and competes with the big boys who have more resources and muscle than you? There are plenty of 5 foot nothing 100 lb Kacy Catanzaro hospitals in healthcare. This could also apply to an undersized hospital IT organization.

Hopefully your undersized hospital or undersized IT organization will take inspiration from Kacy and use your grit, creativity, and determination to find ways to perform as well as the big boys. That’s what a great hospital leader does.

July 17, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Point of Care Systems vs EMR

Bob Brown sent out this interesting tweet about point of care systems that create EMRs.

Obviously, there are a lot of different ways to put together an EMR system. One is to create the system and then push it out to the point of care. Another is to create the systems at the point of care that then push back to the EMR system.

I agree with Bob that EMR systems were created first and we’re now trying to push them to the point of care. Sadly, most of them have done a pretty poor job of pushing the documentation to the point of care. Although, we have made some significant progress on this and will make more in the future.

With that said, I personally don’t think the real problem with useful and usable EMR is how they were created. The real problem with them is that we created big billing engines and now we’ve created big government meaningful use reporting engines. If we’d created an EMR focused on improving efficiencies and providing better quality care, we’d have a very different result. We might even have something that doctors would call useful and usable.

July 15, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Why Might Intermountain Have Chosen Cerner Over Epic?

An anonymous person on HIStalk gave some really interesting insights into Intermountain’s decision to go with Cerner instead of Epic.

Re: Intermountain. The short-term choice (three or so years) would have been Epic, but we went with Cerner because of Epic’s dated technology, Cerner’s openness, and the feeling that we would be more of a partner than a customer with Cerner. The partnership is more than words. We’re working closely with Cerner and their horde of sharp, dedicated people on the implementation. We have some pieces they don’t and those are being built into the Cerner system, while some of our own development efforts have been redirected since Cerner already has that functionality. The first rollout is scheduled for December and I think it will go well due to the way the teams are working together. Unverified.

This is the best analysis of Intermountain’s decision to go with Cerner that I’ve seen. As in every billion dollar procurement decision, it’s always got other nuances and pieces that go into the decision making process. However, the above analysis gives us a good place to start.

Let’s look at the main points that are made:

1. Is Epic technology more dated than Cerner?

2. Is Cerner more open than Epic?

3. Will Cerner be more of a partner than Epic would have been?

I’d love to see Judy’s (Epic CEO’s) comments on all of these. I’m sure she’d have a lot to say about each of them. For example, you may remember that Judy described Epic as the most open system she knows. Ask someone who wants to get Epic certified if they’re open. Ask a health IT vendor that wants to work together if Epic is open. Ask even some of their smaller customers who want to do things with Epic if Epic is open. They’d all likely disagree that Epic is the most open system.

I’d love to hear people’s thoughts on each of these three points. I think it will make for a really lively discussion that will help us get closer to understanding the reality of these assertions.

However, reality aside, I can tell you that the public image of Epic vs Cerner certainly confirms all three of these points. Whether Intermountain indeed used these points as part of their decision process or not, I don’t know. What I do know is that it wouldn’t surprise me at all if they did think this way since there are many in the market that believe and share all of the above three impressions.

July 14, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

More of the Siemens Healthcare Back Story

One of the things I love about blogging is the comments that I receive. Many of them come in the comments of the blog, but just as many get emailed to me privately in response to my posts being emailed to readers. Every once in a while I want to share the emails I receive with the readers (Note: You can now subscribe to all of the Healthcare Scene emails in one place). This is one such response that I got in response to my post about Siemens Selling its Health IT business.

I remember the good ol’ days of being a 25+ year SMS Unity customer. Siemens who had recently purchased SMS told us that Unity would be going away. They showed us Soarian (which at the time was not actually built) and said that they would move us there for free. Of course, since it didn’t yet exist we would have to transition to Invision first for about a year. That would also be free. However, they would have to expense us for professional fees which they estimated to be in excess of $1,000,000. This is how we became a Meditech customer.

This kind of back story is what makes healthcare IT so interesting and so challenging. Many who want to enter the healthcare space forget about all this history and they usually fail. The very best hospital health IT companies that I know usually do an amazing job pairing new innovations and technologies together with someone who understands and has been part of this history. Pairing the two together is a powerful combination.

July 10, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Siemens to Sell Hospital IT Business?

This is some interesting news for the hospital health IT world:

Siemens (SIE) AG is exploring a sale of its hospital database and information-technology unit to focus on energy and industrial businesses, according to two people familiar with the plans.

The German engineering company is evaluating options for the business, and no final decision has yet been made, said the people, who asked not to be identified because the considerations are private. The unit could be valued at more than 1 billion euros ($1.4 billion), said one of the people.

Siemens Chief Executive Officer Joe Kaeser is seeking to focus Siemens around “electrification, automation and digitalization” and has already sold off $2.3 billion euros since late 2012. It seems like Siemens healthcare product line fits great with the digitalization focus, so there’s likely more to the story. My guess is the Siemens healthcare business hasn’t been doing well (Thank you Cerner and Epic) and so he’s looking to get out while there’s still some value in the business.

If you’re a Siemens healthcare customer, you probably welcome this change as well. Hopefully a sale will infuse the company and the product with a new energy that will produce some better results for their customers. Maybe I’m talking to the wrong people, but those I’ve met on Sorian are basically ho-hum about the product. No doubt it will be interesting to watch.

July 9, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Large Health Facilities Have Major Patient Data Security Issues

Many healthcare organizations have security holes that leave not only their systems, but their equipment susceptible to cyberattacks, according to two recent studies.

The researchers included Scott Erven, head of information security for multi-state hospital and clinic chain Essentia Health, and Shawn Merdinger, an independent consultant. According to iHealthBeat, the two presented their findings last week at the Shakacon conference.

Erven and his colleagues conducted a two-year study addressing the security of Essentia’s medical equipment. As part of their study they found that hackers could manipulate dosages of drugs provided by drug infusion pumps, deliver random defibrillator shock to patients or prevent medically needed shocks from taking place, and change the temperature settings in refrigerators holding blood and drugs.

The research team also looked for exposed equipment within other healthcare organizations, and the results were appalling. Within only 30 minutes, iHealthBeat notes, they found one healthcare organization which had 68,000 devices that exposed data.  Across all of the health systems they studied, they found 488 exposed cardiology systems, 323 PACS systems, 32 pacemaker systems, 21 anesthesiology systems and and several telemetry systems used to monitor elderly patients and prevent infant abductions.

Both Erven and Merdinger found that the organizations are leaking data because an Internet-connected computer had not been configured securely. Typically, data leaks occurred because sys admins had allowed Server Message Block –a protocol used to help admins find and communicate with computers internally — and allowed it to broadcast information turning private data into publicly-accessible data.

According to Erven, these issues are “global” and impact thousands of healthcare organizations. He suggests that too often, healthcare organizations focus on HIPAA compliance and don’t put enough effort into penetration testing and vulnerability protection.

This should come as no surprise. After all, Proficio’s Takeshi Suganuma notes, HIPAA was developed to protect PHI for a wide range of organizations, and as he puts it, “one size seldom fits all.”  While HIPAA compliance is important, collection, analysis and monitoring of security events are also critical activities for medium- to large-sized organizations, Suganuma suggests.

He also warns that healthcare organizations should be aware that cyberattackers are exploiting not only traditional network vulnerabilities, but also vulnerabilities in printers and medical devices. Networked medical devices are a particularly significant issue, since provider IT teams can’t upgrade the underlying operating system embedded in these devices — and too many of the devices are using older versions of Windows and Linux with known security holes.

The key point Suganuma, Erven and Merdinger are making is that while HIPAA compliance is good, healthcare organizations must pay greater attention to new attack vectors, or they face high odds of security compromise.  Seems like there’s a lot of work (and investment) afoot.

July 2, 2014 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies.

UPMC Kicks Off Mobility Program

If you’re going to look at how physicians use health IT in hospitals, it doesn’t hurt to go to doctors at the University of Pittsburgh Medical Center, a $10 billion collosus with a history of HIT innovation. UPMC spans 21 hospitals and employs more than 3,500 physicians, and it’s smack in the middle of a mobile rollout.

Recently, Intel Health & Life Sciences blogger Ben Wilson reached to three UPMC doctors responsible for substantial health IT work, including Dr. Rasu Shrestha, Vice President of Medical Information for all of UPMC, Dr. Oscar Marroquin, a cardiologist responsible for clinical analytics and new care model initiatives, and Dr. Shivdev Rao, an academic cardiologist.

We don’t have space to recap all of the stuff Wilson captured in his interview, but here’s a few ideas worth taking away from the doctors’ responses:

Healthcare organizations are “data rich and information poor”: UPMC, for its part, has 5.4 petabytes of data on hand, and that store of data is doubling every 18 months. According to Dr. Shrestha, hospitals must find ways to find patterns and condense data in a useful, intelligent, actionable manner, such as figuring out whether there are specific times you must alert clinicians, and determine whether there are specific sensors tracking to specific types of metrics that are important from a HIM perspective.

Mobility has had a positive impact on patient care:  These doctors are enthusiastic about the benefits of mobility.  Dr. Marroquin notes that not only do mobile devices put patient care information at his finger tips and allow for intelligent solutions, it also allows him to share information with patients, making it easier to explain why he’s doing a give test or treatment.

BYOD can work if sensitive information is protected:  UPMC has been supporting varied mobile devices that physicians bring into its facilities, but has struggled with security and access. Dr. Shrestha notes that he and his colleagues have been very careful to evaluate all of the devices and different operating systems, making sure data doesn’t reside on a mobile device without some form of security.

On the self-promotion front, Wilson asks the doctors about a pilot  project (an Intel and Microsoft effort dubbed Convergence) in which clinicians use Surface tablets powered by Windows 8. Given that this is an Intel blog, you won’t be surprised to read that Dr. Shrestha is quite happy with the Surface tablet, particularly the form factor which allows doctors to flip the screen over and actually show patients trends.

Regardless, it’s interesting to hear from doctors who are gradually changing how they practice due to mobile tech. Clearly, UPMC has solved neither its big data problems nor phone/tablet security issues completely, but it seems that its management is deeply engaged in addressing these issues.

Meanwhile, it will be interesting to see how far Convergence gets. Right now, Convergence just involves giving heart doctors at UPMC’s Presbyterian Hospital a couple dozen Microsoft Surface Pro 3 tablets, but HIT leaders plan to eventually roll out 2,000 of the tablets.

July 1, 2014 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies.

Drop in ED Visits Post-Obamacare?

Dan Munro posted an interesting chart from Gallup that shows the percentage of uninsured in the US since 2008:
Uninsured Americans Since 2008 - Gallup
The chart clearly shows a drop in those that are uninsured. I think we can quite confidently say that this is the result of Obamacare where many uninsured Americans could get free health insurance. While many are proclaiming this data illustrates that this means that Obamacare is a success, I think the jury is still out.

In fact, this reminds me of those who consider the EHR incentive money and meaningful use a success because EHR adoption has increased. This might be true, but it might also be true that the wrong EHRs were adopted and so we wasted a lot of money encouraging the adoption of the wrong EHR. That’s just one example. It’s good that there’s been a change, but change does not always mean that we changed for the better.

Going back to the rise of the insured population in the US, I wonder if those newly insured have stopped going to the ED. That was one of the arguments that were made by proponents of ACA. Basically, the uninsured knew they could go to the ED anytime they wanted and not be turned away. Now that many of those people have health insurance, are they now going to a doctor’s office instead of the ED?

I haven’t seen any numbers that indicate this is the case. Plus, I fear that those who do switch from the ED to the doctors office will learn about deductibles and head right back to the ED.

If you have data on this trend, I’d love to see it. No doubt how this goes will have a tremendous impact on the bottom line of hospitals.

June 27, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.