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Podcast (but not mine): I discuss ACA, HIPAA, consumerism in healthcare

Longtime readers know how I’ve railed against how the mainstream media’s coverage of healthcare reform in general and the Affordable Care Act in particular, notably the fact that Obamacare addresses a lot more than just insurance coverage. I’ve also railed against how hospitals have used HIPAA as an excuse not to give patients copies of their medical records, when, in fact, the privacy rule says the exact opposite, something HHS finally saw need to provide guidance on just this month.

Those of you who have followed me to MedCity News know that I’ve also been covering the Get My Health Data effort since the beginning last summer — and its roots in the HHS decision to water down “patient engagement” requirements in the Meaningful Use EHR incentive program nearly a year ago.

With this in mind, I knew exactly what I was going to talk about when an old college friend, Missouri lawyer and published novelist Dale Wiley, asked me to be one of the first guests on his new podcast, the Dale Wiley Show. We talked for a good half hour, and probably could have gone on for longer, and I am especially grateful he let me talk about multiple system atrophy, the rare disease that took my dad’s life in 2012.

I do have to take Dale to task for picking a photo of me with my face bandaged from my injury at the 2011 HIMSS conference. He told me he picked more for pixel size than for aesthetic quality. Ah, well. I’m probably due for a new professional headshot anyway.

Click here for the iTunes link to the Dale Wiley Show. Music fans will especially like it, as Dale formerly ran an indie record label and knows a lot of people in the business.

January 18, 2016 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Health Wonk Review for the holidays

The final Health Wonk Review of 2014 is up (actually, it’s been up for five days, but I’ve been buried with deadlines until this morning), courtesy of Julie Ferguson  and the Lynch Ryan Workers’ Comp Insider blog. My post on the recent reality checks for healthcare wearables makes this biweekly review of the best of the healthcare blogosphere. (I also did a follow-up, featuring an ESPN “Sport Science” segment sponsored by Fitbit.) FWIW, the comments have been closed on the LinkedIn Digital Health Group item about my original post.

There isn’t much else in the realm of health IT in this edition of HWR, but there are some interesting discussions about the Patient Protection and Affordable Care Act, including an important question from Peggy Salvatore: To whom is accountable care actually accountable to? Yep, ACOs are right there in the Affordable Care Act, lest you think the Obamacare law is only about health insurance coverage.

Enjoy the recap, and enjoy the holidays, whichever ones you celebrate. I’ll see you in January.

December 23, 2014 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Health Wonk Review talks turkey

I’ve been a bit remiss the last few days, in that the latest Health Wonk Review came out Thursday, and I’m  just getting around to sharing it now.( Blog carnivals work best when contributors link back to the compilation.) But, better late than never, right?

In that spirit, and in the spirit of Thanksgiving, I invite you to check out Health Wonk Review: The Turkey Edition, hosted by David Harlow on his HealthBlawg. The big stories this time around are all about insurance coverage under the Patient Protection and Affordable Care Act, a.k.a., Obamacare, but there is also an interesting posts about “wrist slaps” given to pharmaceutical executives for allegedly violating drug-marketing laws.

My post at about the American Medical Association belatedly but predictably fighting the impending Medicare penalties for not meeting Meaningful Use makes the cut. I’m particularly proud of the line, “Ruthlessly Defending the Status Quo Since 1847. :)

Check it out, and for those of us here in the United States, have a happy Thanksgiving. I’ll see you after the long weekend.

November 25, 2014 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Infographics: Health IT leadership and salaries

It’s infographic time! In fact, it’s time for two infographics.

The first is from HIMSS, celebrating 25 years of the organization’s annual health IT leadership survey. Some interesting findings, as pointed out by a HIMSS publicist:

  • 1991- 75 percent say their institution’s financial health is helped by computers
  • 1994 – 14 percent predict that digital patient information will be shared nationwide in 1-3 years
  • 2000 – 70 percent of respondents say HIPAA is a top business issue.


The second infographic comes from Not surprisingly, the most lucrative jobs are in consulting, and those with experience get paid significantly more than newbies.

September 18, 2014 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

About those Obamacare numbers and the ICD-10 delay

While I’ve been busy writing a couple of stories on different topics, you’ve probably heard two pieces of news that will affect healthcare providers nationwide: the close of the first open enrollment period for Patient Protection and Affordable Care Act insurance exchanges and the Congressional “fix” (read “Band-Aid”) to the Medicare sustainable growth rate that statutorily delays the ICD-10 compliance deadline for another year, until October 2015.

The White House yesterday reported that 7.1 million people had signed up for health insurance through or state-run exchanges, barely exceeding the Congressional Budget Office’s projection of 7 million. Independent tracking site says it’s more like 7.08 million, but still just above the goal. That site also tallies the following sign-ups as a result of the ACA:

  • 6.37 million – 12.45 million in private “qualified health plans” (plans that meet ACA standards) via private exchanges, insurance agents or direct purchases from insurers, including deductions for the estimated 3.7 million whose “noncompliant” policies were canceled;
  • 4.71 million – 6.49 million through Medicaid/Children’s Health Insurance Program expansions;
  • 2.5 million – 3.1 million “sub-26ers,” young adults whom the ACA allows to stay on their parents’ health insurance until age 26; and
  • 1.8 million “woodworkers,” those who came out of the woodwork because they did not know before the Obamacare enrollment push that they were eligible for Medicaid or CHIP. places the total range at 14.6 million – 22.1 million as of March 31, not counting the numbers, though my math puts it at 15.38 million – 22.06 million. Add in the sign-ups and you get about 22.5 million to nearly 29 million newly insured people. However — and this is a big however — we do not know how many of the beneficiaries are newly insured and how many were replacing previous coverage.

Personally, I bought a high-deductible, ACA-qualified health plan through an independent agent to replace a rather restrictive high-deductible plan that was grandfathered in, and should save about $70-$80 a month on premiums starting in May. The new insurer rejected me several years ago due to a pre-existing condition; the ACA assures that I can’t be denied for that reason anymore. I imagine there are millions in the same boat as I am.

The U.S. Census Bureau placed the number of uninsured for 2012 at about 48 million, or 15.7 percent of the population. (The same year, 198.8 million had private insurance.) Until we see new figures for uninsured Americans, we will still just have “gross” statistics, not a net figure to show if the insurance part of the ACA is working.

By the way, the ACA is about much more than insurance coverage, despite what the national media have focused on. I encourage you to read up on this before you say Obamacare is saving or ruining our country.

Now, as for the temporary SGR fix, the ICD-10 delay kind of came out of nowhere last week when it got slipped into the House version of the legislation, but the Senate adopted the same language — reportedly without debating ICD-10 at all — and President Obama today signed it into law. I’ve said before that ICD-10 and other transactional elements of healthcare stopped mattering to me as I watched my dad being mistreated in a hospital due to broken clinical processes in his last month of life. I still think this way. However, this sneaky move shows that the AMA, AHA and other groups more intent of protecting the status quo than fixing healthcare still have enormous sway in Washington.

It makes me wonder whether lobbyists haven’t already started pushing hard for Congress to delay the Medicare penalties for not achieving Meaningful Use that are due to kick in next year. Actually, I don’t wonder. I’m sure it’s happening.

All delaying real reform of a broken industry does is prolong the agony, and ensure that millions more people will be affected by errors and neglect in institutions that are supposed to “do no harm.” The status quo is not acceptable.


April 2, 2014 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

All my HIMSS coverage in one place

The last of my 10 MedCity News stories from HIMSS14 has been posted. It’s a nice mix of news, features, analysis and commentary. Here are links to all of them, in chronological order.
NantHealth launches Clinical Operating System – biggest of big data startups – with $1B (Feb. 25)

Body + biology + behavior: Intel exec explains how technology is making N=1 care possible (Feb. 26)

Tavenner: 2014 is your last chance for a hardship exemption for Meaningful Use 2 (Feb. 27)

HIMSS crowd skeptical of promise for flexibility on MU2 hardship requests (Feb. 27)

Google Glass startup expecting third healthcare client in less than 6 months (Feb. 27)

DeSalvo: True EHR interoperability – and a national HIE – is possible by 2017 (Feb. 28)

DeSalvo meets and greets – briefly – while Tavenner keeps her distance at HIMSS (March 3)

HIMSS Intelligent Hospital tracks patients, pills and clinicians in completely connected loop (March 5)

Interoperability Showcase uses car crash to show how connected data really can improve patient care (March 5)

Athenahealth’s first inpatient product isn’t quite an EHR, but a ‘Trojan horse’ into hospitals (March 10)


March 12, 2014 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Health Wonk Review, post-HIMSS

While all the health IT reporters like myself were in Florida last week for HIMSS14, plenty of other things were going on in healthcare. David Harlow of HealthBlawg has a roundup of opinions in the latest edition of Health Wonk Review, entitled “In Like a Lion.”

Yes, HIMSS was a big deal, even for non-IT people, as I captured the top mention in a HWR for, I believe, the very first time, with my podcast interview with HIMSS President and CEO Steve Lieber.

(David, per your note, I only suffered superficial injuries this year, with a couple of scrapes on my face. No stitches needed, and no deaths in my family, though my uncle did lose his mother-in-law the day after I returned. I also broke a wine glass in a restaurant, though it was not my glass, it was empty and I was sober. The moral of this story: I need to avoid HIMSS in Orlando, which will be hard, since it’s on a three-year rotation. But next year, the conference is right here in Chicago, and it will be April 12-16 to avoid the dead of winter. The last time it was here, in 2009, I had bronchitis all week. Good times! The following HIMSS will be in Las Vegas, Feb. 29-March 4, 2016.)

Because it was HIMSS week, Harlow featured other IT posts prominently, including one from Lygeia Ricciardi and Adam Dole of the ONC—new national health IT coordinator Dr. Karen DeSalvo said they’re trying to call it “the ONC” instead of just “ONC” these days—about the recently launched Blue Button Connector. Harlow, an attorney, also referenced one of his own posts about HIPAA compliance audits.

Another section of this HWR examines something that I’ve been saying for a long time, that the mainstream media has been not telling the whole story about the Affordable Care Act, a.k.a., Obamacare. Later, Harlow talks about teamwork and collaboration for the purpose of patient safety. Kudos for highlighting those areas.

Click here to read Harlow’s rundown.

March 3, 2014 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Podcast: HIMSS CEO Steve Lieber, 2014 edition

It’s time for my annual podcast interview with HIMSS President and CEO Steve Lieber, this time from the Orange County Convention Center in Orlando, Fla., on the day before the official opening of the 2014 HIMSS Conference, rather than in his Chicago office a week or so in advance.

Lieber reiterated HIMSS’ position that the federal government should extend the attestation period for Meaningful Use Stage 2 by one year. I wasn’t there, but today at the CIO Forum, one of the preconference educational symposia, ONC Chief Medical Officer Jacob Reider, M.D., hinted that there will be an announcement on Stage 2 flexibility, possibly Thursday morning at a joint ONC-CMS town hall. That session will feature CMS Administrator Marilyn Tavenner and new national health IT coordinator Karen DeSalvo, M.D. I’ve never heard either of them speak, and now I’m excited to be covering that session.

We also discussed other aspects of healthcare reform, trends in health IT and expectations for HIMSS14. Of note, on Monday morning, HIMSS and two other organizations will announce a new initiative on “personal connected health.”

Near the end, I reference the podcast I did last week with Dr. Ray Dorsey about remote care for Parkinson’s patients. For easy reference, here’s the link.

This is, I believe, the seventh consecutive year I have done a podcast with Lieber at or just before the annual HIMSS conference. Another interview that has become somewhat of a tradition won’t happen this time, as Athenahealth CEO Jonathan Bush is not making the trip to Orlando this year.


Podcast details: Interview with HIMSS President and CEO Steve Lieber, Feb. 23, 2014, at HIMSS14 in Orlando, Fla. MP3, stereo, 128 kbps, 36.2 MB. Running time 39:35.

0:40 “It’s time to execute.”
1:40 Challenges for small hospitals and small practices
3:10 New ONC EHR certification proposal and continued questions about Meaningful Use Stage 2
5:00 Prioritizing with multiple healthcare reform initiatives underway, including proposed SGR repeal
6:30 Surviving ICD-10 transition
7:35 HIMSS’ position on MU2 timelines
9:05 Remember “macro objective” of Meaningful Use
10:00 Letter to HHS from organizations not including HIMSS calling for what he says are “very vague” changes to MU2 criteria
11:40 Things in MU2 causing providers fits
13:05 Fewer EHR vendors certified for 2014, but more HIMSS exhibitors
15:00 What this means for providers who bought products certified to 2011 standards
17:20 Progress on Meaningful Use so far
21:00 Looking toward Stage 3
22:42 What struggles might mean for health IT
25:35 Other aspects of the Affordable Care Act being lost in the public debate
27:10 Political considerations related to health IT
29:40 Patient engagement and new HIMSS exhibitors
32:20 Why healthcare spending and provider shortage forecasts don’t account for efficiency gains made from technology and innovation
35:10 Demographic challenges for healthcare
35:45 Shift from hospitals to ambulatory and home care and consolidation of provider organizations

February 23, 2014 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Keep wasting your money, Silicon Valley venture capitalists

Silicon Valley is at it again.

Last week, digital health accelerator Rock Health unveiled its new offices, and from the news coverage, it seems as if it’s creating an image as much as incubating startup companies.

According to Xconomy, “a big crowd of investors, executives, and other life science industry insiders took time away from JP Morgan to attend the grand opening of Rock Health’s stylish new headquarters in the Mission Bay neighborhood of San Francisco.” And stylish it is.

“Rock Health’s kitchen and community gathering space includes a Cirque-du-Soleil-style swing,” Xconomy reported. Because, you know, incubating companies that will fix a broken $2.8 trillion industry with their “solutions” requires a little avant-garde spectacle à la Québécoise — or perhaps Las Vegas. Having been at the Digital Health Summit at International CES in Sin City myself a week earlier, I was happy to see more focus on substance than style in the meeting room, if not in the exhibit hall.

© Bruce Damonte/Studios Architecture

I bet that swing cost a lot of money. So did the design, since Xconomy saw fit to identify the architecture firm. (For that matter, so did I, but only to give proper credit for the photo.) In an industry where a third or more of spending is wasteful — completely irrelevant to care and probably preventable — according to a 2012 report in Health Affairs, are such frills really necessary? I’m certainly not blaming Rock Health here. It’s the investors who are throwing away their money.

In opening the center, Rock Health reportedly dubbed Mission Bay the ‘United States’ New Digital Health Hub.'” That’s a bold statement. There certainly is a lot of potential there, but, as the person who identified San Diego as “a leader in mobile healthcare” back in January 2010, I still see more substance and tangible results in Southern California than in Northern California. For that matter, the Boston area could make a strong case, as could New York City. Smaller but healthy communities have popped up in places like Madison, Wis. That’s fine, competition is good.

However, I’ve seen more failures in Silicon Valley than anywhere else. But does that stop Silicon Valley’s No. 1 media cheerleader, TechCrunch, from declaring, “VC’s Investing To Heal U.S. Healthcare”? No, it does not.

No flame-out has been as spectacular as that overhyped vaporware known as Google Health. Google is back at it again with its VC arm, but this time the Internet giant seems to have a direction and a clue. Maybe.

As TechCrunch reported, “Google Ventures is addressing the nation’s healthcare dilemma with investments in companies like the physicians’ office and network One Medical Group, which raised a later stage $30 million last March. At the opposite end of the spectrum in December 2013 Google invested in the $3 million seed financing of Doctor on Demand, which sells a service enabling users to video chat with doctors.”

Google appears to be scrapping the torturous direct-to-consumer route in favor of going where the money actually is, from third-party payers and from providers, newly incented under the Patient Protection and Affordable Care Act and private reform efforts to work more efficiently and better coordinate care.

On the other hand, it’s been less than two weeks since Stephen Colbert made fun of Doctor on Demand. (Health 2.0 boss Matthew Holt commented on that post that it was “Kind of unfair that Doctor on Demand get the publicity when American Well and a [scad] of others have been doing this at scale for years.” He was right, but, hey, Google.)

Google Venture General Partner Dr. Krishna Yeshwant told TechCrunch the real motive behind all the VC money flooding into healthcare. “As an entity it is where we’re spending 17 percent to 18 percent of GDP, so any one segment is tens of billions of dollars,” Yeshwant is quoted as saying. “Increasingly you’re seeing IT investors who have a fine sense of disruptive opportunities enter the market.” In other words, it’s all about the Benjamins.

But do they understand that healthcare doesn’t work like any other industry? I’m not so sure. And I haven’t even addressed the bigger questions of privacy, data stewardship, interoperability and workflow.

As you prepare your hate mail for me, check out this site, “What the F*** Is My Wearable Strategy?” (NSFW). Refresh the page for more hilarity, but be forewarned: some of the ideas may hit close to home.

You’re welcome.

January 20, 2014 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

The ‘Hospital of Tomorrow’

WASHINGTON—I’ve just finished 2 1/2 days of helping US News and World Report cover its inaugural Hospital of Tomorrow conference. My assignment was to sit in on four of the breakout sessions, take notes, then write up a summary as quickly as possible, ostensibly for the benefit of attendees who had to pick from four options during each time slot and might have missed something they were interested in. Of course, it’s posted on a public site, so you didn’t have to be there to read the stories.

Here’s what I cranked out from Tuesday and Wednesday:

Session 202: A Close-Up Look at EHRs — ‘Taking a Close Look at Electronic Health Records”

Session 303: The Future of Academic Medical Centers — “Academic Medical Centers ‘Must Become More Nimble'”

Session 305: Preventing and Coping With Infections — “How Hospitals Can Better Prevent and Cope With Infections”

Session 401: Provider and Patient Engagement — “Hospitals Grapple With Patient Engagement”

The one on infection control was particularly interesting, in large part due to the panel, which included HCA Chief Medical Officer and former head of the Veterans Health Administration Jonathan Perlin, M.D., Johns Hopkins quality guru Peter Pronovost, M.D., and Denise Murphy, R.N., vice president for quality and patient safety at Main Line Health in suburban Philadelphia.

The session on patient engagement was kind of a follow-on to my first US News feature in September.

If you want to read more about the whole conference, including US News’ live blog, visit

November 7, 2013 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.