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Digital health at the Mid-America Healthcare Venture Forum

In case you haven’t seen the official announcements or caught my tweets, later this month I will be moderating a panel at the Mid-America Healthcare Venture Forum, an event being put on by MedCity News, April 22-23 at the J.W. Marriott hotel in Chicago.

The panel is called “Opportunities (and Challenges) in Digital Health. Per the official description: “Digital health — and its business models — are coming of age. Promising young companies are integrating into healthcare and, in some cases, beginning to find exit partners. But that’s also meant new scrutiny from everyone from investors to the FDA. Learn about the challenges, opportunities and promising new markets in digital health.”

Panelists include: Amy Len, director of Chicago-based accelerator Healthbox; Julie Kling, director of mobile health at Verizon Wireless; and Jack Young, who heads the Qualcomm Life Fund for Qualcomm Ventures. I’ll just be there to keep order, and, of course, to cast my usual, skeptical eye on the field and continue to wonder why investors are throwing so much money at me-too fitness trackers and countless direct-to-consumer products that don’t stand a chance in an industry where nearly everything is paid for by third parties. Or at least that’s my thought at the moment, until we have our conference call next week. :)

The session is scheduled for Wednesday, April 23, at 8:55 a.m. CDT. The hotel is located at 151 W. Adams St. in the heart of the Financial District. Years ago, I worked about two blocks west of there, so I know it’s about 40-45 minutes away from me by public transit, and I’m not a morning person. This could get  interesting. (If any MedCity people are reading this, I’m kidding. I’ll be there on time. Hopefully.)

Our session follows a keynote from James Rogers, chairman of Mayo Clinic Ventures. After the panel is a break, then breakout sessions featuring presentations to investors from startups in digital health, medical devices and pharma/biotech. I hope I don’t prematurely burst anyone’s bubble with too much of a reality check. But, in honor of this week being the 25th anniversary of the release of the great Gen X satire, “Heathers,” I offer this quote from the movie: “Heather told me she teaches people ‘real life.’ She said, real life sucks losers dry.”

Wait, was that too cynical?Let me just say that the panel just got another thing to talk about today, as the FDA, FCC and ONC just released their proposed health IT regulatory strategy, as called for by the Food and Drug Administration Safety and Innovation Act (FDASIA). To nobody’s surprise, they recommend a “risk-based framework” to regulation of health IT and digital health. Now to figure out if there are any details people should be concerned about…

In the meantime, you can register for the conference here.

April 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.

Video: Farzad Mostashari on patient engagement, ‘physician ACOs’

As I alluded to earlier, I was leaving the press room one afternoon at HIMSS14, and there I see former national health IT coordinator Dr. Farzad Mostashari hanging around Gregg Masters and Dr. Pat Salber of Health Innovation Media. It turns out, Masters and Salber had just pulled Mostashari aside to do an interview on video, but they didn’t have anyone to interview him on camera, so they asked me right there on the spot to be the interviewer. Here is the result.

Mostashari, now a visiting fellow at the Engelberg Center for Health Care Reform at the Brookings Institute in Washington, discussed how the years of searching for a business model to coordinate care and engage patients is finally starting to pay off. Always the champion of the little guy in healthcare, Mostashari also brought up the notion of physician-led ACOs, or, as he called it, the “Davids going up against the Goliaths.”

 

I had pretty much no preparation for this interview. It probably shows. I still think it worked out well.

Here’s a link to Salber’s post about the interview because I don’t want to steal page views. :)

March 14, 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.

CMS clarifies MU2 hardship exemptions

As I reported for MedCity News at HIMSS14 nearly two weeks ago, CMS Administrator Marilyn Tavenner announced plans to provide unspecified flexibility in claims for Meaningful Use Stage 2 hardship exemptions this year. Tavenner then left without speaking to the media.

The news left a lot of people scratching their heads and waiting for some details. Today, CMS issued some clarification, confirming that there would be exemptions for healthcare providers unable to have EHRs certified to 2014 standards in place for the 2014 reporting year. This is particularly important now because Medicare penalties for not achieving Meaningful Use take effect next year, but they are based on the 2014 reporting year (Oct. 1, 2013-Sept. 30, 2014 for hospitals, the 2014 calendar year for physicians and other individual “eligible providers.”)

The guidance confirms that CMS is aware of the problems caused by the slow pace of certification to the new, 2014 standards that Stage 2 requires. As of today, according to the ONC Certified Health IT Products List (CHPL), there are 3,736 ambulatory and 1,200 EHRs and EHR modules certified to 2011 standards, but just 899 total that meet 2014 certification.

Here’s the one-page CMS guidance for hospitals/critical access hospitals and the one for eligible providers.

March 11, 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.

HIMSS gossip

ORLANDO, Fla.—Two days of HIMSS14 have come and gone, and I’m not bouncing off the walls just yet. But I did bounce off the pavement Monday night when I tripped exiting a shuttle bus, and have some facial scrapes to show for it. You will see the evidence whenever Health Innovation Media gets around to posting a video interview I conducted Tuesday afternoon.

Health Innovation Media’s Gregg Masters and Dr. Pat Salber have been camped out near the HIMSS press room since Sunday with their video equipment, querying various newsmakers on various health IT topics, and occasionally having guest interviewers. As I walked out of the press room on my way to the exhibit hall, I said hello to former national health IT coordinator Dr. Farzad Mostashari, who looked like he was just hanging around, but was actually waiting to be interviewed. Masters and Salber asked me if I’d be interested in interviewing Mostashari right there on the spot with no preparation, and with just 15 minutes to get down to the show floor.

If you recall, I did a live interview—yes, streamed live on the Web—last year with Athenahealth honcho Jonathan Bush, beers in hand, for the Health Innovation Broadcast Consortium that Masters and Salber were involved in. (I don’t know the status of that project, as there’s nothing new on that site since last July.) So of course I said yes, and I think it went pretty well. Well, there were a couple of hiccups, as in me thinking we needed to wrap up earlier than we actually had to. And then there’s this:

 

Followed by this:

 

Yes, the Twitterverse catches everything.

Now about that facial injury. I think I just need to avoid Orlando. In 2011, the last time HIMSS met here, I needed six stitches above my right eye after I banged my face against the edge of the bathtub in my hotel room. As I arrived for the 2008 conference here, I turned on my phone after landing and got the message that my grandfather had passed away. Just for good measure, I passed through Orlando on my way back from Europe in 2009. As the flight pulled to the gate, the skies opened up with a violent summer thunderstorm, prompting the airport to close the ramp, preventing the ground crew from unloading bags for nearly an hour. I was stuck in the no-man’s land of U.S. Customs for that whole time, where cell phones are prohibited. It was not until I cleared security, took the airport tram to a different terminal, then hustled to the gate that I knew I would make my connecting flight. So yeah, it’s become a pattern.

Anyway, speaking of Jonathan Bush, he is not at HIMSS14 because he is on sabbatical to write a book and who knows what else? Well, here’s a clue. He was spotted at the Winter Olympics in Sochi, Russia, last week with his more famous brother, Billy, host of “Access Hollywood.” (Hat tip to HIStalk for showing this video at HIStalkapalooza Monday night.)

I also heard that Bush is considering a run for political office of some kind, perhaps because it’s, you know, the family business. Anyone care to confirm this?

I do know for a fact that at least one HIMSS attendee is actually seeking office. That would be Dr. Steven Daviss, CMIO of startup M3 Information, maker of a mental health screening app called My M3. Daviss is running for Democratic Central Committee in Baltimore this year. If he wins, he plans on seeking a seat in the Maryland House of Delegates in 2018, in part because he says there is only one other physician among the state legislature.

Daviss himself is on sabbatical from his job as chairman of psychiatry at the University of Maryland’s Baltimore Washington Medical Center in Glen Burnie, Md.

February 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.

Breaking: ONC releases proposed 2015 EHR certification criteria

If you want something buried, release it late on a Friday so it doesn’t hit people’s desks until Monday morning. If you really want something buried in health IT, put it out there late on the Friday before the annual HIMSS conference because nobody will get any real work done for another week.

I’m not sure if ONC is trying to hide anything, or just wanted to get this done before all its top people head to Orlando, Fla., for HIMSS14, but this afternoon, the office issued proposed criteria for the 2015 edition of EHR certification. This is the first time certification criteria haven’t accompanied Meaningful Use standards, which means ONC wants to tighten certification requirements in the midst of Meaningful Use Stage 2, rather than waiting for Stage 3, which won’t start before 2017.

However, the plan is to make the proposed 2015 standards voluntary; vendors would be just fine with 2014 certification and providers would not have to upgrade their systems to achieve or maintain Stage 2 Meaningful Use, according to ONC.

ONC says the proposal will officially appear in the Federal Register on Wednesday, triggering a 60-day comment period that will run through April 28. Expect a final rule this summer.

UPDATE, 5:11 pm CST:  It appears that they’re just happy to have it done and to be able to talk it up. In fact, ONC’s Steven Posnack seems downright giddy.

 

Also, self-described HIT standards geek Keith Boone is reading through the whole thing and posting real-time updates on his observations.


 

February 21, 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.

CCHIT, KLAS might signal new era in EHRs

Two stories that have hit in the last 48 hours illustrate how the status quo in EHRs is being upset.

First off, as John Lynn broke late Tuesday night—first as a rumor and then as a confirmed fact—on his EMR and HIPAA blog, CCHIT, formerly known as the Certification Commission for Health Information Technology, is getting out of the health IT certification business, thus making sense out of the name change. The organization will continue to offer preparatory courses for ONC-sanctioned testing and certification, but no more actual certification.

CCHIT recommended that vendors turn to another authorized testing and certification body, Verizon-owned ICSA Labs, though there are others that still do offer certification, including Drummond Group, SLI Global Solutions, InfoGard Laboratories, and, for e-prescribing technology, Surescripts. Interestingly, CCHIT also announced that it will partner with HIMSS to offer a series of health IT events for vendors and providers. This is interesting because HIMSS was one of the three founding organizations of CCHIT in 2004, and CCHIT was under fire five years ago for maintaining too close of a relationship with HIMSS (also see this link).

When Meaningful Use came along with the passage of the American Recovery and Reinvestment Act in 2009, CCHIT lost its exclusivity in certifying health IT products, as EHR certification essentially became commoditized. Other certifying bodies also have undercut CCHIT on price, so this move really does not surprise me.

The other big story, if you pay attention to things such as vendor rankings, is that Athenahealth just unseated Epic Systems as KLAS Research’s “Best in KLAS Overall Software Vendor” of 2013. Epic had held the top spot for eight years in a row. “The old guard of HIT leaders is finally being displaced by more nimble, innovative models designed for health care’s future—not for its past. The latest KLAS rankings show that closed-system, traditional software offerings are not robust or flexible enough to meet providers’ demands anymore,” Athenahealth CEO Jonathan Bush said in a statement.

I’m not sure I’d go that far, as Epic is still eating everyone else’s lunch in the enterprise market. But, to me, this shows that smaller physician practices that don’t have IT departments are adopting EHRs and want a cloud-based product that is easy to maintain. That certainly heralds a major shift in health IT.

January 30, 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.

Late news, literally: A new national HIT coordinator

Karen DeSalvo, M.D.

 

I’m a little late to the party reporting on the naming of a new national health IT coordinator, Karen DeSalvo, M.D. HHS Secretary Kathleen Sebelius announced DeSalvo’s appointment on Dec. 19, two days after I boarded a plane out of the country for a much-needed vacation. I vowed not to respond to any work-related e-mail while away, and I stayed true to my word, so now I play catch-up.

I honestly know nothing of DeSalvo’s work as health commissioner of the City of New Orleans and senior health policy advisor to Mayor Mitchell Landrieu, even though I visited New Orleans twice in the early rebuilding stages after Hurricane Katrina in 2006 and 2007 to report on the state of the healthcare infrastructure. At the time, Ray Nagin was mayor, though Landrieu was Louisiana lieutenant gove

rnor and his sister, Mary, was and still is a U.S. senator representing the Pelican State.

During my visits, I met with several state and local healthcare officials, but never came across DeSalvo. She is the first national coordinator I did not know prior to taking over ONC, so I guess I’ll be doing some catch-up. From her biography, I see her background is in public health, much like her predecessor, Farzad Mostashari, M.D. That signals to me that there will be a continued strong focus on using IT to improve population health, one of the original 2004 goals of the first national coordinator, David Brailer, M.D.

While Stage 1 of Meaningful Use has been about installing EHRs, we should start to see connectivity and interoperability to help manage populations in Stage 2, which is just getting started, with an eye toward producing measurable outcomes in Stage 3, which probably won’t begin before 2017.

DeSalvo remains in New Orleans at the moment. She takes over at ONC Jan. 13. Acting national coordinator Jacob Reider, M.D., will go back to being ONC’s chief medical officer.

December 30, 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.

CMS proposes MU2 extension, MU3 start date of 2017

Less than three weeks ago, I reported from the American Medical Informatics Association Annual Symposium in Washington that officials from the Office of the National Coordinator for Healthcare Information Technology were publicly saying it was unlikely there would be a delay to Stage 2 of Meaningful Use.

In October, noting that the federal rule-making process can be arduous, former national health IT coordinator Dr. Farzad Mostashari said, “I think folks should assume that the timelines stick.” He was speaking to the College of Healthcare Information Management Executives a week after leaving government service.

Today, we find out that they knew something we didn’t. The Centers for Medicare and Medicaid Services proposed extending Stage 2 to 2016 and delaying the start of Stage 3 to 2017.

Per ONC:

Under the revised timeline, Stage 2 will be extended through 2016 and Stage 3 will begin in 2017 for those providers that have completed at least two years in Stage 2. The goal of this change is two-fold: first, to allow CMS and ONC to focus efforts on the successful implementation of the enhanced patient engagement, interoperability and health information exchange requirements in Stage 2; and second, to utilize data from Stage 2 participation to inform policy decisions for Stage 3.

The phased approach to program participation helps providers move from creating information in Stage 1, to exchanging health information in Stage 2, to focusing on improved outcomes in Stage 3. This approach has allowed us to support an aggressive yet smart transition for providers.

 

The delay to Stage 3 was likely. As I exclusively reported in June, ONC’s deputy national coordinator for programs and policy, Judy Murphy, dropped a strong hint that Stage 3 would not start until 2017, saying, “2016 would be a problem.” By pushing back the start of the third stage, we would automatically get an extension to Stage 2, making it a three-year program instead of two.

The start of Stage 2 already had been pushed back a year from the original plan of 2013. From my reading, what CMS is proposing today is not another delay to the beginning of Stage 2. Hospitals that have begun their attestation periods since Oct. 1 may continue and physicians are allowed to start Jan. 1.

CMS said to expect proposed Stage 3 regulations, as well as proposed ONC EHR certification rules for Stage 3, in the fall of 2014.

What strikes me as odd is that this announcement came late on a Friday afternoon. There is no time stamp on the ONC blog post, but CMS’ Travis Broome tweeted this at 4:05 pm EST:

Late Friday is typically when government agencies take steps they don’t want plastered all over the news. I don’t see anything here that is surprising or controversial, and it could be argued that ONC didn’t mislead people with earlier statements because the start dates for Stage 2 are not changing. Did I miss something?

UPDATE: CMS held a webcast about this that started at 1 p.m. EST. That’s still Friday afternoon, but not so late that it looks like they’re trying to bury the news.

 

December 6, 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.