Who’s Over MACRA? CIO? COO?

In no surprising way, MACRA is a major topic in pretty much every hospital and health system in the US. There’s a lot of money to be had or lost with MACRA. This is especially true for health systems with a lot of providers. Plus, it sets the foundation for the future as well. I believe MACRA will be as impactful as meaningful use, but without as many incentive payments (chew on that idea for a minute).

As I’ve talked to hundreds of organizations about MACRA, I’ve seen a whole array of responses for how they’re addressing MACRA and who is in charge. Is this a CIO responsibility since MACRA certainly requires EHR and other technology? Is this a COO job because MACRA is more of an operations problem than it is a technical problem? Some might make the case for the CMO/CMIO to be in charge since MACRA requires so much involvement from your providers.

From my experience, the decision usually comes down to choosing between the CIO and the COO, but with input and buy-in from the CMO/CMIO. How the CIO positions themselves will determine if they are over MACRA or not. Some CIOs see themselves as tech people and so they shy away from touching MACRA. Other CIOs see themselves as integral part of their business success and so they want to have MACRA under their purview. Most progressive CIOs that I talk to want the later.

I’m an advocate for a CIO that’s involved in the business side of things. Those CIOs that don’t want this duty are going to miss out on strategic opportunities for their organization. I heard one CIO describe that they viewed their IT organization as Information As A Service provider. Their job as the IT department was just to provide the information from the IT systems to someone else who would deal with the information, the MACRA regulations, etc.

The Information as a Service provider concept has issues on multiple levels. The most important is that if you’re just an information provider, then you lose out on the opportunity to be a strategic part of your organization. However, from a more practical MACRA level, it’s really challenging to provide the right information for MACRA when you’re just an information provider and know little about the regulation. We all know how quickly communication can break down when the person needing the information is disconnected from the people who provide the information and they’re disconnected from the people entering the information.

No doubt a healthcare CIO has to be careful what projects they add to their plate. However, I don’t think MACRA is one of those projects that should be pushed off to someone else. Certainly there can be specific organization cultures where it makes sense for the COO to run things, but I think that should be pretty rare.

How are you approaching MACRA at your organization? Who’s over it? I look forward to hearing your experiences in the comments.

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AliveCor Interview – Raises $30 Million

When I look across the mobile health ecosystem, one of the big winners is AliveCor. They’ve done an incredible job with their company and bringing their ECG readings to a much wider audience. The news recently came out that they’d raised their Series D round of investment of $30 million. As part of that announcement, my colleague Neil Versel from Meaningful Health IT News did an interview with the COO from AliveCor, Doug Biehn. You can check out the full interview below:

I hadn’t caught up with AliveCor for a while, so it was interesting to hear how much progress the company has made. Neil does a good job covering how AliveCor has been trying to figure out the balance between a consumer solution and a provider (FDA cleared) solution.

One of my favorite comments from the video above is when Neil asks about their new AlieCor platform and Doug Biehn says, “We’ve been launching new apps in the consumer space every 6 weeks for the past year, but this is our first big entree into the medical professional market.” I love this sort of iterative development in healthcare. While AliveCor does ECG, I think they’re just getting started. I’ll be interested to see what else comes out of this company as it continues to iterate and mature.

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See you at the HIT Marketing Conference in Vegas

After several years of trying, John Lynn — host of the Healthcare Scene blog network, of which this blog is a part — has finally gotten me to speak on a panel at his Health IT Marketing and PR Conference, April 5-7 in Las Vegas. I’ve had schedule conflicts or disinterested bosses in the past, but now that I’m mostly unemployed, hey, let’s do it!

I will be on the panel entitled, “The Best Ways to Interact with the Health IT Press,” along with some familiar names: Author and freelance journalist Dan Munro; Scott Mace of H3.Group, publisher of HealthLeaders, DecisionHealth, HCPro, Patient Safety & Quality Healthcare and ACDIS; conference host John Lynn; and session moderator Shahid “The Healthcare IT Guy” Shah. The panel takes place April 6 at 1:30 p.m. PDT at the SLS Las Vegas, which I’m told is far nicer than the hotel it replaced on the south end of the Strip, the Sahara.

Some of you PR and marketing types might find this ironic because I’m notoriously prickly when it comes to dealing with some of you, particularly in the weeks leading up to HIMSS each year. I can’t speak for the other panelists, but I’m hoping that this discussion can help shed some light on how I think when dealing with a seemingly endless flow of pitches, how journalists and publicists can make best use of each other’s time and how we can forge better working relationships.

I haven’t decided exactly what I’m going to say yet because I’m still mostly flying by the seat of my pants, having lost my full-time job less than three weeks ago.

(Yes, I’m still looking for something full-time, but accepting freelance gigs for now, with a major caveat: I can’t take one-off gigs for vendors or anyone else I might cover because that creates conflicts of interest with other work I do. Here’s an idea of what I’m thinking. And while you’re at it, go read my posts at Forbes.com because I get paid by the click. So does Munro, another Forbes contributor.)

It will be a quick trip to Vegas, less than 24 hours on the ground, but it should be worthwhile. I hope to see you there.

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Bayshore Networks(R) Closes Oversubscribed Venture Funding

Final Investment from Benhamou Global Ventures Completes Series A for Leader in Industrial Cyber Protection

BETHESDA, MD–(Marketwired – March 20, 2017) – Bayshore Networks, the leading provider of cyber protection for industrial infrastructure, today announced the closing of its Series A venture capital investment. With a final investment from Benhamou Global Ventures (BGV), the round was oversubscribed at more than $11M, bringing total investment in the company to $15M. Bayshore will use the investment to aggressively grow go-to-market channels, and further develop its industry leading industrial cyber protection platform.

“The market for Bayshore’s industrial cyber protection solutions is expanding quickly,” said Mike Dager, CEO of Bayshore Networks. “Industrial cyber protection is now a key strategic initiative for large enterprises, utilities, and governments alike. We’re experiencing rapid growth because unlike passive visualization and reporting packages, Bayshore’s comprehensive industrial cyber protection platform stops industrial cyber threats before they start.”

“We are impressed with Bayshore’s experienced management team and differentiated technology,” said Anik Bose, General Partner at BGV, who has joined Bayshore’s Board of Directors following the investment. “There is a compelling global need for industrial cyber protection solutions, and we believe Bayshore is well positioned in this burgeoning market.”

“Bayshore’s innovation in the emerging Industrial IoT cyber protection market is well recognized. We led Bayshore’s Series A in support of their pioneering technology in a critical market that is largely untapped to date,” said Alberto Yépez, managing director of Trident Capital Cybersecurity. “We are happy to have BGV join us in supporting the company’s growth.”

About Bayshore Networks, Inc.

Bayshore Networks® is the leading provider of industrial cyber protection. The Company’s award-winning technology unlocks the power of the Industrial Internet of Things (IIoT), providing enterprises with unprecedented visibility into their Operational Technology infrastructure while safely and securely protecting ICS systems, industrial applications, networks, machines, and workers from cyber threats. Bayshore’s strategic partners include among others Arista, AT&T, BAE, Cisco, Dell, SAP, VMware, and Yokogawa. Bayshore is a privately held company headquartered in Washington, DC and backed by Trident Capital Cybersecurity, Yokogawa, Samsung Next, and BGV Capital. For more information, visit www.BayshoreNetworks.com

About Benhamou Global Ventures

BGV, is an early-stage venture capital firm with deep Silicon Valley roots, with an exclusive focus on enterprise information technology opportunities in global markets. BGV currently has 17 active companies in its portfolio. The BGV team has successfully built and implemented a cross-border venture investing model with companies from Israel, Europe and Asia. The fund was founded by Eric Benhamou, former chairman and CEO of 3Com, Palm and co-founder of Bridge Communications. Comprised of an experienced partnership team of global operating executives and investors, BGV is often the first and most active institutional investor in a company and has a powerful network of technical advisors, executives and functional experts who actively engage with its portfolio companies. The company has offices in Palo Alto, California and Tel Aviv, Israel.

About Trident Capital Cybersecurity

Trident Capital Cybersecurity (TCC) is a $300 million fund that invests primarily in early stage and select growth equity companies. The firm is well positioned as the venture capital firm with the best connections in cybersecurity. Its 47-person Cybersecurity Industry Advisory Council, including industry CEOs, customers and former top-level government leaders is commended for its insights, connections and go-to-market support for TCC’s portfolio companies. TCC’s current portfolio companies include 4iQ, Appthority, Bayshore Networks, ID Experts and IronNet Cybersecurity. Managing Directors Alberto Yépez, Sean Cunningham and Don Dixon jointly lead the investment team and together have made 30 cybersecurity investments during a nearly 20 year period of investing at Trident and Intel Capital. For more information, visit www.tridentcybersecurity.com.

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Emergency Department Information Systems Market Fueled By Growing Patient Flow

A new research report has concluded that the size of the emergency department information systems market is expanding, driven by increasing patient flows. This dovetails with a report focused on 2016 data which also sees EDIS upgrades underway, though it points out that some hospital buyers don’t have the management support or a large enough budget to support the upgrade.

The more recent report, by Transparency Market Research, notes that ED traffic is being boosted by increases in the geriatric population, an increasing rate of accidents and overall population growth. In part to cope with this increase in patient flow, emergency departments are beginning to choose specialized, best-of-breed EDISs rather than less-differentiated electronic medical records systems, Transparency concludes.

Its analysis is supported by Black Book Research, whose 2016 report found that 69% of hospitals upgrading their existing EDIS are moving from enterprise EMR emergency models to freestanding platforms. Meanwhile, growing spending on healthcare and healthcare infrastructure is making the funds available to purchase EDIS platforms.

These factors are helping to fuel the emergence of robust EDIS market growth, according to Black Book. Its 2016 research, predicted that 35% of hospitals over 150 beds would replace their EDIS that year. Spurred by this spending, the US EDIS market should hit $420M, Black Book projects.

The most-popular EDIS features identified by Black Book include ease of use, reporting improvements, interoperability, physician productivity improvements, diagnosis enhancements and patient satisfaction, its research concluded.

All that being said, not all hospital leaders are well-informed about EDIS implementation and usability, which is holding growth back in some sectors. Also, high costs pose a barrier to adoption of these systems, according to Transparency.

Not only that, some hospital leaders don’t feel that it’s necessary to invest in an EDIS in addition to their enterprise EMR,. Black Book found. Thirty-nine percent of respondents to the 2016 study said that they were moderately or highly dissatisfied with their current EDIS, but 90% of the dissatisfied said they were being forced to rely on generic hospital-wide EMRs.

While all of this is interesting, it’s worth noting that EDIS investment is far from the biggest concern for hospital IT departments. According to a HIMSS survey on 2017 hospitals’ IT plans, top investment priorities include pharmacy technologies and EMR components.

Still, it appears that considering EDIS enhancements may be worth the trouble. For example, seventy-six percent of Black Book respondents implementing a replacement EDIS in Q2 2014 to Q1 2015 saw improved customer service outcomes attributed to the platform.

Also, 44% of hospitals over 200 beds implementing a replacement EDIS over the same period said that it reduced visit costs between 4% and 12%, the research firm found.

Posted in Cloud EHR, Hospital EHR, Hospital EHR Company, Hospital EHR Vendor, Hospital Electronic Health Record, Hospital Electronic Medical Record, Hospital EMR, Hospital EMR Vendor, Hospital Healthcare IT, Hospital IT Systems, Hospital Patient Flow | Tagged , , , , , , | Comments Off on Emergency Department Information Systems Market Fueled By Growing Patient Flow

Against Medical Advice – ZDoggMD’s New Show

For those of you reading this that don’t know ZDoggMD, what’s wrong with you? Seriously though, check out some ZDoggMD’s parody videos to see what I mean. Along with making “dope parody videos”, he has just started live streaming a new show he called Against Medical Advice which he streams live each week on the ZDoggMD Facebook page.

Check out the trailer for Against Medical Advice:

I love the goals that ZDoggMD has for the show and he’s such a unique talent so check it out. Against Medical Advice episode 1 and episode 2 are out if you want to see something you’ve never seen in healthcare.

If you’re not a fan of his new show, you’ll probably enjoy this heartfelt parody of 7 Years (A Life in Medicine). It’s a good reminder of the importance of the work we’re doing in healthcare.

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Video: AliveCor’s AI launch, plus $30M investment from Omron and Mayo

I did a video interview this week with AliveCor COO Doug Biehn about that company’s launch today of a physician-side artificial intelligence platform for mining ECG readings for signs of atrial fibrillation, a key early marker of stroke risk. AliveCor also announced it has closed a $30 million Series D investment round, led by Omron Healthcare and Mayo Clinic.

You can read my recap on my Forbes page, but here’s the full video interview.

I goofed in one spot as I was editing the video after midnight: I was in Chicago, not Silicon Valley, as you might be able to tell from the artwork behind me. The error is sorta fixed if you’re watching on a desktop computer, but YouTube annotations don’t show up on mobile devices. (In fact, YouTube is phasing out video annotations this month for that very reason.)

Your feedback is always welcome.

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New .Health Top-Level Domain Announces Launch for the Health Industry

.health will have a phased launch with registrations open to the health industry starting July 2017

MIAMI, March 14, 2017 – dotHealth LLC announced today it will launch the new .health top-level domain (TLD) as a new home for health online. The .health TLD is designed to be the premier web address for those who are advancing the health and wellness industry and will provide a new home for health online for brands, organizations and individuals who provide high-quality health products, services and information.

The Internet makes extensive amounts of information available to consumers, and it can be a challenge for consumers to filter unreliable information from valuable information. The .health extension will set a new benchmark for online health information and help promote peace of mind in health-decision making by enabling people to easily find and connect with credible sources of health information.

Driving the new TLD is dotHealth, LLC, an organization comprised of the same team that launched the .co TLD in 2010. dotHealth’s CEO, Jose Ignacio Rasco, is eager to improve the health industry by advancing the online health and wellness experience. “We are designing .health to be the new industry standard for websites in health and wellness. At dotHealth, we are committed to providing value to the health industry by meeting a need that has long existed for health information online,” said Rasco.

dotHealth is taking steps to ensure the .health domain landscape is backed by reliable technology and policies to provide credible and focused content. Registrants who adopt .health domains will be subject to stringent terms and policies that ensure the integrity of the extension and deter misuse. These terms and policies are being developed with the assistance of an advisory board of health and technology experts. In addition to these policies, dotHealth recognizes the importance of security on health-related sites, therefore .health domains are backed by industry-leading technology and security protocols administered by Neustar, the largest provider of core registry and digital naming services.

.health will launch in a phased process to ensure that domains are available as soon as possible to the appropriate communities, while building a credible domain landscape that meets the needs of end users. Websites on .health will represent all areas of the health and wellness industry including: those who provide healthcare, those who provide health information, those who market health products/services, health IT companies, and those in the broader health and wellness space.

Launch Schedule

May 8 – July 7, 2017 – Sunrise – Trademark holders will have first access to register .health domains aligned with their trademark according to ICANN regulations.

July 20 – Nov 30, 2017 – Industry Access – Qualified health industry entities may register .health domains through a token system administered by dotHealth.

Dec 5, 2017 – General Availability – Registration will open to the public while continuing to be backed by terms and policies that will safeguard the credibility of the space.

“We live in an age where we receive so much information, and we need to distill what is helpful to us. The .health domain extension will provide a new level of confidence for those seeking information about health. As consumers, we have certain expectations of some TLDs. Today more than 1,000 TLDs exist around the world, and only a handful garner instant credibility from end-users. .health will join that elite few as the most respected TLD for health information,” said Rasco.

For more information, go to www.get.health.

About dotHealth

dotHealth LLC is the company behind the launch of .health, a new domain extension for brands, organizations, and people who provide high-quality health information, products, and/or services. .health is designed to be the premier address for those who are advancing the health and wellness space.

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Hospital App Helps Patients After Surgery

Patients are very vulnerable after surgery. If they don’t follow post-surgical instructions, they may be readmitted (never a good thing for hospitals these days), and far worse, may suffer real harm.

Unfortunately, many patients don’t retain or follow doctors’ instructions on how to best recover from surgery, particularly if these instructions aren’t documented well.  For example, a 2015 study appearing in Anesthesiology concluded that only 60% of 519 surgery patients who got verbal post-operative instructions or annotated EMR records complied with medication instructions.

In an effort to improve stats like these, Chicago’s Rush University Medical Center has introduced an app designed to support patients in their post-surgical recovery process. The app, SeamlessMD, prompts patients to ask for reminders about their surgeon’s instructions, according to a HIMSS Future Care article.

Anthony Perry, MD, vice president for ambulatory care and population health at Rush, told the publication that his facility had already implemented protocols for enhanced recovery after surgery before the app was created. But the app has potential to move patients’ post-surgical recovery to the next level, Perry said. “It’s not only a neat technology, but a neat technology that’s truly aligned with our own goals,” he noted.

Dr. Perry believes that presenting prompts and reminders via a personal mobile device offers benefits traditional care instructions can’t, particularly when the app is placed on a patient’s phone. “There’s a bridge that a smartphone gives us into a person’s everyday life that we don’t have when they come visit us in the office,” he said.

Rush’s initiative comes as hospitals around the world consider the benefits of rolling out patient-oriented apps. For example, four National Health Services hospitals serving the United Kingdom are testing apps that monitor patient health at home.

The hospitals are testing two apps, one focused on managing gestational diabetes treatment and the other addressing COPD monitoring and care. (As one might expect, the diabetes app collects blood glucose readings and the COPD app oxygen saturation levels.) The pilot, which is still in its initial stages, has already seen some success. For example, the number of office visits by patients with gestational diabetes has fallen 25% since the app was released to such patients.

This may be the dawn of a new age for hospital use of mHealth apps, which has been at best at a trial-and-error stage for several years. While most hospitals and health systems have toyed with apps to some degree, in the past there was neither a clinical nor technical approach for them to adopt. So many initial app projects went nowhere.

But with evidence piling up that at least some approaches work – such as remote patient monitoring for chronic disease management, as described above – hospitals are beginning to see apps as a practical tool for improving outcomes. Meanwhile, as they’ve adopted mobile-friendly infrastructures, hospitals have become more capable of supporting hospital-developed apps effectively.

Of course, there’s probably a number of functions apps can perform which nobody’s pursued just yet. But with some early successes in place, my guess is that hospitals will try lots of new app projects going forward.

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Did Republicans just say they were fine with ‘death panels’ themselves?

Remember the “death panels” hysteria in 2009 or so when the Affordable Care Act was under development? (PolitiFact called “death panels” the “lie of the year” for 2009, not surprising, since the idea apparently originated with that truth stretcher extraordinaire, former Alaska Gov. Sarah Palin.)

As you may have heard, that rhetoric resurfaced during town halls held by a few Republican members of Congress.

That idiocy came from language in the ACA that authorized Medicare to pay for voluntary end-of-life counseling. It was falsely projected as a “mandatory” activity every five years.

Some of the hysteria also stemmed from a specific clause in the ACA that said:

Establishes an Independent Payment Advisory Board to develop and submit detailed proposals to reduce the per capita rate of growth in Medicare spending to the President for Congress to consider. Establishes a consumer advisory council to advise the Board on the impact of payment policies under this title on consumers.

The fear, from the right-wing punditry was that bureaucrats would start to deny care to older, sicker Americans.

Well, the American Health Care Act leaves that provision in place, according to an analysis by the Kaiser Family Foundation:

Other ACA provisions related to Medicare are not changed, including:
* Increase Medicare premiums (Parts B and D) for higher income beneficiaries (those with incomes above $85,000/individual and $170,000/couple).
* Authorize an Independent Payment Advisory Board to recommend ways to reduce Medicare spending if the rate of growth in Medicare spending exceeds a target growth rate.
* Establish various quality, payment and delivery system changes, including a new Center for Medicare and Medicaid Innovation to test, evaluate, and expand methods to control costs and promote quality of care; Medicare Shared Savings Accountable Care Organizations; and penalty programs for hospital readmissions and hospital-acquired conditions.

So, is the GOP plan embracing death panels, or is Republican leadership simply admitting that they were lying all along to whip up paranoia?

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